Purity Brewing beer Dräger Review 106 in Warstein Into the Fire

Dräger Review Dräger Flashover in the forest Ethics

3/ 2012 Saturation Diving Saturation 3/ 2012 106 Technology for Life 3 / 2012 The burden of decisions

World Under Water Tough job for commercial divers

EN_01_Titel_Tauchen.indd 1 16.11.12 14:28 ORIGINS UB L ECA valve a o l i t u nze, Fo in k t a r : M : aph ogr t o ph Cover A KGa o. o. & C G : Drägerwerk A Drägerwerk : y h ap og t o h P r Did you know... …what a valve for dispensing beer has to do with the company? In 1889 Johann Heinrich Dräger founded a sales and distribution company, which included beer dispensers, that worked with compressed carbon dioxide. But the beer flowed inconsistently – or at least it did, until Mr. Dräger invented his Lubeca valve. From then on the beer poured into glasses in a steady stream. This is the source of an innovative company – the valve, not the beer.

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EN_02-03_Urspruenge_Inhalt.indd 2 15.11.12 12:47 Contents

About of water is needed to brew a liter of beer in Warstein. Even though the water used for processing3.6 raw liters materials is not included in this figure, the brewery’s “water footprint” is small. More starting on page 18. e, Fotolia S z A n

s ku n arti h: M p e n on togra li s n ho p ric E /F1o

Living PR OteCTING EV SEI CUR NG over over M Åke Havyard Global Solution Global Havyard

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4 EXPERIENCE 22 hcEt i s 40 MEDICAL TOURISM T hree people who perform: To-he neur Caring Professions: How do people Thailand: Bangkok Hospital treats anesthesiologist Dr. Dirk Repkewitz shares make the right decisions in critical patients from all over the world. A a his knowledge through practical courses. situations? Ethics helps to find the 44 ROAD TRAFFIC R obert Gutknecht and David Strieth know that answers – even for practice. Interlocks: The Netherlands gives volunteer firefighting is not just a hobby. 26 LAP NT FIRE DEPARTMENT drunk drivers a second chance – and builds 6 Keywords Automotive Industry: In Wolfsburg, on fundamental changes in behavior. Furthermore: What lies behind everything is one or two sizes larger. 48 T INSIGH everything, the topics of this issue. And for the plant’s firefighters, there Production: Hardly any anesthesia device are some special requirements. 8 sFocu is like the other – almost all are produced to S aturation Diving: Professional divers 30 INFORMATION Graphic the customer’s specifications.

& Co. KG & Co. AG Drägerwerk p hy: Photogra have one of the most challenging jobs. U nderwater: More than two thirds of the 52 OUTLOOK Nonetheless, they’re modest people who Earth is covered by water. The depths of S hift Work: It has become indispensable don’t long to be in the headlines. Their the deep-sea are only now being explored. in many occupations, – and in many cases daily work is exciting enough. 32 EMERGENCY RESCUE SERVICES is associated with stress. However, the 18  BREweRIES Carbon Monoxide: This is a perfidious potential health hazards can be reduced. Premium Beers: Perfect raw materials gas that can be neither seen nor smelled. 56  CLOse-UP as well as strictly monitored processes Individually targeted gas measuring devices PAC 7000: A s a part of personal determine the taste of a beer. That’s the key provide safety – also, in Vienna. protective equipment, it warns in advance to success of a brewery like Warsteiner. 36 FIREFIGHTERS of a dangerous gas. T raining: How firefighters in Skövde, Sweden prepare for extinguishing in the blazing inferno.

Dräger Review 106 | 3 / 2012 3

EN_02-03_Urspruenge_Inhalt.indd 3 15.11.12 12:47 Experience Around the world

P eople Who Perform

Dr. Dirk Repkewitz, Chief of Neuroanesthesiology, Günzburg District Hospital / Germany “I love my work and I’m happy to share my knowledge. For the past 12 fidence is the technology available today. I’m still amazed at what is years, I’ve been organizing practical courses in neuroanesthesiology technologically possible nowadays. For example, we perform some This allows young doctors who wish to specialize in anesthesiology operations in our Brain Suite, which enables us to navigate precisely to participate in open skull operations, 25 of which are required for within the brain via intraoperative magnetic resonance imaging. The certification. In our hospital, young doctors are given the opportu- surgeon receives a precise image of the anatomic area in question nity to observe a number of such operations over three days. These before the operation. That area changes once tissue is removed, so operations represent a challenge because the patient’s conscious- new images need to be produced. The patient is often conscious ness must be deactivated during anesthesia, but at the same time, during that process. When a tumor is being removed from an area the surgeon needs to know whether certain brain functions are still close to the speech center of the brain, the patient has to talk to us. intact. A standard anesthetic can’t do that. Nor can the reactions I was impressed by one case in which a young man was talking to of the patient’s arms and legs be tested if the muscles are relaxed, us about his specific field of interest, German History, while a malig- as is done under standard anesthesia. The patient must also lie ab- nant tumor was being removed from his brain! Even though our work solutely still, without twitching or coughing. Today I feel vastly more environment is full of technology, to me the most important thing is self-confident in my work than I did 20 years ago. The fear of mak- human beings and their fate. Empathy is important. Just monitor- ing mistakes has given way to routine. One reason for my self-con- ing our patients is not enough. We need to hold their hands, too!” h c a b Um ilke S er, er, ilk Sp bell a s I xt: e T ; ; eeg R s a iedel; Andre iedel; m h c S s a thi t a y: M y: h ap Photogr

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EN_04-05_Menschen.indd 4 15.11.12 12:57 Photogra phy: Matthias Schmiedel; Andreas Reeg; Text: Isabell Spilker, Silke Umbach EN_04-05_Menschen.indd 5 cloud and protected Both cloud of near the plant. the people living forcannon half an hour. We prevented the formation of a toxic enabledus to which operatebreathing apparatuses, the water hydrogen we air cyanide.had So to depend onourcompressed the was tank cause releasing isocyanate, arelated compound to be were oureyes andnoses burning, breathing equipment, theproached site, feel we could the danger. artificial Without we ap- As at aplasticfoam inOestrich-Winkel. leaking, factory ofchemicals 13,2012,whenatank onAugust the alarm hat’s how itfelt onthe water where we were cannon, beating We down toxic gases. to were amongthe first ing facing danger, and threaten empty, - Silent, on the front lines. if you’re alone, still find yourself you can one of 500 firefighters, operation“It waswe’d the biggest Buteven ever experienced. and David Strieth, Gutknecht VolunteerRobert Brigade, Fire Winkel

–

t r ­ eceive eceive beg ­ an an - just ahobby, it’s acommitment! You but it’s alot more: can’t pared for a as volunteer firefighter. people think this is Some ofthing you That’s thehave kind to bepreis more important! the threat Fighting at home examperiod. dle ofthe university inthe mid- postpone anexamwhen amajor operation occurs, makesThis us agoodteam Now,fire brigade. we’re both studying electrical us have other for known each ever the junior since many years, vent the accident from becoming acatastrophe.” fromvent becoming the accident We were harmed. residents of the local worked together to pre the site Butnone hadto be monitored for alongtime aftward. Evenjob done. were some team though and injured, members there’s InOestrich-Winkelwe got the acrisis. everytime react just show upafew ayear. times We have to stay intraining and

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and it ermany ’s to also easier decideto ­engineer ing. ing. - - 15.11.12 12:57 Keywords

W hat it’s all about Keywords Each keyword you’ll find on these two pages reveals a new aspect of an article and shows it from a new perspective. After all, every topic has multiple facets. The explanations and definitions of the keywords come from lexicons, dic- tio­naries, and specialized encyclope- dias, and they include some detours into other subject areas. As a result, readers may see some things in a S nleepi g and waking different light. Chronobiology For most of human history, people’s work was regulated by the movements of the sun. But with the Industrial Revolution the sun was shadowed by the inexorable regular rhythms of machines and and return on investment. Electricity and its Plant alarm distribution through the electrical grid turned night into day. And the network of Combustion Engine railways and telecommunications also required another time clock, which is Inside it burns fuel and air, specifically for now controlled by atomic clocks. Chronobiology has been researching the “inner generating mechanical energy. About a clock” of plants, animals, and human beings since the 18th century. The research billion automobiles are driven by internal showed such contrast of brightnesses levels in humans triggered or prevented the combustion engines worldwide. Plant production of hormones and neurotransmitters. This production has a direct Fire Departments ensure that in automotive effect on individuals’ moods and their productivity. I nsights that can make the production, everything remains under necessary shift work bearable. control. Something like the third largest From page 52 car manufacturer in the world, VW AG in Wolfsburg, Germany. From page 26 A lcohol Punishment Someone who violates the law, should bear the consequences. Punishment is one consequence, even though legal practice has evolved far beyond the Old Testament’s approach of “an eye for an eye, a tooth for a tooth.” If you want to rehabilitate people and change their behavior permanently, sometimes gentler methods are called for – and more successful. From page 44 e n li n o /F1 ock

H selper t S cific

B iomonitoring a

Whether it is bacteria, crustaceans, or fish – n, P for the quality control of substances, one ricso E

W altz also relies on the observation of organisms in ke water, air and on the earth. They react to Vienna stimuli quickly, sensitively, and consistently. If Å (3), Fiacres, Wiener Schnitzel, Viennese they are used correctly, they are also – un- terstock Waltzes, Gustav Klimt, Prater, Lipizzaner, like many test chemicals – harmless to human t the Stephansdom, the Blue Danube, beings. I n Warstein, they’re even working y: Shu y: and Restaurant Steiereck are some hall- in accordance with the German Purity h marks of the city – as its Emergency Law for beer. otograp

Medical Service. From page 32 From page 18 Ph

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EN_06-07_Stichwoerter.indd 6 16.11.12 14:27 Rolling flames Multi media Flash over QR: More for Mobiles It is a fire that spreads across all the The Dräger Review is combustible surface materials in a room – a expanding its multimedia flashover – is one of the greatest challen­ services. Readers who have ges firefighters have to face. The result of an iPhone or an Android this phenomenon is a full-blown blaze with mobile can now also see videos, graphics, temperatures up to 1000° C. To put out photo series, or product information on this sea of flames, firefighters need certain topics on their smartphones. At the targeted strategies and a great end of the respective articles, readers deal of practice. From page 36 will see a QR code. Those who have the appropriate terminals can download an app from the Internet, such as the free of charge Scanlife program, in order to Tr avel access this additional information. If you point the smartphone’s camera at the QR T ourism code, the information will become visible. According to the dictionaries, “tourism” is “travel undertaken for recreation or to learn about new places.” Tourism was initially limited to the upper class, but it became increasingly widespread starting in the 19th century and is a mass pheno­ menon today. Last year France was the most visited country, with 76.8 million tourists, followed by the USA and China. Germany was in eighth place on the list. A ward A special kind of tourism has now reached the world’s hospitals. S ilver for Dräger From page 40 This year the BCP presented its Silver award to the Dräger Review (issue 104). More than 700 publications were con­ sidered, by the expert jury, in Europe’s largest competition between corporate publishing products. Editorial and art direction received this award for the intelligible communication of complex technology.

“May” and “must” E thics e n When Aaron Alston amputated his li own arm in 2003, ethics wasn’t an issue. F1on k/ c Alston had been trapped in a narrow o t

S canyon for five days, and if he had not cific carried out this heroic self-mutilation a

, P he would have inevitably died of thirst. on However, situations like this one, in rics

E Treasures e which the decision-maker, the implemen­ Åk U nderwater Archaeology ter, and the object of the action are k (3), c one -in-the-same, rarely occur. Ethics pro­ o Sunken ships are like messages in a bottle. They yield up not only porcelain, vide us with guidelines for correct be­ coins, and in some cases even bottles of wine that can still be drunk centuries havior, but each individual must bear the hutterst later, but also information about trade routes. They sometimes provide us

: S : responsibility for his or her own actions. y with riddles, such as the “Antikythera Mechanism,” probably a celestial clock. The question that arises here is: Just as fascinating is the world of professional divers. From page 8 graph o

t What are the basic ways of think- o h

P ing? From page 22

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EN_06-07_Stichwoerter.indd 7 15.11.12 12:58 Extreme Conditions: Safety systems safeguard the lives of saturation divers working at depths of several hundred meters Dräger Review 106 | 3 / 2012

EN_08-17_FokusTauchen.indd 8 15.11.12 13:23 SATUT RA ION DIVING Focus

Welding on the Seabed W orking at depths of several hundred meters below the ocean surface, commercial divers are exposed to extreme conditions. Sophisticated technology enables them to work in this hostile environment and helps safeguard their lives.

eyond the blue pressurized door is the mirror image of the setup above, e

n is a completely different world – a except for the fact that bunk beds are li

on world of stainless steel, recliner mounted along the wall. This is how one /F1

Bs e seats with white plastic covers mounted might imagine a space station. Here too, g a m I on the wall, and a high-pressure water-fog the habitat is designed to support life un- ps fire extinguishing system mounted just der extreme conditions – but life deep un- y: Ti y: h

ap below the ceiling. Over to the left is a lad- der the sea, rather than in space. gr der that leads down, through a narrow For the divers on board the Norwe- oto

Ph tube, to the level below. The lower level gian vessel Seven Havila, this strange- >

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EN_08-17_FokusTauchen.indd 9 15.11.12 13:23 Focus SATURATION DIVING

Deep-sea diving technology has changed comprehensively in recent decades

>

A Closed System: Modern diving support vessels like the S even Havila (above) are built around the saturation suite. During opera- tion, divers live in pressurized chambers (left) for up to four weeks AS tions u l o l S a b o Gl d ar y Hav y: y: h otograp Ph

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EN_08-17_FokusTauchen.indd 10 16.11.12 14:27 o t o ckph o t is : : y h ap r g o t o h P Deep Diving: Sperm wales can reach up to 3,000 meters

> looking environment is home. They maintenance, and repair – they can vary Life ten kilometers spend up to 28 days at a time in this con- from straightforward to reasonably dif- fined system of chambers and tubes, ficult. The installations are almost al- below the surface which comprise of their living and sleep- ways in the oil and natural gas indus- The original form of underwater ing quarters, with passages to lavatory try: the drilling platforms, pipelines, diving is known as free-diving. This is facilities and the two diving bells. When and other huge steel constructions that where divers simply hold their breath the divers are inside, the pressure rises to are required to bring these precious during the dive. The world depth many times above the atmospheric level. resources to the surface. Anyone who record for male free-divers currently They breathe a mixture of helium and ox- wants to work in this environment as a stands at 200 meters. If human beings ygen known as heliox. commercial or saturation diver must not are to remain underwater for longer In the North Sea, for example, the only be an expert diver, but also be able than a single breath, they require an divers work six-hour shifts. The Seven to weld and install equipment according artificial supply of compressed Havila is certified for work at depths of to industrial standards. breathing gases. up to 300 meters below sea level. But in Ward’s employer is the UK company Here we have some mammals – such order to dive for long periods, the human Subsea 7. He has been working on the as elephant seals or spearm whales: body needs to acclimatize to the condi- Seven Havila, one of the most modern they can dive longer than an hour (see A Closed System: Modern diving tions that exist at such depths. The greater vessels of its kind, since 2011. “Up to six page 30f.). In fact, some animals are support vessels the pressure the body is subjected to dur- divers can work simultaneously on the able to survive at much greater depths. like the Seven ing a dive, the longer the time required to seabed,” explains Shift Manager Peter In 2012 an expedition conduct­ed by Havila (above) are built around the decompress afterward. In extreme cases, Alexander. That’s currently the industry the University of Aberdeen, to the bot- saturation suite. several days can be needed for decompres- maximum, he adds. During such oper- tom of the Kermadec Trench off the During opera- sion. By way of comparison, only a couple ations, the vessel’s two diving bells are coast of New Zealand discovered large tion, divers live in pressurized of minutes are required to decompress af- lowered with up to four divers each on amphipods (Alicella gigantea). They chambers (left) ter sport dives near the surface. board. One always remains in the bell live at a depth of over ten kilometers, for up to four for safety reasons. where the pressure is 1,000 times weeks Diving as a family tradition “Saturation diving has advanced greater than at sea level. “Three to four weeks in extremely enormously in recent decades,” Alexan- The ancients were very interested cramped quarters is a long time, but you der says. He should know, since he him- in the use of technical aids that get used to it,” says Neil Ward, a deep-sea self once worked as a saturation diver. “I allowed them to stay underwater for diver specialist. A Scotsman by birth, Ward was there when this form of diving was long periods of time. Back in the

AS has worked as a commercial diver for 22 first introduced in the North Sea over 35 fourth century BC, for example, Alex- ns o years. The job is something of a family tra- years ago.” What hasn’t changed, Alexan- ander the Great is said to have ex- ti u dition: “My grandfather was a diver, and der explains, are the demands made on plored the depths inside a diving bell. l Sol Similarly, there are contemporary ba today my brother and I are following in his the people in the job: “You’ve got to be a footsteps.” Ward has dived off the African total team player who can deal with stress accounts more than 2,000 years rd Glo rd a

y coast, but apart from that, his workplace and adapt to new situations.” old of frogmen attacking enemy ships v a

: H : is in the North Sea – either off the Norwe- underwater, pearl divers collecting y

h A fully automated diving system

ap gian or the British coasts. molluscs from the seabed, and divers r g

o salvaging sunken ships or carrying out t The jobs he does are often similar At least the technology on board the vessel o h

P in nature – installation, construction, does relieve the diving crew of the com- > underwater repairs to harbor walls.

