THE SILENT DANGER - Dräger

Dräger Review Technology for Life 2019

THE SILENTDANGER

The eff ect of fumes and particles – and how people protect themselves from them

UNDERWATERThe world’s quietest submarine p. 26

UNDER ANESTHETICWhat makes induced sleep so special p. 32

UNDER APPLE TREESFresh apples all year round p. 20

2 DRÄGER REVIEW 120 | 2 / 2019

CONTENTS#120

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46RED GOLD

The nerve pathways of technology are often made

of copper. High-quality copper is produced at Aurubis.

42WHITE GOODS

Washing machines make light work of what was once an arduous chore. Today they

combine mechanics and electronics.

6BLACK CLOUDS

They consist of various fumes and particles – many of which

are carcinogenic.

DRÄGER REVIEW 120 | 2 / 20192

3DRÄGER REVIEW 120 | 2 / 2019

The articles in Dräger Review provide information on products and their possible applications in general. They do not constitute any guarantee that a product has specifi c properties or is suitable for any specifi c purpose. Specialist personnel are required to make use of the skills they have acquired through their education and training and through practical experience.

The views, opinions, and statements expressed by the persons named in the texts as well as by external authors of articles do not necessarily represent those of Drägerwerk AG & Co. KGaA. Such views, opinions, and statements are solely the opinions of the people concerned. Not all of the products featured in this magazine are available worldwide. Equipment packages can

vary from country to country. We reserve the right to make changes to products. Up-to-date information is available from your Dräger representative. © Drägerwerk AG & Co. KGaA, 2019. All rights reserved. This publication may not be reproduced, stored in a data system, or transmitted in any form or using any method, whether electronic or mechanical,

by means of photocopying, recording, or any other technique, in whole or in part, without the prior permission of Drägerwerk AG & Co. KGaA.Information on how personal data is processed in line with the provisions of the EU General Data Protection Regulation can be found here:

https://www.draeger.com/en-us_us/Home/Data-Protection

IMPRINTPUBLISHER:

Drägerwerk AG & Co. KGaA,Corporate Communications

EDITORIAL ADDRESS:Moislinger Allee 53-55, 23558 Lübeck, Germany

E-mail: [email protected]

EDITING:Björn Wölke (editor-in-chief), Simone Binder

Tel. +49 451 882 2009, Fax +49 451 882 2080

EDITING CONSULTANT: Nils Schiff hauer

ART DIRECTION, DESIGN, IMAGE EDITING, AND COORDINATION:

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ISSN 1869-7275

CODE NUMBER: 90 70 460

www.draeger.com

4PEOPLE GOING PLACES

Prof. Hinnerk Wulf is calling for better personal care of people in crisis

situations. Mark O’Shane has been on the high seas since he was a boy.

6DANGEROUS SMOKE

Smoke can endanger the health of firefighters – even after the incident.

Protective equipment and clear processes reduce this risk.

16GET OUT OF BED!

Exercise is the best way of preventing muscle weakness, even

for intensive care patients.

20CRISP CULTURAL ASSETS

Fresh apples all year round? In Italy, they have perfected the art of keeping

goods fresh in storage.

26SILENT HUNTERS

An electric drive system and a small acoustic and electromagnetic signature

make these submarines the most inconspicuous on the seven seas.

32FEAR NOT!

How anesthetists allay the fears of their patients prior to an anesthetic.

36SEARCHING FOR CLUES

AMONG THE ASHESFollowing the devastating forest fires in California at the end of last year,

the clean-up operation is in full swing.

42SPINNING STORIES

What goes into making a high-performance washing machine for the household and in industrial settings?

Miele has the answer.

46RED AND GLOWING

From copper ore to pure metal – in Hamburg they know how it is done.

52CURSED PILLS

Medication residue pollutes the environment. New treatment technology

could staunch the flow.

56SAFETY AT SEA

How Dräger Marine Offshore Service supports work at sea.

62BURIED AND FORGOTTENThe world’s first underground final

storage facility for radioactive waste is being built in Finland.

66THE BODY IS THE LIMIT

Focused training strengthens the physique of pilots in the Swiss Air Force.

71OUR CONTRIBUTION

Products from Dräger found in this issue.

72DREAMGUARD

A motion sensor with babymonitor function.

Dräger Review Technology for Life 2019

THE SILENTDANGER

The eff ect of fumes and particles – and how people protect themselves from them

UNDERWATERThe world’s quietest submarine p. 26

UNDER ANESTHETICWhat makes induced sleep so special p. 32

UNDER APPLE TREESFresh apples all year round p. 20

REAL FIRE TRAININGPhotographer Patrick Ohligschläger climbed into a fi re training container to take the cover picture. Firefi ghters

can practice various inside attack scenarios in the Dräger FTS 8000. Two of these facilities can be found

in Germany – in Verden and Augsburg.


FROM AROUND THE WORLDPEOPLE GOING PLACES

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“Those who work in the medical profession can fi nd themselves in very stressful situa-tions: fateful complications, tragic cases, or the consequences of treatment-related errors. A structured approach to dealing with these experiences – by doctors, care professionals, and students – is therefore extremely important! If those aff ected are not identifi ed, the repercussions can range from the need for long-term psychotherapy to addiction problems. It is clear that people involved in disciplines such as anesthetics and intensive care medicine are confronted

with stressful situations on a more frequent basis. And yet in Germany there is gener-ally no structured program for helping them come to terms with their experiences. Ac-cordingly, the subject should be more fi rmly rooted in training measures and in the clini-cal structures. Fortunately, there is greater awareness. The issue of providing support for those dealing with stressful situations has occupied me for a long time. Over the last ten years here in Marburg, we have devised a low-threshold program with three elements. Firstly, regular morbidity and mor-

tality conferences raise basic awareness. However, personal care of people in excep-tional situations is critical. This is assured in the clinic’s psychosomatics department by off ering consultations, which are conducted in a fully protected setting. In addition, ex-perienced doctors, who are also nominated persons of trust within the department, have been trained as peers. Experience shows that professional reassurance in these con-sultations is very important for coming to terms with stressful experiences – for our patients as well.”

COUNTER STRESS!

Prof. Hinnerk Wulf, 60, chair and director of the Anesthesiology and Intensive Care Therapy Clinic at the University of Marburg

5DRÄGERHEFT 405 | 1 / 2019

ON COURSE FOR DEUTSCHE

BUCHT

Mark O’Shane (51), off shore installation manager at Jack-Up Barge

“I used to be a fi sherman, like my father. In the small Scottish coastal town, between Inverness and Aber-deen, I practically grew up on the boat. Life was tough – to make ends meet we also had to catch “black fi sh” – prohibited species that couldn’t appear in the logbook. The oil industry paid good money, so I went into it at the start of the 2000s. I was surprised on the platforms – this safety mentality was every-where! There was nothing like this on a fi shing boat. Suddenly, I needed certifi cates, a health certifi cate, and briefi ngs on how to use equipment. But I like the freelance work on the high seas. Offi ce jobs don’t suit me. Then, four years ago, I took ten months off , went back to school every day, and graduated from the Nautical College. You had to ask for permission to go to the toilet there! No, that’s not for me. I much prefer the unpredictable work on the platform. We once received an emergency call from a boat whose crew was working on our anchoring. Somebody on the boat had had a suspected heart attack. I sent our paramedic down. After 30 minutes, another call came in from below: They needed a second paramedic, because the fi rst had suff ered a heart attack. Fortu-nately, I was able to summon one from a neighboring platform and have him fl own in. Since the middle of last year I have been working for Jack-Up Barge, on a mobile installation platform as an off shore installation manager. We will be leaving Rotterdam in a few days’ time for Deutsche Bucht, where a wind farm is set to be built. I fl y into work from Spain, where I now live. My new partner already knows why she moved to the mountains with me. If I lived too close to the water, I would only buy another boat.”

DRÄGER REVIEW 120 | 2 / 2019 5


FIRE IS DANGEROUSNot only are fl ames a threat to the fi refi ghters, but also the hazardous substances that are released

DANGEROUS SMOKEFirefighters face considerable risks,

including exposure to smoke gases and particles.Many of them are carcinogenic.

TEXT DR. HILDEGARD KAULEN

FOKUSFEUERWEHR

FOCUS FIRE PREVENTION


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The glow of flames can still be seen in the dark. The fire broke out suddenly and spread quickly. Two of the building’s residents were unable to escape and had to be evacuated by the fire department. Firefighters only have one thing in mind in such situations: sav-ing people’s lives. When the pressure is on and every second counts, because the flames are already engulfing the build-ing, their full attention is focused on res-cuing those who are trapped – and doing

everything they can to free them unin-jured. In doing so, the firefighters them-selves can become victims – succumbing not just to the flames, but also noxious gases and particles. That’s because a con-flagration carries far more risks than the actual fire.

When houses, factories, and ware-houses burn, and wood, plastics, or tires go up in flames, a fine film of hazard-ous substances soon settles on the per-sonal protective equipment, helmets, and other equipment used by the fire-fighters. This soot is potentially high-ly dangerous. And the associated risks

don’t end once the fire has been extin-guished, because smoke gases and par-ticles can work their way into the body via the airways and skin, where their effects accumulate when the firefight-ers are exposed to the same substances time after time. The DFV (the associa-tion representing the interests of Ger-man firefighters) estimates that between 150,000 and 200,000 fires are extin-guished annually in Germany alone, providing up to 550 opportunities dai-ly to absorb hazardous substances and spread deposits of smoke gases. In the worst-case scenario they are brought


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CONTAMINATED PROTECTIVE EQUIPMENT

is no good for the heroic epic, but instead endangers the health

of the fi refi ghters

home and end up within the carrier’s own four walls.

NOXIOUS SMOKE GASESHow do fumes form? Many materials are heated by the fire’s radiant heat and discol-or before they go up in flames. At the same time, they begin to outgas. At least nine main products are released when wood carbonizes, including water, methanol, methane, formaldehyde, carbon monox-ide, hydrogen cyanide, and carbon dioxide. The carbonization of polyamide produces 25 gaseous combustion products, while burning car tires produce more than 70. The fumes carry off fine soot particles and droplets – collectively known as smoke gas-es. The look and smell say nothing about how dangerous they are. Nobody should be prematurely lulled into a false sense of security. Ninety percent of victims who

the gas exchange between the blood and cells no longer functions. CO and HCN are referred to as toxic twins, because togeth-er they are more dangerous than the two individual substances. Dräger already sup-plies equipment that measures both gas-es simultaneously and warns firefighters of the presence of the duo in good time (Dräger X-am 5000 and 8000). Anoth-er personal measuring device with dual CO/HCN sensor – the Dräger PAC 8500 – is also set to be launched onto the market in the second half of 2019. Hydrogen chlo-ride and some sulfur compounds are also highly toxic.

Carcinogenic substances are also produced when materials carbonize and burn. These include formaldehyde, vinyl chloride, dioxin, arsenic, and polycy-clic aromatic hydrocarbons (PAHs). The last of these tend to stick to soot parti-cles. Even though studies on the cancer risk of firefighters were conducted back in the 1950s, public pressure only real-ly increased at the start of the new mil-lennium. In 2006, Grace LeMasters and her colleagues from the University of Cin-cinnati College of Medicine published a highly regarded meta-analysis. The scien-

die in a fire do not die from burns, but from smoke intoxication. Some of the gas emissions are life-threatening, such as the colorless and odorless carbon monoxide (CO). It is produced when organic mate-rial like wood, paper, or fuels burn in situ-ations where there is insufficient oxygen. Carbon monoxide poisoning starts with a headache, nausea, and drowsiness – and can quickly lead to death.

Hydrogen cyanide (HCN) is also highly dangerous. It is produced during the burn-ing of materials with lots of nitrogen and carbon, such as carpets, clothing, uphol-stery, and insulation material. However, hydrogen cyanide is also produced when plastic is burned and is 35 times more poi-sonous than carbon monoxide. High con-centrations of hydrogen cyanide damage the heart, respiratory system, and circu-lation. They result in asphyxia, because

“REAL HEROES PROTECT THEMSELVES –

EVEN AFTERWARDS”Awareness campaign by the Berufsverband Feuerwehr e.V.

(a union for German fi refi ghters)


FOCUSFIRE PREVENTION

SEVEN STEPS FOR SAFELY HANDLING CONTAMINATED PROTECTIVE EQUIPMENT

Only remove your breathing apparatus once you are in an area

that is no longer contaminated.

If necessary, remove contaminated protective equipment while

you are still wearing breathing apparatus. Remove protective gloves last whenever possible.

Ask a colleague to help you remove the equipment as and

when necessary, but make sure they are wearing personal protective equipment.

Zip up your personal protective equipment after you have

removed it so that the inside does not get contaminated.

If something undesirable happens, wash your skin immediately after

coming into contact with poisonous sub-stances and consult a doctor if need be.

Safely transport contaminated breathing apparatus and

protective clothing – in sacks, for example – to the breathing apparatus workshop or disposal facilities.

Breathing masks should only be cleaned by specially trained

personnel in a specially designated area.

tists evaluated 32 published studies and classified the cancer risk of the firefight-ers into the categories “likely,” “possi-ble,” and “unlikely.” They rated the risk of a multiple myeloma and a non-Hodg-kin lymphoma – two forms of blood can-cer – as likely, along with risk of pros-tate cancer. “LeMasters’ meta- analysis has generated a considerable amount of dynamism,” says Dr. Dirk Taeger from the Research Institute for Prevention and Occupational Medicine (IPA), a facility of the German Social Accident Insur-ance (DGUV) based at Ruhr University Bochum. “Since then, at least a dozen further studies on the cancer risk of fire-fighters have been published, based on data from more than 300,000 incidents. However, they don’t always paint a con-sistent picture,” says Taeger. “The stud-ies show that firefighters are at greater risk of developing cancer than the gener-al population, but they don’t show it con-sistently across every study for each can-cer case under suspicion.”

HETEROGENOUS STUDY FINDINGSAs a consequence, the discovered risk val-ues diverge and there is no definitive list

of cancer cases that develop more fre-quently among firefighters than among the general population. A Danish study from 2018 found a nine percent higher risk of stomach cancer, for example, while a Swedish study from the same year put the risk at 89 percent.

There are many other examples of such heterogenous findings. “The rea-sons are diverse,” explains Taeger. “It may be due to different circumstances in terms of callouts and exposure, coun-try-specific differences, and the differ-ent decades covered by these studies. It may well also be due to the healthy work-er effect: Firefighters are often healthier than the general population. All of these factors have an influence on the risk of ill-ness and must also be taken into consid-eration,” says Taeger. Among the newer studies, the one conducted by the Nation-al Institute for Occupational Safety and Health (NIOSH) in the USA – with almost 30,000 firefighters – attracted a great deal of attention. Among this group, there was a higher risk of cancer in the mouth, gastrointestinal tract, airways, and kid-neys. It was also apparent that firefight-ers under the age of 65 developed bladder

AIRBORNE SOOT PARTICLES: Their fi ne details can neither be identifi ed in visible light nor under X-ray light. They can only be seen with free-electron lasers

10 DRÄGER REVIEW 120 | 2 / 2019

HOW DOES THE CLEANING PROCESS WORK WITH THE MFC 7000?The MFC 7000 is a multifunction cabin in which personal protective equipment can be gently yet thoroughly cleaned, dis-infected, and dried in less than two hours in just one operation. The cleaning process follows a standard format so that the same hygienic results are achieved. An optional second door can trans-form the multifunction cabin into a wall opening, turning it into a sluice for separating soiled work equipment and personal clothing. The clothing is loaded on one side and removed on the other. Rigid ceiling rails are not needed for this. The multifunction cabin is loaded with the aid of various rollable racks, which can be freely moved around the breathing apparatus workshop. There is a rack for full face masks, for example, and another for protective clothing and chemical protective suits. The cabin is energy-effi cient.

personal protective equipment. The first findings are set to be published in 2020.” Dr. Taeger and his colleagues investigate PAHs because these compounds are prov-en carcinogens and can be easily mea-sured in urine. They also test for the pres-ence of a substance that shows whether the firefighters smoke, because this fac-tor must also be considered in the evalu-ation. The Firefighter Cancer Registry Act was signed into law in the United States in mid-2018, which will see the main-tenance of a voluntary register collect-ing data on exposure among firefighters. The idea is to better record cancer cases among firefighters and step up research into the possible links to exposure dur-ing callouts. The hazardous substances mostly enter the body via the airways. That is why the breathing apparatus is so important and shouldn’t be removed too quickly. Noxious fumes are still released from cold fire scenes and when damping down fires. The skin is also a significant entry point. The pores and vessels dilate at high temperatures, allowing hazard-ous substances to enter the body more quickly. Removal of the personal protec-tive equipment at the end of the callout

while tackling fires, the DGUV and IPA in Bochum have conducted a biomonitoring study involving 250 firefighters in Ham-burg and Berlin, overseen by Dr. Dirk Taeger. Although the personal protective equipment provides a great deal of safe-ty, it does not hermetically seal the body.

HARDLY ANY DATA ON EXPOSURE“We know that fumes can penetrate the work clothing when wearing breathing apparatus and personal protective equip-ment,” says Taeger. “We want to know exactly how high the exposure level is under standard conditions – during a fire in a house, tunnel, vehicle, or basement, for example. Accordingly, in this study we take urine samples before and after every callout and ascertain how many PAHs end up in the bodies of the firefighters,” says the statistician and epidemiologist. “We hope that this will give us concrete data on the actual exposure levels for each fire scenario. At the same time, we also exam-ine the cotton underwear worn at the scene of the incident to identify the area of the body with the greatest exposure to PAHs and learn lessons for improving

and prostate cancer more frequently than the general population.

