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Atopy, airway reactivity and compressed air diving in males.

A decline in expiratory flow rates in divers has recently been attributed to chronic exposure to hyberbaric air. Airway hyperresponsiveness (AHR) to stimuli due to a hyperbaric environment may play a certain role in this context. The aim of this study was to determine the prevalence of AHR in compressed air divers and to assess the value of bronchial challenges for prediction of fitness to dive. A cross-sectional sample of 59 healthy male volunteers--28 divers and 31 diving candidates (controls)--who had been found fit to dive in a diving medical examination underwent additional allergy screening (skin prick and serum IgE) and a histamine bronchial challenge. Pre- and postchallenge body plethysmography was completed to assess AHR. AHR to histamine was significantly increased among divers and positively related to diving experience whereas divers and controls did not differ significantly with respect to age, anthropometric data, current smoking habits, skin prick reaction, and elevated serum IgE. Our results indicate an increased prevalence of AHR to nonspecific inhalation stimuli in experienced divers. Bronchial challenge tests may be helpful to detect asthmatics in the medical assessment of fitness to dive and for follow-up examinations during a diver's career.

Adult↗

Expiratory flow limitation in compressed air divers and oxygen divers.

Divers are exposed to dense gases under hyperbaric and hyperoxic conditions and, therefore, may be at risk of developing respiratory disease. Long-term effects on respiratory function have been found in commercial divers who perform deep dives. This study was conducted to detect possible lung function changes in scuba divers who dive in shallow water using compressed air or oxygen as a breathing gas. A cross-sectional sample of 180 healthy male divers (152 air divers and 28 oxygen divers) and 34 healthy male controls underwent a diving medical examination including body plethysmography, diffusion capacity measurement and a cold-air isocapnic hyperventilation test (CAIH). Air divers and oxygen divers had a lower mid-expiratory flow at 25% of vital capacity (MEF25) than controls (p<0.01 and p<0.05, respectively). Oxygen divers also had a decreased mid-expiratory flow at 50% of vital capacity (MEF50) (p<0.05). Divers' groups and controls did not differ with respect to age, smoking or medical history. The prevalence of airway hyperresponsiveness to CAIH was 1.4% (n=3 divers). MEF25 and MEF50 were inversely related to years of diving (p<0.01 and p<0.001, respectively). The pattern of lung function changes obtained in scuba divers is consistent with small airways dysfunction and the association between diving exposure and lung function changes may indicate long-term effects on respiratory function.

Adult↗

Sample introduction assisted by compressed air in flame furnace AAS: a simple and sensitive method for the determination of traces of toxic elements.

The power of detection of flame AAS for the toxic elements Cd, Hg, Pb and Tl can be improved by 1-2 orders of magnitude by using flame furnace AAS. In flame-furnace AAS, liquid samples are introduced directly into a nickel tube located in the flame, in the simplest case through a ceramic thermospray capillary. Transportation of the samples is achieved by using compressed air only. Comparatively low detection limits are achieved by both beam injection flame furnace (BIFF-AAS) and thermospray flame furnace AAS (TS-FF-AAS). For TS-FF-AAS, a pressure of less than 20 kPa (<80 in. water) is required. The TS-FF-AAS technique is very simple, robust and cheap. The detection limits were 0.2-0.4 microg L(-1) (Cd), 40-100 microg L(-1) (Hg), 5-9 microg L(-1) (Pb) and 4-14 microg L(-1) (Tl), respectively, depending on the method, flow rate and sample volume used. Pb and Cd were found at concentrations of 0.1-2 and 0.005-0.3 microg g(-1), respectively, in samples of various spices.

Cadmium↗

Narcotic effects of nitrous oxide and compressed air on memory and auditory perception.

Three experiments were conducted to examine the effects of 35% N2 O (nitrous oxide) on human memory and auditory perception. In Experiment I, dichotic listening performance was found to be impaired. Experiment II used the same technique but was controlled for attenuation of sound transmission in the middle ear. No impairment was found. The perceptual effect found in Experiment I was peripheral, not central, and N2O did not impair short-term memory (STM). Experiment III used one-trial free recall of a word list. The shapes of the serial position curves were interpreted as indicating that N2O impairs long-term memory (LTM) but not STM. Experiment III provided no evidence, using cued recall, that the LTM deficit was due to impaired retrieval. Comparing these results with those for compressed air led to the conclusion that both N2O and hyperbaric nitrogen display an identical pattern of effects. A reason for the decrement found in some N2O STM studies may have been confounding the measurement of STM with that of LTM.

