Zbigniew Dąbrowiecki, Małgorzata Dąbrowiecka, Romuald Olszański, Piotr Siermontowski and Dariusz Jóźwiak
Many pathogenic micro-organisms are likely to attack passengers of cruise ships and other vessels or travel between continents as a peculiar type of a “stowaway”. The epidemiological tests conducted since 1987 with regard to watercraft led to the coining of a term known as the Sick Boat Syndrome (SBS). The main illnesses encountered on watercraft include gastrointestinal diseases (foodborne) and Legionellosis. Additionally, the ventilation and airconditioning systems of old commercial ships (the so-called Tramps) constitute a real technical challenge. Conditioned air (with removed undesired odour and micro-organisms) should constitute ca. 25% of circulating air. In practice this situation is not typical for vessels of this class. Unclean air poses a real hazard for the crew.
Piotr Radziwon, Romuald Olszański, Jolanta Korsak and Piotr Siermontowski
The lack of evidence for the tissue-factor dependent activation of the coagulation system and the release of thrombin on one hand, and a decreased concentration of factor XII after short term air, saturated air and heliox exposures, as well as an increased concentration of the plasmin-antiplasmin complex (PAP) after short dives indicate that diving and decompression possibly affect fibrinolysis. The aim of our research was to verify the assumption that diving and decompression activate the system of fibrinolysis and the clarification of the pathomechanism of this activation.
The study involved 50 healthy volunteers who were subjected to short-term, air hyperbaric exposures at 400 kPa and 700 kPa, which correspond to 30m and 60m dives. Decompression was applied in accordance with Naval tables of decompression. Before hyperbaric exposition and after decompression the following factors were determined: activity of factor XII, concentration and activity of t-PA, concentration and activity of PAI-1, concentration of alpha2- antiplasmin, concentration of PAP, concentration of neutrophil elastase.
The following observations have been made: a statistically significant increase in the factor XII activity, increase in the PAP complex concentration and a simultaneous significant decline in the α2-AP activity. No measurable t-PA activity or significant changes in t-PA concentration have been observed. In addition, a statistically significant decline in both the activity and concentration of PAI-1 has been observed, which was more pronounced after the expositions that corresponded to 60 m dives. The concentrations of granulocyte elastase did not differ significantly before and after decompression.
Conclusions: People qualified for diving should have the following risk factors examined: risk factors of increased fibrynolytic activity - haemostasis abnormalities that increase the risk of haemorrhage, possibility of parietal blood clots/thrombi.
Małgorzata Remlein, Jacek Buczyński, Romuald Olszański, Andrzej Buczyński, Zdzisław Kobos and Dariusz Juszczak
The article presents a characterisation of stress situations and psychological reactions during diving. It describes the fundamental personality dimensions and temperament features, and discusses the results of research into the methods of coping with stress as well as the levels of anxiety in candidates to the position of a professional driver.
Zbigniew Dąbrowiecki, Małgorzata Dąbrowiecka, Romuald Olszański and Piotr Siermontowski
When working in chemical or biological environments, contamination is an extremely dangerous issue for the rescue services of the fire department, police and the army.
Modern protective overalls worn by fire fighters or dry “Viking” diving suits made from neoprene or nylon covered with polyurethane, have been proven to ensure sufficient protection. However, once the contaminated area is left, there is a need to perform decontamination of the external and internal surfaces of the protective overalls; in order to ensure the clothing continues to offer a high level of comfort and to retain the durability of said protective clothing, it is of course also necessary to perform a drying procedure.
Moreover, there is a risk of a transfer of pathogenic micro-organisms between persons utilising the same protective clothes, particularly in the case of expensive specialist suits. Micro-organisms which may potentially spread through clothing include intestinal bacteria, such as: Salmonella, Shigella, Campylobacter, E. coli (including E. coli O157), C. difficile, viruses inducing infections of the upper respiratory tract and alimentary tract (noraviruses, rotaviruses, adeno and astroviruses). The risk of infection also involves the presence of the flu viruses, herpesviruses and pathogens transferred through skin, such as S. aureus (including MRSA), yeast-like fungi (Candida albicans), fungal strains inducing Tinea pedis and Tinea corporis . Pathogenic micro-organisms can easily transfer from fabric surface onto the body of a person wearing protective clothing.
From the numerous available techniques of decontamination of surfaces, equipment and protective clothing we propose to use for this purpose gaseous hydrogen peroxide (H2O2), a very effective biocidal agent. In field conditions, typical for the activities of rescue crews of the fire department, police and army we assume utilisation of a portable decontamination chamber enabling performance of a complete decontamination process.
The process lasting approximately 3 hours encompasses 3 phases:
• Drying phase;
• Decontamination with gaseous hydrogen peroxide;
• Catalytic combustion phase of hydrogen peroxide residues to a level safe for the environment.
