The article presents a dermatosis that occurs in tropical and subtropical countries. Though the definitive hosts of the cutaneous larva migrans parasite are animals, humans can become accidental hosts and they are infected when their skin comes into contact with damp soil, most frequently sand. The disease is only present in the epidermis where an itch is brought about by the mining activity of the larva. Sunbathers and divers who put on their gear on a beach, on account of the epidermis maceration caused by a prolonged exposure to water, are particularly susceptible to the penetrative activities of the larva. In Poland the cutaneous larva migrans is in most cases mistaken for nettle rash or eczema.
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.
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.
Research shows a potential threat from external environmental factors which might be the cause of upper and lower gastrointestinal diseases in tourists, or soldiers engaged in tropical peacekeeping missions. The research includes infections which due to their spread are also present in their home countries such as Helicobacter pylori infections, viral hepatitis as well as infections which might cause symptoms of upper and lower gastrointestinal tract diseases as a result of poor sanitary and unhygienic conditions. Contact with diseases typical of the tropical climate, especially during longer stays, increases the chances of bringing some tropical diseases back to Poland, which can be problematic for the domestic health care service.
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.
Harmful biological factors accumulated in the ambient atmosphere are a very important and increasingly recognised problem of both occupational medicine and public health. The quantitative and qualitative assessment of harmful biological agents in the working environment is a very important element of the exposure assessment and therefore of an assessment of workers’ health risks. In 2018, a pilot study on the microbiological quality of air was carried out at two facilities of the Polish Navy.
Diving is a kind of human activity that requires special health predispositions due to the nature of an aquatic environment. The environment of an increased atmospheric pressure imposes a significantly greater burden on the respiratory and circulatory system as compared with normobaric conditions. Due to their health status, not everyone among those that wish to take up diving should undergo diving training, as diving can have an adverse effect on their condition while staying under water and considerably raise the risk of an occurrence of a diving accident. As regards diving activities performed within the Armed Forces, individuals with particular health burdens are eliminated via the medical checks conducted at the time of recruitment to the diving service. The checks, based on detailed parameters and described in legal acts, minimise the risk of an occurrence of a diving accident. This problem is quite different when it comes to recreational diving, where quite often, by presenting a health certificate, an interested diver candidate begins a training course and further individual diving activities while being aware of a medical condition that may affect their future safety under water. An analysis of the effect of health selection on the level of diving safety was performed.
Allergic contact eczema is the most common occupational skin disease caused by allergens. Thus far, no research has been conducted in Poland in relation to the development of contact allergies amongst divers resulting from particular diving suit components. A group of 86 divers were examined using allergy patch tests. Standard products of contact allergy diagnostics were used containing 40 allergens.
In the event of an epidemic of Legionnaires’ disease, prompt and unambiguous identification of the source of infection and immediate undertaking of repair actions is a necessary condition to limit and minimise the effects of the developing epidemic. In the classical method for determining the level of Legionella bacteria in water samples, the effectiveness of the reparative action (increase of the water temperature in the water supply system to 600C, additional chlorination) can only be confirmed after 14 days!!! Only by using the IMMS&FCM method can Legionella’s determination time be reduced to 2-4 hours, which is the most important factor in limiting the development of an epidemic.
Allergic rhinitis occurs in various regions of the world and affects from 10 to 40% of the population. The skin prick test is the “gold standard” for the detection of type I allergic diseases according to the Gella and Coombs classification, which is mediated by IgE. For our experiment, skin prick tests were performed on 60 divers aged between 30 and 40 years of age. The following tests for airborne allergens were used: tests for pollen from trees, grasses, cereals, weeds, proteins from house dust mites, animal hair and epidermis, and moulds. On the basis of an interview and a positive skin prick test allergic rhinitis was diagnosed in 17 divers.
Allergic rhinitis can cause health problems in divers and be the cause of diving accidents.
The application of the skin prick test during the health qualification in the Military Maritime Health Commission, would allow the exclusion of diver candidates suffering from allergies.