The risk of lung cancer also grew with increased exposure. And with con-tinued increased exposure, the risk of dying from lung cancer or leukemia also grew. However, all studies published to date have two flaws. Firstly, cancer is a common illness for which there are many causes – from a genetic predispo-sition to lifestyle factors such as smok-ing and alcohol consumption. Most of the studies have not examined whether there are other reasons for the cancer cases among firefighters. Secondly, the actu-al exposure levels cannot be measured just like that. The length of service, num-ber of callouts, and time spent on call-outs are only representative factors that ultimately say nothing about how many carcinogenic substances have found their way into the blood and urine of the firefighters. Somebody who is involved in an inside attack has an exposure lev-el different to the person who is oper-ating the fire truck, even though both people have spent the same amount of time at the same location. Since so lit-tle is known about actual exposure levels



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is also critical. Many firefighters contin-ue to underestimate the risks posed by a lack of hygiene and the associated con-tamination transfer.

CANCER – AN OCCUPATIONAL ILLNESS In some states in Canada and the USA, firefighters are financially compensat-ed if they develop cancer. For Christian Heinz from the HFUK, a German acci-dent insurance company for firefight-ers, this has something to do with the different insurance systems. “In Germa-ny, the statutory accident insurance is liable for any damage to the employees’ health as part of the social security sys-tem,” explains Heinz. “The recognition of an occupational illness is governed by the Occupational Illness Regulation [Berufskrankheiten-Verordnung or BKV] and thus covered by state law. In the Unit-

ed States there is no statutory insurance of this kind with defined benefits for state-recognized occupational illnesses. Instead, the conditions apply that were negotiated when the contract was drawn up with the insurance company. In the event of a claim, the contract deter-mines the benefits to which the claim-ant is entitled. You cannot compare the situations,” says Heinz. The advantage of the German system is that in the event of an occupational illness, the medical and social rehabilitation costs are covered by the accident insurer in addition to finan-cial benefits such as pensions.”

Various conditions must be met to qualify for benefits relating to an occu-pational illness in Germany. Firstly, the illness must be recognized as an occu-pational illness as defined by the BKV. This includes various types of cancer. Furthermore, there has to have been a

ON THE SKIN:A study by the non-

profi t organization RTI International shows that

particles labeled with fl uorescent dyes can

settle beneath protec-tive clothing and show

up under UV light. A German study is current-

ly examining the level of penetration during

fi refi ghting

THOSE WHO PROTECT OTHERS SHOULD

ALSO PROTECT THEMSELVES

corresponding level of exposure that has led to the illness. “In the case of active firefighters, the exposure times are not as easy to determine as in other careers where the employees experience the same exposure levels on a daily basis,” says Christian Heinz. “Firefighting is just one of many jobs undertaken by fire departments. Some of them only seldom extinguish fires, while others do so more often. We hope that the DGUV study will provide us with an insight into the expo-sure levels for standard callouts – the data just isn’t available right now.”

The public debate surrounding the health risks for those who work as fire-fighters has brought home the impor-tance of education and prevention. The times when firefighters were proud of their black helmets and dirty protective equipment should be long gone. The post-er campaign featuring the slogan “Real Heroes Protect Themselves – Even After-wards” run by the initiative known as “FeuerKrebs” (literally “Fire Cancer”) has precisely this objective in its sights. The nonprofit company formed by Marcus Bätge, Dr. Nicola Byok, and Olaf Reichelt is committed to providing better educa-

12 DRÄGER REVIEW 120 | 2 / 2019

tion about health risks and prevention in the fire service and is campaigning to have cancer recognized as an occupation-al illness among firefighters.

RISK OF CONTAMINATION“Hygiene cannot be overemphasized enough,” says Leif Brünslow, segment manager of the firefighting division at Dräger. “It keeps the individual safe as well as others, because contamination transfer can also harm other people.” Dräger sup-plies various solutions for treating con-taminated protective equipment. More recently, its product range has included a multifunction cabin for fully automat-ic cleaning, disinfection, and drying (see also p. 10). “This makes ‘black and white separation’ possible,” says Brünslow. The term “black and white separation” is used in Germany to describe the concept of carefully keeping soiled personal pro-tective equipment separate from person-al clothing in order to prevent the trans-fer of hazardous substances. “Many small fire departments often have neither the space nor the financial means to operate a consistent black and white separation poli-cy,” says Brünslow, who himself is a mem-ber of the voluntary fire service. “That said, quite a lot can also be achieved with simple means, even if there are no sepa-rate lockers. Good equipment, education, and awareness campaigns are important, along with standardized processes when handling contaminated personal protec-tive equipment.”

The example of pleural mesothelio-ma, an aggressive cancer of the lining of the lung, demonstrates that contamina-tion transfer is a serious problem. Asbes-tos was mainly used as a building mate-rial in Germany between 1965 and 1980 and finally banned in 1993. Many people fell ill as a result of working with it. They weren’t alone, however. The wives who washed the dirty work clothing and even the children who lived in the household also succumbed to the condition. This example shows that contamination trans-fer is a silent threat that must be rigor-ously fought.

WHAT DOES PERSONAL PROTECTIVE EQUIPMENT INCLUDE?

2

7

9

6

Firefi ghters need protection from fl ames, soot, and other hazardous substances when they are called out, which is why they use personal protective equipment (PPE): protective pants (1) and jacket (2), gloves (3), and helmet (4). During an inside attack, they also wear a face mask (5) and breathing apparatus (6) with a compressed air bottle (7). If they are attending an incident with hazardous substances, they also wear a chemical protective suit (8) and use a gas detector (9).

Video on PPE What provides protection during a callout? The dress-up model on this double page shows everything schematically. This video shows how to dress the model: www.draeger.com/120-12

Template for fi refi ghters to download: www.draeger.com/120-13

FOCUSFIRE PREVENTIONFIRE


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14 DRÄGERHEFT 405 | 1 / 2019

EFFECTIVE PROTECTION

DOESN’T HAVE TO BE COSTLY

Consistent hygiene measures at callout scenes protect firefighters from hazardous substance contamination.

The costs are reasonable.

TEXT AND PHOTOS PETER THOMAS

When firefighters from Ratin-gen Fire Department return to the vehi-cle wearing soot-covered personal pro-tective equipment after extinguishing a fire, the procedure must be followed in meticulous detail. The outer clothing is removed with the assistance of colleagues wearing disposable gloves, FFP3 masks, and safety glasses to protect themselves from the hazardous substances.

The contaminated protective cloth-ing is then packed up into self-opening cotton sacks (this prevents them com-ing into contact with the hazardous sub-stances later on at the in-house laundry) and stowed away on the vehicles. There is a change of clothes on the vehicles for the firefighters in the form of training suits. Boots are cleaned with water and brush-es, helmets and equipment with damp cloths, and hands with water and deter-gent on the hygiene boards of the auxilia-ry fire trucks. The contaminated breath-

ing apparatus units are transported back to the fire station in the equipment com-partment of the fire truck, while in the cab the holders are loaded with fresh apparatus from the storage space. This is all relatively straightforward and yet highly effective. Consistent separation of “black and white” at the scene of the incident prevents the spread of noxious substances to the skin and the transfer of

contaminants to the fire station or private environment. The procedures in Ratin-gen are regulated by a service instruction manual produced in July 2018.

The inspiration for the manual was provided by Jana Reuter and her work-related thesis on the subject of hygiene at the incident scene, written while study-ing at the University of Wuppertal. The young safety engineer is currently under-going training for the senior levels of the professional fire service in Duisburg. In Ratingen she is a voluntary firefighter on the Ratingen-Breitscheid fire truck and the hazmat response vehicle and assis-tant driver of the atmospheric monitoring vehicle. “The initial literature research phase of the work proved to be difficult. There was comparatively little material on the subject, let alone general studies with reliable data,” she recalls. “Howev-er, in view of the carcinogenic substanc-es present in the smoke, it soon became clear that systematic hygiene at the inci-dent scene was a good idea to prevent contamination of the skin by particles.”

Reuter specifically asked the follow-ing questions: What are the risks asso-ciated with contamination of personal protective equipment after fire incidents? What strategies exist to prevent the trans-

SAFETY ENGINEER JANA REUTER has clear ideas of how fi refi ghters can avoid contamination from materials contained in smoke



fer of contaminants? And how can the strategies be applied in the day-to-day activities of fire stations of various siz-es and organizational structures? The subject of hygiene at the incident scene is highly topical, particularly in view of the carcinogenic nature of the substanc-es involved.

RISKS, STRATEGIES, APPROACHESSuch being the case, a working group from Ratingen Fire Department, which supported Reuter’s work, adopted the academic findings to produce a new ser-vice instruction manual within the space of a year. Jana Reuter has since become an in-demand contact person. “The pro-fessional dialogue with colleagues from across Germany is fantastic,” says the firewoman. “It is amazing how much can be achieved with comparative-ly inexpensive yet effective solutions,” adds fire chief René Schubert. The safe-ty engineer has been the head of Ratin-gen Fire Department since 2007. This is made up of the professional fire service with two watches and seven fire trucks belonging to the voluntary fire service. In total, around 340 men and women are active firefighters in the town with a pop-ulation of around 90,000 in North-Rhine

Westphalia. The self-opening cotton laun-dry sacks are among these “basics” – as Schubert refers to these solutions. They are a standard article rather than a spe-cial design. Training suits and packag-ing and cleaning materials also do not require a great deal of investment. “This makes it possible to put in place effective protection against contamination even at smaller fire stations,” says Schubert. Rolf Schneiders demonstrates how to handle the sacks. He is responsible for personal protective equipment and radio and alarm technology at Ratingen Fire Department. “Once the contaminated clothing is placed in the wrapped sacks, they provide very good protection against soot particles and the noxious substances they contain.” The sacks are then put into the drum of the special washing machine at the main fire station, in which up to four sets can be cleaned simultaneously.

BIG DEMANDNaturally the new system also requires organizational changes. In Ratingen, for instance, a pool system has been set up for reserve clothing, ensuring that firefight-ers are immediately ready for action, even when their clothing has just been put in the wash. “Fortunately, we have our own

washhouse, so the pathways are short here,” says Schubert. The fire department has statistically evaluated how often the different clothing sizes are used across the eight fire stations to enable it to plan reserve stock levels.

More important than the equipment, however, is the firefighters’ awareness of the risks associated with smoke and soot, stresses René Schubert. This issue is also addressed by Jana Reuter: “For a long time, soot-covered PPE was viewed favor-ably by firefighters – as a sign of experi-ence.” The engineer looks positively on the reaction to her work and the way in which her findings have been put into practice at Ratingen Fire Department. Among younger colleagues in particu-lar, there was a great deal of interest in the links from the very start – and the approaches have been accepted by fire-fighters across all age groups. The fire chiefs are also committed to the contin-ued raising of awareness by people whose role it is to spread the word. There is a great deal of interest in the new strategy, says Schubert. “We have received many enquiries about our service instruction manual – even from neighboring coun-tries.” Everybody benefits from this shar-ing of experience.

CLEAR STRUCTURES for the daily routine at Ratingen Fire Department (from left): The hygiene board of the auxiliary fi re truck provides water, detergent, and disinfectant. The contaminated protective clothing is packed into self-opening laundry sacks at the incident scene and washed in the fi re station’s own washhouse – up to four sets can be cleaned at a time. The clothing is dried in a special cabinet for 4.5 hours at 65 degrees Celsius; the impregnation activation is the fi nal step and takes 20 minutes at 95 degrees Celsius

16 DRÄGER REVIEW 120 | 2 / 2019

EVERY MILLIMETER COUNTS:This patient has been on the intensive

care unit at the Charité in Berlin for months. Step by step, he must start by

relearning how to move his fi ngers

GET OUT OF BED!Many ICU patients develop muscle weakness from which

they don’t recover even years later. Only in recent years have doctors been using the best approach to combat it:

Exercise – even when the patient is still being artificially ventilated.

TEXT DR. FLORIAN SCHUMANN PHOTOS SEBASTIAN PFÜTZE

17

HOSPITALICU PATIENTS


Every step must be carefully coordinated here: “After three!” And then a doctor, a nurse, and two physiotherapists grip the sides of a gray support mat on which a young man is lying on his back. “One, two, three!” In one flowing movement, they heave him from his bed onto the trolley. While doing so, they have to take care not to miss any IV lines. They also have to make sure that the tracheostomy tube, through which the patient is venti-lated, doesn’t slip. Above all, however, they have to ensure that the two thick tubes don’t get twisted, because they are connect-ed to a cardiopulmonary bypass machine that pumps oxygenat-ed blood into Manuel’s* body.

Manuel is 25 years old. He was completely healthy until his lungs suddenly failed following a severe infection. That was three months ago. He has been receiving treatment on the ICU at the Berliner Charité ever since. The trolley onto which he has now been moved is actually a mobilization chair that can be con-trolled electronically. It slowly moves him from a horizontal to a vertical position. At the same time, parts of the trolley shift, turning it into a chair with a seat. Manuel’s feet are now stand-ing on a base plate so that they do not slip. Slowly, centimeter by centimeter, they approach the floor. Everyone standing around Manuel is relieved once the feet touch the floor. Now the work really begins, however, because Manuel’s muscles are very weak. So weak, in fact, that he can hardly move them by himself. The respiratory muscles are also affected, which is why a machine must support their work.

The cause of this condition is an illness that was not recognized as such for a long time, but it is now increasingly better under-stood by doctors: intensive care unit-acquired weakness (ICU-AW). Professor Steffen Weber-Carstens – senior consultant and member of the extended management team of the anesthesi-ology clinic specializing in surgical intensive care medicine at the Charité in Berlin – is an expert in this illness. Together with his working group, he has been conducting research into ICU-AW since the end of the 1990s, making him one of the first in Germany to scientifically investigate this illness. And it is abso-lutely relevant. “Around one in four ICU patients develops ICU-AW during their hospital stay,” says Weber-Carstens. The risk is especially high when the patient has sepsis (a life-threaten-ing infection) or multiple organ failure. According to studies, up to 80 percent of patients with such illnesses develop ICU-AW. “The symptom is muscle weakness,” says the consultant. “In actual fact, it is neuromuscular organ failure.”

The illness itself is not new. Back in 1892, the Canadian doc-tor William Osler described a condition known as “rapid loss of flesh.” And this loss of muscle actually plays a role in the muscle weakness. “The body uses the muscle protein for the produc-tion of certain acute phase proteins, which it needs for defense against infections,” says Professor Weber-Carstens. However, this quantitative loss of muscle mass is only one aspect, because ICUAW also impairs the quality of the muscle as a result of two mechanisms. On the one hand, axons degenerate. These are the parts of the nerve cells that conduct electrical impulses to the muscle. As a consequence, the muscle can no longer be con-trolled. As the condition progresses, the nerve fibers are also

THE WHOLE KITAND CABOODLE:

When a lap of the ICU is on the training program, the

whole team is needed, because the equipment has to go too

* NAME CHANGED

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HOSPITALICU PATIENTS

lost and the muscle becomes weaker. This is known as criti-cal illness polyneuropathy (CIP). On the other hand – and this is where Professor Weber-Carstens’ working group is focusing its research – certain changes take place in the muscle fibers themselves, which is known as critical ill-ness myopathy (CIM). “CIM can be iden-tified electrophysiologically much earlier than CIP – mostly within three to five days of the patient being admitted to the inten-sive care unit.” The mechanisms at cell lev-el that cause all of these changes and lead to ICUAW are highly complex and have not yet been conclusively explained. But there are consequences.

It is not only the case that, on aver-age, ICUAW patients are ventilated for lon-ger and cannot be discharged from hospi-tal until much later. “Even if they survive their underlying illness, they often remain weak for a number of years,” says Profes-sor Weber-Carstens. In a widely regarded study published in the New England Journal of Medicine, Herridge et al. established in 2011 that 50 percent of patients with acute lung failure were unable to return to work one year after being discharged from the intensive care unit, because they felt too weak and their muscles soon became fatigued. And even five years later, they were only able to cov-er around 75 percent of the distance of people of the same age in the six-minute walk test. “When we examine our patients in follow-up appointments, we see the same findings,” says Weber-Carstens. The people get tired more quickly and feel weak. And there is a correlation between the degree of weak-ness when leaving the intensive care unit and the risk of not

surviving after a year. Even though there is currently no caus-al treatment for ICUAW, one factor plays a key role in mod-erating the illness: early mobilization. According to Germa-ny’s latest S2e guidelines (covering evidence-based research),

which Professor Weber-Carstens helped to produce, this involves “passive or active exercise that encourages and/or supports the patient with the objective of promoting and/or maintaining their mobility.” This treatment should begin no more than 72 hours after the patient has been admitted to the ICU.

