Occupation as a risk factor in tunnelling decompression illness

摘要

The UK has an extensive collection of records of exposure to compressed air in tunnelling which are analysed periodically. Over the past decade, Health and Safety Executive (HSE) has undertaken a comprehensive research programme into the occupational health and safety risks associated with work in the tunnelling hyperbaric environment. The outcome of this research with the greatest impact on the tunnelling industry was the introduction of oxygen decompression in 2001. As part of that programme however, considerable research was undertaken to quantify the risk of decompression illness (DCI) arising from compressed air tunnelling. DCI is now the accepted generic term for the pressure-related occupational ill health arising from compressed air working. Acute DCI includes both Types 1 and 2 decompression sickness (DCS), niggles, skin bends and barotrauma. Other forms of acute DCI such as pneumothorax and gas embolism are very rare in tunnelling. Chronic DCI manifests as dysbaric osteonecrosis (DON) - a disabling condition in which lesions occur on the shafts and heads of the long bones.