More About Those Medical Exams

In the October issue of Undercurrent, Doc Vikingo reported that in Australia, a medical examination is required before undertaking a scuba diving course to screen for contraindications to diving. No further medical screening is required, and yet divers may develop problems during their diving careers.

A recent study surveyed experienced recreational divers to determine the prevalence of diseases contraindicated in diving. Of the 346 divers who completed questionnaires, 73 percent were male, and 75 percent were aged 31 to 60 years. The mean number of dives undertaken was between 414 and 740 dives. 47 percent were overweight; 13 percent of the divers required regular medication; and 11 percent smoked. Ten percent reported a history of asthma, and 10 percent reported hypertension or coronary heart disease. Twelve percent reported hearing difficulties, and 23 percent of the divers reported past or present tinnitus. (The hearing difficulties and tinnitus may be the result of aural barotrauma.)

The conclusion: experienced, recreational scuba divers continue to dive despite medical contraindications. Did they fail to disclose these conditions at the initial examination, or did these conditions develop subsequently? Is the risk associated with these conditions clinically significant, and should screening examinations be undertaken at regular intervals?

Taylor DM, O'Toole KS, and Ryan CM. Wilderness Environ Med, Fall 2002.
Melbourne Hospital, Parkville, Victoria, Australia. david.taylor@mh.org.au.