Diving and hyperbaric medicine最新文献

{"title":"The influence of wetsuit thickness (≥ 7 mm) on lung volumes in scuba divers.","authors":"Graham Stevens, David R Smart","doi":"10.28920/dhm55.1.27-34","DOIUrl":"10.28920/dhm55.1.27-34","url":null,"abstract":"<p><strong>Introduction: </strong>We hypothesised that although thicker (≥ 7 mm) wetsuits delay hypothermia and allow divers to dive in cooler waters, they may hinder pulmonary function. The aim of this study was to investigate whether thicker wetsuits worn by Tasmanian divers affected lung volumes, primarily the forced vital capacity (FVC) and forced expiratory volume, one second (FEV1).</p><p><strong>Methods: </strong>Sixty-two volunteer active divers were recruited from recreational dive clubs and Tasmania's occupational diving industry. After confirming fitness and that the divers were currently active, spirometry testing was performed with and without the divers' usual wet suits, in a controlled dry environment. Suits were of varying thickness, but all were ≥ 7 mm thickness.</p><p><strong>Results: </strong>All divers had significantly reduced lung volumes when wearing ≥ 7 mm wetsuits. Recreational divers had greater decrements (-7% FVC and -5% FEV1), compared to occupational divers (-3% FVC, -3% FEV1). Males' lung volumes declined -4% FVC and -4 % FEV1, whereas females declined -7 % FVC and -6 % FEV1. Female recreational divers experienced the greatest negative impact from thicker wetsuits (up to 15% reduction in FVC), and this group also demonstrated an inverse relationship between increasing wetsuit thickness and declining lung volumes.</p><p><strong>Conclusions: </strong>Wearing thicker wet suits aids in thermal protection in temperate water diving but this study suggests it has negative effects on lung volumes. The real-life impact of this negative effect may be minor in fit healthy divers but might add additional risk to a less fit, recreational diving population with medical comorbidities.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 1","pages":"27-34"},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss: a cohort study of 10 versus more than 10 treatments.","authors":"Brenda R Laupland, Kevin B Laupland, Kenneth Thistlethwaite","doi":"10.28920/dhm54.4.275-280","DOIUrl":"10.28920/dhm54.4.275-280","url":null,"abstract":"<p><strong>Introduction: </strong>Current treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) includes a combination of corticosteroids and hyperbaric oxygen therapy (HBOT) without established dose. The objective of this study was to investigate whether > 10 HBOT treatments offers improved outcome over 10 treatments.</p><p><strong>Methods: </strong>A retrospective chart review was performed of patients treated with HBOT for ISSNHL between 2013 and 2022 at the Royal Brisbane and Women's Hospital. Pure tone average results from 500, 1,000, 2,000, 4,000 hertz (PTA4) were obtained pre-treatment, after treatment 10, and six weeks post-treatment.</p><p><strong>Results: </strong>There were 479 patients treated for ISSNHL: 144 having audiograms six weeks post-treatment, 140 of whom also had an audiogram after treatment 10. At six weeks post treatment 22% (32/144) had normal hearing (PTA4 < 25 dB), and 69% (99/144) had a PTA4 gain ≥ 10 dB. At the treatment 10 audiogram, 83/140 (59%) were improved. From these, 5/21 (24%) with 10 treatments and 14/57 (25%) with > 10 treatments had a further PTA4 gain of ≥ 10 dB occurring after treatment 10. For those 57/140 (41%) not improved at treatment 10, 7/26 (27%) with 10 treatments and 12/31 (39%) with > 10 treatments were improved at six weeks post-treatment with 5/7 (71%) and 8/12 (67%) of the 10 and > 10 groups respectively having ≥ 10 dB gain in PTA4 occurring after treatment 10. Overall, there was no significant difference in mean (SD) hearing gain from treatment 10 to six weeks post treatment between the 10 treatments and > 10 treatments groups: 4.73 (8.90) versus 5.93 (11.25) dB, P = 0.53.</p><p><strong>Conclusions: </strong>In conjunction with steroids, 10 treatments of hyperbaric oxygen therapy appear to offer equivalent benefit to > 10 treatments. Similar improvements in PTA4 and hearing recovery occur after 10 HBOT treatments independent of ongoing HBOT. A prospective trial comparing 10 versus > 10 treatments for ISSNHL with outcome measured beyond treatment completion is warranted.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"275-280"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five consecutive cases of sensorineural hearing loss associated with inner ear barotrauma due to diving, successfully treated with hyperbaric oxygen.","authors":"David Smart","doi":"10.28920/dhm54.4.360-367","DOIUrl":"10.28920/dhm54.4.360-367","url":null,"abstract":"<p><strong>Introduction: </strong>This report describes the outcomes of sensorineural hearing loss (SNHL) due to cochlear inner ear barotrauma (IEBt) in five divers treated with hyperbaric oxygen (HBOT).