Recreational Scuba Research Articles

Low-back problems in recreational self-contained underwater breathing apparatus divers: Prevalence and specific risk factors

Low-back problems (LBP) are one of the most common musculoskeletal disorders in the general population, with reported lifetime prevalences of 50% to 80%. Also, certain sports participants (e.g. gymnasts, alpine skiers, runners) are at risk of LBP and its repercussions. This epidemiological study was undertaken to examine the lifetime and 1-year prevalence of LBP among recreational Flemish self-contained breathing apparatus (scuba) divers and to identify general and sport-specific risk factors associated with the occurrence of LBP. A retrospective self-assessment questionnaire was developed and assessed for validity and reliability, to gather data concerning demographics, LBP prevalence and associated risk factors and injuries among active scuba divers. A total of 181 recreational scuba divers (men: n = 138, mean age 40.3 ± 12.8 years; women: n = 43, mean age 35.0 ± 10.9 years) from 10 randomly selected internationally recognised scuba diving clubs participated in the study. Lifetime and 1-year prevalence of LBP among recreational Flemish scuba divers were 55.8% and 50.3%, respectively. General risk factors for LBP were found to include prior history of LBP, structural abnormalities, heavy workload, pregnancy and parturition, general fatigue and bending forwards and backwards. Scuba divers suffering from LBP generally had a significantly higher dive certificate than those without LBP (p = 0.007). Symptomatic scuba divers also used significantly more weights on their weight belts during indoor training (p = 0.003) and during outdoor dives with a dry suit (p = 0.044) as compared to asymptomatic scuba divers. In scuba diving, reliable sport-specific risk factors for LBP were found to be scarce. Further biomechanical research is required to point out whether or not scuba diving characteristics actually contribute to LBP.

Safety of recreational scuba diving in type 1 diabetic patients: The Deep Monitoring programme

Aim To verify whether, with thorough practical and theoretical training, well-controlled, non-complicated diabetic patients can safely go diving underwater with no additional medical or metabolic risks. Methods Twelve diabetic patients participated in the study after undergoing training focused on their diabetic status. Two dives per day were scheduled during two five-day stays on the island of Ventotene (Italy). Capillary blood glucose (BG) was checked at 60, 30 and 10 minutes before diving, and corrective measures adopted if necessary, based on BG absolute levels and dynamics. A device for continuous subcutaneous glucose monitoring (CGM), expressly modified for the purpose, was worn during dives. Results Data were gathered from 90 dives; mean BG at 60, 30 and 10 minutes before diving was 205.8 ± 69.6 mg/dL, 200.0 ± 66.4 mg/dL and 200.5 ± 61.0 mg/dL, respectively. In 56 of the 90 dives, supplementary carbohydrates or insulin were necessary, but only one dive was interrupted on account of hypoglycaemic symptoms. Mean post-dive BG was 158.9 ± 80.8 mg/dL. CGM recordings showed that glucose levels gradually decreased during the dives (nadir: –19.9%). Conclusion Experienced, well-controlled, complication-free young diabetic patients can safely go scuba diving, provided that they apply a rigorous protocol based on serial pre-dive BG measurements. The specific variables of underwater diving do not appear to involve significant additional risks of hypoglycaemia.

Benthic impacts of recreational divers in a Mediterranean Marine Protected Area

Abstract Luna, B., Valle Pérez, C., and Sánchez-Lizaso, J. L. 2009. Benthic impacts of recreational divers in a Mediterranean Marine Protected Area. – ICES Journal of Marine Science, 66: 517–523. The features of many Marine Protected Areas (MPAs) have increased scuba diving tourism in these areas. Impacts caused by recreational scuba activity vary widely among different divers with differing underwater behaviour. We studied diver underwater behaviour, the effects on the natural environment, and the characteristics that may influence diver behaviour. In all, 181 recreational divers were followed, and contacts and the effects produced were recorded. Information on diver profile and dive features was recorded. Field sampling revealed that 175 of the divers observed (96.7%) made at least one contact with the seabed, with a mean contact of 41.20 ± 3.55 (mean ± s.e.) per diver per 10 min. Flapping was the most frequent type of contact, and the main damage by this action was to raise sediment. Contact with the seabed was greater for males than for females, inexperienced divers than for experienced divers, camera or lantern (dive light) users than for non-users, and divers unaccompanied by a dive leader or who had not been briefed about avoiding seabed contact before undertaking a dive than for accompanied or briefed divers. A greater understanding of the causes of harmful behaviour may be useful for stricter management, reducing diving damage and assuring the sustainability of this activity in MPAs.

