Medical aspects of compressed air illness / by W.D.M. Paton.

  • Paton, William D. M.
Date:
[1954?]
Catalogue details

Licence: In copyright

Credit: Medical aspects of compressed air illness / by W.D.M. Paton. Source: Wellcome Collection.

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    CHAPTER 4 MEDICAL ASPECTS OF COMPRESSED-AIR ILLNESS W. D. M. Paton HISTORICAL INTRODUCTION Although the ill effects of exposure to compressed air have been known for over a century, and despite the considerable volume of writing about it, there remain many gaps in our knowledge of compressed-air illness as it occurs in industrial undertakings. This is partly because it is mainly divers and (more recently) airmen, who have furnished material sufficiently con¬ trollable and homogeneous for clinical study. The rougher conditions of industrial labour make it very hard to establish even the simplest facts about the genesis, course and treatment of the disorder. Accordingly our knowledge rests primarily on the work of J. S. Haldane, with his colleagues A. E. Boycott and G. C. C. Damant, who first satis¬ factorily studied decompression-sickness in animals (Boycott, Damant and Haldane (1908)), and devised the only generally satisfactory methods of decompression in existence (Haldane and Priestley, 1935). These workers employed animals for the most part, and the Decompression Tables were tested on divers. Later work, particularly during the World War II, has been reviewed by Harvey (1945) and Behnke (1945). An extensive but un¬ critical bibliography has been compiled by Hoff (1948). Useful accounts of experience in caisson and tunnel workings are given by Snell (1896), Keays (1909), Levy (1922), Norrie (1934) and Boulton (1942), but many items of useful information in this field are still lacking. Much of the account that follows is based on experience gained during the construction of the Tyne Tunnel between 1947 and 1949, between Howdon and Jarrow (Paton and Walder, 1954). A discussion with any en¬ gineer having experience of compressed-air work will also prove of great value. Draft regulations issued by the Factory Department of the Ministry of Labour will be found in Work of Engineering Construction {Factories Act, 1937), Revised Draft, Part VII (Work in Compressed Air). DEFINITIONS Since there is apt to be some confusion about nomenclature, it is useful to state precisely what is meant or implied by some of the terms used. The term, compressed-air illness, strictly refers to any illness resulting from exposure to compressed air. It may therefore include: (1) decompression- sickness proper, (2) disorders of the ears and cranial sinuses, and (3) (rarely)