</p><p><strong>Methods: </strong>The case histories of five consecutive divers presenting with SNHL from IEBt due to diving, were reviewed. All divers provided written consent for their data to be included in the study. All had reference pre-injury audiograms. All noted ear problems during or post-dive. Independent audiologists confirmed SNHL in all divers prior to HBOT, then assessed outcomes after HBOT.</p><p><strong>Results: </strong>Three divers breathed compressed air on low risk dives, and two were breath-hold. None had symptoms or signs other than hearing loss, and none had vestibular symptoms. All could equalise their middle ears. Inner ear decompression sickness was considered unlikely for all cases. All were treated with HBOT 24 hours to 12 days after diving. Two divers received no steroid treatment, one was treated with HBOT after an unsuccessful 10-day course of steroids, and two divers received steroids two days after commencing HBOT. All divers responded positively to HBOT with substantial improvements in hearing across multiple frequencies and PTA4 measurements. Median improvement across all frequencies (for all divers) was 28 dB, and for PTA4 it was 38 dB.</p><p><strong>Conclusions: </strong>This is the first case series describing use of HBOT for IEBt-induced SNHL. The variable treatment latency and use/timing of steroids affects data quality, but also reflects pragmatic reality, where steroids have minimal evidence of benefit for IEBt. HBOT may benefit diving related SNHL from IEBt with no evidence of perilymph fistula, and provided the divers can clear their ears effectively. A plausible mechanism is via correction of ischaemia within the cochlear apparatus. More study is required including data collection via national or international datasets, due to the rarity of IEBt.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"360-367"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic analysis of hyperbaric oxygen therapy for the treatment of ischaemic diabetic foot ulcers.","authors":"Robin J Brouwer, Nick S van Reijen, Marcel G Dijkgraaf, Rigo Hoencamp, Mark Jw Koelemay, Robert A van Hulst, Dirk T Ubbink","doi":"10.28920/dhm54.4.265-274","DOIUrl":"10.28920/dhm54.4.265-274","url":null,"abstract":"<p><strong>Introduction: </strong>The aim was to determine the cost-effectiveness and cost-utility of additional hyperbaric oxygen therapy (HBOT) compared to standard care (SC) for ischaemic diabetic foot ulcers (DFUs) regarding limb salvage and health status.</p><p><strong>Methods: </strong>An economic analysis was conducted, comprising cost-effectiveness and cost-utility analyses, with a 12-month time horizon, using data from the DAMO₂CLES multicentre randomised clinical trial. Cost-effectiveness was defined as cost per limb saved and cost-utility as cost per quality-adjusted life year (QALY). The difference in cost effectiveness between HBOT+SC and SC alone was determined via an incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>One-hundred and twenty patients were included, with 60 allocated to HBOT+SC and 60 to SC. No significant cost difference was found in the intention-to-treat analysis: €3,791 (bias corrected and accelerated [BCA] 95% CI, €3,556 - €-11,138). Cost per limb saved showed an ICER of €37,912 (BCA 95% CI €-112,188 - €1,063,561) for HBOT+SC vs. SC. There was no significant difference in mean QALYs: 0.54 for HBOT+SC vs. 0.56 for SC alone (-0.02; BCA 95% CI -0.11-0.08). This resulted in a cost-utility of minus €227,035 (BCA 95% CI €-361,569,550 - €-52,588) per QALY. Subgroup analysis for Wagner stages III/IV showed an ICER of €19,005 (BCA 95%CI, -€18,487 - €264,334) while HBOT did not show any benefit for Wagner stage II.</p><p><strong>Conclusions: </strong>HBOT as an adjunct to SC showed no significant differences in costs and effectiveness for patients with DFUs regarding limb salvage and health status. However, for patients with Wagner stage III/IV ischaemic DFUs there was a trend towards better effectiveness and cost-effectiveness.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"265-274"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Divers treated in Townsville, Australia: worse symptoms lead to poorer outcomes.","authors":"Denise F Blake, Melissa Crowe, Daniel Lindsay, Richard Turk, Simon J Mitchell, Neal W Pollock","doi":"10.28920/dhm54.4.308-319","DOIUrl":"10.28920/dhm54.4.308-319","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen treatment (HBOT) is considered definitive treatment for decompression illness. Delay to HBOT may be due to dive site remoteness and limited facility availability. Review of cases may help identify factors contributing to clinical outcomes.</p><p><strong>Methods: </strong>Injured divers treated in Townsville from November 2003 through December 2018 were identified. Information on demographics, initial disease severity, time to symptom onset post-dive, time to pre-HBOT oxygen therapy (in-water recompression or normobaric), time to HBOT, and clinical outcome was reviewed. Data were reported as median (interquartile range [IQR]) with Kruskal-Wallis and chi-square tests used to evaluate group differences. Significance was accepted at P < 0.05.