Physiotherapist Michelle Bother is standing by the mobilization chair and starting to move Manuel’s left arm. “Try to push my hand away as hard as you can,” she tells him. Manuel’s hand moves gently, but visibly. “He was unable to do that a few weeks ago,” says Bothur. Little by little, she works her way towards the elbow and then the upper arm. She systematically moves his joints in all directions, lastly towards the ceiling. Manuel assists as much as he can. Now it is the turn of the knees. After a few repetitions, Manuel’s muscles tremble; they

are still too weak. He is also due to be brought into a standing position with the mobilization chair in the near future. “This puts weight on his feet, so the back muscles automatically con-tract,” says Professor Weber-Castens, while checking the venti-lation graphs on a monitor. Mobilization also makes it easier to breathe. “When you sit upright, the diaphragm can transmit power more effectively,” says the doctor. It may even then be possible to allow Manuel to breathe spontaneously for a short while. This is very important for weaning him off the ventilator,

EVEN IF THEY SURVIVE THEIR UNDERLYING ILLNESS, THEY OFTEN REMAIN

WEAK FOR A NUMBER OF YEARS

PIONEER AND CARER:Professor Steff en Weber-Carstens has been researching the acquired muscle weak ness of critically ill patients for 20 years


DEXTERITY:Physiotherapist MichelleBothur performs handtraining with Manuel*

HIGH-TECH SEAT: Sascha Schülke from the physiotherapy team wheels the training unit into the room – a state-of-the-art mobilization chair

just like the breathing therapy performed with the patients by specially trained staff, which is also seen as early mobilization. Just one hour earlier, Sascha Schülke from the physiotherapy team electrically stimulated the extensor in Manuel’s thigh. “We can see from our own data that the electrostimulation is helping to preserve the muscle mass,” says Professor Weber-Carstens. “From a histology perspective, we are also seeing less muscle atrophy.” In the next step, it has to be examined whether the patients can also be rehabilitated more quickly as a result.

TAKE A BREAK EVERY NOW AND THENWhile Manuel rests after the mobilization, Weber-Carstens moves onto the next room, where a 26-year-old with ICUAW after developing a severe pulmonary disease is due to do a lap of the unit – the key discipline of early mobilization. A team of five is already on hand to support him. Everything must accompany him: the tubes, the oxygen cylinder, and the ECMO machine that takes the place of the gas exchange in the lungs. When the patient gives the signal, the baggage train is set in motion. He has to stop momentarily every now and then, but he strug-gles on and reaches his bed again about five minutes later. “I could only make it to the door at the start,” he says proudly. Early mobilization is both labor-intensive and time consum-ing, but the Charité tries to offer it to as many patients as pos-sible. “We have been doing it for about eight years,” says Profes-sor Weber-Carstens. When he first started, it was still unusual to mobilize ventilated patients, but a growing number of stud-ies indicate that it has considerable advantages. “The patients leave the intensive care unit in better physical condition in terms of mobility and strength. It is currently our best weap-on against ICUAW.” Even more data will have to be gathered in the future to prove that patients who receive early mobiliza-tion treatment are still more physically active years later and do not tire as quickly. Weber-Carstens would like to help to bridge this research gap in further studies.

The Charité’s concept also includes sedating the ICU patients as little as possible – partly so that they can move spon-taneously and be as actively involved as possible in the early mobilization, but also to prevent long-term ventilation. It is currently decided on a case-by-case basis whether the priority for a particular patient is on mobilization, ventilation, or wean-ing. A current project involving the Charité and Dräger aims to create a new treatment algorithm from the existing individu-al protocols. This should help to prevent immobility and long-term ventilation by mobilizing patients and weaning them off the ventilator more quickly.

Manuel has made good progress over the past few weeks, but Weber-Carstens predicts that it will take months before he has recovered from his severe lung failure and muscle weak-ness. The intensive care doctor and his team will continue to do everything they can to make sure that the young man quick-ly becomes – and remains – mobile again.

RUBRIKTHEMA

FRESH FROM BENEATH

THE GROUNDApples are stored underground at

Melinda in the Italian region of Trentino. The pome fruit from the rose family

is considered an especially healthy food.

TEXT AND PHOTOS BARBARA SCHAEFER

AGRICULTUREFRUIT FARMING


RUBRIKTHEMA

Valentino Dalpiaz lifts the metal bar and opens the safe-ty door with the red warning light. Here, around 300 meters beneath the earth, trucks bearing the name Melinda drive through 15-kilometer cellars cut into the rocks. Melinda is a consortium of fruit producers, an organization made up of 16 cooperatives in the Val di Non and Val di Sole. Apples are mainly grown, processed, and brought to market in these valleys. When a construction company began to excavate dolomite sand from the hills of Trentino a few years ago, people first began to think about the idea of storing the apples in the huge caves. The sand is a coveted construction material used for renovating upscale

buildings, such as St. Peter’s Basilica in Rome. “The nine-kilo-meter-long passages became available – and we needed more space for our apples,” says Valentino Dalpiaz, who is responsi-ble for warehousing at Melinda. In an initial test phase, 120 met-ric tons were stored; that figure has now risen to 30,000 tons – around one tenth of Melinda’s total production. The brand name Melinda is both a girl’s name and a combination of the Italian words mela and linda: crisp apple.

Apples have always been stored in cool cellars. Sometime in the middle of the last century, people began to store them in a controlled atmosphere. Apples also emit ethylene during the ripening process. Since ethylene accelerates the ageing of vir-tually all field crops and garden fruits, experts try to reduce its effect. This is possible by lowering the temperature and creat-

OLD VARIETIES Apples have been grown around Cles Castle in the Val di Non for centuries. As early as 1725, Baron

de Cles supplied the nobility in Vienna with the

Rosmarina variety


22 DRÄGER REVIEW 120 | 2 / 2019


ing a storage atmosphere that is low in oxygen and high in car-bon dioxide. This form of storage is standard worldwide. Melin-da cools the air to one degree Celsius and reduces the oxygen content from 21 percent to two percent, placing the apples in a state of winter dormancy. “The advantage beneath the ground is that the cooling process is more energy-efficient and eco-friendly,” says Dalpiaz. The facility uses 53 percent less energy compared to conventional storage.

2,000 STICKS OF DYNAMITE AND 90,000 CUBIC METERS OF SANDA total of 34 equally sized caves were blasted using 2,000 sticks of dynamite. At the same time, 90,000 cubic meters of sand were excavated. The undertaking cost 26 million euros. Each stor-age hall is 25 meters long, 11 meters high, and 12 meters wide, and holds around 2,800 crates, each weighing 300 kilograms – a total of around 900,000 kilograms of apples. “30,000 square meters of the caves belong to Melinda,” adds Matteo Gervasi, who is responsible for occupational safety. Refrigeration man-ager Roberto Marini also only enters the underground caves for monitoring purposes. Yet opening the door as easily as Dal-piaz is demonstrating is only possible when the fruit farmers deliver their apples immediately after the harvest. “As soon as the apples have been chilled, we extract the oxygen from the caves,” says Marini. Then we switch on the red warning lights and block the doors. Roughly once a month, the employee climbs through a hatch in the cells wearing Dräger protective equip-ment and fetches a few apples. These are then sent to the Mach agricultural institute in Trentino to assess their degree of ripe-ness. At 430,000 metric tons, it supplied around 20 percent of the apples produced in Italy in 2018. La Golden, as Golden Deli-

APPLES THAT REMAIN IN A STATE OF WINTER DORMANCY – AND SO REMAIN CRISP

cious is known, accounted for the biggest share at 70 percent. A further ten percent were Red Delicious, followed by Canadi-an Reinette, Gala, and Fuji.

Apple farming in Trentino is based on an old tradition. When the Val di Non still belonged to Austria, the fruit farmers deliv-ered their produce to Innsbruck. In 1725, the nobility in Vien-na ordered the Rosmarina Bianca apple variety from Baron de Cles. “The fruit has won a number of awards in the past,” says Dal piaz. “The valley runs from north to south and enjoys up to 2,000 hours of sunshine each year.” Despite the good yields, the farmers often had a hard time of it. Their cellars were full of apples that were relentlessly ripening and had to be sold quick-ly. The traders dictated the prices. That is how the farmers got together to form cooperatives and ultimately in 1989 the Melin-da consortium, in which 4,000 fruit producers now work togeth-er. One of them is Brunella Odorizzi from San Zenone, a little village situated above Lake Santa Guistina.

Odorizzi had moved to Milan with her husband. She worked in various museums; her husband was a PR consultant. In 2000, she came back. “My father wasn’t very well and he would have had to sell the business otherwise.” She is now the fourth gen-eration to manage the 1.5-hectare estate. “It is an average size,”

WELL EQUIPPED Melinda uses Dräger products – some daily, others in emergencies.The following products are currently used:1. Oxygen self-rescuer (Type: Oxy 6000), 2. Gas detector (Pac 5500), 3. Breathing apparatus (PSS 3000), 4. Emergency escape breathing appa-ratus (Saver CF), 5. Full face mask (X-plore 6300)

1.

4. 5.

2. 3.

FRUIT OF KNOWLEDGEMario Springhetti’s favorite apple is the Boskoop. Springhetti can choose from diff erent varieties; several dozens can be found in the historical orchard in Cles, which he manages for the community

SOMETHING IN STORE?Valentino Dalpiaz, responsible for

storage at Melinda, checks that the apple harvest is being stored

correctly in the cool caves of Cles


24 DRÄGER REVIEW 120 | 2 / 2019


PH

OTO

: A

RC

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AS

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Alps, red apples are now more popular. As such, Evelina apple trees are increasingly being planted, or the plum-colored Jero-mine. What exactly is the story with the apple varieties? Which are old and how are new ones created? In order to find out, it is necessary to drive to the neighboring village of Cles. This is where Mario Springhetti manages the historical orchard in the Val di Non. Springhetti comes from a family of apple farmers, works in the community as an agricultural assessor, and stud-ied at the Mach institute. Creating a new apple is an art form, he says. “You pollinate the blossom of one tree with the pollen of another – and that’s it.” However, it is uncertain what the result will be. The genetic makeup of La Golden was complete-ly sequenced by Mach researchers in 2010. They established that the total length of the genome is around 742 million base pairs. By way of comparison, human DNA has around three bil-lion genetic building blocks.

NEW TREES EVERY 20 YEARSThe trees have been in the historical orchard since 2008 – at the time, the community took the decision to create an orchard with 55 apple varieties and ten pear varieties. Professional fruit farmers plant new trees every twenty years. On Brunella Odor-izzi’s estate, there is a Canadian Reinette tree that is almost 100 years old – large crown, long branches. However, it is totally unsuited to profitable farming. Long rows of small trees stand 80 centimeters apart in the orchard, with a good three meters between each row – they bear fruit from the second year and are so full in September that you can’t see the trees for the apples. Springhetti draws a knife and cuts off a few apples. What a taste! Yes, and they are said to be healthy too. According to the say-ing attributed to Lucius Annaeus Seneca, “An apple a day keeps the doctor away.” The polyphenols contained in apples bolster the body’s defenses. Old varieties contain considerably more, but they are difficult for the market. “The old varieties only

she says. The consortium does not prescribe which varieties have to be grown, but it is possible to seek advice. For instance, neither the Granny Smith nor the Pink Lady thrives well here. Old grapevines sometimes appear on Odorizzi’s land. “People used to grow all kinds of things for their own needs.” In the 18th century, even mulberry trees were grown for silkworm breeding. Odorizzi points out the enduring palazzo, the family estate just outside San Zenone. “There are no windows on the upper floor, just ventilation shafts. This is where the silkworm cocoons dried.” During the interwar period, the focus switched to apple growing. Odorizzi’s grandfather also planted La Golden trees everywhere – the sweet, yellow apple from the region. It is by far the most popular apple in Italy and every other apple in the supermarkets comes from Melinda. Dalpiaz, Gervasi, and Marini have now returned to their office. Which apple do they like best? “For me, it’s still La Golden,” says Dalpiaz. “With the right balance of sugar and sourness.” Gervasi, on the oth-er hand, prefers the Fuji; Marini the juicy Gala. North of the

AN APPLE A DAY KEEPS THE DOCTOR AWAY!

NO PINK LADYThat’s because

this apple doesn’t thrive at altitude, as

Brunella Odorizzi discovered

FONDAZIONE MACH In 1874, an agricultural institute was founded in San Michele all’Adige alongside an experimental center. The idea was to stimulate agriculture in the Tyrol region. It was a place of research, experimentation, education, and training. Today, it is also involved in environmental protection and off ers management consultancy services. Since 2008, the institute has been known as the Fondazione Edmund Mach, named after the Austrian agricultural chemist and enologist Edmund Mach (1846–1901, pictured above). He also taught at the institute and developed it into a research facility.

“A” IS FOR APPLE!But the Mach agricul-tural teaching facility in Trentino is also involved in viticulture, environmental protection, and coopera-tive systems

RUBRIKTHEMA


taste so good when they are freshly picked from the tree. They are generally difficult to store.” As an agricultural expert, what does he think about the fact that all of the hillsides in the Val di Non are full of apples? “Even though monocultures can be problematic, grapes for cuvées have been grown in the Cham-pagne region for the past 300 years – and it works really well as far as I’m aware,” says Springhetti with a smile. Since the mar-ket demands it, specific red apples and organic apples are also grown and harvested in Trentino. Melinda currently produces around 2,000 metric tons of organic apples each year, a figure that is soon set to rise to 10,000. This isn’t without its challeng-es, however, because estates are traditionally divided up among

the heirs here. As a result, some estates are getting ever small-er, but a small orchard amid more conventional orchards sim-ply doesn’t work. That is why some farmers have got together to grow organic produce on a 30-hectare site.

At harvest time in September, there are quite a lot of tractors on the road. This is also when the Melinda trucks start return-ing to the underground caves, when the members of the consor-tium deliver their harvests. At MondoMelinda, the salesroom at the company’s headquarters, the customers are already waiting for the new goods. “No, sorry, the Fuji is not yet ripe. We only have Gala and La Golden at the moment,” says the store assis-tant. Good things are worth the wait.

THE SCENT OF APPLESThe bewitching scent of

ripening apples is not the reason for the breathing

apparatus: Matteo Gervasi, responsible for occupational safety at Melinda, is wearing

the equipment just for the camera. Various pieces of equipment are on hand in

the event of an emergency (see also p. 22)

26 DRÄGER REVIEW 120 | 2 / 2019

ANCHORS AWEIGH! U-31 can set sail from the dock in Eckenförde at any time and even cross the entire Atlantic underwater – largely undetected

SILENT HUNTERSEven the sensitive ears of a sonar cannot hear it: The Class 212A submarine,

built in Kiel since 1998, moves undetected underwater, where it performs reconnaissance missions, acquires an overview

of the situation, or releases frogmen near the coast.

TEXT NILS SCHIFFHAUER PHOTOS PATRICK OHLIGSCHLÄGER

27

MILITARY SUBMARINES


Where on earth are the Germans?” The participants in a navy maneuver in the Caribbean, in which U-31 also took part, asked themselves this question. It is the pride of the Ger-man Navy and one of the most modern non-nuclear subma-rines in the world. “We were only 300 meters away from them,” recalls frigate captain Timo Cordes in the officers’ mess of his moored submarine off the coast of Eckenförde. “A distance that classes as a near miss!” This way of traveling, as if under a cloak of invisibility, is just one of the outstanding features of the Class 212A submarine that has made it an export hit over the years. That said, the technology and crew must also play their part. “We are the only ones who can safely pass through the Kadetrinne area in the Baltic Sea, north of Rostock, which is precipitous and only 17 meters deep.”

Chief Petty Officer Hans-Jürgen Zörner, responsible for the extensive machine systems on U-31, nods – and remembers that far from being always calm at sea, it can also be pretty rough at times. “In a Force 12 storm, the 56-meter-long and seven-meter-wide vessel rammed against waves eight meters high while traveling on the surface of the water. The maximum per-missible inclination (“listing”) of 45 degrees over a longer peri-od of time was even slightly exceeded – risking a breakdown of the diesel engine that charges the batteries when traveling on the surface. It even ripped out the door to the cold store,

even though “it looks like the door to a bank’s safe,” accord-ing to the then commander Lars Gössing. “I had never experi-enced anything like that before. It was testing.” Equally as test-ing was the 18-day underwater record trip from the Azores to Jacksonville, Florida.

AS SMALL AS A COLA CANLife for the team of almost 30 submariners is hard; each of them is an expert in his or her field – from sonar to mechanical engi-neering. Furthermore, a keen sense of comradeship is required. “Tolerance is one of the most essential virtues,” says frigate cap-tain Timo Cordes. “Sailing in a submarine unquestionably calls for teamwork. The crew soon notices who isn’t suitable, despite their qualifications, and also tells it like it is!” Not just anybody can be assigned to a submarine. You have to want to do it and also be accepted. “It has been my dream since the eighth grade,” says First Petty Officer Zörner, explaining his choice, which often takes him away from his family for long periods of time. They live in the Harz region and are waiting for his next shore leave. At sea, he is practically cut off from any kind of private commu-nication, particularly the Internet.

“On a submarine, if feels as if you are not in this world.” Instead, you are drawn into a world that is dominated by six-hour watches. The fact that the crew is prepared to accept this hardship is one thing. But why does a country even maintain a fleet of submarines when each one costs over 400 million euros, with development costs of 150 million, plus operating

COMMANDER Timo Cordes in the engine room of U-31. He is in charge of a fl eet on which he can rely – and vice versa

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MILITARY SUBMARINES

costs? And why doesn’t Germany have any nuclear submarines? “This is due to the role assigned to modern submarines in our primary areas of operation in the North Sea and Baltic Sea,” explains the commander. Although equipped with six torpedo tubes, their main task is to remain undetected while obtain-ing a reliable picture of the situation on the surface of the water and swiftly passing it on as part of the overall situation. In this regard, the passive sonar is the submarine’s eyes and ears. Water is very good at conducting sound, allowing all of the unavoidable noises emitted by shipping traffic, primarily the propeller, to be heard across long distances. “Low frequen-cies in the infrasonic range – below 20 hertz – travel particular-ly far,” adds Timo Cordes. “As such, a modern sonar allows us to hear when just a single valve has been operated somewhere outside.” Combining these sounds produces the “signature” of a vessel – or its acoustic image, to be more precise. This is so individual that it not only identifies individual types of vessels, but each vessel itself.

