Within the urban area of Bologna and its southern hills and surroundings, huge infrastructure projects have been started over the last ten years : a railway tunnel between Bologna and Florence (about 73 km long) and the widening of the A1 motorway segment from Casalecchio di Reno and Barberino del Mugello (the so called “Variante di Valico”: Appennine Bypass).

To the 73 km of the main railway tunnel, another 30 km of service and rescue tunnels have to be added, leading to a total length of about 100 km of tunnels bored through mountains that often revealed firedamp presence.

The overall length of the A1 “Variante di Valico” is about 60 km of which only 20 km are at ground level, while 10 km are on viaducts and about 30 km in twin-bore tunnels with the same problems of firedamp presence that were encountered in the railway tunnel.

Since 1996 the 118 GECAV team (Gestione Emergenza Cantieri Alta Velocità e Variante di Valico), has been identified as the body responsible for the planning and the management of medical rescue operations in the event of an accident involving workers and the population, within the region where the work sites are located. The very first step was to improve training for the workers, the medical personnel and the population. In particular, a continuing education programme has been adopted for the medical personnel. This programme focusses on specific topics related to rescue operations in a “hostile” environment and includes periodic simulation exercises in "smoke room", on "climbing tower", in tunnels and on rough terrains, in addition to the usual clinical courses :

• “smoke room” exercises are needed in order to keep rescuers familiar with breathing apparatus that doctors and nurses have to wear in case of rescue operations within tunnels currently under construction or planned for the future. A fire inside a tunnel is the most frightening scenario and themost probable. The GECAV “smoke room” in Lama di Setta is the only training structure owned by a medical team in Italy.
• the "climbing tower" is a 20 meter high scaffold used to teach the GECAV team (31 doctors, 120 nurses and 20 ambulance drivers) climbing skills required for rescue operations in mountains, on rough terrains and on viaduct work sites.