</p><p><strong>Results: </strong>A total of 306 divers (184 males, 122 females) were included with a median age of 29 (IQR 24, 35) years. Most divers had mild initial disease severity (n = 216, 70%). Time to symptom onset was 60 (10, 360) min, time to pre-HBOT oxygen therapy was 4:00 (00:30, 24:27) h:min, and time to start of HBOT was 38:51 (22:11, 69:15) h:min. Most divers (93%) had a good (no residual or minor residual symptoms) outcome and no treated diver died. Higher initial disease severity was significantly associated with shorter times to symptom onset, oxygen therapy, and HBOT, and with worse outcomes. The paucity of cases receiving HBOT with minimal delay precluded meaningful evaluation of the effect of delay to HBOT.</p><p><strong>Conclusions: </strong>Most divers had mild initial disease severity and a good outcome. Higher initial disease severity accelerated the speed of care obtained and was the only factor associated with poorer outcome.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"308-319"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in competitive freediving accidents.","authors":"Jérémie Allinger, Oleg Melikhov, Frédéric Lemaître","doi":"10.28920/dhm54.4.301-307","DOIUrl":"10.28920/dhm54.4.301-307","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding safety issues in competitive freediving is necessary for taking preventive actions and to minimise the risk for the athletes.</p><p><strong>Methods: </strong>We analysed occurrence of loss of consciousness (LOC) and pulmonary barotrauma (PBt) in various freediving disciplines in 988 competitions over five years (from 2019 to 2023 inclusive), with 38,789 officially registered performances (starts): 26,403 in pool disciplines and 12,386 in depth disciplines.</p><p><strong>Results: </strong>Average incident rate in competitive freediving (all cases: LOCs plus PBt, 2019-2023) was 3.43% (1,329 incidents / 38,789 starts). The average incident rate of LOC and PBt within five years were 3.31% and 0.38% respectively for all disciplines. Two disciplines present higher risk for LOC: dynamic without fins (DNF) (mean risk ratio (RR) = 1.48, 95% CI, 1.13 to 1.96, P < 0.01) and constant weight without fins (CNF) (mean RR = 2.02, 95% CI, 1.39 to 2.94, P < 0.001). The RR for PBt was not higher in any discipline. The overall risk of all types of incidents (LOC plus PBt) was also higher for DNF (mean RR = 1.55, 95% CI, 1.18 to 2.04, P < 0.01) and CNF (mean RR = 2.80, 95% CI, 1.70 to 5.04, P < 0.001).</p><p><strong>Conclusions: </strong>The disciplines without fins in the pool (DNF) and at depth (CNF) appear to be the most dangerous in terms of LOC. We may recommend that organisers and safety teams should pay a special attention to no-fin disciplines as most risky for possible LOC.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"301-307"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meclizine seasickness medication and its effect on central nervous system oxygen toxicity in a murine model.","authors":"Guy Wiener, Anna Jamison, Dror Tal","doi":"10.28920/dhm54.4.296-300","DOIUrl":"10.28920/dhm54.4.296-300","url":null,"abstract":"<p><strong>Introduction: </strong>Diving utilising closed circuit pure oxygen rebreather systems has become popular in professional settings. One of the hazards the oxygen diver faces is central nervous system oxygen toxicity (CNS-OT), causing potentially fatal convulsions. At the same time, divers frequently travel by boat, often suffering seasickness. The over-the-counter medication meclizine is an anticholinergic and antihistaminergic agent that has gained popularity in the treatment of seasickness. Reports have shown the inhibitory effect that acetylcholine has on glutamate, a main component in the mechanism leading to CNS-OT seizure. The goal of the present study was to test the effect of meclizine on the latency to CNS-OT seizures under hyperbaric oxygen conditions.</p><p><strong>Methods: </strong>Twenty male mice were exposed twice to 608 kPa (6 atmospheres) absolute pressure while breathing oxygen after administration of control solution (carboxymethyl cellulose solvent) or drug solution (meclizine) in a randomised crossover design. Latency to tonic-clonic seizures was visually measured.</p><p><strong>Results: </strong>Mean latency to seizure did not significantly differ between the control group (414 s, standard deviation [SD] 113 s) and meclizine group (434 s, SD 174 s).</p><p><strong>Conclusions: </strong>Based on results from this animal model, meclizine may be an appropriate option for divers suffering from seasickness, who plan on diving using pure oxygen rebreather systems.