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EN_08-17_FokusTauchen.indd 11 15.11.12 13:23 Ready to dive: Two pressurized diving bells docked to the saturation suite in a diving support vessel. In them professional divers can be at overpressure, and let down up to several hundred meters work depth

A basic principle emerges > plicated business of having to manually regulate the gas pressure, mixture, and In the early days of diving, a common solution for the problem of temperature. Indeed, saturation diving providing an underwater supply of oxygen was to run an air line to the would be a lot more complicated without surface. The snorkel principle, however, functions only in shallow the fully-automated immersion system waters. At a depth of 20 meters, the pressure is already three times installed on the Seven Havila. The ves- atmospheric pressure. This demands a somewhat different approach. sel was commissioned last year. The div- The first standard diving suits – equipped with helmets – were developed ing system, which was supplied by Dräger, around 1800. These were supplied with respiratory air compressed was the largest of the key components to by a pump and then delivered via an air line from the surface. be delivered. It includes the hyperbaric Along with the technology, the physiology of diving was developed. chambers; a gas system with control tech- This includes in particular the prevention and treatment of decom­ nology, pipes, and storage elements: in pression sickness. This occurs when the pressure falls too quickly as addition to fire and rescue equipment. divers ascend. In this process, gases dissolved in the blood and body tissues – particularly nitrogen – form bubbles that can then block When the captain blood vessels and damage tissue and nerves. Other com­plications surrenders control that can result from diving include the “rapture of the deep”, the result of Whenever the divers are below the sur- a too high nitrogen concentration in the body. face, the Seven Havila is completely op- Portable devices that supply breathing gas for divers have been erated from Dive Control on A Deck. around for about 100 years. “We’ve been involved in the development of Everything else is subordinate to it. “As such apparatuses from the very start,” says Oliver Schirk, a diving expert soon as the diving bells enter the water, at Dräger. As early as 1912, Dräger unveiled a closed-circuit breathing Dive Control takes over,” Alexander con- apparatus – now commonly known as a rebreather – which was worn firms. “From that moment onward, the with a traditional diving suit and a helmet. In modern rebreathers, soda operating crew, rather than the captain, lime is used to “scrub” carbon dioxide from the exhaled air before has complete control over the vessel. fresh oxygen is added. The milestones in Dräger’s development of re­ The vessel is therefore operated bottom- breather apparatus range from the “Leutnant Lund” of 1953 to the up, as it were, rather then top-down.” current LAR 5000 and LAR 7000 for military use and mine clearance Most of the components of the diving divers. In the 1930s, Dräger also began developing a compressed-air system had to be manufactured indi- breathing apparatuses. Today the company supplies the PSS Dive for vidually. “There are very few standard professional users. Dräger has also been involved in diving research parts,” says Per-Arne Spreemann. An air- from the earliest days of this discipline. In 1913, for example, the company craft engineer by training, Spreemann A KGa

. began operation of a deep-sea diving simulator in Lübeck and then was one of the people at Dräger respon- o & C

introduced a decompression apparatus in 1917. sible for extending the automation soft- G k A r

In addition to scuba diving, there are also modern forms of helmet ware. In order to create a safe, robust, e

diving with the use of an external air supply and specialist fields such and comfortable system, Dräger intro- rw äge as saturation diving. Finally, there is the so-called atmospheric diving suit duced a number of innovative and cus- r (ADS). This is more like a mini-submarine which protects the diver tomized solutions. “That’s also why we D n: against the extreme water pressure while providing the required mobility consulted at an early stage with the Nor- s u ll to carry out work underwater. wegian classification society Det Norske > I TRATIO

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EN_08-17_FokusTauchen.indd 12 16.11.12 14:27 SATURATION DIVING Focus

When divers are in action, Dive Control has command over the ship

Hyperbaric Lifeboat

Chamber 1: Escape route • Transfer chamber for to the hyperbaric up to six people lifeboat • Living, sleeping, and lavatory area

Chamber 3: Living and sleeping area for six divers

Chamber 2: Living and sleeping area for six divers

Diving Bells

Chamber 4/5: A a

G • Transfer chamber K

.

o to diving bells L iving under pressure • Lavatory area for G & C G chambers 2 and 3

k A When they are not working deep r e underwater, saturation divers live in w r

e pressure chambers. These suites g ä

r comprise of their living, sleeping, and

: D : sanitary areas. Diving bells and hyper- baric lifeboats complete the system u

> Ill STRATION

Dräger Review 106 | 3 / 2012 13

EN_08-17_FokusTauchen.indd 13 15.11.12 13:23 Focus SATURATION DIVING

Working with historical equipment provides a highly realistic insight into diving heritage

> Veritas – or DNV – which would later be responsible for approving the whole sys- tem,” Spreemann explains. It’s a warm summer’s day, the 120-me- ter-long and 23.45-meter-wide Seven Havila is tied up to a fitting-out quay in the Norwegian port of Stavanger. There is a deafening screech of angle grind- ers – work is going on everywhere. The vessel is in port for recertification. The strict Norwegian regulations stipulate an- nual or even semi-annual inspection in- tervals, depending on the system in ques- tion. The divers’ quarters at this time are empty and spooky. But it is extremely busy in the diving center, because all the sys- tems are being checked. “In the past, the pressure, mixture, temperature, and var- ious other parameters were all controlled manually via different valves,” Alexander explains. Today everything is done with the click of a mouse. Pressure increases with depth AS (1) According to Alexander, the principle of tions u

saturation diving has remained essen- l o

tially unchanged. Used exclusively in com- l S a b mercial diving, this procedure involves o Gl d

divers living permanently, in an environ- ar y

ment pressurized to the level that exists, Hav

at the depth at where they work. As a rule A (4); a G

of thumb, water pressure increases by one K

. bar for every ten meters of depth. In other o

words, the water pressure at a depth of & C G k A r ten meters is twice the atmospheric pres- e w r e

sure, at a depth of 100 meters over ten bar, g ä and at 300 meters over 30 bar. The record r y: D y: depth reached by means of saturation div- h Peter Alexander (in a test run here) monitors operations while divers are below the surface. Now Shift Manager on the S even Havila, since he himself ing is 534 meters. This was achieved in otograp

once worked as a saturation diver the 1980s. During trials in a pressurized Ph

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EN_08-17_FokusTauchen.indd 14 15.11.12 13:23 SATURATION DIVING Focus

21st century helmet diver: Neil Wark is a saturation diver for Subsea 7. His specialization is mostly in demand for jobs in the oil and gas industry. He relies on state-of-the art gas technology from Dräger during operations

chamber, a simulated depth of over 700 Diving history in action meters was reached. To even breathe at such pressure cre- When members of the UK’s Historical Diving Society (HDS) attend a harbor ates considerable strain on the human festival, the attendees hold their breath. At these performances, the diving enthusiasts body. What must be avoided at all cost are climb into bulky diving suits and heavy metal helmets, some dating back to the very the rapid changes of pressure. Even when early days of commercial diving, and disappear into the murky depths. Yet it’s much ascending from minimal depths, divers more than just the equipment that people find fascinating about such demonstra- need to make decompression stops in or- tions – after all, helmet diving equipment is still in common use today by commercial der to give the body time to get rid of ni- divers. Equally appealing is the opportunity to trogen dissolved in the tissues. experience the use of historical gear under real-life Regular decompression is no lon- operating conditions. In fact, this expertise is ger possible in saturation diving. “When increasingly being exploited these days by the film working at great depths for a number of industry. “We often get requests for help with hours, you need to allow up to an hour of historical film and TV productions,” confirms HDS decompression time per meter,” explains Secretary Mike Fardell. Wark. To avoid this problem, the divers The HDS was founded in 1990, and it now has live in an environment pressurized to the around 200 members in the UK and an additional equivalent atmosphere which exists at the 100 around the world. According to Fardell, there depth underwater where they are work- are also historical diving societies in Australia, ing. At the same time, they breathe a spe- Denmark, Germany, Finland, France, Italy, Canada, cial mixture of gas, principally a mixture Norway, Poland, Spain, Russia, Sweden, Slovenia, of helium and oxygen known as heliox. Pioneer: A Dräger the Czech Republic, and the U.S. This prevents the onset of nitrogen nar- closed-circuit breathing The society does not concentrate on either a apparatus from 1912. cosis at greater depths. It was worn with a helmet specific type of diving or a specific era of diving AS (1) history. “Our members are interested in the complete tions

u 99 Percent Recycled

l history of diving, which ranges from people swim- o

l S The two pressurized diving bells con- ming underwater while holding their breath, to the a b o nected to the living and sleeping quar- early forms of diving equipment and right through Gl ters are also under the same high pres- to the very latest developments,” Fardell explains. vyard a sure. These bells are used to transport the In recent years, the HDS has been able to H divers from their hyperbaric environment realize its long-harbored dream of having its very A (4); a on board the Seven Havila to their work own museum. This new museum is located in KG . o sites deep under the sea. The vessel is also Gosport, Hampshire, on the coast of southern Eng- land. Opened in 2011, it is housed in a Victorian AG & C AG equipped with two hyperbaric lifeboats, which provide a refuge for the divers in battery that forms part of the defenses of Portsmouth erwerk

g the event of fire or an accident. Harbor. The museum is run by HDS members, ä r D : The gas mixture inhaled by the divers many of whom have a background in military, com- includes helium. The use of this noble mercial, or recreational diving. Research: Dräger equipment gas requires the presence of sophisticated enabled prolonged diving www.thehds.com ho P TOGRAPHY technology on board the Seven Havila. > trials at nine bar in 1914 www.divingmuseum.co.uk

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EN_08-17_FokusTauchen.indd 15 15.11.12 13:23 The precise management of gas parameters is vitally important for diver safety and for the efficient use of resources

> This is because helium is not only highly volatile, but also too expensive to be sim- ply released back into the atmosphere. “Instead, the gas mixture exhaled by the divers is reprocessed and 99 percent of it is recycled,” explains Spreemann, the ex- pert at Dräger. Attached to the mother ship by an umbilical cord When they are underwater, the diving bells are connected to the vessel by a bundle of lines and cables several hun- dred meters in length. This “umbili- cal cord” comprises of lines for inhaled and exhaled air, power and communica- tion cables, and a line for warm water, which is used to heat the diving suits in the icy temperatures that prevail at such depths. These multistrand bundles de- scend to each diving bell through “moon- pools” – two 4.80-meter diameter open- ings in the hull, through which the bells can be directly lowered into the water from inside the ship. In turn, the div- ers are connected to the diving bells by their very own umbilical­ cords, which are about 30 meters in length. By way of backup, both the bells and the diving suits are equipped with an emergency supply of breathing gas. For the divers be- low, it is vital to know not only that they can trust the crew on the surface vessel unconditionally, but also that all the vi- tal systems are maximally reliable and possess dual redundancy. Peter Thomas

Interview: GTÜM President Dr. Karin Hasmiller about standards in diving medicine. Living under pressure: Home to the divers for several weeks at a time, Dräger’s pressure www.draeger.com/106/diving chamber is installed in the belly of the Norwegian diving support vessel Seven Havila

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EN_08-17_FokusTauchen.indd 16 15.11.12 13:23 SATURATION DIVING Focus

“For naval frogmen, diving is simply a means to an end” e rivat p

: : Lieutenant Jens Höner has trained mine y clearance divers and naval frogmen. He talked with the Dräger Review about the various diving units ho

P TOGRAPH used by Germany’s Federal Armed Forces.

Lieutenant Höner, in what areas do the Federal Armed Forces use divers? Most military divers are in the navy – ordinary divers, naval divers, mine clearance divers, and frogmen – but there are some in the army, too: the sapper divers, who are trained in Percha on Lake Starnberg, in Bavaria. What kind of work do the various navy diving units typically undertake? Ordinary divers are naval personnel who have completed a diving course. They sail on board naval vessels in another capacity, but they may also be required to undertake small repairs or inspections of the hull. Naval divers, by contrast, are specialists who are used for underwater salvage, maintenance, and repair operations, sometimes during (2)

AS the periods when the vessel is in port. As a rule, they work with surface air lines and are trained to use hydraulic tools and conduct various tasks underwater, ranging from utions ol

S flame-cutting and welding to drilling. Mine clearance divers are trained to clear

obal ordnance of all kinds both underwater and on land – as in Afghanistan, for example. l

G They are trained in all aspects of explosive ordnance disposal and are also capable ar y of recovering and disposing of munitions from the two World Wars. As far as frogmen a H v d are concerned, diving is merely a means to an end, namely, to get them to a mission A (2);

a and back from it. Their tasks include reconnaissance, anti-piracy missions, and sometimes KG .

o even land-based missions, occasionally in cooperation with the KSK, the Special Forces Command Unit. AG & C AG

rk What qualifications do you need to have in order e rw

e to work as a diver in the navy? g ä

r In the first instance, you need no special qualifications at all, but you do need to : D : y have the right physical condition for diving. Prospective divers first of all have to pass the so-called TUVK test at the Naval Institute of Maritime Medicine. This test

ho assesses their general suitability for employment as divers, submarine personnel, and P TOGRAPH Diverse gases, stored in frogmen. Potential users of closed-circuit breathing apparatuses are also tested for pressurized tanks, are transported their oxygen tolerance. All of the candidates must also pass a fitness test before they by a network of lines on board can be admitted to the training program. During their training, maritime divers have the vessel. The whole system is Living under pressure: Home to the divers for several weeks at a time, Dräger’s pressure controlled by state-of-the-art the opportunity to take the Industry and Chamber of Commerce exam in order to qualify chamber is installed in the belly of the Norwegian diving support vessel Seven Havila computer technology as commercial divers.

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EN_08-17_FokusTauchen.indd 17 15.11.12 13:23 Breweries Premium Beers

Flea Circus in Premium Quality T he Purity Law of 1516 has made great German beers, from nothing but hops, yeast, malt, and water. Yet regional brews can still vary widely in taste. It’s the attention to detail that makes all the difference – also in W arsteiner.

