A case of caisson sickness in an underground miner

Information on the detection of cases of caisson disease in workers engaged in the construction of underground tunnels on waterlogged soils under elevated atmospheric pressure is extremely scarce, while the difficulties of proving the connection of this pathology with the profession are not considered. In order to identify the causes of these difficulties, a description and analysis of a rare case of this pathology, accompanied by several examinations and a lawsuit, are provided based on archival data. According to the patient’s medical records, there was a steadily increasing deterioration in health, a number of diagnoses, and repeated treatment in various medical institutions. Changes in the cardiovascular system, dysbaric osteonecrosis, and juxta-articular damage to bones and joints characteristic of the consequences of decompression disorders were noted. However, due to the lack of proper alertness of doctors from the departmental medical service, these changes in health were classified as manifestations of general diseases. Only a thorough analysis of medical documentation with data from a detailed examination of the patient in several medical hospitals with the involvement of experts from an institution specializing in underwater medicine made it possible to properly substantiate the diagnosis of decompression sickness. To prevent such cases, it is necessary to strictly adhere to the requirements of current regulations on periodic medical examinations of underground miners working in waterlogged soils under increased atmospheric pressure, which provide for the mandatory participation of underwater medicine specialists in the examination of these workers. At the same time, doctors of various other specialties must remember the symptoms of decompression sickness and the possibility of its development in those engaged in underground work.