Training Dives Present Serious Hazards to Fire Fighters

Divers Beware: Training Dives Present Serious Hazards to Fire Fighters

Entanglement in rope or aquat- Panic attacks while diving may Summary ic plants is an extremely serious be provoked by situations such Fire fighters who partici- hazard that can prevent divers as entanglement, running out of pate in dive training risk from returning to the surface air, or reasons unknown. Panic lung damage, illness, or [Hendrick et al. 2000]. attacks occur among both veter- drowning. NIOSH in- an and novice divers. Adequate vestigated fatalities that Lung overexpansion most com- attention to panic and anxiety have occurred during monly occurs when divers pan- attacks should be given during these training exercises ic and make rapid ascent hold- diver training. More than half of and developed recom- ing their breath. No sensation experienced divers surveyed re- mendations to decrease of discomfort provides a warn- port having panic episodes while these risks. ing when overexpansion is SCUBA diving [Morgan 1995]. about to occur [NAUI 2000]. Decompression sickness (“the New divers may hold their bends”) occurs after extended Description of breath when first learning to Exposure periods of time at depth fol- use SCUBA equipment [PADI lowed by ascending too quick- Fire fighters may be called on 1990]. Lung overexpansion ly, thus preventing nitrogen gas to perform public safety div- can result in pulmonary baro- accumulated in the diver’s tis- ing actions, including search traumas causing serious dam- sues from dissipating proper- and rescue and recovery mis- age to the lungs, including col- ly. Symptoms of decompression sions. Fire departments and lapse [Bookspan 1995], even sickness can range from skin rash, fire fighters preparing for un- when ascending from relative- extreme fatigue, coughing, and derwater operations must be ly shallow depths and on rela- painful joints to paralysis and un- aware that dive training can be tively short dives. consciousness [NAUI 2000]. hazardous. Diving hazards in- clude entanglement, running out of air, lung overexpansion DEPARTMENT OF HEALTH AND HUMAN SERVICES injury, panic attacks, and de- Centers for Disease Control and Prevention compression sickness. National Institute for Occupational Safety and Health Case Studies was then transported by helicopter to a nearby trauma center where he was pronounced dead. Case 1 The cause of death was stated as pulmonary barotrauma. On July 15, 1999, a 25-year-old male career fire fighter/paramedic/rescue diver drowned during a circular search training exercise at a Controls lake [NIOSH 1999]. Acting as the pivot diver, the victim descended and maintained a fixed To minimize the risk when participating in dive location while extending a length of rope to the training, NIOSH recommends that fire depart- pattern diver. The pattern diver swam increas- ments and fire fighters take the following pre- ingly larger circles around him while holding cautions: onto the rope. Fire departments should do the following: About 2 minutes after the victim entered the water, his rope bag surfaced. The pattern div- n Establish, implement, and enforce standard er surfaced and was instructed by the lead div- operating procedures (SOPs) regarding div- er to retrieve the victim, but was unsuccessful. er training. The boat driver radioed for emergency assis- tance. A rescue search was initiated, and the n Ensure that divers maintain positive com- victim was found and brought to the surface. munication with each other and with per- The victim’s air regulator was not in his mouth sonnel who remain on the surface. and he was cyanotic and unresponsive. The vic- tim was transported by helicopter to a regional n Develop a pre-dive checklist for all diving trauma center, where he was pronounced dead. situations, including diver training, equip- The cause of death was listed as drowning. ment function, and diver experience, which should match the difficulty of the intended dive. Case 2 On August 13, 2000, a 28-year-old male career n Ensure that backup divers are trained to per- fire fighter/SCUBA diver died during a search form rescue operations for other divers who and rescue training exercise at a lake [NIOSH may be in distress. 2000]. During the exercise, a circular search pattern was used from a buoy line. The victim’s n Ensure that an experienced backup diver partner lost the search line and became separat- and a ninety-percent-ready diver are in posi- ed from the victim. The partner was equipped tion to help. with a conventional regulator and had no elec- tronic communications with the other divers. n Provide divers with refresher training on the hazards and prevention measures of lung Another diver saw the victim, who was dis- overexpansion injuries, entanglement, de- tressed and frantically screaming and moving compression, and panic attacks. around, and knocked off the other diver’s face piece. The victim, who was entangled in the n Practice the training exercise in a closed en- buoy line, was pulled to the surface by the buoy vironment such as a swimming pool before line. The victim received medical assistance and attempting it in open water. n Obtain and update appropriate medical Hendrick W, Zaferes A, Nelson C [2000]. Pub- fitness evaluations for SCUBA divers lic safety diving. Saddle Brook, NJ: Fire Engi- annually. neering Books and Videos. n Ensure that equipment checks are per- Morgan WP [1995]. Anxiety and panic in rec- formed on a scheduled basis and defective reational scuba divers. Sports Med 20(6):398– equipment is repaired or replaced before a 421. dive takes place. PADI [1990]. PADI open water diver manu- n Supply divers with an alternative backup air al. Santa Ana, CA: Professional Association of source such as pony bottles. Diving Instructors. NAUI [2000]. NAUI scuba diver manual. Tam- n Ensure that instructors and divers are cer- pa, FL: National Association of Underwater In- tified for SCUBA diving, dive training, and structors. dive rescue operations by a nationally recog- nized organization. NIOSH [1999]. Fire fighter/paramedic drowns during an underwater SCUBA training drill— n Ensure that a medical unit is on site with ox- Missouri. Cincinnati, OH: U.S. Department of ygen in case of an emergency. Health and Human Services, Centers for Dis- ease Control and Prevention, National Institute n Ensure that dive coordinators stay informed for Occupational Safety and Health, DHHS about each diver’s rate of air consumption. (NIOSH) Publication No. 99F–29.