The integrated humidity and H2O2 level sensors ensure automatic control of the entire process and the unique distribution system of gaseous H2O2 secures full accessibility of the biocidal agent to the external surface of protective clothing as well as its interior. Moreover, the container allows for the conduction of the complete decontamination of the rescue equipment, night vision devices, binoculars, field telephones, radio stations, etc. Upon decontamination cycle completion, we obtain a completely dried suit which can be safely used by another crew member.
Zbigniew Dąbrowiecki, Małgorzata Dąbrowiecka, Romuald Olszański and Piotr Siermontowski
Pathogenic micro-organisms can easily transfer from the surface of a diver’s skin onto the surfaces of a protective suit. A long-term stay in a hyperbaric chamber during a saturation dive increases the risk of infection if in the chamber there is even a single carrier of disease-causing pathogens.
The conducted research has confirmed that the diving equipment located in Diving Centres is a place of many different bacteria and fungi, including pathogenic ones. The vast majority of microbes found on the surfaces of wetsuits, etc. are commensals (with some being opportunistic organisms). This fact allows us to realise that the surfaces of diving equipment are an excellent “transmission route” for various dermatoses and other diseases. In order to reduce the risk of infection the diving equipment used by various people should be subject to the process of decontamination. The authors recommend decontamination with the use of gaseous hydrogen peroxide which does not cause damage to equipment.
Ewa Zieliński, Kinga Grobelska, Piotr Dzięgielewski and Romuald Olszański
This paper presents a case report of a patient with a diagnosed complication of a sternum wound which was treated using hyperbaric oxygen, emphasizing the truism of the benefits of combined surgical therapy, antibiotic therapy and oxybarotherapy.
Tadeusz Doboszyński, Bogdan Łokucijewski, Piotr Siermontowski, Marek Rejman and Romuald Olszański
The purpose of the study was to determine the effect of composition of various breathing mixes on physical capacity of rats swimming in hyperbaric conditions. The said effect was determined on the basis of results of a swim test performed in a pressure chamber. The study was performed with the use of atmospheric air, a mixture of nitrogen and oxygen (N2/O2) at a ratio of 89.5/10 and 92/7.5, as well as a mixture of argon and oxygen at a ratio of 79.5/20 (Ar/O2). The tests were conducted at a pressure range between 0-4 atm. The results suggest that the physical capacity of the tested animals decreased along with pressure increase regardless of the breathing mix used. Due to the fact that the burdening of rats with physical effort in hyperbaric conditions intensifies the adverse effects of components of breathing mixes on their performance, it seems appropriate to continue the study of physiological responses to breathing mixtures of various compositions in human body subjected to physical effort while under water.
Dariusz Jóźwiak, Piotr Siermontowski, Zbigniew DąbrowieckiI and Romuald Olszański
The most common question that arose in the course of the analysis of the data concerned with the number of diving accidents in recreational diving as compared with the authors’ own experiences working with military divers was why the number of accidents in recreational diving is substantially higher than that obtained in military diving. The comparison of factors having a direct effect on diving safety, the scope of depths reached, the manner of conducting decompression and divers’ problems reported after diving completion allow to explain the reasons behind the common incidents occurring among recreational divers. The factors which had a very significant impact on safety level included diving frequency, adaptation to higher pressure conditions and overestimation of one’s skills in undertaking challenges.
Dorota Niewiedział, Maria Miłkowska, Piotr Siermontowski, Zbigniew Dąbrowiecki, Dorota Kaczerska, Dariusz Juszczak and Romuald Olszański
The aim of the article is a review of psychological literature relating to the problem of anxiety in divers, where an emphasis is placed on the degree of mental adaptation of the individual to the underwater environment, primarily highlighting the trait of anxiety and the neuroticism of a person involved in a specific type of diving. The article presents selected reports from all over the world regarding research on anxiety in divers. Treating a high level of the indicator of anxiety as a predictor of panic anxiety reveals the importance of this trait in predicting the risk of an occurrence of diving accidents during the operation under water. In the own research presented in the article, the results on the levels of anxiety as a trait and a state in divers taking part in hyperbaric exposures indicate the fact that the majority of the examined divers have low levels of anxiety both as a trait and a state, which most probably indicates the good psychological condition of the examined divers.
Sławomir Kujawski, Agnieszka Kujawska, Mariusz Kozakiewicz, Romuald Olszański, Piotr Siermontowski and Paweł Zalewski
Hyperbaric oxygen therapy (HBOT) is found among the interests of researchers who seek new methods of treatment of diseases of the nervous system. An increase of the partial pressure of oxygen in arterial blood within the appropriate range leads to numerous changes in the cells of the brain tissue. In this paper we analyse the results of selected articles describing HBOT used on pathologies of the nervous system such as stroke, autism, multiple sclerosis and cerebral palsy as well as in the course of research on animal models. The results are promising, although some studies struggled with numerous methodological problems and differences in the applied protocols, which resulted in conflicting results in individual interventions. In consequence, the need for further studies in randomised control trials and determination of the protocol by an international group of researchers dedicated to the use of HBOT was emphasised.