Post-mortems in recreational scuba diver deaths: The utility of radiology

Post-mortem radiology and autopsy findings in a series of six diving-related deaths are presented. The cases had different causes of death but essentially similar radiological findings. We propose that the so-called classical radiological features of cerebral arterial gas embolism more likely represent “off-gassing” (gas coming out of solution into intra-vascular spaces due to pressure changes). As such, we suggest that post-mortem radiology, when accompanying a competent autopsy examination, be limited to the chest, whereby it may be useful in the demonstration of pneumothoraces which might not be demonstrated at autopsy, thereby providing supporting evidence for barotrauma in the context of appropriate clinical and autopsy findings.

Risking comfort? The impact of in‐water constraints on recreational scuba diving

A substantial body of work has considered the role and impact of constraints on the leisure experience. Recent research in leisure constraints theory, however, has moved beyond a preoccupation with barriers to access and identified the importance of in situ constraints and their impact on the leisure experience itself. New directions in constraints research are needed to expand our understanding of in situ constraints in leisure segments like adventure recreation. This paper presents the findings of an interpretive, qualitative study of how in situ (or ‘in‐water') constraints impacted on the experiences of 27 recreational scuba divers in Australia. The notion of comfort as it applies to adventure leisure and diving is also explored. Using a grounded approach to analysis, it was revealed that divers’ comfort was constrained in physical, psychological, social, and visual contexts. This suite of constraints worked to limit, disrupt, or impede divers’ in‐water comfort, bringing discomfort or uncertainty into a dive. The implications and application of these findings for adventure leisure research and practical management of the scuba dive experience are discussed.

Comparison of injuries to New Zealand rock lobsters (Jasus edwardsii) caused by hand versus snare collection

Following the prohibition in New Zealand of lobster snares in late 2005, we undertook research to compare the frequency and extent of injuries to rock lobsters (Jasus edwardsii) (Hutton) caused by recreational SCUBA divers using lobster snares compared with hand collection. Rock lobsters were sampled between January 2006 and October 2006 from multiple dive sites around the North Island of New Zealand. Of the 124 rock lobsters caught, 20.9% were in a soft shell state. Female rock lobsters constituted 43.5% of the catch, but only one was carrying eggs. Female mean tail width was 72.2 mm; male mean tail width was 71.9 mm. We found that hand collection caused significantly more injuries than snare collection, to both soft shell and hard shell animals. Hand collection also resulted in more major injuries, with 18% of hard shell animals and 31% of soft shell animals losing two or more limbs. We recommend that the prohibition on the use of rock lobster snares be lifted, as their use appears to significantly reduce injury and stress to rock lobsters in recreational dive areas, and increase the survival of undersized individuals released after capture.

Diving Medicine: A Review Of Current Evidence

Recreational scuba diving is a growing sport worldwide, with an estimated 4 million sport divers in the United States alone. Because divers may seek medical care for a disorder acquired in a remote location, physicians everywhere should be familiar with the physiology, injury patterns, and treatment of injuries and illnesses unique to the underwater environment. Failure to properly recognize, diagnose, and appropriately treat some diving injuries can have catastrophic results. In addition, recreational dive certification organizations require physical examinations for medical clearance to dive. This article will review both common and potentially life-threatening conditions associated with diving and will review current evidence behind fitness to dive considerations for elderly divers and those with common medical conditions.

Western Australian Dive Industry Growth and Survival, 1969–2005

A review of the milestones of recreational scuba diving within Western Australia (WA) is presented. To quantify growth, Western Australian telephone directories were searched for recreational dive industry advertisements placed between 1969 and 2005 inclusive. The age of dive businesses operating in WA is compared with concurrent population growth within WA over the last three decades, for north, south and central coastal regions. Recreational dive businesses in south WA are surviving the recent industry downturn relatively well, compared to their colleagues in Perth and further north.

