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2005 September;35(3) ISSN 0813 1988 Volume 35 No. 3 ABN 29 299 823 713 September 2005 Quarterly Journal of the South Pacific Underwater Medicine Society (Incorporated in Victoria) A0020660B The safety record of science diving Acute oxygen toxicity during hyperbaric therapy Reverse diving profiles: a riposte Diving’s black box More on jellyfish Print Post Approved PP 331758/0015 South Pacific Underwater Medicine Society (SPUMS) Journal Volume 35 No. 3 September 2005 PURPOSES OF THE SOCIETY To promote and facilitate the study of all aspects of underwater and hyperbaric medicine To provide information on underwater and hyperbaric medicine To publish a journal To convene members of the Society annually at a scientific conference OFFICE HOLDERS President Dr Chris Acott 30 Park Avenue, Rosslyn Park Email <[email protected]> South Australia 5072 PastPresident Dr Robyn Walker 12 Barrallier Street, Griffith Email <[email protected]> ACT 2603 Secretary Dr Sarah Sharkey 1243 Pittwater Road, Narrabeen Email <[email protected]> New South Wales 2101 Treasurer Dr Andrew Patterson 28A Roland Avenue, Wahroonga Email <[email protected]> New South Wales 2076 Editor Assoc. Prof. Mike Davis C/o Hyperbaric Medicine Unit Email <[email protected]> Christchurch Hospital, Private Bag 4710, Christchurch, NZ Education Officer Dr Chris Acott 30 Park Avenue, Rosslyn Park Email <[email protected]> South Australia 5072 Public Officer Dr Guy Williams P.O.Box 190, Red Hill South Email <[email protected]> Victoria 3937 Chairman ANZHMG Dr David Smart Department of Diving and Hyperbaric Medicine Email <[email protected]> Royal Hobart Hospital, Hobart, Tasmania 7000 Committee Members Dr Christine Lee P.O.Box 862, Geelong Email <[email protected]> Victoria 3220 Dr Guy Williams P.O.Box 190, Red Hill South Email <[email protected]> Victoria 3937 Dr David Vote P.O.Box 5016, Moreland West Email <[email protected]> Victoria 3055 ADMINISTRATION Membership Steve Goble C/o ANZ College of Anaesthetists Email <[email protected]> 630 St Kilda Rd, Melbourne, Victoria 3004 Journal Sarah Webb C/o Hyperbaric Medicine Unit Email <[email protected]> Christchurch Hospital, Private Bag 4710, Christchurch, NZ Phone: +6433640045, Fax: +6433640187 North American Representative Jeffrey Bertsch Email <[email protected]> European Representative Henrik Staunstrup Email <[email protected]> MEMBERSHIP Membership is open to all medical practitioners. Associate membership is open to all those who are not medical practitioners but are interested in the aims of the Society, and/or those engaged in research in underwater medicine and related subjects. Membership application forms can be downloaded from the Society’s website at <http://www.SPUMS.org.au> Further information on the Society may be obtained by writing to: SPUMS Membership, C/o Australian and New Zealand College of Anaesthetists, 630 St Kilda Road, Melbourne, Victoria 3004, Australia or email <[email protected]> or go to www.spums.org.au The Society’s financial year is January to December, the same as the Journal year. The 2006 subscription will be Full Members A$132.00 and Associate Members A$66.00, including GST. There will be an additional surcharge of $8.00 for journal postage for all members living outside Australia. South Pacific Underwater Medicine Society (SPUMS) Journal Volume 35 No. 3 September 2005 117 Invited commentary The international safety record for scientific diving Martin Sayer Key words conversions of depths from feet to metres, indicates that the Scientific diving, safety, decompression sickness, types of diving being undertaken by the scientific sectors epidemiology, editorial in the US and UK are remarkably similar (Table 1). The only major difference is in depths shallower than 19 msw, This issue sees the publication of two papers with a common where the majority of US diving is performed shallower element in that they review the safety records of scientific than 9 msw whereas most of the UK diving is done between diving programmes undertaken in Australia and the United 10 and 19 msw. Summing the dives performed shallower States.1,2 Earlier this year, an analogous review was made of than 19 msw produces a very similar trend, with 87% of the a single institution’s scientific diving operations in the UK US dives and 88% of the UK dives being in this depth and the abstract of that paper is also reproduced.3 Such range. This similarity in trend is also shown in the proportion detailed published appraisals of a specific sector of the of dives undertaken in the depth ranges of 20–29 msw (10% divingatwork industry are rare, especially for three in both) and 30+ msw (3% and 2% by US and UK scientific comparable reviews to have been conducted in similar depth divers respectively). By subtraction, this means