S torage in high altitudes: Each of the total of 148 brewery tanks is 24 meters high and has a capacity of about 320,000 liters – Cheers! hutterstock hutterstock S

e (2), pp ru G y: Warsteiner Warsteiner y: h p Photogra

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EN_18-21_Bierbrauerei.indd 18 15.11.12 16:19 Early warning system in miniature: Water fleas in Warstein work with the German Purity Law for beer

ften it’s the little things that may “Barley, malt, and hops are important in- cus, this piece of equipment has a seri- have a big impact. Take for ex- gredients for a premium pils. The qual- ous purpose. The toximeter consists es- Oample, ­Daphnia magna Straus, ity of the water is often underestimated. sentially of a container slightly bigger a species of water flea that is only a few For us it is vital,” says Frank Homann, than an average aquarium, which is millimeters long. Whenever this born Head of Quality Control at Warsteiner. constantly flushed with fresh spring wa- survivor is attacked by predators, it grows Homann is a master brewer with vast ex- ter by two pumps. The water fleas swim like wildfire a “helmet”, a long tail, and perience. He knows all the tricks involved in a small glass cell, which is positioned neck teeth. The water flea is in many in creating a tasty brew. And he knows ex- right before the eye of a high-definition cases too large to be eaten. This defense actly how a “Queen of Beers” (the proud video camera. Even minute traces of mechanism is triggered by semiochemi- claim on the label of Warsteiner Pre- impurities cause the Daphnia to alter cals that are secreted by predators when mium Verum) should taste: “Full-bod- their usually placid behavior and scurry they are feeding. But these small crus- ied, tart, while slightly spicy.” Even the around frantically. This reaction is au- taceans can also do much more. They bright, golden color plays a role: “The eye tomatically registered by image-recogni- are highly sensitive to other substances, always tastes and drinks too!”, he says. tion software. As soon as the Daphnia including pesticides. This makes them change their movement patterns or their an ideal early warning system in minia- Biological Pre-Tester: depth of submersion, the system sounds ture. For this reason, their delicate an- Small, but powerful an alarm. Homann gives a vivid exam- tennas have been at the service of the To maintain water quality to high ex- ple to illustrate the sensitivity of the tox- Warsteiner Brauerei, one of Germany’s pectations, Homann presents his pride imeter: “If you were to dissolve as little oldest and largest private breweries, for and joy: a Daphina toximeter. Despite as ten liters of a specific substance into a number of years now. its passing resemblance to a flea cir- the nearby Möhne Reservoir, which holds 135 million cubic meters of water, the Daphnia would still respond and show contamination.” Three times a week, internal in- spectors take samples from the brew- Brewer from Sauerland ery’s own springs. These feed as many Founded in 1753, the Warsteiner Brewery has remained as five reservoirs located on the compa- in the ownership of the same family, now in the ninth ny’s 80-hectare site. Together they hold a generation. The Warsteiner Group comprises more than volume of 25,000 cubic meters of water,

tterstock tterstock 100 companies and employs around 2,300 people worldwide. enough to cover the daily requirements hu S The company’s flagship product, Warsteiner Premium of a city of over 150,000 inhabitants. Sam-

e (2), e (2), Verum, is exported to over 60 countries. This and other

p ples from the reservoirs are taken daily. p u

r products sold abroad are distributed either via the Some of the water is piped seven kilome- G company’s own sales network or in partnership with local ters from a spring known as the Kaiser- breweries. Warsteiner products are brewed under Warsteiner quelle, which rises in the Arnsberg For-

: Warsteiner Warsteiner : license in some countries. Mobile gas detection devices Premium est, a conservation area situated above hy p from Dräger (Dräger X-am 2000 + 7000) are used in Verum – one the brewery. This water is extremely soft. of Germany’s the production process – e.g. to check that tanks are free most popular Only true pilsner aficionados are prop-

Photogra of CO2 before they are cleaned with alkaline solutions. beer brands erly aware of the vital part it plays in cre- >

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EN_18-21_Bierbrauerei.indd 19 23.11.12 15:24 Breweries Premium Beers

After fermentation ther trim its requirements. “Given the place fresh hops with hop pellets, which current state of science and technology, are milled and pressed from the flower a quality beer is we have exhausted all possibilities,” he cones minus their stalks. cooled down as quickly says. If the brewery wanted to save even Warsteiner’s Premium Verum is more, it would have violated one of its brewed exclusively with hop extract, as possible main principles. “Further saving mea- which helps to ensure a consistent taste. sures are at the expense of quality beer. “We buy our hops in the Hallertau, a cen- That we can not afford!” trally located region in Bavaria,” Him- Whereas sales in the premium seg- melsbach explains. During harvest time, ment, which includes many locally Warsteiner even sends specially trained brewed beers, remains relatively robust, employees to the hop gardens. Following products in the mid-price range are dis- the initial selection process, samples are appearing fast from the German mar- sent back for closer examination by the ket. This is all due to companies such brewery’s own research lab. Once suit- as the Bavarian brewer Oettinger, Ger- able batches have been bought, the fresh many’s largest producer, which has an hops are turned into hop extract. annual output of over six million hec- First of all, the hops are crushed and > ating the characteristic Warsteiner taste. toliters and an aggressive pricing pol- their active ingredients are separated “Our beer is lighter and easier to digest icy to match. Warsteiner’s Managing Di- from the still-intact flower cones by than others,” explains Peter Himmels- rector, Himmelsbach, sees his beer as a means of liquefied natural carbon diox- bach, Head of Engineering. Many peo- premium product in the upper price seg- ide or bioethanol. The carbon dioxide or ple associate a darker colored beer with ment. It costs about 13 euros a case for ethanol is then entirely vaporized, leav- a higher content of wort, the sugar con- the Warsteiner Premium Verum com- ing nothing behind but pure hop extract, tent before fermentation. “In fact, our mercially. All low prices are “driving which is nonperishable and provides an beer has the most unique original grav- forces of trade,” he says. easily quantifiable source of the alpha ac- ity - despite its light color,” Himmelsbach ids that are vital to the brewing process. is sure. “We use 300 to 700 grams more Fresh Hops from the The carbon dioxide or ethanol is lique- malt per hectoliter than other brewers.” Hallertau Region fied once again for reuse in the extrac- Water is crucial to the brewing pro- Whatever the cost of beer, Germany’s tion process. cess. Every liter of wort requires almost breweries have remained largely true to Once the fermentation process has four times as much water – or, to be per- the founding principles of the country’s been completed, a premium beer must be fectly precise, 3.6 liters. All in all, the purity law. Although there have been var- chilled as quickly as possible. Warsteiner Warsteiner Brewery in the German state ious minor modifications of the orig- Premium Verum is flow-cooled to a tem- of North Rhine-Westphalia consumes inal formulation of 1516, the four ba- perature of approximately minus 1° Cel- around 1.1 million cubic meters of wa- sic ingredients – water, yeast, malt, and sius within eight hours and is then stored ter a year. That makes 4,300 cubic me- hops – have stayed the same. Nonethe- in a second tank. There the finished ters a day, including the water used in less, nowadays few breweries still oper- product spends between three and four the actual brewing process. That may ate entirely in accordance with tradition, weeks maturing at a temperature of mi- sound like a lot, but Himmelsbach is using natural hops and their own mal- nus 1° to minus 2° Celsius. It is then fil- doubtful whether the brewery could fur- thouses. In fact, many of them now re- tered, bottled, and readied for shipping.

20 Dräger Review 106 | 3 / 2012

EN_18-21_Bierbrauerei.indd 20 15.11.12 16:19 Each day, around 200 trucks leave the ap- Switchboard Brewhouse: From here, the production process is controlled proximately 13,000-square-meter brew- ery warehouse. From Sunday to Friday there are three shifts a day, ending at 10 p.m. “We know only with the arrival of the truck which of our products the customers want,” says Uwe Salvey, Head of Logistics at Warsteiner Group. Yet it only takes, on average, 45 minutes for a truck to be fully loaded and dispatched to the customer. “Other breweries are working with pre-registration and have turnaround times of up to four hours - in- cluding waiting periods. So we have opti- mized our processes significantly!” From Road to Rail Other unusual features of the Warsteiner setup include the trains standing on the Already in the morning, specially trained staff drink their first beer. Strictly professional. Not one bottle leaves the brewery without their consent. brewery’s own railroad siding. Three Right: One of three rooms for reference samples times a week containers modified for transporting beer depart for Berlin, Mu- nich, and Bussolonga, near the Italian city of Verona. “We are Europe’s only brewery with its very own container ter- A a

KG minal, which discovered the rail to this o. o. extent for themselves,” says Salvey. About & C

AG ten percent of the brewery’s output is k er

w now shipped by rail. From time to time the logistics ex- Dräger

e, perts create, by a lack of flexibility in

pp rail traffic, trouble for him: “You have ru G to book the rail a year in advance - and if a train is canceled, high costs arise,” Salvey explains. For this reason, road y: Warsteiner Warsteiner y: h

p transport will remain the norm. Besides, as Salvey says, “Warsteiner is not a ship- ping company. We are and will remain Photogra Working in three shifts, employees in the 12,640-square-meter warehouse a brewery - albeit with very sophisticated load and dispatch around 200 delivery trucks a day logistics.” Björn Wölke

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EN_18-21_Bierbrauerei.indd 21 15.11.12 16:19 OFF OFF OFF OFF

ON ON ON ON

OFF OFF OFF

ON ON ON

The Burden of Decisions Wherever you look, quick decisions are being made all the time – and many of them mean the difference between life and death. Scarce resources don’t make things easier – but ethical principles can serve as a guide for making the right decisions.

he flight was heading to Atlanta, tice suits and astronomical damage ers there! Ethical judgments here seems Georgia. The cardiologist confer- awards? Still, doctors are doctors, so simple: We feel that passivity is sleazy. ence had come to an end; after they ultimately did help, but not until T Practice, Morality, and Ethics landing, the doctors would all go their one of them had summoned the cour- seperate ways. But for now, the aircraft age to take the first step. There is no morality without people to ap- was still half-filled with heart specialists. This flight took place many years ply it. Ethics poses the question of how hu- No one on the plane, who wasn’t a con- ago, and the liability for good samari- man actions can be morally justified. Peo- ference participant, would have known tans has improved since then. Nonethe- ple whose jobs involve helping others have this - not even after someone suddenly less, the problem has still not been fully accepted the responsibilities associated called out: “Is there a doctor on board?” solved. In many cases, when someone is with their actions. Every doctor, nurse, The request was met with silence. in trouble, people stand around, and no firefighter, policeman, and safety engineer uttmann/toonpool.com t

The cardiologists pulled their heads one makes the first move. “Bystander Ap- knows that certain days can be fateful. On S on: on: back and looked around furtively. And athy” is how psychologists call this paral- these days simply playing by the rules is not i really, who was going to volunteer to ysis of humanity. The one who acts, takes enough; you also have to do the right thing.

help – what with all the crazy malprac- a risk. And there are still plenty of oth- Sometimes it’s easy to figure out what the Illustrat

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EN_22-25_Ethik.indd 22 15.11.12 13:27 Caring professions ETHICS

right thing is – it’s the doing that is diffi- over, the relevant issues must be resolved mitted. Doctors, patients, patients’ rela- cult. The persistence of routine, and the in an environment of contradictory views tives, and future parents can not avoid the rules and hierarchies that are in place, of the world and human nature. Such is- need to make individual decisions. Ethics get in the way. That’s how it was with Ig- sues include prenatal diagnostics, genetic experts can give them guidance but can- naz Semmelweis, a Viennese obstetrician optimization of human beings, the exact not make the decisions for them. who demonstrated, more than 150 years moment of death, and the degree of self- Although debates over ethics may ago, that the use of hand disinfectant by determination that should be granted in sometimes seem academic or even nit- doctors would reduce the mortality rate every life situation. Typical of these discus- picky, they are necessary. A technically of women after childbirth, by over 80 sions is the idea that there are no univer- advanced society must have public dis- percent. He therefore called on all med- sally valid “right answers.” In other words, cussions about how it should use its ca- ical staff to wash their hands with chlo- the correct action can only be determined pabilities. If it doesn’t, the consequences rinated water – but Semmelweis was met by marking out the limits of what is per- can be severe. This happened in Japan – a > with the angry opposition by other physi- cians. They eventually drove him out of­ Vienna, and many women later died due to habit and the arrogance of power. The Tragedy of Intolerance What is ethics? The rejection of objective (and moral) Descriptive ethics is systematic explanations of moral behavior. That’s why we have convention, that has been recognized by ethics councils and commissions that describe ethical behavior in a contemporary a person who did the right thing, is known context or issue guidelines for such behavior (prescriptive ethics). The attitude that today as the “Semmelweis Effect.” From guides virtuous people in their everyday lives can be called their ethics. There are an ethical standpoint, the case is quite also formal professional ethics that have been drawn up by a medical association. simple. Semmelweis was right. Whether T he family of concepts dealing with ethics is based on the Greek word “ethos”. or not a danger of infection exists is not a This word originally meant the place where one is located. Later, it took on the matter of opinion, and there is no moral meaning it has today: a moral standpoint. Every (healthy) person is capable of making reason for tolerating an alternate point of moral judgments. For example, we disdain cowardice and praise fairness. But is view. Those who enter an operating room this intuitive ability adequate to address the complex problems of a world with seven without disinfecting their hands are being billion people and nearly 200 nations? Those who wish to escape moralism must intolerant, unprofessional, and immoral. understand why we have a variety of perspectives today rather than one single system In many cases, it takes more courage to of ethics. According to legal ethics, actions can be justified if they precisely follow

om confront someone else who is acting in- the rules. Deontological (duty) ethics asks whether an action is right – that is, can c correctly, than it does to act correctly. one expect others to act in line with this principle? However, ethical principles require such T here are three basic concepts for judging actions ethically. The ethics of conviction a confrontation. look at intentions; they accept actions that are meant well, even if the actions fail Ethics commissions, councils, and of- miser ­ably. The ethics of responsibility state that a person who commits an action should uttmann/toonpool. t

S ficials did not exist in Semmelweis’ time. bear its consequences; in other words, the individual must accept responsibility even These days they’re everywhere, and what for a bad outcome. The ethics of success evaluate actions on the basis of their results, the German Ethics Council debates to- and are therefore popular in corporate ethics and, most recently, in medical ethics. llustration: llustration:

I day is often complex and unclear. More- T he guiding principle is “all’s well that ends well” or “the ends justify the means.”

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EN_22-25_Ethik.indd 23 15.11.12 13:27 It’s one of those fateful days: Simply playing by the rules is not enough; you have to do the right thing

> country with a less open culture of debate tive for his patient, whose heart valves ceive a transplant. His trailblazing ad- than Germany or the U.S. In 1968 a sur- had almost given out. The donor was vancements uncoupled Wada’s country geon named Juro Wada from Sapporo de- clearly brain-dead, but Wada’s actions from progress for 31 years. The ethical cided to implant the heart of a drowned were a challenge for the society he lived approach that would express this opin- student into an 18-year-old patient. In in to accept. Because hardly anyone in Ja- ion is known as consequentialism. Those Japanese society, an agreement had not pan understood what brain death meant who adopt it are not interested in individ- yet been reached on ethical and medical in 1968, let alone accepted the concept. ual intentions. They’re only concerned guidelines and standards for a procedure Powerful religious beliefs, many deeply with the result, which first has to be de- as this. It happened only eight months af- grounded in Japan’s Shinto philosophy, termined. This requires taking into ac- ter the world’s first revolutionary heart opposed the idea of transplanting body count not only Wada, his patient, and the transplant had been carried out. Wada’s parts of the dead. An ethics council, had organ doners - also countless other indi- euer

patient died 83 days later, and the physi- there been one, would probably have pre- viduals impacted by Wada’s actions. t S cian was subsequently charged with mur- dicted, that competing schools of medi- der. Wada was acquitted in 1970, but as cine would have tried to influence pub- Good intentions are what count y: Petray: h a result of the outrage over the case, no lic opinion about this issue. This summarizing approach seems plau- p other heart transplants were performed Although Wada did something the sible to many in the healthcare sector to- in Japan for another three decades, un- cardiologists on the plane would have day – all the more when it’s applied to the til February 1999. approved of, without reservations - deci- medical field itself. That’s because the sive action to save a person near death - balance between costs and benefits is be- No Therapeutic Alternative one can not escape the impression that coming more important in healthcare as Photogra Bank; artoon he C

Wada could have given good arguments it did more harm than good. That’s be- well. The growing popularity of evidence- T on: on: for his actions. He recognized a revolu- cause the shock Wada’s actions caused based treatments is also doing its part. i tionary advancement in surgery. At the among the public, may have robbed Such treatments are evaluated in terms of

time, there was no therapeutic alterna- many Japanese of the opportunity to re- their outcome – as if they’re judged “back- Illustrat

