Number 5

Position Statement10.22462/9.10.2018.17

Letter and Response 10.22462/9.10.2018.16

Response letter   10.22462/9.10.2018.15

Letter   10.22462/9.10.2018.14

Author Index   10.22462/9.10.2018.13

Session F - Top case reports 10.22462/9.10.2018.12

Session E - HBO2 operations, chambers & equipment 10.22462/9.10.2018.11

Session D - Clinical HBO2 therapy10.22462/9.10.2018.10

Session C - Diving and DCI 10.22462/9.10.2018.9

Session B - HBO2 therapy mechanisms10.22462/9.10.2018.8 

Session A- DCI theory & mechanism10.22462/9.10.2018.7

Diving fisheries are an important source of income and protein for many coastal communities around the world. However, these fisheries are also the cause of both fatal and non-fatal injuries. The aim of this study is to estimate the costs of decompression sickness (DCS) in the diving small-scale fisheries that target benthic resources in the Yucatan, Mexico. The DCS cases that occurred during three fishing seasons for sea cucumber (Isostichopus badionotus) and one for spiny lobster (Panulirus argus) were used to calculate the direct medical costs. The catch data during the same fishing seasons were used to calculate the potential losses caused by disability as indirect costs. In the three years (from 2013 to 2016) the total number of fishermen treated in the region numbered 282; 116 during lobster fishing and 166 during sea cucumber season. The direct medical costs were estimated to be USD $120,269; the temporary loss of income in USD $724,377; and the permanent loss of income was USD $737,053. Considering the direct and indirect costs, the social costs of diving in both small-scale fisheries was USD $1,614,121. This is a first approach to estimate the cost of the use of diving in fisheries for the ..

Introduction: Hyperbaric exposure mimics air-breathing scuba diving, which is reaching enormous popularity around the world. The diver’s body is subjected to a broad range of divergent effects exerted by, e.g.: an increased partial pressure of inert gases, microclotting, oxidative stress and/or production of gas bubbles. However, very little is known regarding the impact of hyperbaric exposure on plasma fatty acids content and composition, together with the body’s sphingolipids profile. Material and Methods: The aim of this study was to investigate the contents of major fatty acids present in the plasma as well as sphingolipids, namely: sphingosine (SPH); sphingosine1-phosphate (S1P); sphinganine (SPA); and ceramide (CER), after hyperbaric exposure corresponding to dives conducted to the depths of 30 and 60 meters of seawater. For the plasma lipids measurements, high-performance liquid chromatography together with gas-liquid chromatography were applied. Results: We demonstrated that hyperbaric exposure does not affect the content and composition of plasma fatty acids of experienced divers. Similarly, the amounts of major sphingolipids fractions were not influenced, as only the content of sphingosine-1-phosphate in the plasma was significantly decreased. Conclusions: Observed lack of significant changes in plasma lipid profile after hyperbaric exposure suggests that the procedure might be considered as secure. ..

This report summarizes some of the most relevant studies during the 2017-2018 academic year of scientific literature for diving medicine. The article selection is the result of a PubMed search for “diving,” as well as a manual review of the journals Undersea and Hyperbaric Medicine and Diving and Hyperbaric Medicine. Four articles were published reporting on new advances in decompression modeling. New consensus guidelines in the prehospital treatment of decompression sickness were published as well as a retrospective review of the efficacy of the U.S. Navy Treatment Tables. Several articles were published this year researching cardiovascular health and fitness to dive. A novel approach by one occupational medicine clinic for referral for hypertension may allow for early intervention of the “silent killer.” Application of the Framingham risk score to commercial divers does not result in an excessive number of disqualifications. The controversy over screening and subsequent repair of a patent foramen ovale in divers was heavily researched this past year. Several groups reported their experience with closure and associated risks. Subjects diving with pre-existing conditions were surveyed and found to be fairly common, with seemingly little ill effect (albeit with a potential survivor bias). Recommendations for diving while using ..

Panic arising from physical or psychological stress is a common issue in reported incidents and accidents in scuba diving. Due to its effect on perception, thinking and diver behavior, the panic reaction is often a significant factor in the generation or escalation of problems, potentially leading to injuries and fatalities. The instinctive behaviors associated with panic are incompatible with the constraints of scuba diving (e.g., flight response to threat, leading to rapid ascent). Although the dangers are wellknown, the psychological mechanisms of panic and the implications for prevention/risk reduction are not sufficiently highlighted to recreational divers. In applied psychology, there are grounded theoretical models which describe the onset and maintenance of anxiety and panic, and an evidence base for approaches to anxiety management. For example, these models are used within structured psychological approaches for people experiencing anxiety disorders; and panic attacks are resolvable. Based on these models and underlying theory, this article proposes a new, accessible model for panic in divers. The potential uses of the model are to: (1) provide a simple framework for divers to understand the onset of panic; (2) promote the need for adequate training; (3) describe the importance of staying within training standards, qualifications ..

Introduction: Head-out water immersion (HOWI) results in diuresis, which could potentially limit performance after egress to land. We examined the effect of rehydration on endurance, cardiovascular stability, and overnight recovery following a fourhour thermoneutral HOWI on 12 subjects. Methods: Twelve males completed a crossover design consisting of no hydration, replacement of fluid loss during immersion (RD), and replacement of fluid after the immersion period (RA). Sixty minutes following immersion, subjects ran to exhaustion at ~80% maximum heart rate. After completing the run, each subject submitted to a head-up tilt test (HUTT). Vital signs and ECG were monitored overnight. Results: HOWI resulted in a transient diuresis in NH and RA, while it was sustained throughout immersion in the RD protocol, resulting in greater urine [l] output (1.27 ± 0.48 (NH), 1.18 ± 0.43 (RA), 2.32 ± 0.77 (RD) (p < 0.001). Body mass change (%) was greater in NH than RD, but not RA (-1.58 ± 0.56 (NH), -0.66 ± 0.47 (RD), and -0.92 ± 0.76 (RA)). Run times were 17% versus 20% in NH compared to RD and RA, respectively, but were not statistically different. Time to orthostasis during the HUTT did not differ by condition. Overnight heart rate ..

The Eurasian Tunnel is a 5.64-km crossroad tunnel that connects Europe and Asia. Located under the seabed for the first time, 3.34 km of the tunnel that crosses the Bosphorus was built by advanced tunneling techniques. An exclusively designed tunnel boring machine (TBM), which has an operating pressure of 11 bars and a diameter of 13.7 meters was used for boring the seabed tunnel. The deepest point was 106 meters below sea level. One bounce diving period and seven saturation diving periods were needed for the repair and maintenance of the TBM during the project. Total time spent under pressure was 5,763 hours. A saturation decompression chamber for four divers was used for the saturation interventions, and divers breathed trimix at storage and excursion depths. The longest saturation run was the second, with storage at 10 bars and excursions to 10.4 bars. Twenty-three professional divers who were all experienced in compressed-air work were assigned to work on the project. Four dive physicians provided medical support, which included screening of divers before and during the hyperbaric interventions as well as on-site supervision. There were no diving-related accidents. A minor hand trauma, an external otitis and occasional insomnia were non-diving-related health ..