Spatial dynamics and substrate impacts of recreational snorkelers and SCUBA divers in Hawaiian Marine Protected Areas

We quantified spatial dynamics and substrate impacts of snorkelers and SCUBA divers within four Hawaiian MPAs to determine: (1) whether coral reefs in these areas are being damaged by recreational activities, and (2) how damage might be mitigated. Observers secretly followed snorkelers and SCUBA divers, and used handheld Global Positioning System (GPS) units to record their geographic tracks and substrate contacts. Most activities occurred within relatively small, well-defined areas associated with access points. Despite heavy use, recreation impact was low at Hawaiian MPAs because most fragile corals occurred below the maximum depth of the dominant recreational activity (snorkeling). SCUBA diving was only common at one MPA with physically durable benthic habitats. GPS tracking provided useful insights into how recreational impacts to MPAs could be reduced. General topography could be used to predict where visitors will go, and designated access points could be used to focus substrate contact away from fragile habitats.

Western Australian Dive Industry Growth and Survival, 1969–2005

A review of the milestones of recreational scuba diving within Western Australia (WA) is presented. To quantify growth, Western Australian telephone directories were searched for recreational dive industry advertisements placed between 1969 and 2005 inclusive. The age of dive businesses operating in WA is compared with concurrent population growth within WA over the last three decades, for north, south and central coastal regions. Recreational dive businesses in south WA are surviving the recent industry downturn relatively well, compared to their colleagues in Perth and further north.

Role of MRI in the detection of marrow bubbles after musculoskeletal decompression sickness predictive of subsequent dysbaric osteonecrosis

Dysbaric osteonecrosis (DON) usually occurs in professional divers or compressed air workers exposed to iterative high ambient pressure, but has also been reported to occur in recreational scuba divers. In certain circumstances, DON can be considered as a late manifestation of a previous musculoskeletal decompression sickness (DCS) or ‘‘the bends’’ (historically, type 1 DCS). However, despite the observed link between the two illnesses, their correlation remains controversial. There is a general consensus that gas bubble formation during decompression is the primary cause of DCS and DON. Most hypotheses focus on an autochthonous bubble mechanism but there is no agreement on the actual site as far as DCS development is concerned, and it is unclear where, or how bubbles form in the bone marrow cavity causing DON. Magnetic resonance imaging (MRI) is a wellestablished technique to diagnose osteonecrotic lesions. However, there are no specific signs on MRI to correlate the dysbaric origin to osteonecrosis, except the patient’s medical history. In this paper, we present two cases of musculoskeletal DCS in recreational scuba divers with DON complications with initial MRI detection of microaeric cavities in the fatty bone marrow, highly consistent with bubble formation. To our knowledge, these MRI findings compatible with bubble-induced

The Benefits of Continuous Glucose Monitoring and a Glucose Monitoring Schedule in Individuals with Type 1 Diabetes during Recreational Diving

Our objective is to evaluate the Medtronic CGMS continuous glucose monitoring system and plasma glucose (PG) measurement performed in a monitoring schedule as tools to identify individuals with type 1 diabetes at risk when diving. We studied 24 adults, 12 type 1 diabetes subjects and 12 controls, during 5 recreational scuba dives performed on 3 consecutive days. The CGMS was used by all participants on all the days and all the dives. Comparisons were made between PG performed in a monitoring schedule during the days of diving, self-monitored blood glucose (SMBG) performed 2 weeks prior to diving, and the CGMS during the study. One hundred seventeen dives were performed. Hypoglycemia (<70 mg/dl) was found in six individuals and on nine occasions. However, no symptoms of hypoglycemia were present during or immediately postdiving. In one case, repetitive hypoglycemia prediving gave rise to a decision not to dive. None of the dives were aborted. The number of hypoglycemic episodes, 10 min prediving or immediately postdiving, were related to the duration of diabetes, r = 0.83 and p =0.01, and the percentage of SMBG values below target (<72 mg/dl), r = 0.65 and p =0.02. Moreover, the number of hypoglycemic episodes was also related to the total duration below low limit (<70 mg/dl), measured by the CGMS, r =0.74 and p =0.006. Safe dives are possible to achieve by well-informed, well-controlled individuals with type 1 diabetes. Using downloaded SMBG, CGMS, and repetitive PG in a monitoring schedule, it is possible to identify those subjects who are suitable for diving.