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EN_22-25_Ethik.indd 24 15.11.12 13:27 Caring professions ETHICS

wards” from the results. This contradicts A regulated market for organs the tradition that has long existed in Ger- many. The ethics of duty formulated by the Should there be a market for human organs? Some would say, “Of course not! philosopher Immanuel Kant’s postulate, Organs should be distributed fairly.” They believe it would be morally wrong if only that a person’s good intentions are deci- the richest or best networked individuals were able to “bid successfully” for organs. sive. If Wada, with a clear conviction and Instead, kidneys or livers should be given to those who need them most. Economic after considering all the facts, had wanted ethicists say it doesn’t matter what the “currency” is; it’s always about a market. only to do good, his actions would have Any commodity – even moral arguments – can create this market. Individuals facing been justified – no matter what the long- death who are on waiting lists for organs have an interest in thinking about what term effects would be. they “have to offer” that would allow them to move up the line and obtain the scarce “commodity.” The cause of the moral dilemma in the organ allocation system is Is financial balancing moral? the scarcity of available organs. If there were a surplus of legally obtained organs, the Neither of these two perspectives is more distribution dilemma would disappear, and so would the illegal trade in human organs. ethical than the other. If that were the In the traditional marketplace, low supply is regulated by rising prices. In the case case, then the reckless spending of pub- of organs, this means transplants would become so expensive that all the organs lic funds – on unnecessary operations, on offer would be bought by the wealthiest bidders. The “customers” here have no emergency transport, rescue diving, and choice – they must have the “product,” or else they will die. Purchasing power emergency flights – would also be morally therefore can not be used as a distribution criterion. Because every sick person has wrong. Still, permanent financial balanc- the same human dignity (ideally equal to the wealthy), the “market participants” ing does seem strange. It’s as if an invis- can’t outbid each other. In such a regulated market, the degree of need corresponds ible third party were present at every ac- to the supply of an organ in the “transplant exchange” – and this is exactly the weak cident, looking over shoulders and typing point where diagnostic “counterfeiting” can arise. figures into a calculator. This sometimes The distribution system is like a food ration card that allocates more milk to chil- makes us uneasy. Authentic moral im- dren and more calories to miners, for example. This view has led to stronger market pulses compel us to discuss the important regulation incentives in some countries. In Spain, for example, people who don’t ER OK J

/ ethical question of our time: How can expressly refuse to donate their organs are considered to have tacitly accepted that E C

AN economic activities be made moral – and they will be donors. Israelis who declare their willingness to donate organs move up ALLI

how can morality be economically viable? on waiting lists, and Singaporeans refusing to donate are placed lower on such lists. URE

T The theologian Michael Fischer has C I P conducted research concerning hospitals Life and death: In Germany, the for a long time. He has come to the fol- approval of ography: lowing conclusion: “Ethics evolves not in organ donation hot P the rarefied air of theology, but rather in is high. Still, only about one the sticky atmosphere of daily conflicts.” in four citizens Rules and consensus guide us in our daily have filed out a toon Bank; Bank; toon actions, but it is up to us as individuals donor card he Car

T whether we can ultimately accept our own actions. History teaches us that not only hands need to be washed but, also an ac- ll ustration: I tive conscience. Silke Umbach

Dräger Review 106 | 3 / 2012 25

EN_22-25_Ethik.indd 25 23.11.12 15:24 Plant Fire Department Automotive Industry

Fire Safety for the Golf and the Beetle T he Fire Department at the VOSWLK AGEN PLANT IN WOLFSBURG is ready for use around the clock. Its technical equipment corresponds to the special conditions of the site. The smallest emergency vehicles are most commonly in use.

shrill signal is followed by a re- ployees. More than 1,000 VW workers go corded announcement: “Pre- through this course every year,” says Frank A alarm!” The men of VW’s Plant Maiwald, Fire Chief of the Plant Fire De- Fire Department run into the vehicle ga- partment. The training course is manda- rage of the fire station and get into their tory for new apprentices, so all of them get protective clothing. The control and dis- to know the members of the Plant Fire De- patch center announces the initial details partment personally. of the emergency over loudspeakers. The firefighters get into their vehicles, raise the A City of Its Own roll-up doors, and pull out of the station The firefighters usually drive to their de- with flashing blue lights and emergency ployments with T4 and T5-model VW vans, A

signals. These three red VW vans, which in part for tactical reasons. Approximately KGa carry a nine-member firefighting team, one fourth of the six-square-kilometer o. & C were built and outfitted according to the site in Wolfsburg consists of factory halls. G By fire three times five: special needs of the Plant Fire Department. That’s where most of the alarms are trig- Particularly the emergency number 555, instead of They can reach any point in just a few min- gered. The factory halls are often so large the usual 112; the fire service rägerwerk A rägerwerk utes – whether it’s in a building or outside. that walking from the door to the location D vehicles are different at y: y: h first glance from public fire

The firefighting capacity at the plant com- of the emergency can cost precious min- ap department vehicles prises of three crews, with more than 70 utes. “With the vans, we can drive to the

members in all. “Organizational and tech- spot where the alarm was triggered,” ex- Photogr nical fire protection systems are also part plains Maiwald. In addition, the firefight- of our responsibility,” says Immo Justingen, ers at the plant have had several vehicles Head of Fire Safty at VW. built according to their own designs and in response to their particular needs: the The equipment is as diverse as the location 18,000 Fire Extinguishers small fire trucks KLF1 and KLF2, and the where it is used. The VW parent plant is the There are four members of the Fire Depart- small tank fire truck KTLF that has a high- largest automotive plant in the world and ment whose sole responsibility is to oversee pressure fire extinguishing system with a has a workforce of approximately 50,000. the plant’s several thousand fire detectors, 100 liter water supply. Compared to the In its structure, it resembles a small city. sprinklers, and carbon dioxide fire-suppres- huge four-axle trucks of the Fire Depart- The production department and the paint sion systems. “The colleagues service the ments at large chemical plants and refin- shop have their own specific risks, as well facility, repair it, and they also accompany eries, these specially designed vehicles as the factory power plant, the adminis- the VdS inspections,” says Justingen. And seem almost delicate. In the fire station, trative center, and the R&D department. then there are the 18,000 fire extinguishers however, there are also monsters like the And then there’s the Autostadt too – VW in- of various models that have to be serviced 30-meter telescoping mast, the swap-body vested hundreds of millions of euros and every two years. The shop is always bustling truck with an attached large-scale fan for built another town on some open land next with activity. “Fire extinguishers are also smoke extraction of buildings and the in- to the power plant, a place that is entirely important for the fire safety training of em- dustrial firefighting vehicle 20/45. devoted to the VW Group and its various

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EN_26-29_Werkfeuerwehr_VW.indd 26 15.11.12 13:32 Automotive Industry Plant Fire Brigade

By fire three times five: Particularly the emergency number 555, instead of the usual 112; the fire service vehicles are different at first glance from public fire department vehicles

brands (from Skoda to Lamborghini). Tra- VW Fire Department dition meets modern here: The Plant Fire Department provides fire protection for “ The key challenges for the work of the VW Fire the original fiery red beetle VW 3 (V1), of Department in Wolfsburg is resulting from the structural 1936 at the automobile exhibition in the situation of the plant and from the production line,” says ZeitHaus museum, as well as for the pro- Immo Justingen, Head of Fire Safety at VW. For example, duction of the new Golf VII and the work I mmo Justingen, the basic structure of some of the buildings dates from on the Volks­wagen models of tomorrow at Director of Fire the 1940s, and the production halls might be up to 300 Safety at VW the Product Development Center. meters deep in some cases, so they require special And the Plant Fire Department some- resources. Furthermore, the Plant Fire Department has to keep pace with the times is even where the music plays – for constantly evolving production technology. The ambulance service is a example, when the crew performs fire- large part of the work. Last year 3,300 trips to rescue victims and transport watch duty during large events in the Au- patients were made. There were approximately 200 deployments to fight tostadt. One is also working their shift as > fires and provide technical assistance.

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EN_26-29_Werkfeuerwehr_VW.indd 27 15.11.12 13:32 Plant Fire Brigade Automotive Industry

Personal protective equipment at the industrial level: gas tight chemical protective suits in the stock, VW Factory Fire Department

I n the control room, responding to emergency T he maintenance of 18,000 fire extinguishers Fresh air for the tank: In the respiratory VW Fire Department has an overview. calls – especially medical emergencies are apart of everyday life for some firefighters protection workshop air cylinders are filled In the background: the old power plant

> the cult band “Kraftwerk” performs in the a medical service vehicle, which is staffed ment of the VW-owned utilities and the old power plant, half of which is now used by an emergency doctor and two paramed- power plant. Multi-gas detectors (Dräger as a venue for concerts and special events. ics. The Fire Department also provides a X-am 5000, 5600, and 7000) and single- This protected historical building on the rescue vehicle when necessary. The pub- gas detectors (Dräger Pac series) are bank of the Mittellandkanal, with its char- lic ambulance service sometimes is called used. When they aren’t on emergency acteristic chimneys, also led to the forma- to the plant too. At such times, the fire- missions or engaged in training, the tion of a special unit within the plant’s fire fighter guide their its fellow rescuers members of the VW fire department usu- department – the high-altitude rescue. through the streets and alleys of the plant. ally spend their days performing inspec- “No one knows the place as well as we do,” tions and maintenance in the production Focus on Ambulance Service says Frank Maiwald. “Knowing precisely shops, which also include a section for The next alarm is due to a medical emer- where things are is the be-all and end-all.” fire hoses. They can tell from the level of gency. A Patient Transport Ambulance A shrill whistle penetrates the respira- activity in the plant that 4,000 units of the (PTA) with a two-person crew is needed. tory equipment shop on the second floor. Golf, Golf Plus, Tiguan, and Touran mod- Three of these vehicles are in use at the The experts for respiratory protection els are being built every day in its produc- Fire Department; approximately two and measurement technology look after tion plant. Most alarms sometimes are thirds of all deployments are for ambu- the equipment for the Plant Fire Depart- sounded on the weekend, when the plant lance services. The PTA cooperates with ment as well as the gas-detection equip- seems especially quiet. That’s when con-

28 Dräger Review 106 | 3 / 2012

EN_26-29_Werkfeuerwehr_VW.indd 28 15.11.12 13:32 Automotive Industry Plant Fire Department

“ Important for a quick and efficient advertment of danger” R aimund Bücher, Head of the Plant Fire Department at Henkel AG & Co. KGaA and Chairman of the German Association of Corporate Fire Protection, Association of Factory Fire Departments (Bundesverband Betrieblicher Brandschutz, Werkfeuerwehrverband Deutschland e.V.), on the role of Plant Fire Department at companies.

M r. Bücher, what role do Plant Fire Departments play in corporate fire protection? No one is better acquainted with the specific conditions of a company than the Plant Personal protective Gas-detection Fire Department. With its special training and equipment, but also with their detailed equipment at the industrial equipment must local knowledge – that is extremely important for a fast and efficient danger adverment. level: gas tight chemical be inspected protective suits in the stock, and calibrated at The work of Plant Fire Departments extends well beyond the actual emergency (1) VW Factory Fire Department regular intervals G response deployments and involves hazard prevention activities and crisis management en A

g too. When an incident occurs, they are also concerned with keeping any interruptions a

sw as brief as possible, prior to the resumption of production operations. Fire Depart- olk V

, ments, thus make a significant contribution to the value of companies. A In Germany there are approximately 25,000 Fire Departments – that’s KGa

o. o. an extensive network for public fire protection. For the sake of comparison, & C G how many Plant Fire Departments are there? In the Federal Republic of Germany, currently 845 Fire Departments are working with 32,915 total active personel, including 7,115 full-time firefighters. In addition, there rägerwerk A rägerwerk D are approximately 300 company Fire Departments. In 2009 a three-year training y: y: h

ap course was established for the occupation of plant firefighters. After some initial training, men and women are also offered the opportunity to complete a one-year vocational

Photogr course for the occupations of Plant Fire Department or Fire Safety Foreman. Fresh air for the tank: In the respiratory VW Fire Department has an overview. What differentiates the various Plant Fire Departments from each other? protection workshop air cylinders are filled In the background: the old power plant S ome are staffed with full-time firefighters, others with part-time workers. The key question is whether a company has been ordered by a regulatory authority to maintain a Plant Fire Department or whether this is done voluntarily. Mandated Plant struction and repair activities take place, Fire Departments must meet the same requirements as a public Fire Departments and these are typical occasions for trigger- with regard to training, equipment, and appearance. In addition, the laws of some federal ing off fire detectors. states include regulations concerning company Fire Departments. These are often caused by a company that wants to do something for the protection of its assets. Both T he Plant Never Sleeps of the Fire Departments work is important to industrial fire protection. In addition Although the assembly lines stand still to the organizational form, which is of course crucial to the industry in which the non- when no one is on shift, the Plant Fire De- public Fire Departments work in. Because production in the chemical industry is partment is always ready for action. Ev- different from a steel plant, an airport or the electrical industry. ery shift begins at 7:30 a.m. and lasts 24 Also depending on such factors, whether a company has set up hours – 365 days per year. On the weekend, a fire department or not? when the company restaurants at the plant Yes, but here again that decision is usually made on the basis of the specific are closed, the firefighters do their own risks involved as well as the size of the company. Typically this is in the relevant legal cooking. Each fire-watch unit has its own texts as follows: “Plant Fire Departments are state-ordered or approved Fire chef. “Here you learn not just how to extin- Departments. The supervisory authorities shall require, after consultation of the guish fires and save lives, but also how to community, enterprises, or institutions to establish a Fire D epartment, when serve a roulade,” says one firefighter who the risk of fire or explosion is particularly great. Or if in case of damage, a large seems to like it. Peter Thomas number of people could be at risk.”

Dräger Review 106 | 3 / 2012 29

EN_26-29_Werkfeuerwehr_VW.indd 29 15.11.12 13:32 INFORMATION GRAPHIC UNDERWATER

Fascination Sea Seventy-one percent of the earth’s surface is covered by water. And around 70 percent of this volume of water is classified as DEEP SEA. These are the areas of the ocean that lie more than 800 meters below the surface. Man can only penetrate with complex technical tools into this cold, largely unlit zone. However it is possible for some mammals to dive hundreds of meters deep. Here they encounter many fish and other sea creatures.

Fangtooth Sperm Whale Habitat: in all oceans, These marine mammals in extreme at depths of 500 to 5,000 cases can reach depths of 3,000 meters. Special charac- meters. It is the only mammal that teristics: enormous teeth, can remain nearly an hour under up to 18 cm long, which water without having to take a breath. prevent him from fully closing his mouth.

Footballfish Habitat: Atlantic Ocean, at depths of 200 to 1,000 meters. Special characteristics: sphe- ri cal anglerfish with a warty skin that is covered with many small spikes.

Deep-Sea Crab Habitat: Japan, at a depth of around 250 meters. Special characteristics: a spiny bottom-dweller. So far, the deep sea crab has hardly been researched.

Barbeled Dragon-Fish Habitat: all oceans except Elephant Seal the Antartic Ocean, at This largest seal in the world depths of 50-3,500 meters. can dive up to 1,500 meters Special Characteristics: deep. The elephant seal can do luminous organs under the this, because it can store 5 eyes emit red light. times more oxygen per kilogram of body weight than a human.

Measuring the ocean depths The free water column of the sea is divided into five zones. The top 200 meters form the Epipelagic, which is Ridge permeated by daylight and responsible for producing Epipelagic: 0–200 m most of the oceanic biomass. Then comes the Mesopelagic, Mesopelagic: 200–1,000 m which descends from 200 to 1,000 meters. This is where the deep sea begins. At such depths there is not Bathypelagic: 1,000–4,000 m enough light to support photosynthesis-based plant life. The Bathypelagic lies between 1,000 and 4,000 me- ters. Only specialized deep-sea submersibles can Abyssopelagic: 4,000–6,000 m reach such depths. The two lowest zones are the Abys- sopelagic (4,000 to 6,000 meters) with temperatures close to freezing and the Hadopelagic (at 6,000 meters), Oceanic Trench which includes the lowest points, the deep sea Hadopelagic: 6,000–11,000 m trenches. But even here, some 11,000 meters below

the surface, animals still live. SENCKENBERG FORSCHUNGSINSTITUTPHOTOGRAPHY: NATURMUSEUM, UND PICFOUR ILLUSTRATIONS: TRÄNKER;SVEN GETTY (X2); PHOTOSHOT. IMAGES

EN_30-31_Infografik_Tauchen.indd 30 16.11.12 15:53 Closed-Circuit Breathing Apparatus Closed-circuit breathing apparatus, commonly known as a rebreather, was the first reliable means of assisted diving without a surface air line. A soda lime filter removes the carbon dioxide from the exhaled air, which is then replenished with the same amount of fresh oxygen that had been consumed. Finally, the diver can breathe the prepared gas mixture again.

Open-Circuit Breathing Apparatus Open-circuit breathing apparatus uses air compressed to as much as 300 bar, carried in tanks on the diver’s back. Two sequential pressure regulators provide the diver with air pressure, which Emperor Penguin is just above the depth-dependent ambient A native of the Antarctic, the pressure. The maximum diving depth with pressu- emperor penguin can dive rized air is around 50 meters. to a depth of 500 meters and remain underwater for up to 20 minutes. Free-Diving Free diving without technical aids is the most primitive form of diving. Athletes try to dive on one breath, as deep as possible, allowing themselves to be pulled down by weights. Record depths are around 200 meters. In addition to the deep diving com- petitions, there is also the discipline of distance diving, without technical aids.

