Vol 70, No 2 (2019)
Original article
Published online: 2019-06-25

open access

Page views 2251
Article views/downloads 1953
Get Citation

Connect on Social Media

Connect on Social Media

Lung function change in hyperbaric chamber inside attendants

Peachapong Poolpol12, Pornchai Sithisarankul2, Thanapoom Rattananupong2
Pubmed: 31237673
IMH 2019;70(2):125-131.

Abstract

Background: Hyperbaric oxygen therapy is one of new trends of additional treatment, especially for non-di- ving-related diseases in Thailand. Hyperbaric inside attendants have to work under hyperbaric environment to provide medical care for patients in the hyperbaric chamber. This study aims to investigate longitudinal change in lung function in hyperbaric inside attendants (HIAs) and the relationship with hyperbaric exposure.

Materials and methods: This is a retrospective longitudinal study exploring the adverse long-term effects to the lungs in HIAs. All inside attendants (HIAs) who worked in the public hospitals or medical centres with multiplace hyperbaric chamber in Thailand were included. To be considered for inclusion in the study, inside attendants were required to have at least two follow-up lung function tests and minimum 1-year interval at baseline from annually periodic examination. Lung function of HIAs were compared against reference values of the Thai population. 

Results: There were 51 subjects with 9.26-year mean period of follow-up. The HIAs showed a significantly decrease in measured lung function in average forced expiratory volume in 1 second (FEV1), forced expi- ratory flow at 25–75% of functional vital capacity (FEF25–75%) and FEV1/FVC ratio over time. The annual reductions in FEV1, FEF25–75% and FEV1/FVC ratio were 22.52 mL per year, 44.92 mL/s per year and 0.48% per year, respectively. The study showed significant differences in annual changes in FVC, FEF25–75% and FEV1/FVC ratio between HIAs and the lung function predicted values for the Thais. However, the results revealed no differences of annual change in FEV1 from predicted values. The average working depths, average session duration and total working hours as HIAs were related with the changes of lung function. 

Conclusions: Working in a hyperbaric environment does affect the lung function of HIAs. In addition to fitness to work implementation, periodic lung function evaluation should be encouraged to monitor further possible harm to the attendants. 

Article available in PDF format

View PDF Download PDF file

References

  1. Fracica PJ, Knapp MJ, Piantadosi CA, et al. Responses of baboons to prolonged hyperoxia: physiology and qualitative pathology. Journal of Applied Physiology. 1991; 71(6): 2352–2362.
  2. Thom SR, Milovanova TN, Bogush M, et al. Microparticle production, neutrophil activation, and intravascular bubbles following open-water SCUBA diving. J Appl Physiol (1985). 2012; 112(8): 1268–1278.
  3. Thom S, Milovanova T, Bogush M, et al. Bubbles, microparticles, and neutrophil activation: changes with exercise level and breathing gas during open-water SCUBA diving. Journal of Applied Physiology. 2013; 114(10): 1396–1405.
  4. Moon RE, Cherry AD, Stolp BW, et al. Pulmonary gas exchange in diving. J Appl Physiol (1985). 2009; 106(2): 668–677.
  5. Segadal K, Gulsvik A, Nicolaysen G, et al. Respiratory changes with deep diving. Eur Respir J. 1990; 3(1): 101–8.
  6. Ozdemir A, Uzun G, Turker T, et al. Changes in pulmonary function in hyperbaric chamber inside attendants: a case-control study. Undersea Hyperb Med. 2016; 43(7): 805–811.
  7. Crosbie WA, Clarke MB, Cox RA, et al. Physical characteristics and ventilatory function of 404 commercial divers working in the North Sea. Br J Ind Med. 1977; 34(1): 19–25.
  8. Davey IS, Cotes JE, Reed JW, et al. Relationship of ventilatory capacity to hyperbaric exposure in divers. J Appl Physiol Respir Environ Exerc Physiol. 1984; 56(6): 1655–1658.
  9. Watt SJ, Watt SJ. Effect of commercial diving on ventilatory function. Br J Ind Med. 1985; 42(1): 59–62.
  10. Thorsen E, Segadal K, Kambestad BK, et al. Pulmonary function one and four years after a deep saturation dive. Scand J Work Environ Health. 1993; 19(2): 115–120.
  11. Reuter M, Tetzlaff K, Steffens JC, et al. Functional and high-resolution computed tomographic studies of divers' lungs. Scand J Work Environ Health. 1999; 25(1): 67–74.
  12. Skogstad M, Thorsen E, Haldorsen T, et al. Lung function over the first 3 years of a professional diving career. Occup Environ Med. 2000; 57(6): 390–395.
  13. Skogstad M, Thorsen E, Haldorsen T, et al. Lung function over six years among professional divers. Occup Environ Med. 2002; 59(9): 629–633.
  14. Fitzpatrick DT, Conkin J, Fitzpatrick DT, et al. Improved pulmonary function in working divers breathing nitrox at shallow depths. Aviat Space Environ Med. 2003; 74(7): 763–767.
  15. Adir Y, Shupak A, Laor A, et al. Large lungs in divers: natural selection or a training effect? Chest. 2005; 128(1): 224–228.
  16. Tetzlaff K, Theysohn J, Stahl C, et al. Decline of FEV1 in scuba divers. Chest. 2006; 130(1): 238–243.
  17. Skogstad M, Skare O, Skogstad M, et al. Pulmonary function among professional divers over 12 years and the effect of total number of dives. Aviat Space Environ Med. 2008; 79(9): 883–887.
  18. Chong SiJ, Tan TW, Lim JY, et al. Changes in lung function in Republic of Singapore Navy divers. Diving Hyperb Med. 2008; 38(2): 68–70.
  19. Sames C, Gorman DF, Mitchell SJ, et al. The long-term effects of compressed gas diving on lung function in New Zealand occupational divers: a retrospective analysis. Diving Hyperb Med. 2009; 39(3): 133–137.
  20. Pougnet R, Anne H, Mialon P, et al. Evolution of the ventilatory function of professional divers over 10 years. Undersea Hyperb Med. 2013; 40(4): 339–43.
  21. Voortman M, Ooij PJ, Hulst RA, et al. Pulmonary function changes in Navy divers during their professional careers. Undersea Hyperb Med. 2016; 43(6): 649–657.
  22. Dejsomritrutai W, Nana A, Maranetra KN, et al. Reference spirometric values for healthy lifetime nonsmokers in Thailand. J Med Assoc Thai. 2000; 83(5): 457–466.
  23. Ong LM, Bennett MH, Thomas PS, et al. Pulmonary dysanapsis and diving assessments. Undersea Hyperb Med. 2009; 36(5): 375–380.