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"296-300"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint position statement on immersion pulmonary oedema and diving from the South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Diving Medical Committee (UKDMC) 2024.","authors":"Neil Banham, David Smart, Peter Wilmshurst, Simon J Mitchell, Mark S Turner, Philip Bryson","doi":"10.28920/dhm54.4.344-349","DOIUrl":"10.28920/dhm54.4.344-349","url":null,"abstract":"<p><p>This joint position statement (JPS) on immersion pulmonary oedema (IPO) and diving is the product of a workshop held at the 52nd Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) from 12-17 May 2024, and consultation with the United Kingdom Diving Medical Committee (UKDMC), three members of which attended the meeting. The JPS is a consensus of experts with relevant evidence cited where available. The statement reviews the nomenclature, pathophysiology, risk factors, clinical features, prehospital treatment, investigation of and the fitness for future compressed gas diving following an episode of IPO. Immersion pulmonary oedema is a life-threatening illness that requires emergency management as described in this statement. A diver with previous suspected or confirmed IPO should consult a medical practitioner experienced in diving medicine. The SPUMS and the UKDMC strongly advise against further compressed gas diving if an individual has experienced an episode of IPO.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"344-349"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"South Pacific Underwater Medicine Society (SPUMS) position statement regarding paediatric and adolescent diving.","authors":"Elizabeth Elliott, David Smart, John Lippmann, Neil Banham, Matias Nochetto, Stephan Roehr","doi":"10.28920/dhm54.4.338-343","DOIUrl":"10.28920/dhm54.4.338-343","url":null,"abstract":"<p><p>This paediatric diving position statement was developed from a targeted workshop at the 51st Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) on 8 June 2023. It highlights the factors that SPUMS regards as important when undertaking health risk assessments for diving by children and adolescents (defined as aged 10 to 15 years). Health risk assessments for diving should be performed by doctors who are trained in diving medicine and who are familiar with the specific risks which result from breathing compressed gas in the aquatic environment. Undertaking a diver health risk assessment of children and adolescents requires a detailed history (including medical, mental health, psychological maturity), a comprehensive diver medical physical examination and evaluation of all relevant investigations to exclude unacceptable risks. In addition, assessment of the individual's motivation to dive and reported in-water capability should occur, whilst engaging with their parent /guardian and instructor, where appropriate, to ensure that safety for the child is optimised. The guideline applies to all compressed air diving including scuba and surface supply diving provided in open and contained bodies of water.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"338-343"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling the risk factors for accidents in recreational divers: results from a cross-sectional evaluation in Belgium.","authors":"Kurt G Tournoy, Martijn Vandebotermet, Philippe Neuville, Peter Germonpré","doi":"10.28920/dhm54.4.287-295","DOIUrl":"10.28920/dhm54.4.287-295","url":null,"abstract":"<p><strong>Introduction: </strong>Characterisation of the recreational diving community could help to identify scuba divers at risk for accidents.</p><p><strong>Methods: </strong>We performed a cross-sectional evaluation in a federation for recreational scuba divers in Belgium (Duiken.Vlaanderen). Using binary logistic regression, factors predictive for accidents leading to hospitalisation were identified.</p><p><strong>Results: </strong>Of the 710 members, 210 (29.6%) participated in the survey, representing 140,133 dives. Age was > 50 years in 55% and the median (interquartile range [IQR]) number of dives was 380 (IQR 140-935). Cardiac (9.5%), orthopaedic (11.0%), ear-nose-throat (ENT, 10.5%) and allergic diseases (30.5%) were the top four morbidities. Twenty percent reported taking cardiovascular medication. Decompression accidents, barotrauma of the ear and musculoskeletal injuries were reported in 11.0, 11.9 and 11.0%. Fifty-five divers (26.2%) reported incidents not necessitating a medical intervention. For 36 divers (17.1%), medical interventions were necessary. Among these, 13 divers (6.2%) were hospitalised at least once and 12 (5.7%) of these needed hyperbaric oxygen therapy (HBOT). The absolute risk for hospitalisation or HBOT was 0.01% per dive. Age, advanced diving qualification, more dives annually, cardiac or ENT pathology and cardiac medication were significantly associated with an increased likelihood of hospitalisation resulting from diving accidents. In a multivariate risk model, ENT comorbidity (odds ratio [OR] 9.3; P = 0.006) and cardiac medication (OR 5.6; P = 0.05) predicted hospitalisation due to a diving accident.</p><p><strong>Conclusions: </strong>One in six recreational scuba divers required a medical intervention at least once during their career, while 6.2% were hospitalised or received HBOT. Ear nose and throat comorbidity and cardiac medication were strong predictors for accidents. These should be given sufficient weight in dive medical examination.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 4","pages":"287-295"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}