Saturation Diving This special type of helmet diving is used for long durations at great depths. The diver lives for several days under high pressure, on land and under water. The record low for saturation diver operations is at 534 meters. Saturation divers are often used to carry out installation and maintenance work on drilling rigs and underwater pipelines.

Atmospheric Diving Suit Atmospheric diving suits are a hybrid technology that combines elements of wetsuit and submarine. A pressure balance with the environment does not take place in the interior of the suit, although the suit follows the movements of the diver. Without extensive compression and decompression, work Elephant Seal can be performed in depths up to 600 meters. This largest seal in the world can dive up to 1,500 meters 14 deep. The elephant seal can do 3 1 this, because it can store 5 2 15 times more oxygen per kilogram of body weight than a human. 13 Dräger LAR 5000 Who dives to what depth? Rebreather 5 7 While open circuit 50 m Human with scuba equipment breathing apparatuses 4 12 provide constant 200 m U.S. Ohio class submarine fresh breathing gas, 600 m Human in an atmospheric diving suit rebreathers rege - 6 nerate the air breathed 923 m A bathysphere 10 by the diver, reple- nishing it with fresh O2 8 and removing CO2 9 11 4.000 m The FNRS-2 submersible 18 with a soda lime filter. The fresh gas then 16 flows into the counter- 17 19 lung, from where it is inhaled by the diver. 1. Inhalation hose, 2. Mouthpiece, 3. Exhalation hose, 4. Exhalation For dives deeper bag, 5. Pressure relief valve, 6. Soda lime canister, 7. Breathing bag, 8. Oxygen cylinder, 9. Oxygen valve, 10. Oxygen pressure gauge, than 10 meters, other breathing gas mixtures 11. Nitrox line, 12. Non-return valve, 13. Dosage unit, 14. Lung Deepsea Challenger, demand valve 15. Hand wheel to adjust the regulator, 16. Nitrox can be added from 11.000 m a research submersible

PHOTOGRAPHY: SENCKENBERG FORSCHUNGSINSTITUT UND NATURMUSEUM, SENCKENBERG FORSCHUNGSINSTITUTPHOTOGRAPHY: NATURMUSEUM, UND PICFOUR ILLUSTRATIONS: TRÄNKER;SVEN GETTY (X2); PHOTOSHOT. IMAGES cylinder, 17. Nitrox valve, 18. Nitrox gauge, 19. Connection line a second tank.

EN_30-31_Infografik_Tauchen.indd 31 16.11.12 15:53 Emergency rescue services Carbon monoxide

Treading Softly Od orless, colorless, tasteless: Carbon monoxide is an insidious gas. In high concentrations it can be fatal. Even professional emergency personnel are not immune – but they can protect themselves.

t was apparently a routine assignment Sebald, Chief Physician at the Emergency These facts were reason enough for the res- that got Georg Schrattenbacher think- Medical Servces in Vienna.” A health haz- cue agency in Vienna to take a closer look I ing. Schrattenbacher, a paramedic in- ard can already be at concentrations of ap- at this situation. In February 2010, they structor with the professional Emergency proximately 100 ppm (see also Dräger Re- began documenting their assignments Medical Service (EMS) in Vienna, had been view 104, pp. 46-47). CO concentrations of for one year, equipped with a Dräger PAC called out to help a young woman. Scantily 150 ppm and up can cause headaches, dizzi- 3500 single-gas detector. “We used to find dressed and visibly confused, she opened ness, fatigue, and nausea, and if levels reach CO more or less coincidentally, and in the the front door. Though her state was in 300 ppm a person will likely lose conscious- worst-case-scenario not until someone was fact slightly drunk, her condition could ness. The average deadly dose is around in a hospital – which of course is much too not solely be attributed to alcohol consump- 1,500 ppm over a period of more than an late,” says Schrattenbacher. “When we tion. After she was examined at a hospital, hour, and exposure to 40,000 ppm or more were in the middle of a job, we had to rely it was determined that she was suffering can kill a person in just two minutes. on our experience. In some cases, fogged- > from carbon monoxide (CO) poisoning. The cause of the CO discharge, within her own four walls, was a defective continuous flow water heater. Schrattenbacher and his colleagues were also examined, and as it R escuers in danger turned out, they too had been exposed to a Carbon monoxide (CO) threatens firefighters and Emergency Medical small amount of toxic CO gas. Services (EMS) more frequently than was previously believed, according to a study conducted by the professional Fire Department in Wiesbaden, C arbon Monoxide Risks G ermany. As part of the study, firefighters and EMS staff continually carried In this case, both the patient and the res- gas monitoring devices on the job. On more than 30 deployments, these cue team were lucky. This example illus- detectors reported dangerous CO concentrations, that were higher than trates the particular danger posed by the had normally been anticipated in the past. The risk of CO poisoning invisible gas. Firefighters are equipped with proved to be particularly high in medical emergencies. measuring devices and protective masks C lear Recommendations: Rescue workers should always be equipped when they go out on assignments, but res- with single-gas detectors. “There should be at least one device per cue workers are often unprepared to deal emergency team provided, for occupational safety reasons, to the personel.” A a

with such dangers. As a result, they them- T he study also showed that in many cases the use of the devices limited KG selves can become victims while they’re try- the damage caused by CO inhalation. One example involved a gas leak o. & C

ing to save someone. CO forms when car- in a multifamily house. An EMS unit was called in to help an individual AG rk rk bon composites catch fire, but do not burn complaining of physical discomfort. As soon as the unit got there, the CO e rw completely – and this phenomenon is by no monitor went off. The rescue workers immediately notified the fire e

means limited to continuous flow heaters department, which sent out a team that evacuated 40 people, of which Dräg , e (see p. 35). “Once inhaled, carbon monox- more than half already had CO poisoning. The study underscores just ide enters through the lungs into the blood- how important it is to provide firefighters and EMS staff with CO monitor- stream, it is 325-times lighter than oxygen, ing technology. “That’s why more emergency rescue organizations y: MEV/F1onliny: h here it bonds with the iron content of the he- have begun to equip their people with the monitors,” says Customer p moglobin - and thus blocks the vital oxygen Process Monitoring Manager Rüdiger Weich. “It’s a very important

transport in the blood,” explains Dr. Dieter issue at the moment.” Photogra

32 Dräger Review 106 | 3 / 2012

EN_32-35_Wien.indd.idml.indd 32 15.11.12 17:44 Always there: Single-gas detec- tors assit the Vienna emergency personnel in their duties – and warns them in case of a CO emergency

> A a KG o. o. & C AG rk rk e rw e , Dräg , e y: MEV/F1onliny: h p

Photogra Difficult to assess: There may be CO poisoning in a medical emergency with an unclear background

Dräger Review 106 | 3 / 2012 33

EN_32-35_Wien.indd.idml.indd 33 15.11.12 17:44 Paramedic Instructor Georg Schrattenbacher (left) from the Emergency Medical Services in Vienna; Third District headquarters (middle); and Rescue Operations Director, Dr. Jochen Haidvogel

> up windows could be a CO indicator, but the new findings from the monitoring proj- is immediately evacuated. After that a that type of condensation could also be ect. “The Dräger devices are now carried as “crash rescue” is carried out. Measure- caused by other things. Consequently, it standard support on the backpack. There ment processes are stopped and the evac- wasn’t really possible for us to take suit- they do not interfere with the processes, but uation of all individuals from the danger able precautionary measures.” are always there,” says Haidvogel, a sim- zone becomes the top priority. “Whether The results of the CO monitoring proj- ple but effective solution. In addition, vari- that is at all possible is at the discretion of ect clearly revealed that rescue workers ous alarm limits have been defined: alarm the specialisits on site, – but they don’t have were being exposed to CO much more fre- limit 1 is a maximum allowable concentra- a lot of time to figure it out,” says Schrat- quently and at much higher levels than was tion of 30 ppm, alarm limit 2 at 60 ppm. tenbacher. “Instead, they have to get fire- previously thought. A total of 38 instances fighters to do the job.” Schrattenbacher of CO exposure were identified; in only Crash Rescues at regards single-gas monitors as important seven of these cases had rescue workers ex- Heightened Levels standard equipment for Emergency Medi- pected to encounter the gas. “Protection is The fire department is immediately called cal Services. “Not one worker has been in- the top priority. After all, our people can’t in if a monitoring unit sounds an alarm. jured by CO since we started using these do their job if they get into trouble,” says Dr. What happens after that depends on the small life-saving devices,” he says. Jochen Haidvogel, Director of the EMS. “So circumstances. “When the first alarm The gas is also so treacherous, be- we had to do something, in order to ensure limit is exceeded, we get as much fresh air cause it is lighter than air and may spread the health of our employees.” More gas de- into the room as possible and evacuate any unnoticed to other apartments. People tectors were purchased and the procedures injured people,” Schrattenbacher explains. are more often than not found uncon- taken by the rescue teams were adapeted to If CO levels have reached 60 ppm, the site scious, away from the actual hazardous area. The cooperation of Vienna EMS with police and fire departments works smoothly. “We have clearly distributed competencies and professional struc- Tracking down CO tures,” said Emergency Medical Ser- During the early stages of the development of modern measurement tubes, the vices Director Haidvogel. “Within about

focus was already on the reliable detection of carbon monoxide. The first patent for ten minutes, we are on-site. This is an ex- OUR a CO detection device was issued in 1919 to the American developers Lamb and cellent figure!” on: PICF on: Hoover. They treated pumice with a mixture of iodine pentoxide and sulfuric acid and To ensure that everything continues to i then inserted this substance into glass tubes. This “hoolamite” is considered the run smoothly, rescue workers undergo both

first device to use a chemical reaction to detect carbon monoxide. Subsequently, Dräger individual and tactical training. Training Illustrat ; A tubes were able not only to identify the presence of CO but also to reliably a exercises are held more or less monthly, KG measure its concentration in air. The operational basis for these tubes still includes and every two months a major exercise that & Co. & Co.

the chemical reaction between iodine pentoxide and carbon monoxide in acidic includes other organizations is carried out. AG conditions. The current range of CO detection tubes (2/a, 5/c, 8/a, 10/b, and “We’re pleased that the city of Vienna con- 0.3%/b; order numbers 67 33 051, CH 25 601, CH 19 701, CH 20 601, and CH 29 siders it important to have a professional 901) also operate in line with this principle. Electronic measuring devices use rescue service,” Haidvogel says. “Rescue y: Drägerwerk Drägerwerk y: h electrochemical sensors to enable rapid and precise measurements of CO concen­ work is not a profitable business, but we p trations in ambient air. Portable single-gas monitors carry out continual individual work in a professional environment that

measurements (see p. 56). offers many opportunities.” H erbert Glass Photogra

34 Dräger Review 106 | 3 / 2012

EN_32-35_Wien.indd.idml.indd 34 15.11.12 17:44 CARBON MONOXIDE EMERGENCY RESCUE SERVICES

The Treacherous Gas CO Threat: The U.S. Consumer Product Safety Commission volume fraction of 0.15 percent in the surrounding air) up to warns that carbon monoxide (CO) is a “deadly, colorless, 40,000 ppm with a contact time of two minutes is considered odorless, poisonous gas” that kills more than 170 people every leathal. By comparison, the German Regulation on Occupa- year in the U.S. That figure does not include deaths that are tional Exposure to Hazardous Substances sets a CO limit of 30 caused by smoke inhalation in fires, in which CO almost always ppm in the workplace (TRGS 900, as of 2012). plays a major role as well. CO can be produced by the in- High CO concentrations in the blood can be measured using complete combustion of hydrocarbons, which typically occurs in seven-wave pulse oxymetry. Such measurements are important smoldering fires. Dangerous emissions can also be caused for patients and EMS personnel alike. For example, the NFPA by defective oil and gas heaters, gas boilers, as well as coal and 1584 code (as of 2008) in the U.S. advises that CO blood wood stoves, or by open-flame grills in closed spaces. Critical saturation should be measured if critical CO levels are detected levels of CO can be produced by internal combustion engines in ambient air or if firefighters experience certain symptoms. operated in closed spaces, and even by people smoking This protocol makes it possible to begin treatment right at the water-pipes in poorly ventilated rooms. site of the emergency. The most effective forms of therapy How CO affects human beings: Once it is inhaled, CO is range from the inhalation of pure oxygen to intubation and hyper- more than 300 times as likely as oxygen to bond with the hemo- baric (high-pressure) oxygen treatment in a chamber. globin in blood. This restricts the oxygen flow to cells in the The symptoms of CO poisoning include dizziness, nausea, body to different degrees, depending on the CO concentration and headaches, lack of concentration, and cardiac arrhythmia. the period of exposure. The effects can be severe enough to However, such symptoms can often be misinterpreted as being cause death by asphyxiation. Exposure over a period of 60 minutes caused by infections, alcohol and drug abuse, or neuro- to a CO concentration from 1,500 ppm (this corresponds to a logical malfunction.

Blocked chimney outlet

Blocked chimney Incorrectly installed exhaust hood

Blocked fire- Laundry dryer place (gas or wood- burning) Car exhaust gas from attached garage

Defective Defective propane fridge portable heater Grill used in an inclosed space

Leak in central heating system

Damaged heat exchanger Possible sources Corrosion or other damage to the water heater’s ventilation system of CO in the home PHOTOGRAPHY: DRÄGERWERK AG & CO. KGAA; ILLUSTRATION: PICFOUR KGAA; ILLUSTRATION: & CO. AG DRÄGERWERK PHOTOGRAPHY:

DRÄGER REVIEW 106 | 3 / 2012 35

EN_32-35_Wien.indd.idml.indd 35 15.11.12 17:45 EN_36-39_Schweden.indd 36 40-foot container 40-foot inFirefighting a modern technology: with view Good 16.11.12 14:29

Photogra phy: Åke Ericson Training Firefighters

Flashover in the Forest R ealistic training makes it possible to deal with difficult situations. A training program in rural Sweden uses real blazes to provide firefighters with the tools they need.

aik Klein is setting one fire af- several missions inside blazing buildings ter another today. With a skill- throughout his nearly 25-year career as a Mful hand, the instructor at the firefighter. Still, Deutloff was impressed Swedish Rescue Training Center (SRTC) by the real-life firefighting training con- in Skövde, turns the valve on a gas canis- ditions in Sweden. “The regulations ter. Flames flare up on the floor of a con- in Germany don’t allow us to produce tainer; for a while they dance around in big flames such as those that are gen- the smoke that rises up to the steel ceil- erated in the combusted material’s liq- ing. Then they roll across a wide area, uid phase,” he says with some regret. rise up several meters out of the win- I nstructor Maik Klein discusses tactics His school does have its own gas-fired dows, and through the double door. Klein for the next exercise training building in Koblenz, but it’s lo- has brought his crew into position. The cated in a residential area. “Whenever “Macken” real-life simulator is a train- employing the proper extinguishing tech- we arrive with our sirens blaring, every- ing unit consisting of two 40-foot stan- nique. “Too much water will be a prob- one starts complaining that we’re dis- dard containers. The unit uses liquefied lem here,” says Klein. “That’s because turbing the peace,” Deutloff says. “But gas and other flammable materials to the steam from the water spreads very to practice realistic situations, we some- simulate blazes that even push experi- rapidly, making it difficult to see things. times need to be able to create a cloud enced firefighters to their limits. It generates temperatures near the floor of smoke!” “Safety is the top priority,” says Klein that would be tough to survive without as he looks at the firefighters, who have protective clothing.” Jet-stream nozzles Cake and pizza come here from Germany and Austria. can help here – and the group did in fact from the fire container? Temperatures can rise up to 800 de- use them extensively the day before, at “You also need to have the right amount grees Celsius near the ceiling of the con- first individually, then with partners, af- of heat,” adds Ola Johansson, Manag- tainer, so those who want to remain cool ter making adjustments in line with the ing Director of the SRTC. “We actually in this atmosphere need to stay close to room volume. This was a complex cho- baked pizza and cake in our container,” the floor. Two firefighters at a time are reographic feat, which Klein explains as he says jokingly. With his sonorous voice, sent into the danger zone, where they im- follows: “We start with a broad stream, broad shoulders, and hands like shov- mediately look up, as the regulations re- catch the flames above us, and then els, Johansson is the picture of calm as- quire. When liquefied gas burns above, make a figure eight in an attempt to hit surance. He looks unflappable – but he a large amount of combustion gas forms the greatest possible volume of the com- knows the challenges firefighters face. and collects under the ceiling. Experi- bustion gases as we narrow the stream Before becoming an instructor at what enced firefighters can recognize the in order to gain depth.” Suddenly a mur- at that time was still a state-run train- signs of an imminent fire flashover. They mur goes through the group. The flames ing school in 2001, he worked for seven watch how the smoke develops and take have rolled up, very far above the other years as an ambulance driver and a fire note of its color and consistency. firefighters who are using a fog nozzle. department crew leader. “Depending on ricson

E Guido Deutloff stands at a safe dis- the structure in question, it takes six to When water tance from the inferno. Deutloff is an in- ten minutes from the initial spark to a

hy: Åke hy: becomes a problem p structor at the Firefighting and Civil Pro- full-blown room blaze – and we don’t al- og

t In large rooms, the dangerous phenome- tection Academy in the German state of ways get to the fire in time,” he explains.