Fire fighters/divers should do the following: NIOSH [2000]. Fire fighter/SCUBA diver dies during training evolution—Indiana. Cincinnati, n Follow all SOPs. OH: U.S. Department of Health and Human n Maintain continuous visual, verbal, or physi- Services, Centers for Disease Control and Pre- cal contact with their dive partner. vention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publica- n Perform equipment checks before each dive. tion No. F2000–38. Equipment checks should be verified by the dive coordinator. Additional resources regarding scuba diving in- clude the following: n Ensure that underwater search teams oper- ate individually to avoid rope entanglement. NFPA 1670—Standard on operations and train- ing for technical rescue incidents. n Regularly monitor their air consumption. NFPA 1006—Standard for rescue technician n Consider performing at least 12 dives per professional qualifications. year to maintain skills. ACKNOWLEDGEMENTS REFERENCES The principal contributors to this publication Bookspan J [1995]. Diving physiology in plain were Jay L. Tarley, Edward L. Husting, and Ste- English. Kensington, MD: Undersea and Hy- ven L. Proudfoot, Division of Safety Research, perbaric Medical Society, Inc. NIOSH. For More Information

The information in this document is based on fatality For a monthly update on news at NIOSH, subscribe to investigations, literature and expert review. More in- NIOSH eNews by visiting www.cdc.gov/niosh/eNews. formation about the Fire Fighter Fatality Investigation Mention of any company or product does not constitute and Prevention Program is available at www.cdc.gov/ endorsement by NIOSH. In addition, citations to Web niosh/firehome.html sites external to NIOSH do not constitute NIOSH en- dorsement of the sponsoring organizations or their pro- Contact the Divers Alert Network (DAN) 24 hour grams or products. Furthermore, NIOSH is not respon- hotline at (919) 684–8111 in the event of a diving sible for the content of these Web sites. emergency or for questions about a diving injury.

To receive more information about occupational safety This document is in the public domain and may be and health topics, contact NIOSH at freely copied or reprinted. NIOSH encourages all readers of the Workplace Solutions to make them NIOSH available to all interested employers and workers. Publications Dissemination 4676 Columbia Parkway As part of the Centers for Disease Control and Pre- Cincinnati, OH 45226–1998 vention, NIOSH is the Federal agency responsible for conducting research and making recommendations to Telephone: 1–800–35–NIOSH (1–800–356–4674) prevent work-related illnesses and injuries. All Work- Fax: 513–533–8573 § E-mail: [email protected] place Solutions are based on research studies that show how worker exposures to hazardous agents or or visit the NIOSH Web site at www.cdc.gov/niosh activities can be significantly reduced.

Divers Beware: Training Dives Present DHHS (NIOSH) Publication No. 2004–152 Serious Hazards to Fire Fighters

Safer • healthier • Peopletm June 2004

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health 4676 Columbia Parkway Cincinnati, OH 45226–1998