New Polish occupational health and safety regulations for underwater works

In Poland, the new regulation of the Ministry of Health on Occupational Health for Underwater Works (dated 2007) pursuant to the Act on Underwater Works (dated 2003) has just been published. It is dedicated for commercial, non-military purposes. It defines health requirements for commercial divers and candidates for divers, medical assessment guide with a list of specific medical tests done on initial and periodical medical examination in order for a diver or a candidate for diver to be recognised fit for work, health surveillance during diving operations, compression and decompression procedures, list of content for medical equipment to be present at any diving place, formal qualifications for physicians conducting medical assessment of divers, requirements for certifications confirming the medical status of divers and candidates for divers. Decompression tables cover divings up to 120 meters of depth using compressed air, oxygen, nitrox and heliox as breathing mixtures. There are also decompression tables for repetitive diving, altitude diving and diving in the high-density waters (mud diving). It this paper, general description of health requirements for divers, as well as decompression tables that are included in the new Regulation on Occupational Health for Underwater Works are presented

Recompression treatment for decompression illness: 5-year report (2003-2007) from National Centre for Hyperbaric Medicine in Poland

A serious diving accident can occur in recreational diving even in countries where diving is not very popular due to the fact that diving conditions there are not as great as in some tropical diving locations. The estimated number of injured divers who need recompression treatment in European hyperbaric facilities varies between 10 and 100 per year depending on the number of divers in the population, number of dives performed annually, and number of hyperbaric centres in the country. In 5 years of retrospective observation in Poland (2003-2007) there were 51 cases of injured recreational divers recorded. They either dived locally or after returning home by air from a tropical diving resort. All of them were treated with recompression treatment in the National Centre for Hyperbaric Medicine in Gdynia which has capability to treat any patient with decompression illness using all currently available recompression schedules with any breathing mixtures including oxygen, nitrox, heliox or trimix. The time interval between surfacing and first occurrence of symptoms was significantly lower in the group of patients with neurological decompression sickness or arterial gas embolism (median 0.2 hours) than in the group of patients with other types of decompression sickness (median 2.0 hours). In both groups, there were different types of recompression tables used for initial treatment and different number of additional sessions of hyperbaric oxygenation (HBO) prescribed, but the final outcome was similar. Complete resolution of symptoms after initial recompression treatment was observed in 24 cases, and this number was increased to 37 cases after additional HBO sessions (from 1 to 20). In the final outcome, some residual symptoms were observed in 12 cases. In 2 cases initial diagnosis of decompression sickness type I was rejected after initial recompression treatment and careful re-evaluation of diving profiles, risk factors and reported symptoms

Pneumoperitoneum after diving – two clinical cases and literature review

Pneumoperitoneum after diving is a rare symptom. Diagnosis and treatment strongly depends on the primary source of the air in the abdominal cavity. There are two main sources of air entering the perineum: perforation of the gastrointestinal tract and pulmonary barotrauma. The management is different and additionally, in both cases, the decompression sickness and arterial gas embolism as consequences of inappropriate decompression phase of the diving should be included in the clinical diagnosis and treatment. The multidisciplinary team including hyperbaric physicians and surgeons is necessary for proper management of such cases. In this paper two cases of pneumoperitoneum of different origins are presented and similar cases reported in the literature are discussed. 1 National Center fo