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Aseptic necrosis in compressed air tunnel workers using current OSHA decompression schedules
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
|October 1, 1982
Summary
Occupational Health and Safety Administration (OSHA) decompression tables caused aseptic necrosis in tunnel workers. New, more conservative tables are being evaluated to prevent decompression sickness and bone damage.
Area of Science:
- Occupational Health
- Diving Medicine
- Radiology
Background:
- Compressed air tunneling involves significant pressure exposure.
- Current Occupational Health and Safety Administration (OSHA) decompression protocols are used for workers exceeding 36 pounds per square inch gauge (psig).
Observation:
- A study examined 21 compressed air tunnel workers exposed to pressures up to 43 psig.
- Roentgenographic and bone scan imaging were employed to assess for bone abnormalities.
Findings:
- Aseptic necrosis (dysbaric osteonecrosis) was identified in 33% of the workers studied.
- Affected areas included shoulders, hips, distal femoral shafts, and proximal tibias.
- The current OSHA decompression schedules were found to have an unacceptable incidence of decompression sickness and aseptic necrosis.
Implications:
- The findings necessitate a revision of current OSHA decompression tables for compressed air tunneling.
- Development of more conservative interim tables using air or oxygen is underway.
- These new protocols aim to mitigate risks of decompression sickness and dysbaric osteonecrosis.