Caisson Disease

By Stuart M. Smith, MD and B. James McCallum, MD

Caisson disease (now known as decompression sickness, or more commonly "the bends") is the name given to a variety of symptoms suffered by a person exposed to a reduction in the pressure surrounding their body. Typically it occurs when a person subjected to great atmospheric pressure suddenly has that pressure removed – as when a scuba diver returns rapidly to the surface after a long submerged period.

When under pressure, inert gases, particularly nitrogen, remain dissolved in body fluids and tissues. When that pressure is removed, however, the gases bubble out of solution like foam from a freshly poured beer.

The bubbles wreak havoc on the body, causing at best horrific joint pain and possibly even strokes, paralysis, and death. Recompression chambers, such as a hyperbaric oxygen chamber, force the gas back in to solution and therefore can be used to treat the disease.

Though usually thought of as a modern affliction, a disease later identified as Caisson disease was first described in 1841 in coal miners who were laboring inside a mine that had been pressurized to keep water out.

The disease obtained its name, however, from the large pressurized cylinders that are used to give workers access to the bases of bridges or dams.

Commercial divers minimize their risk of the disease by utilizing a mixture of oxygen and helium as opposed to nitrogen.

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