The submarine can chart the traffic on the surface of the water by changing its position and taking bearings – based on the principle of triangulation – to determine the location, course, and speed. The situation is then passed on via the Cal-listo radio buoy tied to a towing line, generally by satellite. Two-way radio traffic beneath the water is not possible. However, even diving submarines can be reached using very low frequen-cies, like those emitted by the German Navy via eight anten-na masts, each around 353 meters tall. It goes without saying that the vessel itself should have a signature that is as small as possible – acoustically, but also electromagnetically and ther-mally. This is precisely the case with the Class 212A subma-rine, of which the German Navy currently has six. It is said that their signature is the size of a cola can, which is down to their design. “A nuclear submarine, on the other hand,” explains Timo Cordes, “not only has completely different strategic, oper-ative, and tactical tasks, but also leaves behind an unmistak-

able acoustic and thermal signature with its reactor and the necessary steam turbine.”

SIMILAR TO A STEALTH BOMBER The Class 212A is built at thyssenkrupp Marine Systems in Kiel, which boasts a history totaling more than 180 years following the merger with HDW and Blohm+Voss Naval and the acquisi-tion of Atlas Elektronik. Germany’s first submarine, U-1, was also built by a predecessor of this company in 1906. Today, around three submarines are built in two years in Kiel. “One and a half per year sounds a little odd somehow,” says production manag-er Frank Mallon, while pointing out the modular technology at the shipyard. “Space is very tight in the submarine. As such, we generally produce the modules complete with all the cables and conduits before installing them in the pressure hull.” It is much like the approach used to make a ship in a bottle, albeit one that weighs around 1,500 metric tons. Top-quality German engineer-ing is in demand, taking about five years from the order to the delivery. Almost everything in these halls is secret – from the sonar and the tubes for the fiber-optic cable-guided heavyweight torpedoes (with a diameter of 533 millimeters) on the bow to the propeller on the stern, the shape and number of whose blades primarily produce the acoustic signature of the submarine. The propellers developed and built here almost entirely avoid cavitation – small and loudly collapsing vapor bubbles. And the sides – with their flank array sonar, which features high sensi-tivity even at frequencies as low as 10 hertz and good resolution of ambient noises – are also a secret. We agree to accept that the pressure hull – the outer shell, made from non-magnetic steel, making it almost impossible to locate electromagnetical-ly – is about “the thickness of a thumb.” How much pressure can it withstand? A smile must suffice as the official answer, because otherwise the maximum diving depth can be worked out, which is at least 250 meters. Enormous pressure is thus exerted on the outer hull, whose fiber-glass paneling scatters

THE SONAR PROVIDES ACOUSTIC IMAGES OF ALL SHIPPING TRAFFIC

DREAM REALIZEDHans-Jürgen Zörner wanted to be a submari-ner ever since the eighth grade. The chief petty offi cer is now aboard U-31


THE JOURNEY MUST CONTINUEEverything is functional on a submarine. Its form follows the logic of hydrodynamics and inconspicuousness – mainly acoustically

IT IS TIGHT HERE, REALLY TIGHTEvery square inch is used in the submarine, more by the technology than

by the crew members, who cohabit for weeks on end in the tightest of spaces. Safety is also assured by the emergency breathing air systems from Dräger in

their orange bags, with which it is even possible to evacuate the vessel underwater

ENTRANCE AND EXITSubmariners usually call out “up/down ladder” prior to ascending/ descending. This is certainly no place for those who suff er from claustrophobia!

A POWDER STORES THE HYDROGEN FOR THE FUEL CELLS

30 DRÄGER REVIEW 120 | 2 / 2019

MILITARY SUBMARINES

the pulses of a hostile active sonar in all directions. It is a tech-nique similar to that used on stealth bombers. At the heart of the submarine is the drive system. It must be powerful, dura-ble, and absolutely quiet. All sound-producing machines are encapsulated in a sound-absorbent chamber, which is acousti-cally isolated and suspended within the submarine using rub-ber and springs. As a pleasant side effect, it is also very quiet in the finished submarine. The main propulsion is provided by a Permasyn electric motor fitted with permanent magnets, pro-ducing around 1,700 kilowatts of power, which accelerates the boat to around 20 knots (around 37 km/h) when diving. It gets its power from a battery system, which the 1,000 kW diesel gen-erator charges. The fuel cells, which are not reliant on external

air to generate power, permit even longer dives. This principle is based on electrolysis in reverse: When their polymer electro-lyte membranes are supplied with hydrogen and oxygen, the products are power and water.

THE FUEL CELLS ARE THE KEYWhile the liquid oxygen is conventionally stored in tanks direct-ly below deck, the hydrogen can be found at the bottom of the vessel. “We accumulate it in tanks filled with a metal hydride,” says electrical engineer Jan Schade, who is manager of the department responsible for this technology at thyssenkrupp Marine Systems. The metal hydride is delivered in slabs that are reminiscent of a moderately successful chocolate cookie base. The slabs are carefully inserted in shallow stainless-steel canisters with a diameter of around 50 centimeters. These in turn can be fitted together to form stacks several meters tall. A semipermeable sintered tube runs through the center, letting hydrogen pass through for refueling and removal, but not the later metal hydride powder. The latter is produced by a process known as “initial cyclization,” which takes about four weeks. No form of hydrogen storage is more efficient. At 90 percent, the efficiency level of the fuel cells powered by the hydrogen is also better than the maximum of 50 percent achieved by marine diesel. Yet the development work continues. “This is our methanol reformer,” says operations manager Jan Schade, pointing to a device that turns liquid alcohol into hydrogen for the fuel cells. “Methanol is easier to work with, making refu-eling more efficient,” says Schade. “Anyone who orders the methanol reformer nowadays will have it delivered within a short space of time.”

Will autonomous submarines, sensor buoys, and satellite observations make the crew superfluous to requirements at some point? “I don’t think so,” says frigate captain Timo Cordes confi-dently. “We will only remain sufficiently flexible with a subma-rine manned by humans – after all, we also have other tasks.”

DRÄGER AND SUBMARINES Since the invention of the submarine escape set in

1907, one year after the fi rst German submarine was built, Dräger has been partly responsible for the

safety of the crew, but it is also responsible for gas protection in the shipyards. On the vessel, emergency

respiratory masks (Dräger Panorama Nova full face mask with built-in voice diaphragm in conjunction with the U Lung Demand Valve, or half mask with U Lung Demand Valve) that can be connected to the emergency breathing air system provide protection. They supply breathing air even in a fl ood-ed submarine, allowing the crew to escape when underwa-ter. At the submarine yard owned by thyssenkrupp Marine Systems in Kiel, the fuel cell production plant, among other places, is equipped with a Dräger fi xed gas detection sys-tem, which automatically halts production and closes the gas valves when the pre-set limit of certain gases is exceeded. Portable gas detectors from Dräger are also used.

FRANK MALLON is production manager at thyssenkrupp Marine Systems in Kiel, where the fi rst German submarine was built in 1906


THREE SUBMARINES are built in Kiel within the space of two years. The later shape can be discerned here with the conning tower

MODULAR PRODUCTION EVEN FOR THE WIRINGA submarine is welded together out of modules that have already been fi tted with pipes and cables. It is the only way to achieve the high packing density

ONLY THE SHAPE OF THE PRESSURE HULL provides a clue that this module will also be part of a

submarine later on. It takes around fi ve years from the order to the delivery, including the testing phase

32 DRÄGER REVIEW 120 | 2 / 2019

MEDICINEANESTHESIA

Provide orientation! That is the essential thing when the induced sleep wears off. Feeling orientated is the key. It takes away the fear that many people asso-ciate with the alien world of a deliberate-ly instigated loss of consciousness. Prof. Bernhard Zwißler can provide plenty of orientation – not just for his patients, but for anyone who is interested. His branch

of medicine holds a fascination that the director of the anesthesiology clinic at Ludwig-Maximilians-University (LMU) Munich clearly shares and has done ever since a chance encounter brought him to the discipline several years ago.

Zwißler met Prof. Klaus Peter, the then head of the clinic that he now man-ages. “As an anesthetist,” Peter told him back then, “you learn things that come in useful always and everywhere.” In other words, anesthetists are eminently capable

of providing orientation within the med-ical profession. Professor Zwißler puts it like this: “We deal with every area of surgery and therefore know what is hap-pening in the world of medicine; Where is the latest development? What do they do there? This gives us an overview. And we also gain an insight into conservative medicine, the non-surgical areas. That’s because we often see patients who not only have a surgical problem, but are also chronically ill with diabetes, cardiac

FEAR NOT!Anesthetists accompany patients during the operation

and from their induced sleep back to normal life. Munich-based consultant Professor Bernhard Zwißler

talks about the essential aspects – and what makes his branch of medicine so special.

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and circulatory disorders, or other con-ditions of our age.” As such, anesthetists have to know what they are doing when performing preoperative examinations or risk assessments. “It is my assertion that the anesthetist is the most broadly educat-ed doctor of all.”

NOTHING WORKS WITHOUT THEMAnesthetists also know, however, that the general public’s admiration for the spectacular world of modern medicine

is primarily reserved for others, because they do not wield a scalpel and only sel-dom do all the talking. Yet without this foundation, which their branch of medi-cine has laid for the surgical disciplines over the decades, there would hardly be this wonder of modern surgery. These complex procedures can only be per-formed with a combination of deliberate unconsciousness, precisely controlled pain relief and medically aided muscle relaxation. Nothing works here without

them. Nor would it work in an emergen-cy situation, when anesthetists stabilize the circulation, steady the breathing, and keep the patient alive so that their col-leagues can treat the cause of the threat-ening incident.

In addition to everything else, both anesthesia nursing staff and doctors also assume the role of counselors on a dai-ly basis, because what they do causes a degree of anxiety among some patients. “There are always patients who are more

OVERACTIVE IMAGINATION

The patient’s fear of the anesthetic and its

side/after-eff ects is primarily all in the mind

34 DRÄGER REVIEW 120 | 2 / 2019

MEDICINEANESTHESIA

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anesthetic.” The peripheral blocking of nerve fibers that transmit pain to the brain does not impair the patient’s con-sciousness. “Generally speaking, such patients are also convinced that this method is less drastic than a general anesthetic. This is often the case, but by no means always. Here, too, the anesthe-tists provide orientation, primarily in the form of education and guidance, because each anesthetic is individually prepared and adapted in terms of the choice of method, suitable medication, and possi-ble risk factors.

A QUESTION OF RISKThe choice of anesthetic strategy is made based on the premedication visit. A full history is taken, the patient is examined, and their medication plan is checked along with their laboratory results, doc-tors’ letters, and much more. It is a matter of give and take. From this point onwards, the patient should know that they are in good hands until they wake up in the recovery room. “If they wish to avoid a general anesthetic and the type of proce-dure permits it, we explain the possibili-ties and limitations of the local anesthet-ic,” says Prof. Zwißler. “Many things are possible nowadays thanks to sophisticated technology. This applies to practically all arm and leg operations and to many low-er abdomen procedures.” Just like in all areas of modern anesthesia, progress in this field has also benefited from a close collaboration between medicine and med-ical technology.

“We used to learn from the anato-my book: The nerve should be here! So we made an incision where we suspect-ed it to be, stimulated it electrically, and checked whether it twitched. Nowadays, local anesthetic is performed almost exclusively under the control of ultra-sound. We can see the nerve and accurate-ly guide our puncture needle to adminis-ter the local anesthetic in precisely the right place. By blocking the nerves, the sensation of pain disappears in the oper-ative area, for hours or sometimes even days, depending on what is required – for

“ALERT AGAIN AND IN GOOD SPIRITS”

Dr. Andreas Nugent works at a women’s hospital in Hamburg, Germany. He is specialized in operations to treat gynecological disorders.

Dr. Nugent, how is an anesthetic experienced by an operating doctor whose normal role is to administer them on a daily basis?None of us comes into the world as a doctor. I had my fi rst general anesthetic at the age of 14 and I was really scared. It was a subconscious, pretty inexplicable fear of the unknown. But I also remember the experience of regaining consciousness as being very pleasant. I noticed that I slowly came around again. I was lying in bed, surrounded by friendly voices; everything was very nice and not at all threatening.

Does this help you to understand your patients’ situation?Absolutely. As doctors, we are often confronted with paradoxical ideas that we have to deal with. Patients often fear the anesthetic more than the actual operation – even though the doctors know that the operation is much riskier.

What is the surgeon’s attitude towards the anesthetist?They famously poke fun at them – their typical pose is said to be either standing with hands in pockets or with coff ee cup in hand. But they should be in no doubt that this is purely meant in jest. The surgical options available to us today have only been made possible by advances in the fi eld of anesthesia. It is also important that this branch of medicine focuses specifi cally on the well-being of the patient – by monitoring and managing the anesthetic and thanks to the frequently big role played in the fi eld of emergency medicine. When I had my last anesthetic for a knee operation, I peacefully drifted off to sleep and woke up again in good spirits, because I really trusted the anesthetist.

afraid of the anesthetic than the actual operation,” says Prof. Zwißler. When looked at from a purely mathematical perspective, this is hardly reasonable, because the procedure and the poten-tial complications, such as an infection, are much riskier than the effect of the anesthetic. And yet: “Patients say to me: ‘I have a problem with the loss of con-

trol. I have been in charge of my desti-ny my whole life and now I am about to relinquish control completely!’” A gen-eral anesthetic is thus not exactly com-patible with the current zeitgeist of lead-ing a self-determined life and making independent decisions. Yet the world of medicine provides options. “Those who feel this way often ask us for a local


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INFORMED AND IN CONTROL AT ALL TIMES: THE TECHNOLOGY IS NOW PART OF THE TEAM

example, to treat the pain after the oper-ation, for which a fine catheter is placed in the vicinity of the nerve.” However, the doctor would then also firmly advise the patient to have a general anesthetic, if this is the better option.

If such a general anesthetic repre-sents the better route, Zwißler advises his patients to be honest during the consulta-tion. “Let’s take the example of a 40-year-old man who weighs 150 kilograms and has a long history of alcohol intake and needs an operation.” The man should not conceal his dependency, “because he would need considerably more anesthet-ic to ensure that he was nonresponsive during the operation than an 80-year-old woman who weighs 50 kilos and has never touched a drop in her life.” Older people in particular can exhibit restricted cog-nitive ability after operations. This sub-ject is high on the agenda of anesthesiol-ogy and intensive care medicine all over the world.

Intensive research in recent years has yielded a number of insights here. “The older the patient and the more the inva-sive the procedure, the greater the risk of suffering from (mostly temporary) sen-sory or concentration disorders,” says Prof. Zwißler. “There may even be signs of delirium when the patient is not of sound mind for days on end and it proves

difficult to talk to them.” However, such disorders cannot be predicted with any reliability in individual cases. Just like with other illnesses, the anesthetist must weigh up the overall risk. If the risk is high, anesthetists sometimes advise oth-ers to exercise moderation. “Every now and then, we say to the surgeon: ‘Please be careful, this case could be unexpect-edly complicated. Is the operation real-ly necessary and have all the different aspects been carefully considered with the patient?’”

THE COMPLEXITY IS GROWINGThe critical factor is the quality of life pri-or to the procedure. Before surgeons get down to work, once the drip is inserted, the patient has been medically sedated, and all of the technical aspects required for continuously monitoring the patient’s vital functions – such as ECG and blood pressure – are in place, the anesthesia machine is ready to do its job. The amount of work involved for man and machine increases with the complexity of the sur-gical procedure. “Further technical mea-sures are often taken when the patient is already sleeping,” explains Professor Zwißler. “An additional catheter may be inserted, for instance, or another monitor set up. When major heart surgery is being performed, ultrasound equipment is in

place so that we can monitor the cardi-ac function. We sometimes also use mea-suring probes – more or less as an early warning system – to measure the oxygen level in the brain and quickly give notice of a critical drop.”

The anesthetist’s semi-automat-ed workstation is not dissimilar to the cockpit of a plane; and just like a pilot, he maintains complete control over his sophisticated equipment and full power to make decisions. With SmartPilot View, for example, Dräger supplies a piece of software that assists anesthetists by visu-alizing the complex effects of anesthetics; it displays both the current and predicted anesthesia levels.

As an academic instructor and rep-resentative of his branch of medicine – until the end of 2018, he was president of the DGAI (the German Association of Anesthesiology and Intensive Care Med-icine), and remains vice president – Prof. Bernhard Zwißler is teaching the next generation reasoning skills: “Train-ing is everything – practicing the inter-pretation of all parameters and draw-ing the right conclusions.” He considers training to be a lifelong task. As a senior consultant, Zwißler himself spends as much time as he can in the operating room. After all, a sense of orientation must be preserved.

OVERVIEWAnesthetists are always in the picture thanks to clearly displayed anesthetic data and vital parameters

FeuerwehrAusland

36 DRÄGER REVIEW 120 | 2 / 2019

FIRE DEPARTMENTENVIRONMENTAL PROTECTION

SEARCHING FOR CLUES AMONG THE ASHES

Once a fire has been extinguished, the work continues – and that is also the case in the US. As soon as a major fire such as the devastating

Camp Fire in Northern California has been put out, the hazardous materials experts from the US Environmental Protection Agency (EPA) move in.

TEXT STEFFAN HEUER PHOTOS PATRICK STRATTNER


A number of weeks after the most devastating forest fire in Californian history, the working day follows a som-ber routine for Jeremy Johnstone from the EPA. His ten-person team has a well-practiced rhythm on this cold and damp December day as it makes its way around the remains of Old Magalia, a neighbor-ing community of Paradise, which was engulfed in flames in November 2018. The conflagration destroyed around

19,000 structures; almost 90 people lost their lives.

