Oct. 13, 2010 -- It has been more than two months of darkness for the 33 miners, trapped more than 2,000 feet below the earth in Chile -- and last night the operations commenced to hoist these miners to safety.
The collapse of the copper and gold mine in the Atacama Desert captured the world's attention, along with that of some of the foremost medical organizations in the world.
But while the rescue of the miners is a light at the end of the tunnel in every sense of the phrase, the ordeal may not be over just yet. Doctors are prepared to treat a host of health conditions caused by their entrapment, from skin infections to post-traumatic stress disorder.
Health Hazards 2,000 Feet Below
Medical professionals said the dark, dank environment of the mine is a breeding ground for many physical ailments.
Dr. Neil Schachter, medical director of the Respiratory Care Department at Mount Sinai Medical Center in New York City, said that the poor air quality may cause miners to suffer from pulmonary issues -- including a depressed immune system, partially collapsed lungs from shallow breathing, and asthma due to mold and dust inhalation. And, even with the lack of fresh air, the miners were given the go-ahead to smoke while trapped.
"I would expect respiratory infections in this weakened state," said Schachter.
Doctors said fungal infections like ringworm, athlete's foot and jock itch are also likely -- not dangerous but often very uncomfortable. Treatments are available for the miners once they surface, but it can take months to be fungus-free.
Plus, dental hygiene -- an issue that is not usually a primary concern in traumatic events -- could be a looming issue. The miners were not able to brush their teeth for the first 17 days. Because of this, some developed the gum disease gingivitis. Smoking, diabetes, poor nutrition, and hormonal changes all exacerbate the risk. Many of the miners have been smoking, and one is diabetic. Many of their hormone levels are likely to have changed due to the stresses of being trapped. Fortunately, a good dental cleaning will help treat the gum disease.
A Perilous Journey Into the Light
In order to escape the mine, each miner will take a 15-minute to one-hour ride to the surface in the rescue capsule known as the Phoenix. While the capsule is equipped with oxygen masks, a radio, video camera, and medical instruments, experts said the rescue process itself may be particularly arduous, as they will be squeezed into a cylinder that is only 21 inches wide.
Clinton Cragg, a NASA engineer who worked on the Phoenix's design, said that he and his colleagues were not certain what the atmosphere in the shaft would be like; they prepared the cylinder for rocks and debris that may fall while it is being pulled up.
"In the design process, you try to think of everything you can think of that can go wrong, and you try to put something in the design to mitigate or deal with that," said Cragg. "Apparently they tested the capsule in a shaft, and everything is working properly."
Chilean Health Minister Jaime Manalich told reporters on Sunday that the miners could suffer from dizziness or fainting spells, and said they may even experience anxiety attacks from claustrophobia during the half-mile ride back up to the surface.
Doctors also worried the miners could suffer blood clots and even heart attacks on ascent; they sent aspirin down to the miners to thin their blood prior to the journey.
Once the miners emerge from the shaft, those who are rescued during daylight hours will wear sunglasses to protect their eyes from the blazing Atacama Desert sun. The glasses will ease the magnified exposure to UVA and UVB light.
"[The miners'] extended exposure to darkness may make them more light-sensitive than most people who would be if dark-adapted, but it will not take them long to adjust," said Dr. Ivan Schwab, professor of ophthalmology at University of California Davis School of Medicine and director of corneal services at UC Davis Medical Center. "I also suspect that the overwhelming joy of the miners and their families will quickly limit their brief light sensitivity."
Health Risks on the Horizon?
Doctors are giving each miner a primary health exam to ensure that their vital signs are stable and intact. The miners will then go to the hospital for another exam, which will include blood work and a check for skin and respiratory infections. Vitamin levels, especially Vitamin D, will be checked and regulated if necessary with supplements.
"There's also the risk of reactivating certain viruses after a high-stress situation [like] Epstein-Barr, herpes viruses, chicken pox," said Dr. James Polk, NASA's chief of space medicine.
Doctors have reportedly sent down vaccines for pneumonia and influenza, which were administered by one of the miners.
And the Chilean government has already said that each of the miners will have access to mental health professionals for at least six months after their rescue.
Many mental health professionals said a major psychiatric concern is post-traumatic stress disorder, or PTSD -- an anxiety disorder sometimes brought on by traumatic events such as natural disasters, accidents, personal assaults, or military combat. Symptoms include flashbacks, bad dreams, frightening thoughts, difficulty sleeping and emotional numbness.
"There may also be depression or guilt reactions to how they reacted while being confined and how people treated each other," said Dr. Howard Zonana, professor of psychiatry at Yale University in New Haven, Conn. "Not everyone reacts in a fashion they are proud of when facing what must have seemed like imminent death."
But PTSD symptoms may not be apparent right away, if at all, in many of the rescued miners. Some just may be happy to be home.
"It is possible only to say that the psychiatric issues are not likely to be immediate unless there is a lot of anger being directed toward the company or government," said Zonana. "Reunion with families and the support from them will most likely be the initial reactions to survival."