Dysbaric osteonecrosis in a compressed air tunnelling project in Hong Kong

In the largest compressed air tunnelling project using the Blackpool Decompression Tables in Hong Kong, 912 men had radiological examination of major joints and 12 definite and 30 suspected cases of dysbaric osteonecrosis were detected by the compressed air physician. Distribution of the lesions was symmetrical and 43.1 per cent were juxta-articular. All the cases were asymptomatic. The infrequent occurrence of osteonecrosis in Hong Kong in general and in this project in particular suggests that the Blackpool Tables were relatively effective in preventing the disease. Definite and suspected cases were pooled together for the study of risk factors for osteonecrosis. Logistic regression analysis showed that the number of bends ever experienced, number of hours worked in the present contract, age and obesity were important independent risk factors. Because of the impossibility of a suitably long follow-up for all workers, the prevalence of osteonecrosis may be under-reported in Hong Kong.