Work in hypoxic conditions--consensus statement of the Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom).

OBJECTIVES: The Commission gives recommendations on how to provide health and safety for employees in different kinds of low oxygen atmospheres. So far, no recommendations exist that take into account the several factors we have outlined in this report. METHODS: The health and safety recommendations of several countries were analysed for their strength and deficiencies. The scientific literature was checked (Medline, etc.) and evaluated for relevance of the topic. Typical situations of work in hypoxia were defined and their specific risks described. Specific recommendations are provided for any of these situations. RESULTS: We defined four main groups with some subgroups (main risk in brackets): short exposure (pressure change), limited exposure (acute altitude disease), expatriates (chronic altitude disease), and high-altitude populations (re-entry pulmonary oedema). For healthy unacclimatized persons, an acute but limited exposure down to 13% O(2) does not cause a health risk. Employees should be advised to leave hypoxic areas for any break, if possible. Detailed advice is given for any other situation and pre-existing diseases. CONCLUSIONS: If the specific risk of the respective type of hypoxia is taken into account, a pragmatic approach to provide health and safety for employees is possible. In contrast to other occupational exposures, a repeated exposure as often as possible is of benefit as it causes partial acclimatization. The consensus statement was approved by written consent in lieu of a meeting in July 2009.

Water disinfection in the mountains - state of the art recommendation paper of the Union Internationale des Associations d'Alpinisme Medical Commission.

This paper provides the official recommendation of the Union Internationale des Associations d'Alpinisme (UIAA) Medical Commission to manage the problem of safe drinking water. The recommendation was accepted and authorized for publication by the Medical Commission during their annual meeting at Treplice, Tzechia, 2008. Safe water is essential for mountaineers worldwide in order to balance challenges associated with high altitude dehydration. The paper summarizes the advantages and disadvantages of several procedures used to procure safe drinking water in the mountains or at high altitude. Limitations or critical details, which may cause failure of the methods are mentioned systematically. We differentiate between "conventional" methods, which should be preferred because they produce safe water and "improvisation". The latter does not produce safe water but may be used if conventional methods are not available for any reason. They decrease the concentration of pathogenic microorganisms and by this they reduce the risk of enteral infection. Water filtration using a ceramic filter system or chemical disinfection is recommended as a standard method. Boiling water should be avoided because it is too fuel consuming and has the potential to increase deforestation. Generally, with regard to infections by water or food, all mountaineers should be vaccinated against hepatitis A and poliomyelitis in regions where they may be at-risk.