Why Divers Die: Part I

Diving is more than just a leisurely recreational activity. It can quickly turn into an extreme sport, with the risk of serious injury or death. Unexpected conditions and incidents can appear instantaneously. Good physical and mental conditioning can often make the difference between a memorable experience and a serious tragedy.

Annually, we review deaths recorded by the Divers Alert Network and try to make sense of them so that our readers can avoid fatal circumstances. A review of DAN's most current report, 2002, in which 89 deaths of American and Canadian recreational divers were recorded, reminded us of a letter we had recently received from a long-time dive operator in Hawaii:

"Operators around here have been noticing a disturbing trend of grossly overweight, horribly out-of-shape divers. The other day, of 10 divers on our boat, six were considerably overweight, two easily 100 lbs. overweight. One could barely haul himself up the ladder and was shaking so hard by the time he reached the top (a tiny distance) I was mentally reviewing my CPR. Another couldn't climb the ladder with the added weight of her gear. It's a bit frightening!"

For many overweight people, diving is a dream sport. They become weightless. They participate in an adventure. They can't hike or mountain bike, but they have a sport to call their own. But it's often a deadly sport. About 1/3 of those who died diving in 2002 were obese, some morbidly obese.

A diver's weight is often a clue to his or her physical conditioning. Take the case of the 48-yearold overweight fellow diving near the Halona Blowhole and the Here To Eternity cove. He surfaced with a group and then headed back alone to the cove. When he got within 15 feet of the shore, he yelled for help, and someone from the beach rushed into the water, grabbed him, and brought him to the beach. But he was not breathing, didn't have a pulse, and couldn't be resuscitated. The autopsy disclosed severe coronary arteriosclerosis, heart disease, emphysema, and that he was a heavy smoker.

A 49-year-old obese male making a wreck dive in a deep freshwater lake complained of fatigue prior to descending. He aborted the dive at 30 feet during the descent, visibly in distress. After ascending, he switched to his snorkel but then lost consciousness and sank below the surface. His dive buddy rushed to assist him, released his weight belt, and got him back to the surface, but he could not be resuscitated. He drowned.

Making his first dive after a 10- year layoff, an obese 52-year-old became distressed 10 minutes into a shore entry dive to 30 fsw. He surfaced and told his instructor his heart was beating fast and he was having trouble breathing. Nevertheless, he went back down but surfaced again, breathing even harder and with more difficulty. He lost consciousness and could not be resuscitated.

According to the National Institutes of Health (NIH), an increase of 20 percent or more above your ideal body weight is where excess weight becomes a health risk. It's a greater problem for divers, because even easy diving is a stressor. And when long swims, struggles against currents, marching about carrying heavy tanks and weights, or climbing back into a bouncing boat gets added, the risk of a cardiac event increases dramatically. If you're concerned about your own weight, you can find a user-friendly body mass calculator at http://nhlbisupport.com/bmi/bmicalc.htm.

A 54-year-old male student in an open-water certification course had a medical history that included insulin-requiring diabetes and hypertension. His physician advised him to at least have an exercise stress test prior to taking the course, but he ignored the advice. He made a shore entry for his very first open-water dive. After completing the skills test and spending time at 15 fsw, he surfaced complaining of chest pain. The diver lost consciousness while being helped to shore. The medical examiner determined the cause of death to be cardiovascular disease.

As divers age, so do their hearts and cardiovascular systems. You owe it to yourself to ensure that yours are in good shape, and only the proper tests will tell you. Only then can you decide whether the risks are worth the rewards. After all, some people who fully well know they have problems will still decide to go diving, either because it's worth the risk ... or they are in denial.

A 69-year-old advanced open water diver entered the water off a boat but never descended. He swam back to the boat and collapsed and couldn't be resuscitated. He was morbidly obese, had a 100-plus pack-a-year history of cigarette smoking and had undergone coronary artery angioplasty with a stent placed. A heart attack got him. (Of course, smoking and diving are incompatible, but don't tell that to the crews of too many dive boats.)

Ron Lennerd, a 63-year-old obese diver from Pacific Beach, CA, who had not dived for 30 years made a night dive in La Jolla Cove (30 years out of the water? Reason enough not to make a night shore dive). He controlled hypertension with a medication, had a heart attack six years ago, and wore a pacemaker. He and two buddies made a shore entry night dive during rough seas in kelp to collect lobster. He struggled on the surface and got hung up in kelp. His buddies went to free him and found him floating face down. They were unable to revive him.

Coming up: equipment problems