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挪威潜水研究的未来。

The future of diving research in Norway.

作者信息

Møllerløkken Andreas

机构信息

Former Associate Professor, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, NTNU, Trondheim, Norway.

出版信息

Diving Hyperb Med. 2018 Jun 30;48(2):72. doi: 10.28920/dhm48.2.72.

DOI:10.28920/dhm48.2.72
PMID:29888377
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6173353/
Abstract

Norway has a long tradition of quality research within the field of baromedicine. With the discovery of oil in the North Sea, it became important to establish scientific research facilities to overcome immediate challenges, but also to work towards long-term goals. For the diving community, an understanding of the pathophysiology of decompression sickness (DCS) has been one of the major forces to maintain focus on the importance of scientific research in this field. In addition to oil, the aquaculture and fish farming industries are increasing in size and are Norway's second biggest export industry today. It also requires underwater workers for the inspection and repair of underwater structures and fishnets. The importance of health and safety for the underwater worker was identified early on by the offshore industry. The Norwegian Petroleum Safety Authority publishes a yearly report that identifies all offshore diving activity. The last reported incident of DCS was in 2002, whilst the last fatal saturation diving accident was in 1987. In-shore diving operations in Norway are regulated through the Norwegian Labour Inspection Authority and here the track record is different; since 1979 there have been 28 fatalities, and they continue to occur. At the Norwegian University of Science and Technology (NTNU), there has been a research group investigating barophysiology since the early 1980s. Led by Professor Alf O Brubakk, this research has been recognized internationally and has provided ground-breaking insights into the pathophysiology of DCS. This has included the identification of vascular gas bubbles through the use of ultrasound and identifying the importance of both protecting the vascular endothelium to maintain fitness to dive and also regular physical activity to reduce the risk of the adverse effects of diving. The group has educated many students, physiologists, engineers, medical doctors and researchers, all in the spirit of Professor Brubakk who considered that education was at least as important as the research itself. In 2008, Professor Brubakk was concerned about the future, as he was soon to retire. Great effort was put into perpetuating his position but this process ended when the University axed the only professorial position in environmental physiology in Norway. Today, there is only one non-permanent barophysiology research position at NTNU. This position and all research activity is dependent on external funding, so the education and research environment has changed drastically. Whilst there are clinicians in Norway working at different hyperbaric centres who participate in research related to barophysiology, this is not their primary task. With the lack of funding to include education and students in research, the rich history of barophysiological research at NTNU will be at an end. In Norway, the majority of grant-funded scientific programmes last only three years, so it has not been easy to recruit or to keep expertise between grants. So, who is planning for long-term research efforts in Norway? Whilst there are obvious challenges left to study in barophysiology, there is a lack of understanding amongst those responsible for decision-making and funding of the importance of having an academic-based research centre for diving research. NTNU, one of the world's most advanced hyperbaric laboratories, built up at considerable capital expense to investigate the pathophysiology of diving and decompression, is about to be closed and dismantled. At a time when the off-shore industry is putting greater focus on finding better solutions for safer underwater work environments, and in-shore diving is facing huge challenges due to a worrying level of serious accidents and increasing activity, there is no political drive in Norway to acknowledge the importance of maintaining the research facilities that support this industry. If the door does close on the NTNU facility, it will take many years and substantial funding to re-establish a modern research centre. Most importantly, it will be impossible to bring new students into the field of barophysiology in the foreseeable future. Whilst the off-shore oil industry has a finite future, aquaculture and other in-shore activities requiring diving support continue to expand. Good barophysiological research in established centres will be essential to support these industries into the future. Alf Brubakk often quoted an old Chinese proverb: "When planning for a month, sow rice, when planning for a year, plant trees, when planning for a decade, train and educate men". In Norway, we are only planting trees.

摘要

挪威在气压医学领域有着悠久的高质量研究传统。随着北海石油的发现,建立科研设施以应对眼前挑战并朝着长期目标努力变得至关重要。对于潜水群体而言,了解减压病(DCS)的病理生理学一直是促使该领域持续关注科研重要性的主要动力之一。除了石油行业,挪威的水产养殖和渔业规模不断扩大,如今已成为挪威第二大出口产业。该行业同样需要水下作业人员对水下结构和渔网进行检查与维修。近海行业很早就认识到了水下作业人员健康与安全的重要性。挪威石油安全管理局每年发布一份报告,记录所有近海潜水活动。最近一次报告的减压病事件发生在2002年,而最后一次致命的饱和潜水事故发生在1987年。挪威的近海潜水作业由挪威劳动监察局监管,其记录情况有所不同;自1979年以来已有28人死亡,且此类事故仍在发生。自20世纪80年代初以来,挪威科技大学(NTNU)就有一个研究小组在研究气压生理学。在阿尔夫·O·布鲁巴克教授的带领下,这项研究在国际上得到认可,并为减压病的病理生理学提供了开创性的见解。这包括通过使用超声波识别血管气泡,以及认识到保护血管内皮以保持潜水适应性和进行定期体育活动以降低潜水不良影响风险的重要性。该小组培养了许多学生、生理学家、工程师、医生和研究人员,全都秉持着布鲁巴克教授的精神,他认为教育至少与研究本身同样重要。2008年,布鲁巴克教授对未来感到担忧,因为他即将退休。人们付出了巨大努力来延续他的职位,但当大学撤销了挪威唯一的环境生理学教授职位时,这一进程结束了。如今,挪威科技大学只有一个非永久性的气压生理学研究职位。这个职位以及所有研究活动都依赖外部资金,因此教育和研究环境发生了巨大变化。虽然挪威有临床医生在不同的高压氧治疗中心工作,他们参与与气压生理学相关的研究,但这并非他们的主要任务。由于缺乏资金将教育和学生纳入研究,挪威科技大学丰富的气压生理学研究历史即将终结。在挪威,大多数由资助的科学项目仅持续三年,因此在不同资助项目之间招募或留住专业人才并非易事。那么,挪威谁在规划长期研究工作呢?尽管气压生理学仍有明显的研究挑战,但负责决策和资助的人员对拥有一个基于学术的潜水研究中心的重要性缺乏认识。挪威科技大学拥有世界上最先进的高压氧实验室之一,该实验室耗费大量资金建成,用于研究潜水和减压的病理生理学,如今却即将关闭并拆除。在近海行业更加注重为更安全的水下工作环境寻找更好解决方案,而近海潜水因严重事故令人担忧的发生率和活动增加面临巨大挑战之际,挪威却没有政治动力去承认维持支持该行业的研究设施的重要性。如果挪威科技大学的设施真的关闭,重新建立一个现代化研究中心将需要数年时间和大量资金。最重要的是,在可预见的未来将不可能让新学生进入气压生理学领域。虽然近海石油行业的未来有限,但水产养殖和其他需要潜水支持的近海活动仍在不断扩展。在现有中心开展良好的气压生理学研究对于支持这些行业的未来发展至关重要。阿尔夫·布鲁巴克经常引用一句中国古老谚语:“一年之计,莫如树谷;十年之计,莫如树木;终身之计,莫如树人”。在挪威,我们只在种树。