title: An in-field demonstration of the true relationship between skin infections and their sources in occupational diving systems in the North Sea.
abstract: BACKGROUND
  Skin infections in saturation diving are caused by microbes that flourish in saturation environments. Improvements in the prevention of infections must therefore be based on environmental control and elimination. Furthermore, only a few genotypes seem to be responsible for the majority of infections in the Norwegian sector of the North Sea, and these have all been demonstrated in saturation systems for many years. Although reservoirs of infectious genotypes have been identified, their true sources have not been identified.
  
  
  OBJECTIVE
  The purpose of this field study was to log the contamination by Pseudomonas aeruginosa of the saturation system throughout a diving operation.
  
  
  METHODS
  Daily water samples from the vessels drinking water system and from the heated seawater systems to divers suits were taken throughout the diving period of 1 month in the summer of 2001. All P.aeruginosa isolates were genotyped by pulsed field gel electrophoresis.
  
  
  RESULTS
  A total of 17 P.aeruginosa genotypes were identified in the course of this field study. None of the most common infectious genotypes previously observed in the Norwegian sector were among these strains. Two genotypes were involved in skin infections during the period of operation: TP2 and TP12. TP2 was shown to be an inhabitant of the diving systems throughout the investigation period, while TP12 was introduced from seawater in the course of the operation and rapidly spread and established itself throughout the diving system.
  
  
  CONCLUSIONS
  The study has demonstrated seawater as a true source of an infectious P.aeruginosa genotype in occupational diving systems.
authors.affiliation: Division of Microbial Exposure and Indoor Air, SINTEF Unimed, N-7034 Trondheim. catrine.ahlen@sintef.no
authors.forename: C
authors.initials: C
authors.lastname: Ahlen
authors.forename: L H
authors.initials: LH
authors.lastname: Mandal
authors.forename: O J
authors.initials: OJ
authors.lastname: Iversen
mesh_terms: D004269:DNA, Bacterial / Q000032:analysis; D004242:Diving; D006801:Humans; D009664:Norway; D009784:Occupational Diseases / Q000382:microbiology*; D016273:Occupational Exposure; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa; D012623:Seawater / Q000382:microbiology*; D017192:Skin Diseases, Bacterial / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial