Decompression Illness in CA workers

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What safety options are available for compressed air tunnelling at working pressure higher than 3.45bar? Dr. Ronson. C.T. LI DFM., DOM., MsOHS, Diving & Hyperbaric Medical Consultant Decompression Illness in CA workers While tunnel workers working at depth with compressed air, the discrepancy between nitrogen absorption and elimination resulted in the occurrence of Decompression Illness (DCI) in the compressed air (CA) workers. Skin bend scarlatiniform rash Joint bend, bone necrosis

Decompression Tables with oxygen for decompression Employed and modifier regularly worldwide to reduce Decompression Illness. In Europe, such as France, adding oxygen for decompression in compressed air work within 3.0bar had been employed since 1974 and became mandatory in 1992, application up to (4.0bar) in 1997 Sydney airport link, similar mandatory requirement applied in Germany up to 3.6bar (1997) and U.K. up to 3.45bar (2001)

Current known Air Decompression Tables on CA work regulations In U.S., U.K, France, China Mainland does not have any approval tables which allow working pressure over 3.45bar (3.6bar in Germany). When compressed air work beyond 3.45bar, the usual compressed air containing 80% nitrogen would generate neurological narcosis, affect tunnellers orientation and work capability. Simply increasing the percentage of oxygen is unsafe as it would increase the risk of fire and becomes toxic to the body in high concentrations French Oxygen Decompression Tables German Oxygen Decompression Tables

In commercial diving industry In to reach greater working depths without suffering from nitrogen narcosis or oxygen toxicity, helium is used in place of nitrogen. With years of research & development resulted in the successful application of varies mixed gases (Trimix O2/N2/He) for deep diving. Available options for TBM tunnelling - I Mixed gases technique (Trimix) as commercial diving with modified Trimix Decompression Tables for CA work Applicable in short working time, usually within 2 hours

Available options for TBM tunnelling - II Mixed gases diving in Saturation mode A diver (CA worker) when expose to a constant pressure of 24 to 48 hours, body tissues become saturated with inspired inert gases; further time at depth requires no additional decompression time - known as saturation, avoid the stresses of multiple decompressions where long working times are needed. There are set of Unlimited Duration Excursion Tables which allow safe multiple excursions (downward diving) to be conducted during the course of a saturation, allow a large vertical range of working depths without time limits Mixed gases diving saturation mode, for prolonged working time The diving shuttle in Saturation dive

Near 4 hours working time (Oxygen/ Nitrogen/Helium as 9%/18%/73% ~ 10%/18%/72%) Realistic validation of trimix tables for model TBM & compressed air work Netherlands Western Scheldt TBM Tunnel up to 6.9bar Employing mixed gases for caisson in Japan

Samples of built-in breathing system (BIBS) with full face mask inside DDC/PTC On going deep TBM tunnel with mixed gases for compressed air work Russia St Peterburg TBM Tunnel up to 5.5bar In Sweden Hallandsås Tunnel U.S. Seattle Brightwater Tunnel up to 6.1bar

Advantage of adding Oxygen for Decompression Zero decompression illness recorded in two KCRC tunnels with oxygen decompression in KCRC West Rail DB 320 & West Rail LBD-201 (working pressure < 3.45bar) May prevent late bone necrosis Advantage of Mixed gases (Trimix) Decompression Zero decompression illness recorded in Netherlands Western Scheldt Tunnel & Russia St Peterburg (working pressure >3.45bar) Limitation in Mixed gases & Oxygen Decompression In Hong Kong, you must first obtain approval from Labour Department The TBM man-lock is small, hot and humid, delivery oxygen by mask is difficult, these problems must be solved from TBM design and build Risk of fire safety must be complied with applicable safety standards with proper risk management plan Risk of oxygen toxicity need experience Diving & Hyperbaric Medical Physician support for advisory, medical management

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