One parcel of land after another, the experts in white protective suits always tick off the same points on their check-list: Search for sources of danger, secure hazardous waste, and prepare it for trans-portation to a disposal site. “I’ve seen many fires,” says Johnstone, “but this one has affected people especially deep-ly because the magnitude of destruction is so much bigger.” Accordingly, the team turns its attention in the first instance to the charred trees that now line the desert-

ed streets. A tree specialist inspects the trunks and marks them with white sym-bols. A “T” gives the all-clear, while two horizontal lines advise caution and an “X” indicates a source of danger. Even though many of the pine trees are still standing, they may pose a hazard to the environmen-tal experts as they work their way around the site. After an initial walkabout with a radiation measuring device, which warns of potential radioactivity from disused mil-itary technology, a handful of specialists begin to spread out. Since the houses were made of wood and plastic panels and had

DEVASTATINGThousands of buildings like this

family home suff ered the same fate in Paradise. The blaze consumed

the wooden and plastic houses surrounded by coniferous woodland

at lightning speed

38 DRÄGER REVIEW 120 | 2 / 2019


no basements, there is generally only a square area of ash and melted debris left behind after the fire. The ash footprint is used in the first instance to identify the areas where the experts suspect there might be hazardous waste – primarily for-mer garages and kitchens. “We are look-ing for the usual suspects,” explains John-stone, while his colleagues carefully poke around in the ashes wearing a breathing apparatus. “Mainly for propane gas tanks, aerosol and paint cans, batteries, contain-ers filled with acid and oil, munitions, or panels that may contain asbestos.” The team enters every cleared parcel of land into a notebook and a tablet, before it ends up in the “digital cloud” and turns up a little later on the EPA website highlight-ed in green. This allows former residents to track almost in real time whether the all-clear has been given for their particu-lar street. By mid-January 2019, the envi-

ronmental experts had cleared almost 50 percent of the area in this manner and marked it with white wooden stakes fea-turing two signs that have been laminated to protect them from the wind and weath-er. A green tick on one of the signs signal-izes that the hazardous household waste has been removed, while also warning that there may still be hazardous materi-als concealed among the ashes. The other sign advises people how best to deal with hazardous materials that are still present.

RACE AGAINST TIMEFor the roughly 400 EPA employees who have been working in the disaster area in 28 different teams since the start of December, the clean-up operation is a race against time. Rain and landslides may wash hazardous substances (such as asbestos, mercury, and lead) contained in the ash into nearby streams, which means they could end up in the groundwater. On top of this, following the lifting of manda-tory evacuation orders, the residents want

to inspect what is left of their possessions and take them to a safe place. On the oth-er hand, five other authorities (at the fed-eral level and from California) are work-ing to prepare the town of Paradise for the second phase of the clean-up operation. Once 13,000 parcels of land had been suf-ficiently cleared of hazardous materials, the excavators and bulldozers got down to work in January. They have a year to remove the ash and debris as well as a 15-centimeter layer of soil so that each of the former residents who wish to move

SENSITIVE HAZARDOUS WASTE MAY BE LURKING ON EVERY PLOT WRECKED: Hundreds of burned-out cars left

behind by the fl eeing residents must be disposed of by environmental protection experts

ON THE SCENE FAST: EPA manager Steve Calanog has been chasing one natural disaster after the next for several years

THE MOST DEVASTATING FIRE in California around the area of Paradise in November 2018 reduced about 19,000 buildings to ash and rubble – and claimed almost 90 lives


back here will at least have a parcel of land cleared of all hazardous materials by 2020. Most of the costs for this operation are being met by the state of California. “We have been doing this kind of work for many years and are now an experienced team,” reports Steve Calanog, who hur-ries from one disaster to the next as the on-scene coordinator for the Region IX in the Western part of the US. Over the past twelve months, he has tried to mitigate the direct environmental consequenc-es of nine major fires. “That’s not even including other disasters such as Hurri-cane Maria in Puerto Rico or the typhoon on the Pacific island of Saipan.” Calanog compares the work to searching for clues at the scene of a crime. “We have learned to recognize where the hazardous materi-als are located and how to dispose of them in the safest way.” Every major fire is none-theless different, because the settlement

structure and the topography differ from one place to the next.

WITH ALL AVAILABLE MEANS

“Paradise presents us with new challenges, because it is a very mountainous and dense-ly forested area with just a few roads lead-ing to it. And also because many people over the age of 55 lived here, who pursued their hobbies restoring cars, collecting guns and munitions, or using old equipment for gold mining that contained mercury.”

In contrast to other disaster areas, in a completely destroyed town like Par-adise there is also no telling when people will be able to live and work here again – even though individual buildings such as schools, churches, and hospitals were saved from the flames and were able to open again at the beginning of 2019. “All of these factors have to be taken into consid-eration when planning the clean-up oper-ation,” says Calanog, taking stock. And yet they didn’t really have much time to plan, because one devastating major fire has

been swiftly followed by the next in Cal-ifornia in recent times. The Tubbs Fire in October 2017 ravaged the counties of Napa and Sonoma – both famous for their vineyards – and reduced more than 2,800 homes in the city of Santa Rosa to rub-ble and ash. In July 2018, the Mendoci-no Complex Fire consumed around 1,800 square kilometers of mostly uninhabited land north of San Francisco. Shortly after-wards, in August 2018, the Carr Fire in the north of the state raged on an area cov-ering some 929 square kilometers. Then, on November 8, 2018, in addition to Para-dise going up in flames, the Woolsey Fire broke out north of Los Angeles. The crime scene cleaners from the EPA are called upon after each of these major fires. “If you learn anything from these disasters, it’s that you have to be completely ready

ON THE SAFE SIDE: Well protected and equipped with special rubber boots and a Geiger counter, EPA specialists scour every single parcel of land

REMAINS: Among most of the buildings in Paradise only metal parts remain, like this staircase. A thick layer of ash lies all around, under which hazardous goods and dangerous holes may be concealed

40 DRÄGER REVIEW 120 | 2 / 2019


with existing maps and other data from geographical information systems. If the mobile communications network is still (or once again) working, these updates occur almost in real time; otherwise they occur in the early evening when the teams are within range of the command center again. Calanog himself juggles two smart-phones, a tablet, and a laptop twelve hours a day, seven days a week to keep up to date.

FRUSTRATION AND DISILLUSIONThis is all the more important, because in a disaster area there is always plenty of input, all kinds of questions, and no short-age of surprises – for instance, when it was discovered in May 2019 that the drinking water pipes had been contaminated with benzene. The EPA teams also work with the specialists at California’s Department of Toxic Substances Control and the Federal Emergency Management Agency (FEMA), communicate with the county, or are out and about with the employees of the power company PG&E, the telecommunications

for action very quickly,” says Calanog, who sums up this advice in one sentence: “Go big, go early!” This means mobilizing a cri-sis management team of specialists as soon as a fire breaks out and immediately decid-ing which experts and subcontractors need to be dispatched as soon as the firefight-ers and other emergency teams have extin-guished the fire. “We want to get all of the staff and equipment to the scene quick-ly instead of just mobilizing our resourc-es gradually,” explains the EPA manager. He controls the clean-up operation from a command center located in an empty office next to the small airport in Chico, around half an hour west of Paradise. This is where the lines of communication con-verge for the operation to clean up the haz-ardous materials. Software experts and app developers enter the measurements and notes gathered by the individual teams in the field into databases and link them

company AT&T, and the local cable opera-tors, who are rebuilding the infrastructure in Paradise on a piecework basis. Anyone who drives through the disaster area will see teams on virtually every corner mark-ing, felling, and chopping damaged trees as well as erecting new masts and laying new cables that were destroyed in the fire. Like almost everywhere else in the USA, the cables are not laid underground for time and cost reasons. As a result, they may be quickly destroyed in natural disasters, but they can also be quickly relaid. The haz-ardous material that accumulates in the course of the work ends up at a collec-tion point on the outskirts of Chico. Every evening, EPA trucks arrive here to dump the loads they have collected throughout the day from several hundred parcels of land – everything ranging from empty pro-pane tanks and pipes containing asbes-tos packed in airtight drums to burned-

ALL CLEAR: Each parcel of land from which hazardous materials have been removed is marked with a sign so that the owners can arrange for the rest of the debris to be disposed of

GHOST TOWN: Until November 2018, this was the site of Ridgewood Mobile Home Park, a modest settlement for pensioners who wanted to live out their remaining years in Paradise


out ammunition boxes and car batteries. Hazardous waste and recycling materials are sorted by specialist staff and prepared for removal in large drums and contain-ers. In certain cases, suspicious contain-ers and substances may be subjected to a more thorough examination with mea-suring equipment (such as the Dräger X-am 5000 or the Dräger Chip Measure-ment System), although this seldom hap-pens in Paradise compared to other major fire sites, because almost exclusively resi-dential homes burned here and no indus-

trial buildings, which means that all vol-atile materials have long since escaped. “We have the necessary equipment with us, but we haven’t had to use it yet,” says EPA spokesman Rusty Harris-Bishop. For the survivors of the catastrophe, the remov-al of the hazardous materials is just one small step towards returning to everyday normality. Julie Banwellund and her fam-ily fled on the morning of November 8, 2018 with everything that could fit in the back of their car. They only just escaped the disaster. The family was lucky. Just a month later they found a house a couple of hours’ drive away, whose rent is being cov-ered by the insurance company. Since the fire, although they have inspected the ruins twice, they most likely will not rebuild their destroyed house there. “We lived in Para-dise for two years and also felt at home there, but the risk is just too big for us to start again from scratch in the town,” says the artist and yoga teacher. Months later, she is still trying to allay the fears of her two children – aged seven and three and a

half – when they see fire and hear sirens. The EPA experts are also suffering, despite all the professional distance that is a basic requirement of their job: “Anyone who spends hours every day seeing nothing but burned-out ruins and the remains of a family’s life can’t get rid of those images that quickly,” says Tony Honnellio. The specialist, who is also a trained radiation safety expert, is one of several counselling psychologists who work on the ground with the teams. Along with other mem-bers of the Critical Incident Stress Man-agement (CISM) team, he regularly visits the workers in Paradise and Magalia and, above all else, listens carefully to them. “We are kind of like first aid for the mind and soul. Since we are all in the same boat, we are very good at identifying those who are suffering as a result of the job and need to talk about it,” says Honnellio. On this particular afternoon, he and his col-league are checking that everything is OK in Jeremy Johnstone’s team, which is working its way through the ashes along Cascade Drive. The more disasters that strike within short spaces of time, the more important the psychological support becomes, says EPA colleague Rusty Harris-Bishop in agreement. “Anyone who does this kind of job often sees themselves as a tough person – someone who runs towards the fire as soon as it burns. Yet beneath that hard shell you have to take a step back and realize that you have a family at home and that there are also good things in life and not just debris and ash. Talking about it helps, before putting on the protective suit again the next morning.”

“THE RISK IS TOO BIG FOR US TO

START AGAIN FROM SCRATCH HERE”

Julie Banwellund, former Paradise resident

IN DEMAND: As a counselling psychologist, Tony Honnellio encourages his colleagues to talk

Modern washing machines have been relieving people of the burden of washing clothes by hand

for more than 110 years. Miele in Gütersloh has helped to shape developments from the beginning –

and is already working on the future.

TEXT NILS SCHIFFHAUER PHOTOS PATRICK OHLIGSCHLÄGER

WHEN WASHING LAUNDRY in a machine, it all revolves around the drum, which produces incredible centrifugal forces and must gently clean the clothes

SPINNING STORIES

42 DRÄGER REVIEW 120 | 2 / 2019

INDUSTRYCLEANING


A stronauts don’t wash! “When engineers from the ESA recently paid us a visit,” recalls Bernhard Roth, “we dis-covered that space travelers wear their clothes for three days and then simply change them.” The engineer had natu-rally already outlined the idea of a wash-ing machine in space, because that is his job at Miele, even in earthbound Güter-sloh. Up to 900,000 washing machines are manufactured here every year; around 70 percent of them are destined for export. “Our appliances are developed for a ser-vice life of 20 years,” says Roth. “At the same time, we keep an eye on the entire chain of laundry care – from production to use,” he says, describing the development process of a washing machine, which can take between six and seven years. Firstly, you have to know what the customer actu-ally wants to wash. Synthetics call for a different strategy to cashmere. Breathable yet sweaty running gear must be treated differently to oil-soiled work clothes. “We also conduct research into how our cus-tomers’ preferences may change over the coming decades,” adds Roth, who studied electrical engineering in Hannover.

CLEANING IS ALL ABOUT SINNER’S CIRCLEIn the next step, the optimal cleaning pro-cess is developed for each type of laun-dry – based on the principle of Sinner’s Circle, which applies to cleaning process-es of any kind – from buildings to laundry and even operating instruments. Sinner’s Circle is named after the chemist Herbert Sinner (1900–1988), who defined chemis-try, mechanical work, time, and temper-ature as the four elements that play a key role in cleaning. All of these elements are needed, but the proportions can be adjust-ed to a certain extent. “The Americans prefer shorter washing cycles,” reports Roth, “sometimes as little as 20 minutes.”

a little uneasy about giving certain laun-dry items to just anybody.” Despite the advantages, commercial washhouses or even laundry services are not an option for many private individuals. That is why 95 percent of all German households had a washing machine in 2018. The fig-ure was 91.6 percent 20 years previously. Unless a trend develops for people to own a second washing machine, South Korea marks the upper limit with 100 percent market saturation.

To laypeople, all domestic wash-ing machines look similar: a white box whose dimensions and connections con-form to slightly different standards in dif-ferent regions around the world. In terms

TAKE IT FOR A TEST SPIN: Engineer Martin Horsthemke is head of the physics testing laboratory, one of the cornerstones of quality assurance at Miele

In order to ensure that the laundry is nonetheless clean, more detergent should be added to compensate for the shorter washing time, assuming that the user doesn’t wish to increase the temperature or increase the mechanical forces. In Chi-na, people traditionally wash their own underwear, either in the shower or in their own washing machine. Only the out-er clothing ends up in the shared washing machine. How do you know such things? “We simply ask people,” laughs Bernhard Roth, and points out that the Germans’ relationship to their underwear is equal-ly delicate: “Not least because the concept of ‘one household, one washing machine’ is well established. People in Germany are

44 DRÄGER REVIEW 120 | 2 / 2019

of performance, operation, service life, and particularly price, however, there are big differences. Even though Miele is characterized by that renowned East Westphalian sense of understatement, it nonetheless likes to live up to its rep-utation of supplying the world’s best appliances.

LIKE A CAR WITH ONE HUNDRED THOUSAND MILES ON THE CLOCK“We are a family-run business like Dräger. We plan for the long term and always opt for the more solid solution – even if it works out a little more expensive,” says Bernhard Roth, who should know in his role as supervisor of around 300 develop-ers and designers. “Miele tests its appli-ances for a service life of 20 years; for a washing machine, that is 10,000 hours.” Translated to a car, that is the equiva-lent of one hundred thousand miles on the clock. During its lifetime, a washing

machine’s electric motor (which spins at a speed of up to 1,600 rpm) has to do a considerable amount of work, producing huge forces in the process. “The first ful-ly automatic washing machines had to be securely anchored to concrete floors to prevent them from running away,” says Jörg Huckenbeck, customer service advis-er at Miele.

A terry cloth bathrobe is the big-gest torture for a washing machine. It absorbs a huge amount of water and the drum then spins within the outer tub with an asymmetrically distributed load. “Forces of up to 5,000 Gs act on the mechanics as a result of this imbal-ance – that’s 5,000 times the acceler-ation produced by the earth’s gravita-tional field!” Intelligent control systems and modern washing processes, aid-ed by mechanical components such as shock absorbers and springs, compen-sate for this in modern machines to

QUALITY, MADE IN GERMANY: A high vertical range of manufacture, innovative solutions, and constant testing ensure the legendary long service life of Miele washing machines. The patented honeycomb structure of the drum (center) plays its role here, along with the fatigue tests (right)

keep the load to a minimum. Just like with humans, a broad back also helps: 13 kilos of cast iron on the back of the drum and around five kilos on the front help to absorb these forces. “When mov-ing to a new house with a Miele washing machine, you can soon tell your friends from your acquaintances,” says Jörg Huckenbeck with a smile. Quality sim-ply weighs more – around 98 kilos on the top model. Incidentally, the cast-iron ele-ments are made in-house in Gütersloh, along with the electronics.

OWL – A CREATIVE NETWORK IN NORTH-RHINE WESTPHALIAProducing consumer goods in Germa-ny with a high vertical range of manu-facture is rather the exception to a rule that tends to see production steps divid-ed across the globe. There are good rea-sons for this exception, which converge into one single word: quality. This is also


INDUSTRYCLEANING

Miele has got together with Dräger to develop special inserts for a professional washer that cleans fi refi ghters’ lung demand valves and face masks within a short space of time.

A lung demand valve like the Dräger PSS provides security in a life-threatening, gas and smoke-fi lled environment when worn in conjunction with a face mask (such as the Dräger FPS 7000). The sophisticated pneumatic system used on the lung demand valve is controlled by the wearer’s natural inhaling and exhaling, allowing them to breathe eff ortlessly from the compressed air cylinder. No fi refi ghter would want to be without it. “Every time the alarm sounds, we always send four breathing appara-tus wearers to the scene,” says Uwe Theismann, head of the company fi re department at Miele. “While traveling to the scene, our colleagues put on the masks, which subsequently have to be cleaned.”

Professional cleaning and dis-infection are performed at 60 degrees

Celsius in a process that must be strictly observed using specifi c chemicals for a certain period of time. The lung demand valve can normally only be cleaned if its pneu-matic system is fi xed by the externally supplied compressed air. Lung demand valves and masks used to be cleaned by hand, just like at many other fi re stations. “When you have between four and six systems to clean and disinfect, it takes up a considerable amount of time,” says Uwe Theismann. “And people don’t exactly jump at the chance to do the job!”