Diving down the reefs? Intensive diving tourism threatens the reefs of the northern Red Sea

Intensive recreational SCUBA diving threatens coral reef ecosystems. The reefs at Dahab, South Sinai, Egypt, are among the world’s most dived (>30,000 dives y −1). We compared frequently dived sites to sites with no or little diving. Benthic communities and condition of corals were examined by the point intercept sampling method in the reef crest zone (3 m) and reef slope zone (12 m). Additionally, the abundance of corallivorous and herbivorous fish was estimated based on the visual census method. Sediments traps recorded the sedimentation rates caused by SCUBA divers. Zones subject to intensive SCUBA diving showed a significantly higher number of broken and damaged corals and significantly lower coral cover. Reef crest coral communities were significantly more affected than those of the reef slope: 95% of the broken colonies were branching ones. No effect of diving on the abundance of corallivorous and herbivorous fish was evident. At heavily used dive sites, diver-related sedimentation rates significantly decreased with increasing distance from the entrance, indicating poor buoyancy regulation at the initial phase of the dive. The results show a high negative impact of current SCUBA diving intensities on coral communities and coral condition. Corallivorous and herbivorous fishes are apparently not yet affected, but are endangered if coral cover decline continues. Reducing the number of dives per year, ecologically sustainable dive plans for individual sites, and reinforcing the environmental education of both dive guides and recreational divers are essential to conserve the ecological and the aesthetic qualities of these dive sites.

Impacts of recreational scuba diving on a marine protected area in central Philippines: A case of the Gilutongan marine sanctuary

Impacts of recreational scuba diving on a marine protected area in central Philippines: A case of the Gilutongan marine sanctuary

The Economic Value of Scuba-Diving Use of Natural and Artificial Reef Habitats

Artificial reefs may attract and sustain fish populations, but whether they resemble natural reefs is open to conjecture. This article addresses the question of whether artificial reefs are functionally acceptable to scuba divers. Research objectives were (1) to identify the nonmarket value of recreational scuba diving in offshore marine waters and (2) to ascertain whether the willingness to pay for scuba diving varied between users of natural and artificial reef habitats. A random sample of 1,059 scuba divers was used to estimate consumer's surplus associated with the diving experience. While natural and artificial habitats provide substantial economic value associated with diving, results indicate divers using natural reef habitats value their diving experience significantly more highly than those using artificial reef habitats. Also, substantial value from recreational diving use of artificial reefs suggests they serve as potential substitutes and thus may alleviate pressures on natural reef areas for conservation purposes.

스쿠버 인증과 동남아의 레저 잠수 현황 연구

본 연구는 동남아 각국에서 시행되고 있는 레저 스쿠버 잠수 인증 제도에 대한 자료를 수집하고, 잠수 현황 및 인증 현황을 비교하였다. 자료 수집을 위해 인터넷에 게시된 내용을 많이 활용하였고, 관련 문헌을 조사하였으며, 자료 보완을 위해 잠수 협회 관계자, 2007년 동남아 각국의 DIVE EXPO에 참가한 동남아 각국의 관공홍보 정부 관계자, 잠수 리조트 운영자 및 강사들과 폭 넓은 인터뷰를 하였다. 논문에는 인증 제도에 대한 이해를 돕기 위해 스쿠버 인증과 국제 표준의 관계에 대해서도 언급하였다. 조사 결과, 동남아 지역은 레저 스쿠버 잠수 활동이 매우 활발한 지역으로 관광 산업에서 중요한 부분을 차지하고 있었으며, 전 세계 레저 다이버 인증 숫자의 30% 이상을 차지하고 있는 큰 시장으로 발전되어 있었다. 그러나 스쿠버 잠수 활동이 구미 지역에서 도입되었고 잠수 단체의 총 본부가 구미 지역에 있는 만큼 잠수 제도나 정책 문제에 있어서 조직 체계상 아시아에서 주도적인 역할을 하기 어려운 구조이며, 현재 상태로는 개선책을 찾기가 매우 어려울 것으로 예상된다. 또한 동남아시아에서는 유럽이나 미국과 같이 국제 표준 제도와 협력하여 교육의 질을 높이기 위한 프로그램 도입 및 단체 결성에는 아직 무관심한 것으로 나타났지만 이에 대한 필요성이 곧 대두될 것으로 예측되고 있다. This study is about the status and comparison of recreational scuba diving certification system in Southeast Asia countries. For the collection of the information, the contents of the numerous corresponding Internet sites were utilized, related documents were surveyed. And to supplement the information extensive interviews were held with the representatives of tourism department of many countries as well as staffs of diving associations, resort operators and diving instructors during various 2007 Dive Expos held in Southeast countries. In this paper, the relation between scuba certification and international standards were introduced for better understanding of the certification system. The research result shows that the scuba diving industry plays an important role in their country's tourism and the certification market of the Southeast Asia has grown to be greater than 30% of the world total market. However due to the facts that the scuba activity is originated from the western world and the controlling headquarters of the most certification agency are also located there, Southeast countries cannot take any leading roles in the scuba diving policies and systematic issues. Accordingly any modifications or improvements are expected to be very difficult. Also while Europeans and Americans have launched the programs and organizations for the quality assurance by cooperating with the international standards, but no such activity has yet appeared on the surface in Southeast Asia. According to the investigation the necessity will become bigger in near future.

