Acute decompression illness in UK tunnelling

Civil engineers have used compressed air to stabilise wet ground for over 150 years and continue to do so. But since 2001, compressed-air workers in the UK can no longer decompress on air alone—it now has to be done with the aid of oxygen. Despite one of the strictest regulatory environments in the world, Britain's construction industry recorded 428 cases of decompression illness between 1984 and 2002, leading to air-only decompression being banned. This paper provides an analysis of the UK's uniquely comprehensive database of compressed air exposure and decompression illness records which led to the ban. It provides a benchmark for assessing the effectiveness of oxygen decompression as well as informing other countries considering making the change.