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The decade since the first Handbook on Hyperbaric Medicine has seen major advances: studies have clarified the actions of hyperbaric oxygenation; clinical practice is becoming more scientific; various organisational and operational guidelines are now widely accepted. This new Handbook arises from the EU Co-operation in Science and Technology (COST) programme for hyperbaric medicine, COST B14, in combination with the results of a number of recent experimental and clinical studies.