Pho ra non of flashover can only be managed by Rhineland-Palatinate. He has carried out Fighting massive flames in the inte- >

Dräger Review 106 | 3 / 2012 37

EN_36-39_Schweden.indd.idml.indd 37 15.11.12 17:45 Firefighting Training

> rior – the preferred training scenario in H ands-on experience: “Catching the flames” the central Swedish city of Skövde – is not the firefighting norm. “Most firefight- ers will only experience a few situations like that throughout their careers,” says Johansson. Training is therefore all the more important, in order to ensure the correct approach, if such a blaze does occur. The multi-stage firefighting train- ing concept first gives participants a ba- sic understanding of how a fire forms. The various phases of a fire through its development, from the initial spark, to the discharge of pyrolysis gases. The eruption of smoke into flames are dem- onstrated by instructors using a con- tainer they call “The Lab.” Wooden boards are hung up and set on fire in the container. These boards simulate only a fraction of the actual severity of a blaze, that can occur in a Wall of flames: Practical experience in a realistic environment normal room, when things like furni- ture, electrical appliances, and curtains catch fire. Backdrafts are also simulated in “The Lab.” Here, an almost extin- guished smoldering fire creates a vac- uum when the room cools. If a window is opened, the combustible gas mixture will ignite as result of the incoming ox- ygen. Such a flue gas explosion causes intense flames to shoot out of the con- tainer with tremendous force. As much practical experience as possible ricson

Whereas other firefighting training E centers are forced to rely on the partici- hy: Åke hy: pants’ powers of imagination, the SRTC p og

instructors give the firefighters as much t

practical experience in a realistic envi- An exercise dummy is “rescued” from the smoke filled container Pho ra

38 Dräger Review 106 | 3 / 2012

EN_36-39_Schweden.indd.idml.indd 38 15.11.12 17:45 Training Firefighters

From the initial spark to complete room fire, it takes six to ten minutes

ronment as possible. They also ensure ducted. The expansive structure of piled- vation for the equipment rack. “Getting that the participants understand the up containers with steel steps and cat- into the rooms quickly is the key – and the consequences of their actions. “Train- walks has 15 rooms that can be ignited crew that goes in should be able to see ing containers are known all around with solid materials and that are used to what’s going on,” he says. The cameras the world and can be easily installed,” simulate either a ship or a hotel. Here and their batteries are also now smaller Johansson says. And yet, only the variety the training goals are to utilize a tacti- and easier to handle than before. of the containers and related training cal approach while searching for miss- After the long training day, Paul sits scenarios at the SRTC are extraordinary. ing people. Also to effectively integrate exhausted, next to the exercise dummies, It’s time for a coffee break and a cooperation between two crews under se- sipping water from a bottle. He’s very sat- breather in the shade of “Luleåhuset.” vere heat and smoke conditions. Thermal isfied with the tactical performance of This training unit has containers piled imaging cameras are used extensively in his crew. “We couldn’t see anything, but up to simulate a large two-story building. Sweden to assist in rapid rescue opera- we stayed close together and got the ex- Maik Klein prepares one blaze for each tions. “We also use the video recordings tinguisher hose to many different areas. of the two floors. A quarter of the usual these cameras make if we suspect arson Nothing got snarled.” The participants load is enough here; black smoke is al- and if we want to give the police material, all agree, that their training in Sweden ready starting to billow out of the walled- that shows them what a room looked like has enriched their firefighting experi- in stairwell. Klein also gives the crew at a certain point in time,” says Klein. ence. Every fire is different, but those valuable tips for using the high-pressure Karl Paul joined the Fire Department who can “read things” from the smoke blowers, that are standard issue on the as a teenager. Today he’s a 46-year-old in- and flames – who have experienced the firetrucks in Sweden. structor at the State Firefighting Acad- heat of a wall of fire – can fall back on emy in Salzburg, Austria, where he’s learned behaviors, that will help get An endurance test for responsible for respiratory and body pro- them through even more extreme situ- men and materials tection. Today he is using a Dräger UCF ations. Modern technology helps – and Like all of the course participants, Guido 6000 thermal imaging camera to maneu- so would a common agreement on uni- Deutloff is wearing a Dräger FPS 7000 ver through the thick smoke. For him, form standards for firefighter training full-face mask, as he fights the fire in the the device is a significant technical inno- throughout Europe. Alexander Budde smoke-filled “Luleåhus.” He’s also wear- ing the Dräger PSS 7000 breathing ap- paratus that goes with it. “The mask fits comfortably, closes tightly, and adapts to your face well,” he says. Deutloff also T he Swedish Rescue Training Centre (SRTC) likes the wider field of vision it gives The SRTC has been operating under private ownership since 2009. The him. The compressed air breathing ap- center uses practice facilities that can be fired with wood, gas, or both in order to paratus is designed to keep a firefighter teach firefighters how to rescue people, battle blazes, and leadership practice. as comfortable as possible. “These mod- The participants of the training sessions are issued personal protective equipment ricson

E ern composite units are much lighter and vehicles. The experts at SRTC also advise companies in the chemical than the steel cylinders that we used to industry on the best ways to handle hazardous materials. “We can create leaks hy: Åke hy: p have,” Deutloff explains. with acids and real ammonia,” says Ola Johansson during a tour of the SRTC’s

og 308-acre site. If a customer desires, the center can also obtain actors wearing t Lunch and one last cylinder change.

Pho ra To conclude the day, a fire exercise is con- makeup to simulate injured people. www.srtc.se

Dräger Review 106 | 3 / 2012 39

EN_36-39_Schweden.indd.idml.indd 39 15.11.12 17:45 Medical Tourism Thailand

The Global Patient Health care in Germany has an excellent reputation. As a result, patients from all over the world travel to G ermany for treatment. The situation is similar in the U.S., France, or Great Britain. But medical tourism is also prevalent in Asia. One prominent example of this development is Ban gkok Hospital. z t i t s o N ick ick N hy: hy: p og t

E xcellent staff-to-patient ratio, hotel-like comfort, and professional medical help: No wonder this stroke patient made the long trip Pho ra

40 Dräger Review 106 | 3 / 2012

EN_40-43_Medizintourismus.indd 40 16.11.12 14:36 From 100 to 600 beds in 40 years: Bangkok Hospital was the first private clinic in Thailand

muezzin calls the faithful to has worked for many years to make this doctors and staff who speak Japanese. prayers over the loudspeaker a reality. He has traveled to the Middle Across from the counter for patients A in the Arab section of Bang- East dozens of times, trying to convince from Bangladesh, scaffolding has been kok Hospital. Patients and their fami- various national ministries to cooperate set up. Soon a separate section for pa- lies from the Middle East are comfort- with his clinic. “This didn’t work out at tients from Myanmar will open here. ably seated on dark brown leather sofas. all in the beginning,” he says. Then his “Some nationalities expect a bit more They are separated from the lobby by a team decided to hire a local consultant service than others,” Krewer observes. partition. “Arab patients prefer things to instead, who introduced Krewer to var- For example, he has noticed that Ban- be a bit more private,” says Ralf Krewer. ious members of the upper class. They gladeshi patients tend to be very ser- A tall, lean German in his mid-forties, in turn had started sending younger vice-oriented and value personal atten- he has been in charge of International friends and relatives to Bangkok. “These tion, whereas Europeans are generally Management at this private 600-bed patients were extremely satisfied with more independent. Each section of the clinic for twelve years. Specifically, he our service and began spreading the hospital is also specialized in order to is responsible for the well-being of the word back home. After that we saw a cater to each country’s typical illnesses. hospital’s patients from abroad. steady influx of patients from the re- For instance, Krewer explains, “Japa- “Up on the seventh floor,” explains gion,” Krewer explains. nese diets include lots of raw fish, so Krewer, “our prayer rooms are large Ethiopia is perhaps his greatest those patients tend to have more stom- enough so that we can host Friday success story. When he told the hospi- ach problems. Therefore, for them in prayer service here. At noon an imam tal management about the country’s their check-ups, different things are from a local mosque comes here to potential as a source for medical tour- examined, than in patients from other lead the prayers.” Until recently, a Bed- ism, no one really believed him. After countries.” ouin tent was set up outside, he adds. a while, the chairman decided to give Bangkok Hospital, located in the Huai him a chance. Krewer flew to Ethiopia, Affordable and Kwang district not far from the city cen- but wasn’t allowed to spend more than Similar to a Hotel ter, could be located in any Western me- 1,000 US dollars on advertising. In re- As a university student, Krewer focused tropolis. The floors are made of marble, turn, he was expected to ensure that the on Chinese and Vietnamese as well as and the lobby is bright and airy. Also, hospital would earn about 100,000 US on Asian political science. In the mid- technically speaking, the private hospi- dollars from Ethiopian patients within 1990s he worked for a French company tal is cutting-edge. the next three months. in China that was setting up bus stops “After three months, the sum had featuring advertisements. Soon after Effective reached 160,000 US dollars,” Krewer that, he moved to Thailand when his Word of Mouth says. Today, between 600 and 800 Ethio- British wife was offered a job there. In It all started in 1972 with a handful pian patients come to the hospital every an English newspaper he was reading, of doctors, pharmacists, and three month. Krewer is a reserved man who that the Bangkok Hospital was look- dozen nurses. Today, with 13 branches doesn’t like to boast about his achieve- ing for a European with multiple lan- throughout Thailand, this is one of the ments, but in this case, he admits, “Of guage knowledge. This is how he came largest private clinics in Southeast Asia. course I’m rather proud of that.” to bring patients from all over the world y: Nick Nostitz Nick y: h p Approximately one out of five patients In addition to a large section for to Bangkok. is a medical tourist, and many of them Arab patients, Bangkok Hospital has The phenomenon of medical tour-

Photogra are from the Middle East. Ralf Krewer an area for Japanese patients with ism is relatively recent. Just over ten >

Dräger Review 106 | 3 / 2012 41

EN_40-43_Medizintourismus.indd 41 16.11.12 14:36 Medical Tourism Thailand

Patients like to choose a scenic location for their recovery

> years ago, the first Europeans and Americans began taking trips abroad for medical procedures. At first, private clinics in Mexico, the Czech Republic, and Turkey sought to attract patients with affordable dental treatment and plastic surgery. Nowadays medical tourism is a boom- ing business worth billions. There are several good reasons to travel abroad to receive medical treatment – above all, af- fordable prices and luxurious hotel-like conditions. Thailand alone attracts more than two million foreign patients per year. Numerous private clinics through- out Asia offer a level of service that many patients, with statutory health insurance in Germany, can only dream of. For in- stance, they employ doctors who have had many years of experience working Friendly and welcoming: The reception area at Bangkok Hospital in top institutions , with in Europe and the United States. Also the rule is, that patients receive their own room. C ertifications that Guarantee High Standards Yet medical treatments abroad can also pose a certain risk. On the Internet, it is often hard to tell serious offers from scams. Especially for plastic surgery in the past there have been cases of severly botched jobs. Additionally, many doctors in foreign hospitals do not have profes- sional liability insurance. In cases of z t i

medical malpractice, medical tourists t s o can usually only file a lawsuit in the N ick ick country where the operation was car- N hy: hy: ried out. And in many countries, they p og

hardly stand a chance of winning a suit t

against an established hospital. A reflection corner decorated with a portrait of Thailand’s King Bhumibol Adulyadej Pho ra

42 Dräger Review 106 | 3 / 2012

EN_40-43_Medizintourismus.indd.idml.indd 42 15.11.12 17:32 Efficient quality assurance: Ralf Krewer is Head of International Management at Bangkok Hospital

Ralf Krewer also admits that things living room that boasts a large flat- ­people like to choose a scenic location don’t always go according to plan. “Of screen TV on the wall. A pantry kitchen for their treatment and recovery pe- 10,000 surgeries now and then one or and a bathroom are also included. riod.” This puts Thailand at a signif- two go wrong, which is relatively nor- Apart from the slight smell of disin­ icant advantage compared to other mal,” he adds. For instance, Bangkok fectant, he could be sitting in a five- countries, he concludes. Hospital is regularly assessed and cer- star hotel. Krewer goes on to explain that grad- tified by the Joint Commission Interna- ually more and more patients are com- tional (JCI). The JCI is a nonprofit or- When Patients Become ing to Bangkok Hospital from Germany. ganization based in the United States Consumers The hospital is now planning to offer that reviews healthcare services all Salah is from Yemen and lives in Saudi two “test products” throughout the over the world. What’s more, the hos- Arabia. A year and a half ago he had a German-speaking countries and Scan- pital as well as all of its treating physi- serious stroke and was in a coma for al- dinavia: artificial hip joints and preven- cians have signed professional liability most three weeks. When he regained tive medical check-ups. Says Krewer: insurance contracts. consciousness, he was no longer able “This is perhaps, medically speaking, But what would happen if some- to walk. “My doctor told me that noth- not rocket science, but they are in thing really went wrong one day and a ing could be done – apart from physio- strong demand.” legal battle with a patient ensued? The therapy,” he recalls. Krewer in discussions with private hospital, that would invole itself with Salah began to search online for health insurance companies, a major ho- legal proceedings would be ill advised, clinics abroad. He found a rehabilita- tel chain, and various travel agencies. As Krewer openly answers. One would tion center in Slovakia, but he wasn’t he explains, however, the ­legal situation probably settle out of court. If you would satisfied with the treatment he re- in Germany is still somewhat unclear. have to lose a good reputation, you could ceived there. He then tried a private If something were to go wrong during a not afford something like that. clinic in Manila. Another patient there heart operation, a patient would theoret- As a general rule, Bangkok Hospital told him that he was in the wrong ically be able to sue the travel agency for offers to correct any treatment errors place for his condition and recom- compen­sation. Nevertheless, Krewer in- free of charge. “For example, if one of mended flying to Thailand instead. A tends to attract more German medical our German patients were to think that few weeks later Salah arrived at Bang- tourists to Thailand in the future. The one of our doctors had made a mistake, kok Airport, where he was picked up aim is to have between 4,000 and 5,000­ he or she would have to ask a certified by a staff member from Bangkok Hos- German patients treated at Bangkok German hospital or specialist for con- pital. “When I arrived here, I was very Hospital and its partner clinics in the firmation,” Krewer adds. Then Bangkok surprised,” he says. He emphasizes next five years. Hospital would fly that patient in free of that the price-quality ratio in Thailand The only drawback to the increase charge and correct the mistake – or pay is excellent. in medical tourism, in Krewer’s view, for the treatment in Germany. So he speaks, Ralf Krewer, from the is carbon dioxide emissions. “I try to Mohammed Ahmed Salah is clearly heart. He believes that the classic rea- be environmentally friendly, and air a satisfied customer. The 57-year-old son to go for medical treatment abroad, ­traffic certainly isn’t doing anything ­patient, who is seated on a bed in the the lack of care in their own country, to help the environment,” he admits. y: Nick Nostitz Nick y: h p international wing of Bangkok Hos­ is becoming less and less important. Does he have a guilty conscience? He pital, can hardly contain his enthusi- Nowadays, patients have become con- pauses and says, “Maybe, just a tiny

Photogra asm. His hospital suite includes a small sumers. Krewer explains: “In addition, bit.” Sascha Zastiral