Atmospheric Pressure↗

[A case of isocyanate-induced hypersensitivity pneumonitis and a compression-air mask thought to be effective in its prevention].

A 41-year-old paint sprayer, who had worked with polyurethane paint since the spring of 1989, developed exertional dyspnea and dry cough and entered hospital on December 4, 1989. Plain chest X-ray film and a computed tomogram of the lung revealed diffuse micronodular shadows in both lower lung fields. DLco was shown to be significantly decreased in a pulmonary function test. A sample of bronchoalveolar lavage fluid showed increased T lymphocytes and a decreased CD4/8 ratio. A lung biopsy specimen revealed alveolitis, but neither Masson body nor granulomas were seen. Serum antibody specific to TDI-HSA was detected, and an environmental provocation test was positive. From these results, the patient was diagnosed as having isocyanate-induced hypersensitivity pneumonitis. We advised him to wear a compression-air mask when he worked, because he did not want to quit his job. Respiratory symptoms have not been seen since then, but careful observation was thought to be necessary. The involvement of type III humoral and type IV cellular immunity was suspected in this case.

Adult↗

Continuous recording of intrapulmonary "compressed air" as a sensitive noninvasive method of measuring bronchial obstruction in guinea pigs.

The method presented is based on whole-body plethysmography. The apparatus consisted of two chambers (a = respiratory, b = body chamber) separated by a tight water-filled rubber cuff which was fixed around the head of the animal. Experiments were performed under constant gas conditions: temperature 30 degrees C, 100% relative humidity, the volumes of the two chamber being identical. Volume changes in the chamber (delta Va, delta Vb) were recorded continuously by means of pressure transducers. Respiratory flow was calculated by differentiation of delta Va with respect to time. The three parameters delta Va, delta Vb and respiratory flow allowed the calculation of breathing frequency, inspiration/expiration ratio, (peak) expiratory flow and specific airway conductance. In addition we describe a new parameter indicating bronchial obstruction: a graphical plot of delta Vb against delta Va produces a closed loop, the area of which reflects the degree of airway obstruction, and we read off the parameter we term "compressed air" from this graph. In our hands this parameter was more than ten times as sensitive as other measures of bronchial obstruction. Using this new technique we have carried out pharmacological studies with eicosatetraynoic acid (ETYA), 2-aminomethyl 4-t-butyl-6-iodophenol (MK 447 = radical scavenger), the histamine antagonist clemastine and the histamine antagonist cimetidine. In allergen-tested animals we observed mild protective effects of ETYA when given as an aerosol (3 mg) and pronounced effects of MK 447 (4 mg i.p.). Combined H1 H2-antagonism was much more effective in preventing allergen-induced bronchial obstruction than H1-antagonism alone.

Airway Obstruction↗

Inner ear decompression sickness in sport compressed-air diving.

OBJECTIVE: We report our experience over the past 12 years with recreational diving-related inner ear decompression sickness (IEDCS). STUDY DESIGN: Retrospective, consecutive case series. METHODS: Twenty-four divers, representing 29 cases of IEDCS, are presented with regard to evaluation, treatment, and follow-up. RESULTS: These 29 cases represent 26% of the severe decompression sickness (DCS) cases treated in that period. The patient group includes 22 divers who had a single event of IEDCS, one diver who had two events, and one with five repeated episodes. The cause of injury in 23 cases (79%) was violation of the decompression schedule. The mean time from surfacing to appearance of symptoms was 47 +/- 65 minutes. In 83%, symptoms appeared within 1 hour of ascent, in 97% within 2 hours, and in only one diver after 5.5 hours. Ten divers (34%) had pure vestibular involvement, 4 (14%) had cochlear insult alone, and 15 (52%) had combined vestibulo-cochlear injury. Except for one patient who had central as well as peripheral vestibulo-cochlear DCS, all the remaining patients had end organ involvement only, as demonstrated by physical examination and laboratory test results. Fifteen (52%) had isolated IEDCS, whereas 14 had additional symptoms of DCS. Twenty-six cases were treated by hyperbaric oxygenation with supplementary daily hyperbaric sessions. Of the 25 cases with vestibular injury and the 19 with cochlear damage, only 7 (28%) and 6 (32%), respectively, made a full recovery, whereas the others remained with residual damage. Of the 17 treated within 6 hours of symptom appearance, 9 (53%) were cured, compared with one of the 9 treated later (P <.05). CONCLUSIONS: IEDCS related to compressed-air recreational diving is more common than previously thought, and might occur even when no decompression schedule violation took place. Prompt diagnosis leading to the early commencement of hyperbaric oxygen recompression therapy is the key to complete recovery of cochlear and vestibular function.

Adult↗