Color-coded basket

But this is a company that builds its own washing machines and dish-washers! So the experts from Miele got together with the experts at Dräger to develop a combination of professional dishwasher and special baskets that can hold up to six face masks and lung demand valves. The lung demand valves are connected to a pipe with a square profi le, which is supplied with compressed air prior to cleaning and disinfection. There is room for various components of the lung demand valves in a small com-partment. Color coding ensures that everything is put back in its right place after cleaning. “Now we can place up to six masks in one basket at an ergo-nomic height and no longer have to work while bending over the basin,” says equipment manager Ralf Auster-mann, citing another advantage of the automatic washer (Type: PG 8063 Safety). Depending on how dirty they are, the products are cleaned and disinfected within 24 to 33 minutes.

THE AUTOMATIC WASHER

evident in the small things, such as the clearance – the distance between the drum and the outer tub. “If it is too nar-row, the drum may not move freely,” says development manager Roth. “If it is too wide, small items of laundry can slip through – and people often think that the washing machine has eaten their socks.” In the course its development work, Miele can draw on a dense network of universities and research establish-ments – the OWL Cluster, which is not even that well known in other regions of Germany. OWL stands for “Ostwestfalen-Lippe” (the East Westphalia and Lippe region), but it also evokes the image of the owl, the bird of wisdom.

It remains to be seen how the tech-nology of washing will look in the future. Bernhard Roth is not prepared to reveal anything right now. But it would surprise nobody if tomorrow’s automatic washing innovations also come from Miele.

WASH AFTER USE: The lung demand valves are placed in the washer’s baskets

46 DÄGER REVIEW 120 | 2 / 2019

INDUSTRIEPRECIOUS METALS

RED GOLDCopper wires are the nerve pathways of industrial society.

Aurubis in Hamburg produces the preliminary products in pure form.

TEXT CONSTANZE SANDERS PHOTOS PATRICK OHLIGSCHLÄGER

47DÄGER REVIEW 120 | 2 / 2019

Copper is everywhere. It is in refrigerators, cell phones, and e-bikes. Nothing works without cables, wires, and coils. Modern technology depends on cop-per wire. Without the red metal, nights would be dark, roads would be empty, and the world would suddenly be analog. Cop-per is coveted. “The copper price is an indicator for the state of the global econ-omy,” says Caspar Burgering, metal ana-lyst at ABM Amro. The fever chart tracing price and demand is seen as an early sign of the economic health of the world. If it fluctuates, attention turns to many other parameters, such as the price of oil and gold or the Dow Jones Index.

“Doctor Copper,” as it is known, takes the pulse. The plethora of technical pos-sibilities makes the raw material a com-modity metal – it is the world’s most used metal after iron and aluminum. “Chi-na’s rapid rise to become the world’s most important production location is also reflected in the use of copper,” say researchers at the Fraunhofer Institute

for Systems and Innovation Research. In 1990, Chinese consumption per cap-ita was running at seven kilograms, but by 2015 that figure had risen to 60 kilo-grams. At the same time, China’s share of global economic output rose more than fivefold.

A MATERIAL WITHOUT LIMITSCopper is virtually an all-rounder. It can be shaped, forged, sawed, and hammered. It connects and separates, cools and con-ducts heat. It doesn’t crack or rust. Cop-per can be alloyed, coated, or refined with countless other metals. It is also a germ killer. “The antibacterial effect of copper remains on the surface for a long peri-od of time,” says Frank Mücklich, presi-dent of the German Materials Society and professor at Saarland University. Hospi-tals benefit from copper alloys to prevent germs on door handles and light switch-es. The research group is currently devel-oping contact materials with an active germicidal effect. It has been known

HOT AND FLOWINGBlister copper comes from the

converter furnace at 1,200 degrees Celsius. The heart of

Aurubis’ copper smelting works in Hamburg beats 24 hours a

day, seven days a week

48 DRÄGER REVIEW 120 | 2 / 2019

since the end of the 19th century that cop-per conducts electricity. Only silver can do it better, but it is much more expen-sive. “The transformation of the ener-gy system would not be possible without copper,” says Michael Sander from the German Copper Institute in Düsseldorf. Coils in the generators of large wind tur-bines need kilometers of flat and round copper wire.

A RAW MATERIAL WITH A FUTUREAn offshore wind turbine contains up to 30 metric tons of copper, which also pro-tects the turbines from the sea climate in the form of a rust-resistant copper-nickel alloy. Almost 24 million metric tons were produced worldwide in 2018 (see also Dräger Review 119, p. 6 ff.). Production is growing at a rate of over three percent annually. Copper is an almost inexhaust-ible resource. In terms of figures, the sup-ply is secure for the next three centuries, with reserves estimated at 5.6 billion met-ric tons. At 1.2 million metric tons annual-ly, Germany is the third-biggest consum-er after the USA. China consumes the most. Electric mobility and rapid urban growth are fueling the demand. A fully electric car needs 80 kilograms of copper,

HELMET, BREATHING PROTECTION: Project manager Torben Edens during a safety training session at Aurubis in Hamburg

LAST STOP in the smelting works: the

casting carousel forms anodes from raw

molten copper – each weighing 400 kilograms

COPPER IS ANALL-ROUNDER


INDUSTRYPRECIOUS METALS

49

plus 20 kilograms per charging station. In the short term, China is planning to build almost five million electric charging sta-tions. As more research is conducted into the raw material, a growing number of usage options emerge. The German Min-eral Resources Agency (DERA) has identi-fied a need for five million metric tons by the year 2035. It won’t be long before cop-per will permit everyday things to commu-nicate with us independently. On a water bottle, for example, an ultrathin film of copper will monitor the current fill level. The user can access the data via Wi-Fi and check their daily water consumption. The label comes from the printer and requires no chip, battery, or mains supply. That’s how the researchers at the University of California in San Diego see things. A clear case for Doctor Copper.

NUMBER ONE IN EUROPEThe base product is produced from cop-per concentrate in huge smelting works. At the Aurubis plant in Hamburg, Torben Edens opens the door to the works. The air is vibrating and the generators and platforms are covered in the gray and brown dust of the copper concentrate. There is also a smell of sulfur in the air. “We use large filters to extract everything

from the hall,” says Edens, project man-ager at Aurubis.

The heart of the copper works in Hamburg’s port beats 24 hours a day, seven days a week. There is molten rock and no daylight. The constant pounding of the heavy machinery can be heard. It may not be an easy job, but it is certain-ly an extraordinary one. Thirty process mechanics per shift work in the eastern plant of the smelting works, which is the third-largest of its kind in the world by capacity, processing more than one mil-lion metric tons of copper concentrate per year. It is number one in Europe. The previously dried and roasted ore mixture

sweeps down the tall reaction shaft with sand and hot air and melts at a tempera-ture of 1,100 degrees Celsius.

In the process, copper matte with a copper content of 64 percent is extract-ed. Iron silicate slag floats to the sur-face and is skimmed off; gasiform sul-fur dioxide goes to the contact process plant. Both are intermediate products that are further processed to produce base materials for the building sector and chemical industry. “The plant produces about one million metric tons of sulfu-ric acid and 700,000 tons of iron silicate each year,” says Edens. “Copper comes in at third place at almost 400,000 tons.”

PURE SCRAP COPPER is recycled as a crushed package without the need for additional energy

VALUABLE COMPANIONSCopper ore contains other valuable by-products: A precious metal content of between six and 15 percent, primarily silver and gold, is found in the anode sludge at the end of the electrolysis process. Aurubis produces around 900 metric tons of silver and 48 tons of gold every year. The gold is sold exclusively to commercial users (jewelry manufacturers, dental technicians, or the electrical industry). The number of diffi cult-to-process by-products in complex concentrates is rising. Urubis develops techniques that optimally process all contents, including nickel, selenium, tellurium, and metals in the platinum group. New technologies for extracting lead are planned. This is used for air-conditioning systems or batteries that power the automatic start-stop system in cars. The copper smelting works is turning into a multi-metal operation.

50 DRÄGER REVIEW 120 | 2 / 2019

INDUSTRYPRECIOUS METALS

FROM ORE TO COPPERSmelting and refi ning are processes used to concentrate ores and clean raw metals. Copper (Cu) with a purity of 99.99 percent is ultimately produced from copper concentrate. The by-products are sulfuric acid and iron silicate. The concentration increases after each step of the process. Follow-up processes isolate elements such as gold, silver, lead, and others.

A spark-emitting steel bucket, suspend-ed from the crane’s heavy hinges, trans-ports 85 tons of molten copper matte to one of the three converters. Injected air combines here with the residual sulfur, leaving 98 percent crude copper. The oxi-dation produces so much heat that the converter has to be cooled with scrap. Old copper material goes to be recycled here without the need for additional energy. “Recycling is one of our strengths,” says Aurubis spokesman Malte Blombach. In the works yard stand mountains of neatly separated stamped parts, printed circuit boards, and wires. Copper can be recy-cled an infinite number of times with no

Copper oreMined

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loss of quality. At Aurubis, 400,000 met-ric tons of old copper and 300,000 tons of electrical waste are recycled annu-ally across four different sites in Ham-burg, Lünen, Olen (Belgium), and Pirdop (Bulgaria). The company is the world’s biggest recycler.

SLABS WEIGHING 400 KILOSOre contains barely more than two per-cent copper nowadays. This is too expen-sive to transport, which is why the mines in Chile, Peru, and China grind it down to a fine dust and enrich it to a concen-trate using the flotation method until its copper content is 30 percent. The mixture

travels by ship to Hamburg via Brunsbüt-tel, where it is presorted. “The anode is a product of the smelting works,” says Edens. The thick, 400-kilo slabs consist of 99.5 percent copper when they leave the smelting works. Beforehand, the fire refining process in the anode furnace removes oxygen and residual sulfur. Mol-ten copper pours out of the rotary furnace into a swinging trough, which transfers it to the casting wheel’s molds with a copper green flame. Empty rotating molds make their way to technicians wearing reflec-tive heat protection. They chip crusts off the grooves, because the anodes have to be perfect. Finally, the cold immersion

EUROPE’S BIGGEST COPPER ELECTROLYSIS PLANT in Hamburg produces almost 400,000 tons of cathode per year

ALL OK? Process mechanics check the values at the anode furnace

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bath. The most important job of the pro-cess mechanics is quality control and tak-ing samples. Using a steel lance, depos-its are broken off at the run-off about twice an hour. Dräger breathing protec-tion (especially full-face and half masks with filters to protect against dust par-ticles, SO2, and CO2) is routinely worn here. And Dräger gas detection technol-ogy monitors carbon monoxide escaping from the electric furnace. “This can form when the slag is reduced,” says Edens. “We also measure the oxygen content by the drum dryer, because we use nitrogen for drying the concentrate.”

ELECTRIFYING FINALEOne of the most important properties of copper is its electrical conductivity. Even a slight impurity can impair this. Electrol-ysis makes the material a real all-rounder, a multi-talent in industrial production. It extracts the remaining by-products from the anode in a copper sulfate solution at a temperature of 60 degrees Celsius. The electricity that flows prompts the copper ions to adhere to two stainless-steel cath-odes. Emil Wohlwill, former head chem-ist at the plant, invented this process back in 1876. He calculated the voltage in the electrolyte so that ions of arsenic, nickel, and zinc remained in the alkaline solu-tion. Gold, silver, selenium, and lead do not dissolve and sink to the bottom of the trough as anode sludge – a brown, highly valuable slush. After one week, millimeter-thin, salmon-red copper cathodes measur-ing two square meters are produced, made of 99.99 percent pure copper. The plant uses this to produce heavy preliminary products for industry, continuous casting formats, special wire, but also alloys. “The main preliminary products are coils,” says Edens. “Rolls of wire weighing five tons and as tall as a human being.” Everybody pulls their weight at Aurubis.

READY FOR DISPATCH: Employees cut the endless roll of copper wire. A new fi ve-ton coil is produced every ten minutes

PROVISIONAL END PRODUCT: Copper cathodes as a raw material for a wide range of uses in industry and the energy and IT sectors

A HIGH-QUALITY METAL

52 DRÄGER REVIEW 120 | 2 / 2019

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CURSED PILLSWhen medication ends up in the sewage system, nature has to fear for its health.

In the Ruhr region, businesses and politicians are therefore clearing matters up by educating people about environmentally responsible disposal.

This knowledge has been lost in many ways.

TEXT FRANK GRÜNBERG


I n India, white-rumped vultures and long-billed vultures only seldom circle over-head these days. Once upon a time, they would devour the carcasses of cows, tak-ing on the role of the natural health police. Then the birds perished on a massive scale after consuming the carrion. The cause of this was diclofenac. In the 1990s, Indi-an farmers began to treat their cattle with the anti-inflammatory drug. It was said to provide pain relief for sick or injured ani-mals. For the vultures, it was the beginning of the end. Just a few cow carcasses con-taminated with diclofenac were enough to wipe them out like flies.

This set alarm bells ringing across Europe, which is regarded as the center of diclofenac consumption. Yet how does the drug end up in the food chain and how dangerous is it to humans and animals? One thing is certain: It won’t be that easy

to get rid of. Diclofenac is one of the trace synthetic substances that can appear in sewage and endanger nature. Experts put the number of trace substances in circu-lation in Germany alone at around 3,000. However, there are only reliable ways of confirming their presence for about 150 of them. The problem is further com-pounded by the fact that it is now difficult to imagine our daily lives without trace substances – they make our shower gels smell nice, relieve pain in pharmaceuti-cals, and enhance the visibility of inter-nal structures as radiocontrast agents in X-ray-based imaging.

“Trace substances are the result of our lifestyle,” says Dr. Issa Nafo. “Most people, however, have never even heard of them, much less the fact that they cause massive problems in sewage.” Nafo is an expert in sewage. He oversees the devel-opment department and manages fund-ed projects at the Emschergenossenschaft in Essen, Germany’s biggest wastewater

ENVIRONMENTSEWAGE

NOT EXACTLY HARMLESS:Experts put the number of trace substances polluting the sewage system in Germany alone at around 3,000

management organization in conjunction with the Lippeverband. The focus of one of these projects is currently on how to keep the sewage free from trace substanc-es. The solution may be a technical one, but preventing consumers from contribut-ing to the problem in the first place would be more effective. Trace substances are a mass phenomenon rather than merely a side issue.

Take diclofenac, for example: Around 90 metric tons of the drug are consumed in Germany each year. Diclofenac is mas-saged into the skin as an ointment, but it is also absorbed by clothing and this ends up in the washing machine and ultimate-ly the sewage system. “Trace substances are one of the biggest challenges current-ly faced by wastewater management com-panies,” says Nafo. “Traditional treatment plants can no longer filter them out.” As a result, they end up in the environment. Research is still being conducted into the extent to which they affect humans and

54 DRÄGER REVIEW 120 | 2 / 2019

ing of the treatment plant in Bad Sassen-dorf to include an ozone stage, funded by the state of North-Rhine Westphalia, and the treatment plant in Dülmen over-seen by the Lippeverband. All three con-cepts are designed to show the instanc-es in which the introduction of a fourth purification stage is a sensible idea. Those involved even went public with the sub-ject, initially in the setting of the Marien-hospital and ultimately in Essen in 2017. The city launched the “Essen makes it clear” initiative to raise awareness among its 580,000 residents about how to respon-sibly deal with old medication – one of the main sources of trace substances. After all, the method used to dispose of them in an environmentally friendly manner is somewhat different today to how it was 25 years ago. Large sections of the popu-lation, however, remain unaware. Since household waste mostly used to end up in landfill sites, Remedica was formed in 1995. The company picked up old medica-tion from pharmacies free of charge and disposed of it properly.

Around 19,000 pharmacies in Germa-ny participated in the scheme at its peak –

animals. Feminized (and actually male) frogs and fish that have effectively swal-lowed the birth control pill for a second time are among the rare, but already doc-umented victims in Germany. Treatment plants are actually reliable filters. From 1900 onwards, solid items such as hygiene articles and fecal matter were mechanical-ly combed out of the water. The biological purification stage followed in the 1920s, which converted the dissolved organic mat-ter into sewage sludge that could be dis-posed of easily. In the 1990s, a chemical purification stage was added to the sys-tem. Dräger has also constantly updated its safety technology to stay abreast of the latest developments and protect the health of the workers at the treatment plants. The Emschergenossenschaft, for example, uses Dräger gas detectors (Type: X-am 5600 & 7000) and oxygen self-rescuers (Type: Oxy K 30 and 3000) when hazardous gases sud-denly appear.

Many trace substances can now be fil-tered out of the sewage at a high percentage rate using a fourth purification stage. One technical option is oxidation using ozone, which oxidizes the trace substances with

the aid of oxygen. Activated charcoal rep-resents another option. Trace substanc-es cling to the charcoal filter in granular or powder form. However, very few treat-ment plants have been equipped with a fourth purification stage. Switzerland is the only country in Europe that prescribes it by law. Experts are not expecting it to be rolled out across Germany anytime soon, not least due to the high investment costs. Consumers would have to foot most of the bill. A family of four could expect to pay an extra 100 euros per year in sewage charg-es. The German government is therefore searching for alternatives and has brought all of the involved parties around the table as part of its “trace substance strategy” launched in 2017. Together they set the tar-get of reducing the discharge of trace sub-stances into the environment.