스쿠버 다이버의 사고 예방을 위한 교육과정 개선 및 활성화 방안

스쿠버 다이버의 사고 예방을 위한 교육과정 개선 및 활성화 방안

Risk Factors for Dive Injury: A Survey Study*

Scuba diving is a world sport, but it is not medically regulated. Study objectives sought to identify risk behaviors, preexisting medical conditions, compliance to dive guidelines, and injury patterns of recreational scuba divers. An Internet-based survey examined risk behaviors and diver safety practices. Responses from 682 of 770 (88.6%) divers revealed that 80.6% were certified; 51.7% of certified divers reported diving injuries versus 75.0% for noncertified divers (RR = 1.31; 95% CI: 1.16–1.48; P < 0.001); suspected decompression symptoms were witnessed by 52.6% of divers; 32.7% of certified divers reported medical problems including hypertension, asthma, diabetes, and epilepsy. No significant differences were observed in injuries among the certified divers based on dive frequency (P = 1.000), medical conditions (P = 0.750), smoking (P = 0.545), alcohol (P = 0.649), or illicit substances use (P = 0.230). Among certified divers, there was a positive association with fewer diving injuries but not with diving frequency, preexisting medical condition(s), smoking, alcohol, or illicit substance use.

Artificial Reefs as Recreational Scuba Diving Resources: A Critical Review of Research

This paper reports on the increasing practice of developing and promoting artificial reefs as sites for scuba diving tourism and recreation. A comprehensive definition of artificial reefs is presented that encapsulates the diversity of structures used by marine recreationists, particularly scuba divers, followed by a review of existing literature that specifically examines artificial reefs as a resource for the conduct of recreational scuba diving. Three main thematic areas were identified in the existing literature: social dimensions, socioeconomic impacts and environmental engineering. A typology of artificial reefs is offered to better describe and categorise artificial reef structures according to unit characteristics that may influence recreational use such as material used, appearance, complexity and cost. The paper presents a conceptual model that identifies the components of an artificial reef scuba diving experience and discusses the potential of artificial reefs to act as tourism resources and management tools to redistribute scuba diver numbers away from natural reefs. Directions for future research are suggested, emphasising collection of data on aspects of the artificial reef scuba diving experience to better inform marine resource management.

Epilepsy and Recreational Scuba Diving: An Absolute Contraindication or Can There Be Exceptions? A Call for Discussion

Recreational scuba diving is a popular sport, and people with epilepsy often ask physicians whether they may engage in diving. Scuba diving is not, however, without risk for anyone; apart from the risk of drowning, the main physiological problems, caused by exposure to gases at depth, are decompression illness, oxygen toxicity, and nitrogen narcosis. In the United Kingdom, the Sport Diving Medical Committee advises that, to dive, someone with epilepsy must be seizure free and off medication for at least 5 years. The reasons for this are largely theoretical. We review the available evidence in the medical literature and diving websites. The risk of seizures recurring decreases with increasing time in remission, but the risk is never completely abolished. We suggest that people with epilepsy who wish to engage in diving, and the physicians who certify fitness to dive, should be provided with all the available evidence. Those who have been entirely seizure-free on stable antiepileptic drug therapy for at least 4 years, who are not taking sedative antiepileptic drugs and who are able to understand the risks, should then be able to consider diving to shallow depths, provided both they and their diving buddy have fully understood the risks.