Dräger Review 106 | 3 / 2012 43

EN_40-43_Medizintourismus.indd.idml.indd 43 15.11.12 17:32 Road traffic InterlockS

Last Exit for D runk Drivers Driving under the influence of alcohol is penalized worldwide. The Dutch have taken a new approach that incorporates methods of monitoring and rehabilitation. Drivers caught with a blood-alcohol concentration of over 0.13 % may remain on the road – under certain conditions.

henever Patrick van Vugt ers based on breath-alcohol concentra- climbs into his car, he first tion. The intention is twofold: to prevent W fastens his seat belt and then convicted drunk drivers from taking to reaches for the Dräger Interlock XT . Af- the road while under the influence of al-

ter briskly blowing into the mouthpiece, cohol, and to help them achieve a last- zalez on he can turn the ignition key and then ing change in their behavior. G quel start the engine. For the Dräger man- “One in five road accidents is alcohol- i y: M y:

ager, the exercise is a piece of a volun- related; that’s simply unacceptable,” says h p tary self-regulation – as well as handy Desirée Schaap, project manager for the promotion for a potentially life-saving Alcohol Interlock Program at the Nether- Photogra product. For over 1,000 Dutch drivers, lands Ministry of Transport. “After four on the other hand, the use of this de- years of hard work, we’re delighted that vice – a breath-alcohol measuring in- the program has gotten off to such a suc- strument with a vehicle immobilizer – is cessful start.” Ramón Gouweleeuw, In- compulsory. That is because they have ternational Inspector Certification at drivers from being repeat offenders, been caught driving while seriously un- the Netherlands Road Traffic Authority but but also to educate them and turn der the influence of alcohol. (RDW), provides the latest figures: “We them into more responsible members This scheme marks a new era in fitted the 1,000th car with an interlock of the Community. They will ultimately Dutch law enforcement. On December system only yesterday. That’s much more be able to draw a line between drink- 1, 2011, at the end of four years of legal than we anticipated when the program ing and driving, even without the help and technical groundwork, the Nether- was launched nine months ago.” of an interlock. “The Institute of Safety lands launched a bold program, which Research compared various studies of is still unique in Europe, it is aimed at Up to 75 Percent the effectiveness of vehicle immobiliz- bringing about a lasting reduction in Fewer Relapses ers,” Schaap explains. “This showed the number of alcohol-related road-acci- Vehicle immobilizers connected to a that the completion of an Alcohol Inter- dent victims. The program comes on the breath-alcohol measuring device are lock Program can reduce relapse rates heels of a pilot study, of 80 volunteers, already in use elsewhere in Europe, as by as much as 75 percent.” At the same which was conducted in 2008. After this well as in the U.S., Canada, and Austra- time, however, studies from the U.S. re- study a decision was made by the Dutch lia. Yet the Dutch model is different. It veal that relapse rate rises once again cabinet to introduce vehicle immobiliz- aims not only to prevent known drunk after four to six years, unless the use of

44 Dräger Review 106 | 3 / 2012

EN_44-47_Interlock_NL.indd.idml.indd 44 15.11.12 17:30 InterlockS Road traffic

A s important as the ignition: A breath test with the inter- lock (right) determines whether the engine will start

an immobilizer is accompanied by sup- tional effect is much stronger when terlock immobilizer. In addition, they portive measures. drivers are made aware of their viola- must apply for a new driver’s license On June 4, 2010, the Dutch passed tion, at the moment when it counts,” that identifies them as AIP participants. a law mandating the introduction of says Schaap. All in all, the costs quickly add up to the Alcohol Interlock Program (AIP). Drivers who have been stopped with thousands of euros. The program is tied to strict conditions blood-alcohol concentrations of 0.13 of security and data confidentiality in to 0.18 % are required to follow a two- D riving Under order to protect the privacy of partici- year-long, strictly monitored AIP. This Supervision pants. They are also required to attend comes after a fine and, in some cases, Offenders who refuse to participate in the professionally led group sessions. These forfeiture of their driver’s license for a AIP are automatically disqualified from sessions teach offenders how to sepa- period of several months. Before they driving for five years. Once the immobi- rate drinking from driving. Unlike sim- start the program, they must pay the lizer has been installed in the vehicle, all ilar programs in other countries, in the 700 euros fine for driving under-the-in- further journeys are strictly controlled. Dutch AIP, the data from the devices is fluence of alcohol, plus the fees for reg- Before the engine will start, the driver evaluated immediately, providing driv- ularly attending the group sessions, and must provide a breath sample. At breath- ers with rapid feedback. “The educa- the monthly leasing charge for the in- alcohol levels in excess of 0.02 % the ig- >

Dräger Review 106 | 3 / 2012 45

EN_44-47_Interlock_NL.indd.idml.indd 45 15.11.12 17:31 Road traffic InterlockS zalez on > nition ceases to function. The results of G quel each test are stored in a unit mounted be- i y: M y:

neath the dashboard. Every six or seven h p weeks, the data from the device is down- loaded at a installation and service cen- Photogra ter and sent straight to the RDW. Within a week or so, drivers are informed as to whether their behavior complies with the “We fitted 1,000 “We’re delighted requirements of the program, or whether interlocks in nine that the program they are to be subjected to a regime of more frequent testing. months – that’s has gotten off to much more than such a successful Strict Requirements for Data Security we anticipated!” start” Ramón Gouweleeuw, International D esirée Schaap, Project That all sounds very straightforward. Inspector Certification at the Netherlands Manager at the Netherlands However, as van Vugt reveals, the prac- Road Traffic Authority (RDW) Ministry of Transport tical implementation was by no means easy. The crucial issue was the strict Dutch legislation on data protection. In addition to meeting the internation- ally standard requirements of the Euro- sponsibility for data recovery to the man- couple of problems due to the sheer pean standards for alcohol interlocks, ufacturer of the device. The Privacy Act in volume of data the system had to deal the devices and their usage also had the Netherlands closely guards personal with,” recalls van Vugt. “Some custom- to satisfy a set of rigorous domestic re- data, restricting access exclusively to ers were irritated by how long the com- quirements. This is known as a protec- those with legitimate legal authorization. puters took to communicate with each tion profile developed by the RDW. This In order to gain the necessary certifi- other. But after a few adjustments we protection profile is designed to ensure cation and approval of the RDW, Dräger were able to quickly fix that.“ that all data storage and transfer is ab- had to substantially modify the software Naturally not every AIP driver is solutely secure and that the devices are used in its interlock system. After be- thrilled about being under long term protected against manipulation. ing downloaded, the data is first trans- RDW supervision for two years. Human “Based on the data, we’re making ferred, in encrypted form, to a com- nature being what it is, some people some far-reaching decisions about the puter at Dräger known as the D-Safe. will to try to beat the system. Therefore, participants – in some cases, whether Here it is converted into the format re- much care was invested in designing the they must forfeit their driver’s license or quired by the RDW. The data is then re- device in such a way, to make it tam- remain in the program,” Gouweleeuw encrypted, deleted from the D-Safe, and per proof. The Interlock XT cannot be explains. “We therefore need to be sure sent to the RDW mainframe, which can opened, and all the wires are soldered that the data is 100 percent reliable.” also be accessed by the Dutch driver’s li- in such a way that makes any manipu- For this reason, the Dutch have set up cense authority CBR. After a few bumps lation immediately evident. For exam- a central data register, administered by in the road the system is now running ple, to prevent drivers from blowing into the RDW, rather than delegating the re- perfectly. “At the beginning we had a the mouthpiece with a balloon or a bicy-

46 Dräger Review 106 | 3 / 2012

EN_44-47_Interlock_NL.indd.idml.indd 46 15.11.12 17:31 The Dräger Interlock XT Capitalizing on more than 50 years of experience in the development of measuring breath-alcohol concentration, the Dräger Interlock XT is the company’s second generation of interlock devices. The Interlock XT employs the same electro-chemical sensor that is fitted in police breathalyzers. This provides a very precise reading of the alcohol content, in a breath sample. The complete system is mechanically robust and displays outstanding reliability even at low temperatures and high humidity. At the same time it meets all the requirements for alcohol interlocks world- wide. Its use helps to reduce the incidence of alcohol-related road accidents and helps bring about a change in drivers’ behavior.

cle pump, they must use a specific tech- nique: a powerful exhalation, followed by a short inhalation. Preventing Manipulation “Obviously we can’t rule out manipu- lation altogether,” says Gouweleeuw. “We’re assuming a certain sense of re- sponsibility – that driver’s don’t, for ex- ample, get somebody else to blow into the device.” The Privacy Act forbids the use of direct camera surveillance, but participants are retested on a random basis. Therefore, they can never be sure when they might have to provide an- other breath sample. If their breath-al- cohol concentration is elevated, drivers must abandon their vehicle. The conse- quences are serious, in the case of too many failed retests: participants must The interlock system delivers data that can be crucial to people’s lives. Regular leave the program and forfeit their li- maintenance and inspection of all the functions is therefore vital. The picture shows cense for five years. the technician, Dennis Weber, in an authorized facility in Nootdorp, Netherlands Vincent Broeksema runs one of the 50 facilities that are authorized to install and service alcohol interlock systems in the Netherlands. He has first-hand experi- ence of what happens to program partic- ipants:: “We’ve seen no evidence of tam- pering so far. The participants are just relieved that they’re still allowed to drive. They’re not going to jeopardize that in a hurry.” To date his installation and ser- vice center has installed 100 interlocks. “Right now we’re fitting two or three a week,” he adds. Regina Naumann Left: Calibration with a test gas ensures reliable measurement of breath-alcohol Information: concentration. The device is recalibrated whenever data from the Alcohol Alcohol: The social drug – Interlock Program is downloaded in the facility. Right: Gerrit Grefelman (left), often a taboo subject from Dräger, consults with facility owner, Vincent Broeksema, on his ex­- www.draeger.com/106/alcohol periences with installation and maintenance of the Dräger Interlock System

Dräger Review 106 | 3 / 2012 47

EN_44-47_Interlock_NL.indd.idml.indd 47 15.11.12 17:31 Thomas Graf inspects the mixer unit of the Perseus A500, shown here in his hands

EN_48-51_Schulterblick.indd 48 16.11.12 14:32 Production Insight

Custom-Made in Series T he production of an anesthesia machine is percision work, almost all of the machines are made to customer-specific requirements. Yet they are alike in one respect: extensive and thorough tests are part of the manufacturing process.

his 20-liter glass bottle is sup- milestones called ‘gates’. Only the prod- posed to be the lung? “Well,” says ucts that fulfill all these requirements T Ludovic Vieillemard, “for our new ultimately pass through the last gate for anesthesia machine, there isn’t much shipping – and are then sent all over the of a difference between this bottle and a world on pallets. After Gate 3, a project human lung in our final test of the sys- leaves what Vieillemard refers to as the tem!” The Frenchman leads the start- ‘paper-intensive phase’. up of Dräger’s series production for the In the case of the Perseus A500, the A a

Perseus A500. He nimbly winds his way KG last phase of this process – series produc- through the manufacturing hall in Lü- tion – has been reached. “First we produce & Co. & Co.

beck where production of the anesthetic AG the part of the anesthesia machine that’s workstation has been under way since the same for all later variants,” explains March 2012. With this product, Dräger Vieillemard as he opens the door of a cli- is once again defining the state-of-the-art; matic test chamber. Inside here the mixer y: Drägerwerk Drägerwerk y: h technology that starts here. p unit – one of the two central assemblies of The green light for a product so com- the anesthesia machine – is currently be-

plex and individual as this one was natu- Photogra ing artificially aged (at temperatures fluc- rally given at a much earlier point in time. A special wool simulates the behavior tuating between 5° and 55° C). The sec- “We plan the individual steps from devel- of the human lungs during tests ond assembly is the ‘base unit’ (see also opment to production in a cross-func- Dräger Review 105, p. 56). tional team, or CFT,” says Vieillemard, agement to service, research and develop- a trained mechanical engineer who pre- ment, purchasing and quality assurance S ubstantial investments viously worked at Renault, among other to production, all project leaders meet in quality assurance places. He explains the CFT as follows: “In regularly to share their needs.” This pro- “Here we have one of the most expensive this team they come from product man- cess has to get past six carefully defined test stations in the entire company,” says Vieillemard as he closes the door with the observation window. For the first time in the production of anesthesia ma- chines, Dräger is adding a component Reduced anesthetic consumption stress test to the classic functional test. T he essential functional units of an anesthesia machine are a mixer unit This additional test is carried out prior for the fresh gas, a ventilation module including a rebreathing system, a to the product system test. “That accel-

CO2 absorber, an anesthetic gas scavenging system, as well as a respiratory erates production and simultaneously bag and breathing tubes. The anesthetics are metered by classic anesthe- increases quality and reliability,” says tic vaporizers (called “Vapors”; see also Dräger Review 96.1, p. 36) with Vieillemard, sketching out a shape like an innovative optical interface that supplies data used to forecast the a bathtub on a piece of paper. “If some- course of the anesthesia, which is shown on the display. If, for instance, the thing is going to break down, it will prob- anesthesiologist puts the patient under anesthesia in the minimal-flow range, ably happen during the first weeks. Af- he can markedly reduce the consumption of expensive anesthetics. The ter that, things are quiet for a long time. sys ­tem is then fed only as much anesthetic as the patient absolutely needs. And only after years of trouble-free oper- >

Dräger Review 106 | 3 / 2012 49

EN_48-51_Schulterblick.indd 49 16.11.12 14:49 There is little debate when it comes to investing in quality assurance

> ation does the likelihood of component failure begin to rise again.” At each station, sophisticated meth- ods test the system’s behavior during the critical initial operating period at time-lapse speed. The machines are subjected to a great deal of stress: se- vere temperature fluctuations, abrupt changes in settings, frequent switching on and off with voltage spikes, and con- tinuous operation. Artificial aging is a complex production method that has been increasingly perfected in recent decades. It isn’t enough to simply in- crease the temperature so that the days shrink in proportion. “That would be too mundane,” says Vieillemard, refer- ring to the long series of tests that lead precisely to the stress profiles that reli- Every employee in the assembly department wears a wrist strap connected to ably cause the service life to decrease. the ‘ground’. That keeps electronic components safe from static discharge “It isn’t just the high temperature gra- dients in the climatic test chambers. What’s just as important is the software we’ve developed that allows us to sim- ulate several days of normal machine operation in just four hours by running more than 200 test cycles.” RFID technology for

even greater safety A a KG After every procedure the testing mod-

ule responds with a specific code in- & Co. AG dicating whether everything is OK, or whether an expected value was not reached. And if not? “Then we cool it y: Drägerwerk Drägerwerk y: h

down to 20° C, find out the reason, and p eliminate the source of the fault – then we send it off on our obstacle course Photogra again,” says Vieillemard. Did he have to Ergonomics is a top priority – even when mounting the anesthesia machine. justify the investments in climatic test This is the only way to achieve a consistently high level of quality

50 Dräger Review 106 | 3 / 2012

EN_48-51_Schulterblick.indd.idml.indd 50 15.11.12 17:27 Production Insight

Ludovic Vieillemard­ in the produc- tion hall where anesthesia machines are manufactured

chambers and so forth from an eco- simulate the respiratory cycle by pro- “Not quite,” counters the Frenchman, nomic standpoint? The answer is ob- viding mechanical and thermal resis- pointing to the special lowered pallet vious: “When it comes to investments tance similar to lung tissue,” Vieille- that keeps the anesthesia machine un- that improve our quality, there’s little mard explains. der 1.60 meters in height for shipment. debate!” he says. Finally, at the end of the assembly “Otherwise the shipping costs would The mixer unit has approximately line, the Perseus A500 is finished in ac- be much higher,” Vieillemard explains. 30 design-specific parts; these are usu- cordance with customer specifications Money is again saved at precisely the ally so special that they are manufac- and is ready for delivery. Now a final sys- point where this can be done, without tured exclusively for a single purpose. In tem test is carried out – a ten-day period sacrificing quality or safety – to the very addition, the base unit is made up of five of continuous operation, with the respi- end. Nils Schiffhauer times as many parts that are found in ratory bag and the attached breathing- the mixer, and the machine as a whole tube-set. “It’s a real marathon,” says Video: Thoroughly checked – pro- ducts that go through the Dräger Test has many more. The assembly and Vieillemard, opening the door to the Center have to pass stringent tests. testing processes are therefore corre- shipping department. That’s familiar! www.draeger.com/106/testcenter spondingly elaborate. On the produc- tion line, a cover plate hasn’t yet been mounted on one of the machines, leav- ing a huge number of printed circuit boards, modules, and control elements open to view. They show the challenges involved in combining mechanics and Optical image processing and infrared electronics into a life-sustaining system. Among the many innovations Dräger is using for the first time in an anesthesia Any mistake – whether it occurs during machine, one of the most prominent is the optical interface between the Perseus development, manufacturing, or the fi- A500 and the anesthetic vaporizers (the “Vapor” models). “With this development,” nal assembly stage – would be a poten- says Project Manager Claus Bunke, “we considered how the classic field-tested and tial source of hazard later on. “This is fully mechanical Vapors can be integrated with regard to the data connections.” where the RFID modules are located,” A Bluetooth link was ruled out, for example, because it would have required a supply says Vieillemard, pointing to some of electrical power for the Vapors. Instead, an optical solution was developed. In small circuit boards. “For instance, they the immediate vicinity of every Vapor there is an LED and a camera behind a red ensure that the ‘water trap’ is replaced pane of glass. The light-emitting diode gives off infrared light toward the Vapor; for the sake of patient safety before it the camera records this image, and it is then evaluated by software. “We chose infra­- stops carrying out its protective and fil- red light, which is invisible to the human eye, because the long wavelength doesn’t tering function.” disturb anyone. The ambient light can’t disturb the camera either,” says Bunke.