EDUCATION IS ESSENTIALThey have gone one step further in the Ruhr region. In 2011, the Emschergenos-senschaft commissioned its first treat-ment plant with a fourth purification stage at the Marienhospital in Gelsen-kirchen. This was followed by the upgrad-

ECO-FRIENDLY DISPOSAL TODAY IS DIFFERENT TO HOW

IT WAS 25 YEARS AGO

1TRACING THE SUBSTANCES:

These six modules play a key role in the purifi cation of sewage at the

decentralized treatment plant of the Marienhospital in Gelsenkirchen. The membrane bioreactor (1) fi lters out biomass and guarantees a germ-free process. Part of it is retained by the

permeate tank (2) as prepared water for membrane cleaning. The

ozone reactors (3) remove a broad spectrum of trace substances from the

sewage by means of oxidation and/or adsorption on the activated charcoal

powder (4). Remaining suspended particles are captured at the sand fi ltration stage (5) before running off into the water. The exhaust-air

treatment plant (6) fi lters out odorous substances, among other things

EYE-CATCHING: An advertising cam-paign in Essen raised awareness among the population about the sewage pollution caused by medication residue


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around 90 percent of all pharmacies in total. Many people not only collected new medication from them, but also left their old drugs behind while they were there. It wasn’t long before this routine was regarded as basic environmental knowledge among the population. At the end of 2016, however, Remedica ceased operations, due to insuffi-cient funding. Since the pharmacies were no longer accepting old medication, peo-ple began to look for new ways to dispose of it, but many of them were not sufficiently informed about what to do. Nowadays, the best way of disposing of medication is in the household waste, because it is incinerated at such a high temperature that even trace substances are killed off. The message of the “Essen makes it clear” initiative was there-fore “Medication does not belong down the lavatory.” Posters were put up all over the city to encourage people to rethink.

The campaign really did have an effect, increasing awareness among the popula-tion about the pollution caused by medi-cation residue and the correct disposal method. At the same time, indiscriminate consumption of medication fell. And yet it will still take a very long time to firmly root the knowledge about the best way to dis-pose of medication in people’s minds. A decision will be made in Essen in summer 2019 as to whether and how the initiative will continue. It remains to be seen what will happen in the rest of Germany.

“EVERYTHING TURNS UP AT THE TREATMENT PLANT AGAIN”Since 2011, a treatment plant with a fourth purifi cation stage has been removing trace substances from the sewage at the Marienhospital in Gelsenkirchen. Frank Netz, technical manager, is well aware of the challenges.

Mr. Netz, the managers at the Marienhospital appeared to be rather reticent when the Emschergenossenschaft wanted to build the plant on the hospital site in 2011. Why?We were concerned about our image at the time by assuming that the residents may wrongly interpret this project and think that the sewage at the Marienhospital is especially polluted and could even endanger the environment. This fear did not come to pass, however. Our sewage is now cleaner than ever. The plant is completely odorless and so quiet that it can even be operated at night.Why was it built on the site of the Marienhospital of all places?Because we provide the right conditions for it. Firstly, our buildings have fl at green roofs that make it easier to separate the rainwater and channel it off to green spaces. As a result, we increase the concentration of medication residue in the sewage. Secondly, the Schwarzbach River fl ows past here, which can directly absorb the treated sewage. Thirdly, we channel a cross section of trace substances typically produced by a hospital into the sewage system – medication residue, radiocontrast agents, and dialysis liquids.What is the project designed to show?The amount of eff ort involved in fi ltering out trace substances from the sewage. Since we are able to tell precisely how much we discharge and at what time, the Emschergenossenschaft gets valuable input from us. However, the pilot project wasn’t explicitly designed for hospitals, but for the fourth purifi cation stage. The project is funded by the EU and is a cost-neutral measure for us.Has the consumption of medication at the Marienhospital dropped since?No, because our top priority is to discharge the patient in a good state of health. Their clinical picture informs the amount of medication or radiocontrast agents needed. What has changed, however, is the disposal of diapers, gauze bandages, and cleaning cloths in the wards. Many of them used to be fl ushed into the treatment plant via the lavatories. The rakes became blocked and operations ground to a halt. We have now reduced the number of breakdowns to almost zero.What do you put this success down to?Our information campaign and the fact that patients are no longer able to secretly fl ush away solids in the hospital lavatories. Everything ultimately turns up again at the treatment plant a short while later – and can cause a great deal of trouble.

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56 DRÄGER REVIEW 120 | 2 / 2019

INDUSTRYOFFSHORE

Ruud Maasland is well prepared as he walks along the gangway to board JB-115. The 61-year-old employee of Dräger Marine Offshore Service in the port of Rot-terdam knows what’s coming next. Wait-ing for him on the deck is Mark O’Shane, offshore installation manager at Jack-Up Barge, an operator of self-elevating plat-forms.

Steel platforms like JB-115 use a pro-peller to move through the water like a ship or they are towed – to the construc-tion site of a wind farm off the coast, for example. Once they have arrived at their destination, they plant themselves on the seabed using four huge pillars. Their rotat-ing crane is thus stabilized and they can

then maneuver components such as wind turbine shafts and rotors into position. In a short while, JB-115 will leave Rotterdam on course for Deutsche Bucht. The next construction site is already waiting. But before then, the Scot Mark O’Shane has to clear the decks as the man responsible for safety and procedures on board.

PROVEN RECIPE FOR SUCCESSDutchman Maasland has to rely some-what on O’Shane’s goodwill because he has a colleague and two visitors in tow to show them the platform’s safety equip-ment, which is supplied and maintained by Dräger. “You always drag along these people,” says the good-natured Scotsman,

APPROACHABLE: Ruud Maasland (r.) from Dräger Marine

Off shore Service also visits his cus-

tomers on board

SAFETY AT SEAAt first glance, the office on Beurtschipperstraat in the port of Rotterdam

looks like the newsroom of a press agency. However, the constant stream of messages received here relate to customers’ vessels sailing on

all seven seas in this world. A visit to Dräger Marine Offshore Service.

TEXT OLIVER DRIESEN PHOTOS PATRICK OHLIGSCHLÄGER

teasing him, “and I never even get a bar of chocolate out of it. But that’s OK!” O’Shane rolls his eyes in playful resigna-tion. After a short safety briefing for the visitors, who are wearing protective cloth-ing, he lets them on board. “You are wel-come to take a look around!”

Few people know Dräger Marine Off-shore Service’s recipe for success better than Maasland, who has been working in the so-called FRS business with mar-itime customers for more than three decades. FRS stands for firefighting, rescue, and safety. Dräger has a com-prehensive global product portfolio in these three areas, allowing it to supply everything a decent-sized ship needs –

RUBRIKTHEMA

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IMPOSING STRUCTURE: The self-elevating platform JB-115 is still in the port of Rotterdam. Soon it will be moved to Deutsche Bucht, where a new off shore wind farm is being built

58

LINED UP: These fi re escape hoods, part of the safety equipment on ships and drilling platforms, wait for their regular inspection

URBAN MEETS MARITIME: Rotterdam, the second-biggest city in the Netherlands, is Europe’s most important oil and gas port

HOMEMADE: Experts from Dräger Marine Off shore Service maintain and repair the customers’

equipment in the company’s own workshop

59

INDUSTRIEOFFSHORE


from the simple fire extinguisher to the high-tech foam cannon, as required by law on floating helicopter landing pads. From first aid kits and emergency ven-tilators to gas detectors for drilling plat-forms and survival suits for sea res-cue missions, Dräger not only sells all of these products, but can also service them if required. Many aspects are tak-en care of on board, including regular maintenance, function testing, test cer-tification, spare parts provision, repairs, and training. On deck is the place where the customers are – and also where the potential lies for sales employees like Maasland to network with people.

“A bar of chocolate and a few friend-ly words won’t secure any contract,” says Maasland. “You have to show your coun-terpart that you speak the same language on an equal footing. Then you can demon-strate that you are not only able to make promises, but also keep them.” After all, it is not just the price that counts or the high quality of the available products, or even the often extremely long maintenance periods of up to ten years on account of this high quality. Above all else, it is the chemistry that someone like Maasland establishes. It subtly says: “You can trust us, because we tick in the same way as you! We won’t leave you in the lurch when

you change your course or schedule on the high seas.” All of these are unspoken messages that are received – or not, as the case may be.

A number of different pieces of equipment on board platform JB-115 shows that Dräger has struck the right tone with Jack-Up Barge. “This partic-ular platform benefits from our entire FRS equipment portfolio – both in terms of products and services,” says Roland Schwegman. The 32-year-old is responsi-ble for business development at Dräger in Rotterdam. He points out the foam extin-guishing system on the helicopter deck as one example: Their “monitors” – mobile foam cannons that are used in the event of a crash landing – are regularly ser-viced by experts based at the Rotterdam headquarters.

TODAY NIGERIA, TOMORROW RUSSIAThe service also includes fire extinguish-ers, respiratory masks, survival suits, and CO2 pressure cylinders for smothering fires in the engine room. Many of these refills, regular inspections, and repairs can neither be carried out in the safety of the port or in Dräger’s big workshop on Beurtschipperstraat. Foam cannons, for example, cannot be used at all in ports

THE CUSTOMERS ALWAYS NEED TO BE ON THE HIGH SEAS, WHERE THEY EARN THEIR MONEY

for environmental reasons. Accordingly, their functional safety can only be test-ed at sea. Customers need to be at sea anyway, because this is where they earn their money with their vessels, rather than wasting time and frittering away money on fees in the port. Very few busi-nesses are structured to be as mobile as Dräger Marine Offshore Service, whose customers operate thousands of vessels around the globe. And very few have to deal with so many imponderables, from logistics to politics.

“Some of our employees returned from Nigeria last week,” says Dick de Fries, 56, head of almost 80 Rotterdam-based Dräger employees. “One of our customers has a pipelaying ship off the coast there. They jumped into the heli-copter, carried out the service, and took off again. But to get to the helicopter in the first place, our people in the Jeep had to be escorted by armed vehicles due to the tension surrounding the presiden-tial election. The destination this week is Russia. Oh yes, and then we have just taken on a new gas tanker project for Mozambique; an international joint ven-ture.” It is therefore no coincidence that the planning department in the offices of Dräger Marine Offshore Service is rem-iniscent of a newsroom. On countless

MARITIME EXPERTS: Dick de Vries (l.), manag-ing director, and Roland Schwegman, responsible for busi-ness development at Dräger Marine Off shore Service in Rotterdam

INDUSTRIEOFFSHORE

60 DRÄGER REVIEW 120 | 2 / 2019

screens, linked to one control desk after another, orders and price enquiries are received, alongside the latest updates from all over the world, including off-shore construction sites that have report-ed problems, gas tankers that have been hampered by storms, and ships whose plans have been changed by custom-ers. Yet the show must go on – even in the face of adversity – and the business must also continue to provide its servic-es on the seven seas of this world. It is a business that is special in many ways. For one thing, Dräger Marine Offshore Service also has third-party products in its portfolio, because shipowners most-ly prefer this or that brand. For another, it is almost impossible to separate sales from service.

“It is different here to other Dräger business divisions,” stresses de Vries. “There are usually experts in one specific field or another. That isn’t the case here!” In the maritime business, people like to entrust the servicing to the same party that sold the equipment. Every Monday at 11 a.m. at the weekly planning meet-ing, de Vries and Schwegmann there-fore get together with their most experi-enced colleagues to adapt their strategy to whatever is happening in the world. They call it a flow meeting, although it

usually involves addressing things that have come to a standstill. The nine peo-ple gathered in the room survey the latest situation on a large screen on the front wall. Every supplied vessel between Cape Horn and the Bering Strait appears on a list, complete with name, service status, details of any delays, and all other note-worthy information.

BREXIT UNCERTAINTYThe meeting is rather laid-back on this particular day, until one item arises on the agenda that has increasingly been causing consternation among planners for a number of weeks on both sides of the English Channel: Brexit. “We move a lot of goods and people between Rot-terdam and our key location in Aber-deen,” explains Schwegman. “That is why we want to permanently station our two maintenance containers there, with everything required to provide on-board service.”

Yet before the planned Brexit date, nobody knows the legal implications of this from a customs and trade perspec-tive in the future. “The biggest concern is that speed and flexibility may suffer.” And those are the trump cards in the global game played by Dräger Marine Offshore Service. These things were still a long way

off when the forerunner to Dräger was founded on the site in the port of Rotter-dam in the 1970s. “Back then, the owner initially concentrated on inland ships that traveled along the Rhine,” says de Vries, who was still chartering towards the end of this era. Oil, gas, and chemical freight-ers continue to make up part of Dräger’s customer base to this day. “Over time, the authorities prescribed ever more safety equipment for these vessels and we even-tually became the biggest supplier after Dräger itself. Dräger then acquired the company in two stages and had completed the takeover by the year 2000. At the same time, the business grew with oceangoing ships, where the focus has now been for some considerable time.

Most of the work has now been dig-italized and is performed across differ-ent time zones. On Beurtschipperstraat, radar contacts on computer screens show all relevant ship movements in real time – whether in the port of Rotter-dam or somewhere in the North Atlan-tic. New markets such as cruise ships are being targeted. The image of the family-run business leisurely floating along is long gone. Yet some things never change. “Personal eye contact remains crucial.” The sales veteran Ruud Maasland knows this in his sleep.

THE SHOW MUST GO ON – EVEN IN THE FACE OF ADVERSITY

OVERVIEW: Mark O’Shane, off shore

installation manager, on the self-elevating

platform JB-115 owned by Jack-Up Barge

61

DIALOGUE: A long-standing relationship founded on trust

often develops on the basis of conversations between crew

members and Dräger employees

AN EYE FOR DETAIL: The Dräger X-plore 6300 full face mask on the deck of a customer’s ship.

Onboard visits are an essential part of the service business

ROOTS: The business run by Dräger Marine Off shore Service started with inland ships in the port of Rotterdam – and continues to this day

62 DRÄGER REVIEW 120 | 2 / 2019

The world’s first underground final disposal facility for highly radioactive nuclear waste is being built in Finland.

In 100,000 years from now, it could still be leaving traces from an era when mankind exploited nuclear energy. However, the

operators believe that people will never find it in the distant future.

TEXT OLIVER DRIESEN

BURIED AND FORGOTTEN

SCIENCENUCLEAR WASTE


The elk stalks the birch forest with steam rising from its body heat – a sign by the side of the road warns of surprising encoun-ters of this kind. In contrast, nothing will prepare travelers for the place that lies at the end of the road. Here, on the Finnish island of Olkiluoto, is the entrance to eternity. The tires of heavy vehi-cles have already turned the snow blanket into slush to reveal the dark asphalt beneath. The access road leads into a tight right-hand bend. The ramp is completely free of snow on these final meters above the ground, shielded from the wind by the granite rocks lined with gray concrete. A massive roller door comes into view. When it opens, the underworld of Onkalo is revealed.

The word Onkalo is Finnish and means “cavity.” This is some-thing of an understatement, because Onkalo is a huge, complex underground structure. A five-kilometer-long tunnel road twists and turns to a depth of around 450 meters. One day, the main tun-nel will branch out here into a labyrinth of systematically designed dead ends. The Finns are considered to be pioneers of innovative underground engineering.

BUILDING SITE FOR THE NEXT 100 YEARSHelsinki is the only city in the world that has developed a land-use plan for its underground space, with parking garages, shop-ping arcades, an IT data center, a swimming pool, and a sewage treatment plant. Even parts of a hospital have been sunk below the ground since the plan was devised. However, the consignment set to be stored at the Onkalo site a three-hour drive away can be quite literally described as hot goods: containers filled with high-ly radioactive atomic waste. The building project, which began in 2004, will be the world’s first final disposal facility for spent ura-nium. Onkalo has been designed to store waste for 100,000 years. Only then will the radiation inside the containers be fully decayed.

This planning horizon, prescribed by the Finnish Radiation and Nuclear Safety Authority (STUK), is thus 20 times longer than the age of the oldest preserved structures in human history – the Egyp-tian pyramids. There are also other reasons why the time periods under consideration here are probably record-breaking. “Onkalo will remain a construction site for the next one hundred years,” says Pasi Tuohimaa, spokesman for the operating company Posi-va. The final extensions are set to be completed sometime in the early 22nd century.

TUBE MAIL TO THE FUTURE:

A copper capsule for nuclear waste during

a test storage run deep beneath the

Finnish birch forests

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64 DRÄGER REVIEW 120 | 2 / 2019

SCIENCENUCLEAR WASTE

This won’t prevent the first nuclear waste containers from being delivered to the site in just a few years’ time. Large trucks are set to bring them from the temporary storages already in operation on Olkiluoto. Together, these nuclear power stations have been assigned a key role in the energy concept of the nuclear-friend-ly Finns, generating 32 percent of the country’s electricity from this particular energy source.

