Compressed air diving and respiratory disease: A discussion document of the Thoracic Society of Australia and New Zealand

Abstract

OBJECTIVE: To review the pathophysiology and respiratory complications of compressed air diving, and to formulate guidelines for assessing respiratory fitness to dive so that diving candidates can be advised of the risks associated with respiratory disease, in particular asthma. DATA SOURCES: Specialist medical journals in the areas of respiratory medicine, physiology and diving medicine. Morbidity and mortality statistics were obtained from international diving bodies, diving medicine scientific meetings, and papers. SYNTHESIS: The major complications of underwater diving in subjects with compromised respiratory function are drowning, pulmonary barotrauma and arterial gas embolism. Diving candidates with a history of asthma, pneumothorax, obstructive or restrictive lung disease, lung cysts or thoracic trauma should be advised not to dive in view of these risk factors. CONCLUSIONS: Several respiratory diseases carry an increased risk of morbidity and mortality from compressed air diving. An accurate history and measurement of lung function are an essential part of assessing fitness to dive, both to advise potential divers appropriately and to reduce risks associated with this increasingly popular recreational activity.