Finishing with an Three types of information read from the optical interface: ultra-marathon u T he type of anesthetic – in which the Vapor’s filling nozzle always In the base unit test, the 20-liter glass receives only the specific anesthetic. bottles come into play as ‘artificial u T he handwheel position – and thus the fresh gas concentration of lungs’. “The copper-colored special- the chosen anesthetic. ized wool inside the bottles helps to u T he fill level – if a minimum capacity is exceeded

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EN_48-51_Schulterblick.indd 51 16.11.12 14:31 Outlook Shift work

1 1:00 p.m. 2:00 a.m.

New Ideas for the 24/7 Society T hese days, people are used to getting whatever they want – from groceries to services – anytime they want it. This is possible because millions of others are willing to work ARO UND THE CLOCK. Shift work is one price that’s paid for this luxury, but it’s also problematic. Eliminating it is not an option, but making it more bearable is a goal that is also being pursued in Germany.

t takes Andreas Gattermann five min- are from the mid-19th century, while the ducts research on behalf of the Associ- utes to walk from the old mansion with large production hall, which could eas- ations of the Metal and Electrical In- I the ivy stretching up to the roof to the ily be located in China, India, or Poland, dustry. “The jobs that stay in Germany new production center – a fully climate- was completed in 2008. “We decided usually involve expensive machinery. controlled facility made of glass and steel to stay here,” Gattermann, the plant The type of competitiveness that safe- that is his pride and joy. The way he takes manager, states proudly. Nevertheless, guards employment requires long oper- through the town of Aerzen in northern “we wouldn’t have been able to stay if ating times. The business principle here Germany passes by a stream, where Gat- we didn’t have shift work, that includes is that the longer the production facili- termann points to the trout swimming night shifts. If you want to survive in this ties operate each day, the lower the costs upriver. The fish only stop at night, when economy, you can’t really afford to shut will be. However, only around one third they retreat to niches in the stream’s your machines down at night.” of shift employees in Germany work banks to sleep, even as forklifts from the in commercial manufacturing.” For Where the lights machine factory roll over the small bridge them – and everyone else – that means a-location PantherMedia; ure; ict above them. never go out leading a life determined by a constantly p ain l The stream divides the site of the Most manufacturing firms are dealing changing shift plan: going to work while p y: y: h Aerzener Maschinenfabrik, a family-run with similar issues, according to Frank others are eating dinner with their fam- p business, into old and new. The build- Lennings from the Institute for Applied ilies, or out seeing the latest movie; hav-

ings from the early days of the company Labor Science in Germany, which con- ing to focus when others are relaxing; Photogra

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and sleeping when it seems that every- sis of their internal clock or a large one Tips for shift one else is going through their regular on the factory wall. working day. Machines built to order for custom- workers Such a normal working day is no lon- ers are manufactured in one of the oldest u E at lightly at night ger as common as it used to be. This is ap- production halls at the 18-hectare site in u Power naps for a few parent in the 24/7 gas stations and peo- Aerzen. The machines are giant cast iron minutes increase concentration ple working around the clock at airports, fans that weigh tons and are used to ven- at around 2 a.m. train stations, hospitals, in addition to tilate biogas facilities. In a brick building u T ry to avoid activities between police and fire stations. “We’ve gotten next door machines, that look like robots 2 a.m. and 5 a.m. that require intense used to getting whatever we want at all and cost millions of euros, are operated concentration hours, and that has a price,” says Len- by a single person. This person controls u If possible, use light with a nings. All of this started when the inven- work processes that used to be carried out luminance of more than 2,000 lux tion of electric lighting turned night into by perhaps ten individuals. These rooms u A dditional brief exposure an extension of the day. Around 16 per- tell their own stories; they bring to life to bright light keeps one awake cent of the German workforce does shift the history of the old factory that made u Keep your body from going work today, which makes Germany more the leap into the modern age, while still into the daytime mode after or less average, compared to the rest of remaining true to itself. It smells like lu- a night shift by avoiding sunlight Europe. Croatia and Slovenia have the bricant in here– and it looks as though and normal daytime activities most shift workers (more than 30 per- there’s a lot of work going on. Neverthe- u T o make it easier to fall asleep cent each). Shift work can be in the less, the floors are as clean as the rail- during the day: Cool down morning, afternoon, or at night; it can ings, door handles, and windows, which the bedroom and keep hands be limited to weekdays or run the entire the sun is shining through this afternoon. and feet warm week. After all, packages need to be trans- u Sleep for a shorter time during Not everyone is made ure; PantherMedia; a-location PantherMedia; ure; ported, goods shipped, fires extinguished, the day after the last night shift ict p guests served, patients cared for, passen- for shift work u D on’t take long afternoon ain l p gers flown, and customer requirements “Our people have to focus all the naps after a day shift, and go to y: y: h p met. In some places, the lights never go time – whether it’s 10 a.m., 3 p.m. or two bed earlier in the evening out. Workers in halls with no windows ex- in the morning,” says Gattermann, who u Pay attention to sleep hygiene: Don’t

Photogra perience night and day solely on the ba- is familiar with the difficulties of night > work, eat, or watch TV in bed

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T he jobs that stay in Germany often Rotary blowers for biogas facilities are involve hard work, especially in Aerzen, currently in demand. The company responds where machines are built to order flexibly to this demand

> work. He places emphasis on contact with symptoms of illness appear.” Such symp- one a night creature - the human is sim- his shift workers, theoretically he knows toms include stomach and intestinal ply confused. This scientific knowledge is all of them. Every day, he gets a computer problems, caused by the fact that these slowly making its way into the minds of de- readout of the production status that tells organs are not used to digesting food at cision-makers, human resources manag- him if his machines are operating at full night. Sleep disorders are also common, ers, supervisors, and workers themselves. capacity, which work stations are meeting and in extreme cases shift workers can This process is being accelerated by labor their targets, and which ones are having suffer from cardiac and circulatory dis- research institutes and insurance compa- problems. People who continually make eases. “None of this usually happens im- nies. They are troubled by the increase in mistakes on night shifts are eventually mediately,” says Brenscheidt. In fact, accidents caused by a lack of concentra- discovered. “Not everyone is made for most people don’t experience symptoms tion during night shifts. A paradigm shift shift work,” explains Gattermann. He’s until after 15 years of shift work. can be seen. “Just ten years ago, no shift not made for it either, he admits read- “People who live by a circadian worker building a house would ever forgo ily. Still, “if you’ve learned an industrial rhythm get disturbed by night work,” says the extra pay for night work – at the price trade like cutting machine operator, you Gundula Grzesik from Zeitbüro FOM, a of their own health and for the sake of know what’s probably in store for you in project at the University of Economy and loan repayments,” says Lennings. this country.” Management that is funded by Germany’s Today, however, young fathers in par- Ministry of Labor and Social Affairs. In ticular oppose the traditional shift model. Chronobiological processes other words, night work is very taxing on Because they want to spend more time control the people the body. “The body needs to recuperate at with their families, which they sometimes “There are people who have big prob- night, and it can’t do that if it has to work,” don’t see for weeks on end when shift lems working in shifts,” says Frank Bren- Grzesik explains. After thousands of years schedules are unfavorable. Works coun- scheidt from Germany’s Federal Insti- of a life regulated by the sun, the human cils and management are also taking ac- tute for Occupational Safety and Health. internal clock has been set to a 24-hour tion. Managers are concerned about their Night work, for example, runs so counter cycle. Specific biological processes result- companies’ reputation and the health of to the biological clock of morning people ing from this circadian rhythm continue their employees in the face of a short- (“early birds”) that it’s difficult for them to operate and cannot be changed. The in- age of skilled workers. “Our aging soci- to adjust even for short periods of time. In ternal clock located in the hypothalamus ety is trying to keep its aging workforce some cases, they can become physically sets the rhythm, and it controls the hor- healthy,”says Grzesik. ill. “Medical exams on the job are there- mones responsible for wakefulness and That’s also why the management fore important,” Brenscheidt explains. tiredness. Constant food intake through at Aerzener Maschinenfabrik has made Adding that it makes sense for shift work- the programmed resting phase leads to a shift work at its plant as smooth as possi- ers to undergo additional checkups every desynchronization – but instead of receiv- ble. The occupational physician is located couple of years – “preferably before any ing the positive benefits that would make in the old mansion, he or she gives advice

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EN_52-55_Ausblick_24.indd.idml.indd 54 15.11.12 17:26 “If you want to survive in this economy, you can’t really ­ afford to shut your machines down at night.” schinenfabrik a M ener z er : A : y

older can eliminate three night shifts a IMPRINT

ho year without any loss of pay; once they Publisher: Drägerwerk AG & Co. KGaA, P TOGRAPH turn 57, the number of free night shifts Corporate Communications Tradition meets modernity: Editorial Address: Moislinger Allee 53–55, The new production hall increases to six. 23558 Lübeck, Germany / Aerzener Maschinenfabrik Other companies allow workers to de- [email protected], www.draeger.com Editor in Chief: Björn Wölke, cide every two years whether they want to Tel. +49 451 882 20 09, Fax +49 451 882 39 44 work 15 or 35 hours. One of the pioneers Editorial Consultant: Nils Schiffhauer (responsible according to press law) and recommendations to employees. More of shift work design is the tinplate manu- Art Direction, Design, Picture Editing and importantly, the machines are shut down facturer Rasselstein. They have been us- Coordination: Redaktion 4 GmbH, Hamburg Translation: TransForm GmbH, Cologne on weekends. Aerzener Maschinenfabrik ing rapidly rotating shift schedules since Printing: Lehmann Offsetdruck GmbH employees work 35 hours a week in rotat- the end of the 1980s. This exemplary ISSN 1869-7275 Code number: 90 70 321 ing shifts. Overtime is credited to working model has workers doing two day shifts, time accounts, from which hours can be two late shifts, and two night shifts, af- deducted when production volume is low ter which they get four days off. “We rec- or if a worker needs time off. When pro- ommend the smallest possible number The articles in Dräger Review duction needs to be stepped up and work of consecutive night shifts,” says Bren- provide information on products and their possible applications has to be done on Saturdays, the shifts scheidt. That’s because the quicker the in general. They do not constitute any guarantee that a product has are adjusted and temporary workers are lost sleep can be recovered, the better it specific properties or is suitable for brought in rather than having the regular will be for the worker. any specific purpose. All specialist personnel are required to make use employees work overtime. This arrange- When the sun shines through the exclusively of the skills they have ment is very popular with the employees. factory windows in Aerzen at 6 a.m., the acquired through their education and training and through practical experience. The views, opinions, and state- night shift heads home past the trout ments expressed by the persons named in the texts as Many ways to ease the burden well as by the external authors of the articles do not -filled stream. Once the workers are necessarily correspond to those of Drägerwerk AG & on shift workers home, they try to avoid light and any stim- Co. KGaA. Such views, opinions, and statements are solely the opinions of the respective person. Not all of However, some companies have problems ulus that could shift the body into day- the products named in this magazine are available making adjustments within the shift sys- time mode. They close the blinds and put worldwide. Equipment packages can vary from country to country. We reserve the right to make changes to tem. “A lot of employees have difficulty ear plugs in. “Most of them don’t do ev- products. The current information is available from your Dräger representative. adapting, because they’ve gotten used to erything they should,” Gattermann says. © Drägerwerk AG & Co. KGaA, 2012. All rights working seven night shifts in a row, for ex- “I’ve never seen anyone leave the plant reserved. This publication may not be reproduced, stored in a data system, or transmitted in any form ample,” Grzesik explains. Such workers wearing sunglasses.” Isabell Spilker or using any method whether electronic or mechanical, have aligned their social lives with their by means of photocopying, recording, or any other technique in whole or in part without the prior permis- shifts, and they become disoriented when Further information sion of Drägerwerk AG & Co. KGaA. u U.S. Department of Health and Human new plans with frequent shift changes are Services: “Plain language about shift work” Dräger Safety AG & Co. KGaA, Lübeck, Germany, introduced. “We tell them they have to go http://www.cdc.gov/niosh/pdfs/97-145.pdf is the manufacturer of the following products: PAC 7000 (pp. 3, 56), LAR 5000 (pp. 12, 31) through it, even though it’s often difficult u Institute for Work and Health / Canada: + 7000 (p. 12), X-am 2000 (p. 19), 5000 (p. 28), http://www.iwh.on.ca/shift-work-symposium 5600 (p. 28) + 7000 (pp. 19, 28), PAC 3500 at the start,” says Grzesik. u IARC: “SHIFTWORK” http://monographs.iarc. (p. 32), Dräger-Tubes (p. 34), FPS 7000 + PSS There are plenty of ideas for easing fr/ENG/Monographs/vol98/mono98-8.pdf 7000 + UCF 6000 (all p. 39), Interlock XT (p. 44). Dräger Medical GmbH, Lübeck, is the the burden on shift workers. The Hydro u Journal of Pineal Research: “The dark side of light at night – physiological, epidemiological, and manufacturer of the Perseus A 500 (p. 49-51). company in Hamburg gives its oldest em- ecological consequences” http://www.psy.ohio- www.draeger.com ployees “Grandpa Days.” Workers 55 and state.edu/nelson/documents/JPinealRes2007.pdf

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EN_52-55_Ausblick_24.indd.idml.indd 55 15.11.12 17:26 CLOSE-UP PAC 7000

2 3

4 6 5

10

9 9 8 11 7

5 1

This Sensitive Nose Detects Dangerous Gases As a part of personal protective equipment, this single-gas 90 dBs at a distance of 30 cm, gives an acoustic warning. In ad- detector warns when the atmospheric concentration of a par- dition, a vibrator generates vibrations much stronger than those ticular gas exceeds a preset limit. The case has a clamshell de- produced by any cell phone. All of the functions are controlled sign 1 and is reinforced with tough rubber. Within, it houses a by a microprocessor. The Pac 7000 can save all important infor- two-sided printed circuit board 2 . The desired sensor 3 is at- mation, which can be read out via an infrared interface 7 . The tached to the circuit board – as for the detection of carbon mon- battery 8 operates for around 5,500 hours. Because it doesn’t oxide (see pp. 32-35). A replaceable filter 4 permits the gas to have any exposed electrical contacts, the Pac 7000 is also appro- enter from the front and from the top. This is important, for ex- priate for use in environments where there is a risk of explosion. ample, if the device accidentally slips into a shirt pocket. As a A pressure equalizing membrane automatically ensures that the result, the air outside the unit is diffused by the shortest route air pressure inside the device is the same as the ambient atmo- to the quick-response electrochemical sensor. The electrical sig- spheric pressure. The single-gas detector pictured here is oper- nal of the sensor changes according to the concentration of the ated using two buttons 9 . The device is operated and measure- gas being measured. If the preset allowable concentration is ex- ments are checked with the help of a high-contrast LCD display ceeded, two LEDs 5 on the front of the unit give a visual warn- 10 . The Pac 7000 can be securely attached to clothing using a

ing. In addition, an electric alarm tone 6 , which generates over crocodile clip 11 . KGAA & CO. AG DRÄGERWERK PHOTOGRAPHY:

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