that the in different national programmes. In this commentary I will proportion of scientific dives performed shallower than 30 contrast the safety trends of the three studies in a way that msw is 97% in the US, 98% in the UK and 100% in Australia. presents an international evaluation of the relative risk levels for the scientific diving sector as a whole. This overview examines both the rates of decompression illness (DCI) and those of serious diving incidents. Lang As with any metaanalysis of data sets that have been questions whether some of the incidents reported as developed in isolation, there will be difficulties in making “pressure accidents” in his pre1981 data set refer exact comparisons or when trying to combine the specifically to incidents of DCI or not. I have assumed here information into single estimates. At least Carter et al and that they do but they are also grouped, along with the deaths, Sayer and Barrington had the relatively straightforward task within the “serious accidents” category. The relative sizes of examining records from single institutes. Lang’s work of the three studies means that any ‘international’ risk factor has had to make some assumptions because of a lack of that is constructed will be heavily influenced by the US consistency in some of the reporting phraseology made study. The lack of any incidents in the Australian account during two longterm, multiinstitute assessments. and only a single incident in the UK study produce their own statistical problems when attempting to apportion risk In their intersectorial comparisons, Sayer and Barrington rate. That notwithstanding, combining the three data sets argue that the unit of ‘a dive’ does not necessarily convey produces a total of 508,771 dives in which there were 7 the true risk to the individual as differences in diving deaths, 21 cases of DCI and, by summation, 28 serious practices will produce varying ratios of person dives to diving incidents. This produces rates of 0.06 and 0.04 dives. For the UK study that ratio was just over 1.8 but this respectively for serious incidents and DCI cases per 1,000 value could potentially vary considerably within and dives. The incident rates from this analysis for scientific between the other studies. Conceivably, the US data diving are lower than those previously reported for military expressed as ‘dives’ could refer to the number of divers per personnel (0.14 serious incidents per 1,000 dives),4 amateur person. The study of Carter et al does relate their findings recreational divers in the UK (DCI only, 0.07),5 recreational to the ‘person dive’ level. However, the overall lack of clarity divers in the Caribbean (DCI only, 0.09),6 recreational divers in the reporting terminology between the three studies does in western Canada (serious incidents, 0.12)7 and wreck divers influence the levels of certainty in some of the joint incident in cold water (serious incidents, 0.25–0.49).8 rates calculated below. Table 1. A comparison by maximum depth of the types The Australian study does not give a detailed breakdown of scientific diving undertaken in the US (Lang)2, UK of the actual maximum depths dived to but the diving was (Sayer and Barrington)3 and Australia (Carter et al)1 restricted to depths shallower than 30 metres’ sea water (msw) or 15 msw depending on the level of qualification because Depth range (msw) US (%) UK (%) Australia (%) of the statutory limits for scientific diving in that country. 0–9 49.20 31.90 The UK study does not discriminate between depth classes 10–19 37.93 56.40 deeper than 30 msw but the statutory maximum for diving 0–19 87.13 88.30 on scuba at work in the UK is 50 msw. The maximum depths 20–29 10.10 9.60 reported from the US were in excess of 50 msw. Looking at 0–30 97.22 97.90 100.00 dive numbers only, and making some allowance for 30+ 2.78 2.10 0.00 118 South Pacific Underwater Medicine Society (SPUMS) Journal Volume 35 No. 3 September 2005 The assumption made from all three studies is that the vast was classified as multiday this may not be true for the US majority of scientific diving operations are performed using and UK. However, it is possible that the neartotal scuba equipment and equipment configurations that have, proportion of dives being shallower than 30 msw in all in general, been developed for and employed by the three programmes is not typical of recreational diving. recreational diving sector. Although scientific diving may have been a driving developmental sector during the advent In all three cases there was a high use of tables to control of scuba, the massive expansion of the recreational sector decompression, from 100% in the UK and Australian in recent decades has accelerated development and, as a programmes to about 50% usage in the US.
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