NO REPAIRS OR MAINTENANCE NEEDEDYet even the Scandinavians cannot infinitely store the nuclear waste in aboveground spent fuel pools and maintenance-inten-sive intermediate storage facilities after it has already been there for more than 40 years. Onkalo is thus the kind of permanent dis-posal solution that is not yet available in industrialized nations such as Germany – around 60 years after commercial nuclear power generation began. Work on the interior of the storage facil-ity is already under way; Dräger has supplied refuge chambers, escape hoods, Alcotest devices, and gas detectors, for example. But why exactly will the problematic waste be buried underground on a small promontory that projects into the Gulf of Bothnia of all places? The region’s geology provides the answer – because the continental shelf here is made of granite that is 1.9 billion years old; highly stable and fracture-resistant, isolated from all known

sources of seismic disturbance. The containers with the spent fuel rods are made of cast iron housed within corrosion-resistant copper canisters. In addition, they are encapsulated in bentonite within their “graves.” This is a mixture of different clay miner-als that would absorb any water ingress and swell up to act as a sealant. A cement block serves as a further protective layer, seal-ing off each of the storage areas. Packaged in this way, everything should take care of itself once the storage process is complete. That is precisely the point of a final disposal facility: no need for main-tenance or repairs, no energy supply necessary, and no employ-ees required to check that everything is in order underground for evermore. At best, all of this can be planned and maintained for a few decades. History teaches us, however, that civil unrest, natu-ral disasters, economic crises, and wars have thwarted plans that have gone beyond such periods of time. This is a risk that final disposal facilities cannot take. Instead, they have a self-sufficient,

ESCAPE ROUTE: A goods lift in the ventilation shaft can be used in an emergency to transport the workers to safety from a depth of 290 meters

MEDIA CROWD: Posiva spokesman Pasi Tuohimaa (right) and a geologist give journalists a tour of the underground facility

ONKALO PROVIDES THE SOLUTION THAT THE OTHERS DON’T YET HAVE


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fully passive, yet multilevel safety system. It monitors the situa-tion underground, which is almost completely uneventful, aside from the decaying radioactive isotopes. “Onkalo can become an international model project,” says Tuohimaa. “Even though each country has its own unique geological features, which is why the storage facility cannot be exactly copied, the concept of multiple barriers can nonetheless be copied.”

MESSAGES TO FUTURE GENERATIONSThe outermost of these barriers is still a long way from comple-tion: Once the storage of at least 6,000 tons of radioactive “souve-nirs” is finally complete sometime after the year 2100, the descen-dants of today’s engineers will have the job of sealing the entrance to the underworld against any kind of trespassing with an impen-etrable concrete plug. Then the aboveground section of the facil-ity will be dismantled and the original landscape rewilded. And then the grass will grow above Onkalo. This raises almost philo-sophical questions: Should the world be warned against the forc-ible opening of the burial chamber containing the hazardous waste of our civilization for a period lasting up to 100,000 years? And in what kind of medium could this message even survive a new Ice Age – which scientists expect in 60,000 years – with ice-bergs several kilometers thick covering Onkalo? Would the for-getful yet curious human species perhaps even misconstrue the ancient warnings as an invitation once the ice has melted?

The Danish concept artist and filmmaker Michael Madsen explores these questions in his award-winning documentary film Into Eternity about Onkalo. Madsen presents some ideas for intu-itively effective “deterrent landscapes” above the nuclear waste tomb. They are sketches of timeless symbolism: a thicket of stony thorns, for example, or a relief of Edvard Munch’s alarming paint-ing The Scream. Another possibility is a field of monoliths whose

hieroglyphics mark the location and hazardous nature of the arte-facts buried deep beneath the rocks. Yet the director also contem-plates the possibility of the inscriptions being eroded by the weath-er over the years so that the warning message can only be passed down by word of mouth from one generation to the next: “Have your parents warned you about the burial chamber that should always remind you that you must forget it?” The melodramatic poetry of the film essay is not exactly something that the opera-tors of Onkalo consider to be reasonable. For now at least, Posiva spokesman Tuohimaa doesn’t think much of the thesis that Onk-alo will continue to pose a danger so far into the distant future: “Even though the waste will still be active after 400 or 500 years, you could still theoretically take it home with you for a while with-out exposing yourself to a particularly high dose of radiation.” In any case, Posiva has no plans to place any kind of long-term warn-ing notice on the surface. “We view Madsen’s film as pure spec-ulation. In 100,000 years, this entire site will be nothing but ordi-nary rocks.”

The “petrification” of Onkalo’s hazardous waste site and its expunction from the memory of mankind would certainly be a favorable outcome for this once-in-a-hundred-millennia project, which has thus far cost almost one billion euros. It is expected that a similar figure will be paid out before the first nuclear waste is stored – and then the tunnel construction will continue for anoth-er hundred years. A fund set up by the Finnish nuclear power sta-tion operators, financed from their profits, will pay for it rath-er than the taxpayers. Tuohimaa considers this to be a fair deal: “When you think about how much electricity has been done here, the price for the final disposal facility really isn’t that high.” That is probably the secret of Onkalo: Against the backdrop of a suffi-ciently large magnitude, any figure and any problem then seems small by comparison.

TUNNEL ROAD

STORAGE AREAS

COPPER LINING

FINAL DISPOSAL FACILITY

SUPPLY SHAFTS

TRANQUIL WORLD: Highly radioactive

nuclear waste from Finnish nuclear power

plants is set to be transported to Onkalo

fi nal disposal facility. The special waste con-tainers have a rustproof

copper lining. The special trucks will take each container along a winding, fi ve-kilometer-long tunnel road to in-dividual storage areas 450 meters beneath the ground. Vertical supply shafts will ventilate the

underground facilities

NUCLEAR POWER PLANT

66 DRÄGER REVIEW 120 | 2 / 2019

THE BODY IS THE LIMIT

Military pilots need a well-trained physique to maintain control under extreme conditions – sometimes they are

exposed to forces up to nine times the acceleration produced by the earth’s gravitational field. At the Swiss Air Force’s

Aeromedical Center, Dräger supports them with a testing and training unit.

TEXT TOBIAS HÜRTER PHOTOS PATRICK OHLIGSCHLÄGER

FULL CONCENTRATION: Swiss military pilots like Jürg Niemeyer (l.) must complete many missions. Among other things, they provide support in search and rescue operations, take aerial shots, and hunt for fugitive criminals


MILITARYPILOTS

The military air base in Düben-dorf has a great history. Swiss aviation began here at the start of the 20th cen-tury. This is where the physicist and inventor Auguste Piccard took off on his legendary balloon flight into the strato-sphere, and this is also where Allied planes landed that had been damaged by gunfire during World War II. The vast site near Zurich remains an important base for the Swiss Air Force to this day. Light and heavy-lift helicopters regular-ly take off from here on sorties and train-ing flights. The PC-7 aerobatic squadron is also stationed here.

However, an essential part of the dai-ly lives of the Swiss military pilots plays out not in the hangars of Dübendorf, but a five-minute drive away – at the

Aeromedical Center. The pilots come here for health-related reasons. They are thoroughly examined before they are accepted by the squadrons. In addition, they must undergo annual tests to make sure they are still mentally and physically fit enough to perform their extremely demanding job. They also receive health advice at the center and are able to train.

NO BLACKOUTSDräger has been managing the center’s testing and training unit since 2004. It is run by Sven Rochelt, product manager at Dräger. The sports scientist devised the initial concept when the Swiss Air Force launched the public tendering process to award the contract for the unit. At the beginning, he managed the unit from Germany, but after a few years he moved to Zurich. He is supported by a team of

seven people so that the pilots always have somebody to speak to. The initial health-related focus was on strengthen-ing the cardio vascular system.

Military flying places the heart under a great deal of stress. When the plane climbs, the blood sinks. The heart must significantly increase the resting blood pressure in order to be able to continue to supply the brain with oxygen, otherwise there is a danger of the feared G-LOC – a blackout – which can quickly cost pilots their lives in a supersonic plane. That is why they use centrifuges to build up their resistance to high acceleration and wear anti-G trousers, which use compression to prevent blood from accumulating in the legs.

Aeromedical physicians explain it as follows: The blood vessels in the arms, legs, and stomach suddenly dilate under extreme acceleration. Even though the

STRONG BACK: How long can

pilot Jürg Niemeyer maintain this

position? Dräger employee Janine

Rochelt times him

68 DRÄGER REVIEW 120 | 2 / 2019

MILITARYPILOTS

heart powerfully pumps the blood at a rate of between 190 and 200 bpm, it is no longer able to supply the parts of the body above the rib cage. As a result, there is a lack of blood in the brain. The blackout is the last brief warning sign before uncon-sciousness. Even though the pilot can still hear, they are unable to react. Untrained people would immediately lose conscious-ness in an agile fighter jet. It is apparent, however, that the cardiovascular system is not the most critical component of the pilot’s physique. Even more important are strong muscles, particularly in the back and neck.

The Boeing F/A-18 Hornet intercep-tor jet exposes the pilots to forces up to nine times the acceleration produced by the earth’s gravitational field, although such extreme values are seldom produced in training, because they not only take a lot out of the crew, but also the aircraft. Nonetheless, the pilots must be able to withstand such forces in an emergency situation. The neck muscles must keep the five-kilo head and three-kilo hel-met stable while a force equivalent to

a weight of over 70 kilos pulls on it. As such, it is the job of the 200 Swiss full-time military pilots to undergo a health check at least once a year in the rooms of the testing and training unit at the Aero-medical Center.

REGULAR TRAININGThe employees of Dräger’s vital manage-ment team test the strength of the pilots not with heavy weights, but primari-ly with isometric and dynamic exercis-es. For instance, they get them to do a side plank on a mat or stretch out their legs horizontally while laying face down on a box – and time them with a stop-watch to see how long they can hold this position. The results are then evaluat-ed to establish how they have changed since the last test and work out whether the training needs to be modified. The pilots can then implement the recom-mendations just next door in the unit’s training center, which is equipped with free weights, cable crossover machines, TRX bands, gym balls, and endurance machines. In addition to building up

strength, Sven Rochelt recommends that pilots and anyone else who does sport should regularly “roll out” the muscles with foam rollers and fascia massage balls to keep the muscle fibers supple. The 40-year-old helicopter pilot Jürg Nie-meyer comes to train here once a week. It is not difficult for the son of a German father and Swiss mother to keep himself fit – in summer he rides his racing bike and in winter he does cross-country ski-ing in the Zurich highlands.

Niemeyer originally f lew tamer planes as a commercial pilot for Swissair, but the airline ceased operations right at the end of his training period. Niemey-er applied to the air force and passed the entrance tests. That is how he came to wear the green flying suit of the Swiss Army – which bears his nickname “Nimi” – rather than the blue uniform of an airline pilot. There is a tradition among military pilots of using nicknames to address each other. One day, Niemeyer was presented with a form on which he had to select one of two options for his career as a pilot – either jet or helicopter.

PRECISELY PLANNED: Dräger employees use the test results to draw up recommendations for the pilots’ training

MENTAL SKILLS: The pilots also take

cognitive tests while deprived of oxygen

PILOTS NEED A STRONG PHYSIQUE TO MAINTAIN A CLEAR

HEAD IN CRITICAL SITUATIONS


HEAVYWEIGHT FLYER: The Aérospatiale AS 332 has a maximum takeoff weight of nine metric tons

He opted for the helicopter. Flying jets may be more spectacular, but it mainly involves training. Even though the heli-copter pilots don’t have to endure any-where near the same acceleration levels as their jet-powered colleagues, the vib-rations and longer missions are no less stressful for them. The squadron to which Niemeyer belongs flies in the Aérospatiale AS 332 medium-lift helicopter also known as the Super Puma. It has a maximum takeoff weight of nine metric tons, inclu-ding one and a half tons of fuel. Niemeyer and his comrades use the helicopters to fly a wide range of missions. Among other

things, they support Rega ( Switzerland’s air rescue service) in search and rescue operations, take aerial shots for maps, hunt for fugitive criminals, and escort high- ranking politicians.

SEARCH MISSION IN A STORMNiemeyer especially remembers one dra-matic operation – the search for a Ger-man doctor who had got into difficulty on a mountain in the region known as Appenzeller Land. They flew for over an hour through the storm, rain, and thick clouds in a helicopter equipped with an infrared search system and a strong

70 DRÄGER REVIEW 120 | 2 / 2019

MILITARYPILOTS

searchlight. He had to make the decision to abandon the search, otherwise he would have endangered his own life and those of his colleagues on board.

This story illustrates what Niemey-er calls the key skills of a good pilot: situation awareness and decision-making. They are mental skills. Yet a strong mind can only function in a strong body. The long search mission in the storm took the well-trained Niemeyer to the edge of his physical capabilities.

TESTING AND SUPPORTINGIn the rooms of the testing and train-ing unit, Niemeyer proves that he is also equipped to deal with critical situations. He lies on his stomach on a bench with his head over the edge, while an eight-kilo kettlebell hangs from his forehead on a band. A Dräger employee starts the stop-watch. Niemeyer holds this position for ten minutes. The fact that he and his col-leagues like to come to the Aeromedical Center these days is also down to its direc-tor, Colonel (Doctor) Andres Kunz. When

Kunz took over the management of the center in 2010, he noticed that the pilots tended to shy away from going there. They were almost always examined here to test their suitability for service. “We wanted to show them that we not only want to examine them, but also support them above all else.”

Kunz promoted an open, integrative feedback culture, expanded the medi-cal support, and made visits to the air base instead of waiting for the pilots to come to the center. “It is only possible to understand the kind of stress to which the pilots are exposed when you see them at work,” he says. The testing and train-ing unit plays an important role here. “We regard Dräger as an essential part of our operation and appreciate the knowl-edge involved.” The Aeromedical Center not only works with Dräger when look-ing after the pilots, but also in the field of research and development. In the base-ment, for example, is Switzerland’s last remaining hypoxia chamber, built in 1951 and tested for simulated heights of up to

20,000 meters, although used up to 9,000 meters.

COMPLEX DEMANDSThis is where the pilots can gain vital expe-rience of how the deficiency symptoms associated with extreme altitude feel. In other words, they learn how to remain alert when a lack of oxygen disorients the brain and the high concentrations of car-bon dioxide in the blood trigger feelings of panic. The medical demands made on military pilots are more complex than almost any other profession. As such, the demands made on the Aeromedical Cen-ter are equally complex. It tests the pilots’ eyesight and hearing as well as their den-tal health. It even runs its own medical laboratory. The pilots are also psycho-logically tested and supported here. In today’s high-tech aircraft, which cost mil-lions of Swiss francs, humans are the lim-iting factor. The aim of the Aeromedical Center in Dübendorf is to prepare them as best as possible for the task – and Dräger supports this aim.

HUMANS ARE THE LIMITING FACTOR IN THE AIRCRAFT

PERFECT POSITION: The pilots spend a great deal of time doing TRX suspension training

AT ALTITUDE IN THE BASEMENT: The Aeromedical Center is home to Switzerland’s

only hypoxia chamber

Technology for LifeHere you will find some of the PRODUCTS featured in this issue.

The QR codes lead to additional information for each product shown. If you have questions about a particular product or Dräger Review, write to us: [email protected]

Dräger Safety AG & Co. KGaA, Lübeck, manufactures the following products: FTS 8000 (p. 3), X-am 8000 (p. 8), MFC 7000 (p. 10), Oxy 3000/6000 MK II + Pac 5500 + PSS 3000 + Saver CF (p. 22), X-plore 6300 (pp. 22, 61), U Lung Demand Valve + Panorama Nova (p. 30), X-am 5000 + Chip Measurement System (p. 41), FPS 7000 (p. 45), X-am 5600 + 7000 (p. 54),

Oxy K 30 + 3000 (p. 54). Drägerwerk AG & Co. KGaA, Lübeck, manufactures the SmartPilot View software (p. 35).

SMARTPILOT VIEW This software calculates and displays both the current and predicted anesthesia levels for the next 20 minutes on the basis of the administered medication. Page 35

PAC 6500 (successor to the 5500)This personal single-gas detector measures up to 29 gases, including carbon monoxide, hydrogen sulfi de, and oxygen. Page 22

FPS 7000 Full-face mask with wide fi eld of vision (made from distortion-free polycarbonate), which can be combined with various accessories. Available in three sizes. Page 45

X-AM 8000 This gas detector simultaneously measures the presence of up to seven toxic and fl ammable gases as well as vapors and oxygen – in either pump or diff usion mode. Page 8

OXY 3000/6000 MK II Whether in mining or many other industries around the world, these devices supply their wearer with breathing air for 30 or 60 minutes when there is a lack of oxygen. Page 22

PSS 3000 The lightest self-contained breathing apparatus in the Dräger PSS series. It is solidly built, very comfortable to wear, and easy to operate. Page 22

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SERVICEINFORMATION

INSIGHTSENSOR TECHNOLOGY

ALL IS CALM THANKS TO THIS MONITOR

New parents are well aware that there is nothing nicer than when the baby is sleeping peacefully. The Dräger Dreamguard ensures that a sense of calm

prevails in the room next door, or when sitting on the park bench. That’s because the device intelligently notifies whether everything is OK with the baby.

QUIET AND LOUD

In the event of an emergency, the device will sound at its maximum volume level, which

is piercing. Volume levels for non-emer-gency alerts on the baby monitor, however,

are controlled using these buttons.

SOUND ASLEEP

When this symbol is lit, a sensor and algorithms notify that the baby is in a restful sleeping position. If this is not the case, the baby is probably awake. A signal is also triggered if the baby is lying on its stomach.

DISPLAY

This three-level display shows at a glance how loud the baby is. Incidentally, the wearable can also be monitored using an app for iOS or Android – free of charge.

ON/OFF

The receiver is normally plugged into the mains, but can also be used when mobile and even outside the home for longer periods of time thanks to the integrated and automatically recharging batteries. It receives the signal from the wearable via Bluetooth as metadata.

MUTE SWITCH

An algorithm carefully developed in conjunction with the University of Lübeck

analyzes the movement pattern of the wearable and raises the alarm if something may not be right with the baby. This alarm

can be muted for a short period of time.

WEARABLE

This is attached to the baby’s clothing; a magnet and counter magnet ensure that it

remains securely in place. Two sensors detect movement as angular acceleration on all axes.

It is charged via contacts located on the back of the receiver and has a microphone

(baby monitor function) on the front.

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LIGHT RING

This ring is green when everything is OK and changes to amber if

there is a technical issue. And if the alarm is raised, it turns red!

Documents

THE SILENT DANGER - Dräger