title: The effectiveness of a health-surveillance program for caisson saturation divers in a tunnel-boring machine: a microbiological survey.
abstract: The purpose of this field study is to report and evaluate the implementation of a health surveillance program we developed to monitor the microbiological load for saturation divers, including preventive and therapeutic interventions. We extended the DMAC protocol for Saturation Diving Chamber Hygiene and added some components: ear inspections, swabs and environmental swabs every third day. The implementation was evaluated by analyzing the results of the activities. In a pre-saturation dive check we examined a total of 17 divers. Here we present the data from all seven saturation phases, collected over a period of 1.5 years. In every saturation phase we have found pathogenic bacteria or fungi in divers and in the environment, but more in some periods than in others. We did not observe any serious infection that required a diver to abort his stay in the living chamber. This health surveillance program has demonstrated the potential value of an early warning system to prevent problems. The bacterial load found in divers and in the environment was clearly visible. Prevention could be improved by more consistent implementation of the protocol. Fortunately, the infections had no serious consequences for the health of the workers or for the continuation of the work process.
authors.affiliation: Coronel Institute for Occupational Health, Academic Medical Center University of Amsterdam, The Netherlands. t.p.vanreesvellinga@amc.uva.nl
authors.forename: T P
authors.initials: TP
authors.lastname: Van Rees Vellinga
authors.forename: W
authors.initials: W
authors.lastname: Sterk
authors.forename: F J H
authors.initials: FJ
authors.lastname: Van Dijk
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis / Q000517:prevention & control; D058491:Bacterial Load / Q000379:methods; D002056:Burns / Q000209:etiology; D015169:Colony Count, Microbial / Q000379:methods*; D020378:Confined Spaces; D004242:Diving; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D009181:Mycoses / Q000175:diagnosis / Q000517:prevention & control; D009784:Occupational Diseases / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control; D009787:Occupational Medicine / Q000592:standards; D016730:Program Development; D015397:Program Evaluation; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification