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The Magazine of Divers Alert Network Asia-Pacific

The Magazine of Divers Alert Network Asia-Pacific

The Magazine of Asia-Pacific

REMOTE RESTRICTIONS MASTERCLASS THE VALUE OF EXPERIENCE PLASTIC’S IMPACT

Quarter 4, 2015 danap.org ON THE COVER Contents A diver explores a canyon in the Solomon Islands Image © Settings: f/15,1/80s, ISO320

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51 Perspectives WHAT IS REMOTE? by Scott Jamieson Content Coordinator Stephen Frink Incident Insight 52 Editors REMOTE RESTRICTIONS by DAN AP’s Scott Jamieson, John Lippmann and Mel Cefai Brian Harper and Diana Palmer Founder, Director of Research & Skills & Safety 58 Chairman of the Board BUOYANCY CONTROL by John Lippmann, DAN AP Founder & Chairman and John Lippmann Stan Bugg, DAN AP Director General Manager 62 Expert Opinions Scott Jamieson THE EFFECT OF EXPERIENCE ON RISK Administration Manager by Peter Buzzacott, PhD Sim Huber 68 Life Aquatic Marketing & Communications OCEANS OF PLASTIC Manager by Melissa Gaskill Melissa Cefai 70 Gear DAN AP Board of Directors UP! 68 John Lippmann, David Natoli, by Marty McCafferty, EMT-P, DMT, and Patty Seery, MHS, DMT Malcolm Hill, Dr David Wilkinson, Mick Jackson, Stan Bugg, Tom Wodak, Nicholas Cheong ALERT DIVER’S PHILOSOPHY Memberships & Certifications Alert Diver is a forum for ideas and information Alert Diver is published as a separate, Heidi Powell, Julie Parsonson, relative to , education and practice. independent magazine within Scuba Diver Cynthia Van Zyl, Mina Chivotti, Any material relating to dive safety or dive AUSTRALASIA (SDAA) magazine. DAN Asia- Adam Lippmann, Sophie Kayne, Pacific is not responsible for the content provided medicine or accident management is considered and Diane Boyle for publication. Ideas, comments and support are elsewhere within SDAA, and therefore this content encouraged and appreciated. The views expressed should not be assumed to represent the views, Training policies or practices of DAN Asia-Pacific or Alert by contributors are not necessarily those John Lippmann, David Natoli advocated by DAN Asia-Pacific. DAN is a neutral Diver magazine. public service organisation which attempts to and Tim Vernon-Smith ©Alert Diver text, illustration or photographs interact with all diving-related organisations Marketing Assistants or persons with equal deference. Alert Diver is may not be reproduced or reprinted without the published for the use of the diving public and it expressed consent of Divers Alert Network and Haili Mu & Adam Lippmann is not a medical journal. The use and dosage of its authors, artists and photographers. Many any medication by a diver should be under the articles are reprinted with the kind permission of Accounts supervision of his or her physician. DAN America. Anny Limbek

Email: DAN AP does not necessarily endorse the [email protected] products or services of any organization For more information on membership, insurances and training programmes, or company whose advisements appear in visit our website: www.danap.org Alert Diver Perspectives

From DAN Asia-Pacific WHAT IS REMOTE? With more divers adventuring to far-flung locations, DAN is managing incidents that present increasing challenges By Scott Jamieson

AS DIVERS, the thrill of diving a virgin wreck or During the past month I assisted a DAN a or cave system that has seen few divers Member who had travelled to an island in Fiji is enticing, so it isn’t surprising that increasing that was less than a one hour flight from Nadi numbers of DAN Members are travelling to International Airport. Whilst the island doesn’t remote, untouched diving destinations. However, sound remote it did present challenges, such remoteness creates issues for DAN and our as the fact the island had a landing strip but no assistance providers, as we find ourselves lights in order for a plane to safely land in the helping increasing numbers of divers in remote evening. You can read more about this particular regions with infrastructure that often isn’t ideal challenge, and others, in our “Incident Insight” when managing a diving emergency. section on page 52. But what is considered a remote location? This incident demonstrates that even if a The dictionary defines remote as being: a place location is not geographically distant from a that is situated far from the main centres of major centre it can still be considered “remote” population. However, in the event of a diving when an is required. Part of the DAN Asia Pacific team. accident, we can modify this a little bit to include Diving always carries some risk and the From left, Mel, Cynthia, Julie, John, Heidi, Scott, Haili, Anny, places that are distant from the services we more remote you are, the greater that risk Adam, Sim would expect in a main centre of population. becomes. As responsible divers you should be aware of the fact that remote doesn’t just mean a long air flight to get to your holiday destination but it can mean the facilities at your destination are more rustic than ideal in the event of an incident. It is up to you, , to make sure you minimise the risks, especially as you go more remote. Dive conservatively, try to limit your number of daily dives, take longer surface intervals, drink lots of water, and stay well rested. And make sure that DAN coverage is part of your dive kit. Enjoy your travels, evaluate the risks and dive safely and conservatively.

Scott Jamieson, DAN AP General Manager

Dive Tip Engage with DAN on Facebook for insights into various dive safety and medical issues. Scan here or search DAN Asia Pacific. 3 Research, Education & Medicine Image © Jan Novak/123rf

Incident Insight During the safety stop, Sam felt as though REMOTE RESTRICTIONS everything was spinning around him. He Evacuations to the high-level medical care can be surfaced and swam to the boat, at which point hampered by unexpected restrictions in remote places he lost all feeling in his body. His wife described Text by DAN AP’s Scott Jamieson, John Lippmann and Mel Cefai him as having his eyes open but not responding. The diver has full memory of these events but was unable to respond, as he had no movement CASE REPORT in his limbs. The boat crew commenced

Sam (not his real name) is a healthy 47-year-old (O2) immediately. Sam breathed O2 via a man who was diving with his wife in Kadavu, Fiji. non- mask with a flow rate of 10 litres He had completed a total of 120 lifetime dives per minute (lpm) and regained some feeling in and is described as fit and healthy. Sam has had his legs and arms. no previous history of illness. Upon reaching shore a call was immediately The incident occurred on Sam’s fourth day placed to the DAN/DES (Diving Emergency on Kadavu. On both the Monday and Tuesday the Service) Hotline. diver completed two dives that were uneventful After being given the details of the dives from a safety/incident perspective. He rested undertaken and the description of symptoms, on the Wednesday. On the Thursday he dived to the diving doctor assessed the cause as possible 27m for a total bottom time of 41 minutes. His CAGE (cerebral arterial gas embolism) with computer displayed no warnings, however, he the need for further medical evaluation and felt dizzy and disoriented on his way to the safety recompression treatment. Symptoms commonly stop. He completed approximately two minutes associated with a CAGE diagnosis include at the 5m safety stop before he underwent a disorientation, as well as difficulty walking and rapid ascent to the surface. talking; all symptoms exhibited by Sam.

4 There is no recompression chamber located on oxygen was located and he was able to continue Kadavu so DAN Asia-Pacific connected with DAN oxygen at 10lpm via a non-rebreather TravelAssist to prepare an assistance plan. Two mask without any breaks. options were considered: Whilst his condition did improve, in that he was able to move all extremities and his speech 1 An air evacuation 2 An air evacuation was no longer slurred, he remained unable to Suva on the to Nadi (also on to urinate. It is understandable that both Sam main island, Viti Viti Levu), where and his wife were anxious and restless. DAN Levu, where a the international continued to reassure them that many people recompression airport is located, were working on getting him to higher-level chamber is approximately a medical treatment. located. 50-minute flight The next morning, Sam was evacuated by time from Kadavu, helicopter from Kadavu to the Colonial Memorial and then a further Hospital in Suva for evaluation and treatment. He flight to Brisbane, received a treatment (approximately two hours in . the chamber), and underwent the same treatment the following day. The DAN/DES doctors still recommended The preferred option was getting Sam straight an air evacuation to Brisbane for further to Australia for higher-level care. However, treatment and this was organised accordingly. the evacuation company advised that a landing While the air evacuation was co-ordinated, permit would be required for an international Sam underwent another treatment with some rescue plane and medical team to land in Fiji, improvement. However, his wife reported that which would take approximately 6–18 hours. As his walking was limited to a shuffle and he still such, it was decided that getting Sam to Suva could not urinate. Upon reaching the Royal and into the chamber for treatment was the best Brisbane Hospital he was diagnosed with spinal option given his condition and the unknown time and underwent a T62/T6 it would take to secure a landing permit. treatment, spending approximately five hours in Another issue arose as night was the chamber. approaching. Despite the island of Kadavu In total, Sam received three short having a landing strip it doesn’t have lights, recompression treatments in Fiji before being which meant that any plans to have a plane or transported to Australia. He then had 15 further helicopter land that evening were not viable. treatments. At the time of writing, Sam was able Consequently, Sam had to spend the night in to walk, and although he is still unsteady on his Some locations may not Kadavu. There were concerns that the medical feet, he was becoming increasingly stable, with seem to be extremely remote centre did not have a sufficient supply of oxygen strength continuing to return to his legs, and with geographically, but restricted infrastructure can create to get him through the night. Fortunately, more hope of a full recovery. problems for evacuations

Despite the island of Kadavu having a landing strip, it doesn’t have lights, which meant that any plans to have a plane or helicopter land that evening were not viable Image © haveseen/123rf

5 DISCUSSION

O2 Availability Immediate Call to DAN/DES Hotline It was fortunate that the dive operator was well Fast action in calling the DAN/DES Hotline is equipped with oxygen on-board, and the dive to be commended as it meant that emergency boat and staff trained in oxygen provision so evacuation procedures were implemented that appropriate first aid could be commenced immediately. It also meant the instructions of immediately. In addition, the operator had a non- the DES doctors could be followed from the rebreather mask available, which can provide outset; such as the instruction for the diver to

a high level of oxygen to a breathing diver. The continue breathing O2 all night at the highest flow rate was also in the recommended range possible flow rate. The hospital, in an effort to of 10–15 lpm, albeit at the lower end. It is likely conserve oxygen (and in the absence of diving that the outcome of this incident would have medical knowledge), suggested lowering the been very different without the immediate and flow rate to 4lpm, or less. However the DAN/ prolonged oxygen first aid. DES doctor and DAN on-call staff rejected this as high oxygen was vital to help reduce the diver’s symptoms.

DAN membership means that you will have the best support possible, even if you have an incident in a remote environment

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A brand new offer from Scuba Diver Option 2 AUSTRALASIA + OCEAN PLANET and MAIL TO: DAN Asia-Pacific now lets you get your dive safety, travel, education, entertainment, Asian Geographic lifestyle and , in one Magazines Pte Ltd fell swoop and for a killer price. 20 Bedok South Road Singapore 469277 Don’t miss out! Become a Member of DAN Asia-Pacific and have the world’s best dive As part of this exciting partnership, we are offering Email: [email protected] DAN Asia-Pacific Members, anywhere in the world, magazine land on your doorstep eight times a Tel: +65 6298 3241 FREE access to our joint publication. year, all for the special price of just S$90! Fax: +65 6291 2068 Scuba Diver AUSTRALASIA, now with DAN Asia- Pacific’s Alert Diver, is published four times a year þ YES! and is full of fascinating content – compelling, relevant My name is information and images from some of the world’s best underwater photographers. I live in the Asia Pacific region, and I would love to get my DAN Asia-Pacific Membership and a subscription to If you are a DAN Asia-Pacific Member, scan the QR code and follow the Scuba Diver AUSTRALASIA + OCEAN PLANET, instructions to receive your free issue bundled together for the crazy price of just SGD 90! of Scuba Diver AUSTRALASIA and Alert Diver! Here is my email address, please write to me at

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Image credit: Stephen Frink In remote environments it is even more important that the dive operator staff are trained in oxygen provision and the operator has adequate oxygen first aid equipment

Issues Associated with Remoteness Coverage for Diving Incidents This diver chose Fiji as a destination because it In this case, the air evacuations alone cost in was “not too remote”. Unfortunately, even being excess of US$110,000 and that doesn’t include close to a major city and international airport the cost of the chamber treatments! As a DAN can still be considered remote depending on Member, these evacuation costs were fully the associated circumstances. Whilst Suva has covered. And, in this highly stressful situation, a recompression chamber (which is something it meant neither Sam nor his wife had to many places don’t), no technician was available worry about arranging, or paying for, the two to run the chamber until the following day. As evacuations. such, even if DAN had been able to evacuate the diver to that chamber on the first evening, he would not have been treated, and this is Whilst another reason why an evacuation to Australia Suva has a was considered. recompression chamber, no technician Arranging an Emergency Medical Evacuation was available Even though DAN are the experts in diving Dive Tip to run the accident management with more than 30 years Planning a Dive Trip? Check out chamber until of experience in helping sick and injured divers, DAN AP’s list of safety aspects the following the unique set of circumstances that present for to consider when deciding which operator to dive with. day. Even if DAN each case can and do create challenges. In this Visit danap.org/planning.php had been able case, whilst the island of Kadavu has a landing to evacuate the strip, it doesn’t have the lights needed to guide Engage with DAN on diver to that planes in for a safe night landing. Sam was Facebook for insights fortunate that the island had a medical centre into various dive safety chamber on the and medical issues. first evening he with oxygen, although the supply was limited and Scan here or search would not have would have run out if further supplies had not DAN Asia Pacific. been treated been found.

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I was diving in the and had pain and tingling in one arm, an itching sensation on my back plus pins and needles in both feet. I called a DAN Hotline for help and was sent to the local chamber where I underwent two treatments that cost more than US$6,000. Fortunately, these expenses were fully covered by DAN. - S. Lee,

www.danap.org Skills & Safety

Techniques in Depth BUOYANCY CONTROL Learn it, practise it, master it, and never take it for granted Text by John Lippmann, DAN AP Founder & Chairman and Stan Bugg, DAN AP Director Images by Stephen Frink

Good buoyancy control is the cornerstone of safe and enjoyable diving. Despite this fact, too many divers lack real skill in this vital area. Anecdotes abound of divers who, due to lack of buoyancy control, have a miserable and stressful time underwater.

Diving fatality statistics highlight the role poor buoyancy plays in dive accidents:

1 In a DAN America analysis of over 900 diving fatalities, buoyancy trouble was reported in 31 percent of cases.1 2 A DAN Asia-Pacific study of over 350 Australian deaths found that buoyancy problems were highlighted in at least 17 percent of these incidents. As many earlier reports are incomplete, we suspect the actual figure is higher.2

BUOYANCY 101 To appreciate what is going on, it can be helpful for less experienced divers to refresh the basics of buoyancy control. We encourage you to visit www.danap.org/buoyancy.php for a summary of “Buoyancy 101” from basic .

GETTING BUOYANCY RIGHT Buoyancy control begins with correct weighting. You should generally aim to be neutral while on the surface with all air drained from your BCD. When you exhale, you should begin to sink. Incorrect weighting is all too common, and it invariably means OVERWEIGHTED. This process usually begins during basic training when new divers should be taught the importance of being correctly weighted, and should be guided through the steps needed to achieve it. But this surface if required, and has led to fatalities. is often not the case. In addition, this practice, unless corrected Add and dump air slowly to adjust your buoyancy It is not uncommon for instructors to once the skills are covered, potentially turns overweight their students for pool and shallow “trained” divers loose with an inaccurate Getting your weighting right ocean classes so they are not floating all over the notion of how much weight they should use for can mean taking the time to experiment and make some place during instruction. This overweighting can subsequent dives. adjustments in controlled make it extremely difficult for a panicking diver Flip to the Gear section on page 70 for a environments and under supervision (student or otherwise) to reach or remain on the thorough rundown on proper weighting.

10 BUOYANCY COMPENSATOR PROBLEMS POSITIVE BUOYANCY IN AN EMERGENCY BCD inflator-deflator mechanisms are common It is very important that a diver who is at risk causes of buoyancy control problems because of becoming unconscious underwater gains poorly maintained mechanisms often jam. Poor positive buoyancy. The need to locate a diver, design, where the inflator and deflator buttons especially underwater, delays the opportunity are close together and/or easily confused, for relatively early resuscitation efforts so it is have also caused errors and subsequent far better for an unconscious diver to be at the buoyancy-related accidents. Careful choice of, surface, rather than to have to be searched for, and familiarity with, such a device will help to and recovered from, underwater. minimise problems: When positive buoyancy is needed in a hurry, your BCD can be inflated, or you can jettison your . The latter is the only alternative if 1 Your BCD is a mechanical device that the gas supply is exhausted. needs regular inspection, and professional All divers are told this in their training, but maintenance. it seems that few actually act upon it when an 2 Know your BCD. Know where the inflate/ emergency arises. Of the 350 compressed gas deflate buttons are located, and how much divers who died in Australia between 1972 and is required to activate them. 2006, three quarters of them were found with their weights still in place. Many were also found 3 Add and dump air slowly. Sudden with their BCDs deflated. adjustments equate to dramatic and Emergency drills such as ditching weights dangerous changes in your buoyancy. need to be practised REPEATEDLY in order 4 Practise in a controlled environment if you to embed the skill. Certified divers need to are not familiar with the BCD, or if you have continue to practise these skills periodically (as not dived for a while. well as additional skills such as air-sharing and 5 Check your BCD function before every mask-clearing) so that these important self- dive, to ensure the mechanism is working preservation skills are sufficiently honed and smoothly. ready if required.

11 Good buoyancy control is an essential part of safe diving and care for the

WHY DON’T DIVERS DITCH THEIR WEIGHTS?

1 Many weighting systems are unduly complicated, and the ditching procedure is not well learned. 2 At times, other equipment hinders access to the weights. 3 Some see throwing equipment away as economically unsound. Increasingly expensive integrated systems must increase this mindset. 4 We suspect that ditching weights either did not occur to some divers during the crisis, or they were too incapacitated to do it.

So how often did you actually practise ditching your weights during your training? It is likely that, for most of you, the answer is NEVER. If you are not prepared to actually drop your weight systems (after all, repositioning integrated pockets is not easy, and they do cost a fortune!), get into the habit of actually going through the physical motions of ditching, both topside and underwater. Find the release mechanism by FEEL alone, and grasp the release as if you were going to dump it.

TAKE-HOME MESSAGES Good buoyancy control is an essential part of safe diving and care for the underwater environment. Divers need to use the minimum amount of weight to attain from the outset and should be taught, and regularly practise, good buoyancy control. It is important to revisit this when changing relevant equipment (e.g., converting to a drysuit) or when using ancillary equipment (e.g., an SMB) References that can impact on buoyancy. As with other dive

1. Denoble PJ, Caruso 2. Lippmann J, Baddeley A, equipment, BCD inflator mechanisms need to JL, Dear G de L, Vann RD. Vann R, Walker D. An analysis be regularly inspected, tested and serviced to Common causes of open- of the causes of compressed ensure functionality. circuit gas diving fatalities in fatalities. Undersea and Australia from 1972–2005. It is also important for a diver to be very 2008; Undersea and Hyperbaric familiar with his/her weighting system, 35:393–406. Medicine 2013; 40:49–61. Further training can help you specifically how to dump weight readily in the fine-tune your buoyancy for even safer, more enjoyable diving event that this is required.

12 DivingDiving locallylocally withwith youryour clubclub oror buddy?buddy? MakeMake SureSure YouYou AreAre OxygenOxygen Prepared.Prepared.

To determine the right DAN Oxygen Unit for your diving, consider: • If Shore Diving: Time to appropriate medical care (Chamber or Hospital). • If Boat Diving: Time to shore plus the time to appropriate medical care. To be fully prepared, make sure: • Your DAN Coverage is . • You are Trained in Oxygen First Aid. • You have an Emergency Plan.

www.danap.org or email [email protected] for advice Research, Education & Medicine Image © Becky Kagan Schott/Liquid Productions

Expert Opinions individual measure has been identified as clearly THE EFFECT OF providing the most protection against diving injuries. Each measure may be relevant to some EXPERIENCE ON RISK and less so to others. Can safety be determined by a combination A study of more than 1,000 recreational of time underwater and training? scuba dives in Western Australia found that 38 Text by Peter Buzzacott, PhD of the dives exceeded commonly accepted no- decompression limits and also that those divers were unlikely to have dived as deeply previously.1 INEXPERIENCE is often listed as a factor during Though they had been diving for twice as long analyses of deaths on roads, falls in climbing as the other divers (10 years vs. five years), they and fatalities in diving. But what is experience, were reaching new depths and then incurring and how does it affect divers’ risk of injury? decompression obligations. This increased their Experience involves some exposure to diving, risk of (DCS), though but more than that it implies learning from that none reported symptoms of DCS following these exposure, developing judgment about what to do dives. A 2004 survey of 305 trained recreational when faced with similar situations in the future. divers found that within two years of certification The implication is that with time divers should be 20 percent had not dived for at least a year,2 but better equipped to make wiser choices. A single that does not mean they had given up diving. measure of experience for recreational divers Research shows that divers often return to does not exist, but some approximate measures the water after a year or more of inactivity; for may include the lifetime number of dives, years example, a survey of 528 recreational divers diving, highest certification level, number of aboard dive charter boats in Texas headed for an dives made in the past year, number of hours offshore dive found that 13 percent had not dived diving and other logged diving variables. No during the previous year.3

14 In these examples we see both longtime of 30–39, and thereafter claim rates fell in divers going beyond their previous experience every 10-year period that followed.4 This may and relatively new divers returning to diving suggest that divers make safer choices with after more than a year out of the water. Both increasing age. We asked two experts in diving groups might be considered at risk when and diver training for their opinions on the compared with divers who have recently dived interplay between dive experience and the risk of to similar depths. This assumption forms suffering a dive injury. the basis for requiring minimum levels of experience for participation in certain training How do we measure experience? such as , instructor, cave diver and Keith Cardwell: Experience in the context closed-circuit rebreather courses. During of recreational diving could be measured these courses divers learn new skills, and this by number of dives, hours accumulated highlights the difference between experience underwater, frequency and currency of diving and skill set: Experience is earned over time experiences, locations dived and/or types of through exposure to diving, while skills may be diving. Measurement of experience by many learned. Experience enhances a diver’s level of dive operations takes into account all of these comfort and self-awareness in the water, while indicators and often relies on reviewing log skills concern a diver’s mechanical ability to books and/or the presentation of a certification perform certain tasks. Indeed, it is even possible card both to confirm experience and to indicate for an inexperienced diver to be highly skilled, level of certification (and assumed skill level). especially if the diver is eager to reach the “top” Bill Oigarden: Experience is multifaceted. For of the sport as soon as possible. we usually think of experience as An analysis of insurance claims for DCS the classes we’ve taken, certifications we’ve among DAN America members found that earned and our time in the water. But I contend claims peaked for divers between the ages that experience also includes your lifestyle

Meet the Experts Keith Cardwell, PhD, has trained more than 2,000 instructors and established highly regarded training centres in Australia, , the Maldives and the USA. Cardwell holds a master’s degree in education, postgraduate diplomas in business administration and sport and recreation, and a doctorate in the study of workplace competence for recreational dive instructors. He has been operating on the out of Cairns, Australia, for the past 16 years.

Bill Oigarden, PhD, began diving in 1967 and was certified in 1974. His expertise now spans four decades of , technical mixed-gas and operating a charter boat in South and the Bahamas. Oigarden, who has degrees in underwater technology, business management and counselling, is trained in all facets of open-circuit sport and , recompression chamber operation and as a life support technician. He earned a doctorate in 2013 while researching personality traits among cave divers. Image © Stephen Frink

15 and how you view the world. A diver with an what I do. Buddy checks, ascent and descent aggressive personality style might say he or she checks, and regular communication with is experienced after a short period, while a more buddies are still necessary even after thousands laid-back or reflective personality may tend to of dives. Ignoring basic rules such as these is a seek more knowledge because there’s always precursor to trouble. something new to learn.

A diver with an aggressive personality style might say he or she is experienced after a short period, while a more laid- back or reflective personality may tend to seek more knowledge Image © Stephen Frink

How does inexperience relate to risk of Oigarden: Humble divers realise that they’re injury among new divers? only as experienced as their last dive. Divers Cardwell: Considerably. Many new divers, who consider themselves experienced can fall particularly those in training, often have into several categories. One category includes equalisation injuries due to lack of familiarity divers who have been diving for 30 years or with the available techniques. The worst- more and have made thousands of dives. These outcome diving events with which I am familiar divers are now in their 50s, 60s, 70s and, in occurred predominantly with relatively some cases, 80s. We are living and diving much inexperienced divers. longer than anyone expected. I think it’s safe Oigarden: I suspect most divers who continue to to say that some of these thousands of older dive in open water after their initial certification divers have some degree of cognitive decline. continue to dive for the beauty of an environment This decline might interfere with preparation that non-divers never see. Inexperienced divers of dive equipment, , willingness to might get into trouble and , resulting in admit to poor decisions and/or inability to solve a dive injury. Driven divers may be more likely a problem that 20 years earlier might have been to get into trouble by exceeding their training solved instinctively. As experienced middle-aged and limitations. divers, we may no longer be able to get away with a diving style we embraced decades earlier. How might having considerable diving experience relate to risk of injury among Could an extended break from diving experienced divers? increase the risk of injury even in Cardwell: One concern witnessed frequently experienced divers? is the effect of aging on abilities that require Cardwell: Yes, risk can be increased by strength and/or stamina. I’m no spring chicken presumptions about one’s capabilities after anymore, and I have to be more deliberate about a long period of not diving. Short refresher

16 DAN Q4 30+ Years advert 202x262 14/9/15 1:02 PM Page 1

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An educated diver is a safer diver. That’s why education is a key component of DAN’s mission. DAN training programs prepare you to safely and properly manage an injury and are available for divers of all levels. DAN members also have access to free online educational resources via our Members-Only portal (located within the Membership & Insurance section of the DAN AP website).

www.danap.org/DAN_training.php courses are available through all training How do we recognise a diver going too agencies. Risk can also be exacerbated by the far too soon — beyond their training and use of unfamiliar equipment. experience? Oigarden: I took a break from diving while I Cardwell: One good indicator is a diver who was raising my children. So about 15 years ago holds certifications that appear to have been I sought out an instructor I had known since the gained with the minimum required experience. 1970s and signed up for an open-water course This is often reflected in the speed at which and a course. I took my time and learned certifications were acquired and in the number the rationales underlying new techniques of dives logged (assuming the dives logged are and procedures. I also spent a great deal of genuine). In my experience, those who wish time learning about the new technology and to fast-track their qualifications are usually its underpinnings. those who are more concerned with having the certification than having the skills. Oigarden: A controversial answer would be a diver who completely relies on his dive partners’ experience. When divers can accurately explain the who, what, why, when and where of a dive from preparation to debriefing, then they are probably pacing themselves appropriately. Image © Stephen Frink Is there a particular type of diver who is at higher risk of injury because of inexperience or because of considerable diving experience? Cardwell: I can’t answer regarding someone with a lot of experience other than leaning on knowledge of the very few I have known who had accidents because of not accepting the limitations that aging imposes. Oigarden: I speculate that divers such as Hal Watts, , , and Casey McKinlay have a References combination of physiology, psychology and drive that allows them to make extreme dives that 1. Buzzacott P, Pikora T, most of us, no matter how much experience Heyworth J, Rosenberg M. Exceeding the we gain, would not be able to duplicate. So in limits-estimated tissue relation to these divers and others like them, the among Western Australian rest of us – if pushed to the extremes – have a recreational divers. much greater risk of a dive injury. Diving Hyperb Med. 2010; 40(4):201–205.

2. Buzzacott P, Pikora Is it possible to gain experience quickly? Is it possible that certain levels of experience T, Rosenberg M. Post- relate to certain types of dive injuries? training dive inactivity Cardwell: Yes, but gaining experience takes in Western Australia. time. Divers who devote a lot of time to their Cardwell: Accidents can happen at any Diving Hyperb Med. 2008; 38(4):197–199. sport can arguably become better at it by experience level but are more common among meeting challenges and overcoming them less experienced divers. Certainly, as mentioned 3. Ditton RB, Osburn HR, Baker TL, Thailing through good training and other preparation; earlier, equalisation problems occur during CE. Demographics, plenty of varied diving that sees a diver training or early in divers’ experiences. This is attitudes, and consistently following basic rules may prevent due to either unfamiliarity with the available reef management preferences of sport a host of potential problems from occurring. techniques and/or high anxiety levels. Accidents divers in offshore Texas Similarly, more formal training can also speed with the worst outcomes have been the result of waters. J. Mar. Sci. 2002; 59:S186–S191. learning. For example, being trained as a rescue neglecting basic safety precautions, presuming diver could make dealing with a distressed diver that all environments are similar and arrogantly 4. Denoble PJ, Ranapurwala SI, underwater somewhat easier than it would be and thoughtlessly ignoring the hazards involved. Vaithiyanathan P, without the knowledge and skills learned in Oigarden: I look forward to reading and maybe Clarke RE, Vann RD. the course. Oigarden: Yes and no. Some divers even being a part of a longitudinal look at divers’ Per-capita claims rates for decompression seem to have a natural disposition for being experience, physiology, psychology and outlook sickness among insured in a technically complex situation underwater on life to draw a set of new conclusions that Divers Alert Network members. Undersea in strenuous or stressful conditions. I would continue to advance the safety of the sport we Hyperb Med. 2012; speculate that every buddy, instructor, dive love so much. 39(3):709–715. leader, dive site and dive plan could influence how quickly a diver might become what could be considered experienced. 18 Dive Accidents Do Happen. Don’t Let Your DAN Coverage Expire.

Four days after a Member allowed his DAN coverage to expire, he suffered a severe case of inner ear DCI. A local air ambulance was organised to get him to care quickly.

Out of Pocket Cost: $8,000 If he had Renewed his DAN Coverage: $0

www.danap.org Water Planet

Life Aquatic OCEANS OF PLASTIC The shocking impact of our addiction to plastic Text by Melissa Gaskill

On a dive over reefs near Ambergris Caye, Belize, a few years ago, I snagged a napkin-sized piece of drifting plastic and tucked it into my BC pocket. A few minutes later I noticed a smaller piece and plucked it up, too. Before the dive ended, I had collected half a dozen bits of plastic. This prevalence of plastic was disappointing, but I was soon dismayed to learn that Belize is far from the worst offender.

275 MILLION TONS A YEAR A recent study by a group at the National Center for Ecological Analysis and Synthesis at the University of California, Santa Barbara, found that 20 of the world’s nearly 200 countries with coastlines account for 83 percent of the total volume of plastic that washes into the sea – an amount that researchers estimate to be between 4.8 and 12.7 million metric tons each year. That’s at least 10 billion pounds of plastic. To put this in perspective, Jenna Jambeck, the principal author of the study, explained that the volume of plastic entering the oceans each year is equivalent to five grocery bags filled with plastic for each foot of coastline in the world – and that includes only municipal waste. When we consider other types of waste as well, we discard a total of some 275 million metric tons (606 billion pounds) of plastic each year. “Until now, what we knew about plastic

in the ocean was from observations at sea,” Image © C Facker/NOAA National Marine Sanctuaries says Kara Lavender Law of the Sea Education Association, one of the study’s authors. “That only accounts for a fraction, though, since only which debris literally picks up and moves an certain plastics float. The difference with this animal. Plastic rope and netting cause most work is that we were looking at the flow coming entanglements, which particularly affect from land.” northern right whales and green, loggerhead and hawksbill sea turtles. The Project Aware PLASTIC’S DEADLY IMPACT Foundation reports that an estimated 50,000 Plastic debris is unsightly for divers and others to 90,000 northern fur seals die each year who enjoy the oceans, but more important, it entangled in marine debris. Nearly 80 percent threatens marine life. Scientists at Plymouth of the entanglements observed in the Plymouth University in England documented encounters study harmed or killed the animal. between 693 marine species and manmade Green sea turtles, California sea lions and debris; 92 percent of these involved plastic. The Atlantic puffins are some of the species known encounters included entanglement, ingestion, to ingest plastic fragments. According to one direct damage to the ecosystem (such as study cited by Project Aware, 95 percent of dead, coral or seagrass destruction) and rafting, in beached northern fulmar birds had plastic in

20 their stomachs, and a North Pacific Central Gyre more people are willing to make changes, the The more study found that 35 percent of plankton-eating bigger the difference. “Carry your own reusable people are fish had ingested plastic. Australian researchers water bottles and bags, buy less packaging, willing to make found that Great Barrier Reef corals will eat and pick up what you see when diving or on the changes, the microplastic (the bits of plastic left when larger beach,” Law suggests. “Talk to dive operators. bigger the pieces break down), consuming almost as much Point out that the industry depends on the ocean difference. plastic as they do marine plankton. environment and say, ‘What about not using Everyone disposable water bottles?’” can make a A SOLVABLE PROBLEM Even something as simple as a proper trash difference in Theoretically, plastic debris is a solvable receptacle on a to keep trash out mitigating the problem. “If we increase waste management to of the water is a fine start. “Everyone can play ocean plastic 100 percent coverage in the top 10 countries and a role in mitigating the ocean plastic problem,” problem. Be cap our waste generation and the percentage of says Nicholas Mallos of Ocean Conservancy. aware of your it that is plastic,” Jambeck says, “we could stop “Be aware of your own plastic use, and ensure own plastic use 77 percent of the input by 2025.” Halving the that your trash, on land and water, is disposed amount from the top 20 countries would reduce of properly.” the total amount of plastic reaching the sea by Divers can also take part in several initiatives almost 40 percent. to remove plastic already in the ocean. Project Law said the authors were initially hesitant AWARE encourages divers to collect debris to publish a ranking of countries. “But I’ve heard through its Dive Against Debris programme and people say they are happy someone is noticing recently launched a specialty certification to help this problem and are optimistic about the train divers to be debris-fighting citizen scientists. prospect of people being motivated to act,” she The Ocean Conservancy sponsors an explains. “We’re hopeful this will result in a first annual International Coastal Cleanup (ICC), a step toward international-scale .” worldwide volunteer effort to clean waterways In developed countries, improving waste and the ocean. While many volunteers work management offers less of a benefit: “The U.S. on beaches and shorelines, some work does a pretty good job and yet is still number underwater. “Divers play an integral role in the 20,” Law says. Capturing more plastic in the ICC and Dive Against Debris, collecting debris recycling stream also offers limited benefit, that’s already made its way into the marine as only a few types have real market value. ecosystem,” Mallos explains. Dive groups can Ultimately, she said, we must reduce the amount also organise underwater cleanups with guidance of plastic produced. “We use a valuable resource from the Ocean Conservancy’s Do-It-Yourself – oil – to produce a material designed to be Cleanup Tool Kit site. strong and durable but then use it to make many Defining a problem is the first step toward things that we need for only a few minutes,” she solving it. Now that we see the astonishing said. And virtually every piece of plastic ever quantity of litter and poorly managed waste made still exists today. ending up in the ocean, perhaps we’ll be inspired Both Jambeck and Law emphasise that to make changes. Meanwhile, I’ll continue individual choices make a difference, and the nabbing those bits of plastic on my dives.

References

Jambeck JR, et al. Plastic waste inputs from land into the ocean. Science 2015; 347(6223):768–771; doi:10.1126/ science.1260352.

21 Image © Kip Evans Gear

DON’T WORK TOO HARD Improper weighting makes it harder to achieve Know Your Kit neutral buoyancy. Many divers who wear too much weight do not even realise they are WEIGHT UP! overweighted. The excess weight means that Mastering the art of getting your buoyancy spot on to achieve neutral buoyancy the diver has to Text by Marty McCafferty, EMT-P, DMT, and Patty Seery, MHS, DMT put more air into the BC bladders, which can Images by Stephen frink create a more upright profile in the water. The upright position increases drag when swimming, causing the diver to expend more effort and Early in dive training, students learn consume more air. Underweighted divers can that there are three elements involved also become significantly fatigued while trying to in buoyancy control: the buoyancy stay down. In addition to increasing breathing- compensator (BC), weights and lung gas consumption, extra exertion can elevate volume. Although most divers are decompression stress. familiar with the need to be properly weighted, many do not understand all GET IT RIGHT that it entails. Students and experienced You may have heard a diver say, “This is divers alike make two common errors how much weight I always use.” While field when it comes to weighting: diving while testing and prior experience can be useful, overweighted, and failing to adjust the this statement shouldn’t be the endpoint of a amount of weight used in response to dialogue about weighting. Proper weighting changes in equipment and environment. requires thought and practice, and the amount

22 of weight worn is not fixed. Over the course of our lives, we experience change in muscle mass, body fat and physical fitness. Equipment, including , wears out and gets replaced. Dive environments differ. All these factors affect buoyancy and require adjustments to the amount of weight used. To determine how much weight you need, consider your body weight, the exposure protection you will be wearing, the weight of your equipment and the environment in which you will be diving. Start with weight equivalent to 10 percent of your body weight, which is a good baseline for a 6mm full . For a 3mm suit, use 5 percent of your body weight. Remember that these percentages are simply starting points. Drysuits and thick neoprene necessitate more weight to counter the suits’ buoyancy than do thin neoprene or dive skins. Body composition (muscle density, for example) will influence whether more or less weight is needed. Diving with an aluminium tank requires more weight than diving with a steel tank. Salt water is denser than fresh water, thus increasing the buoyancy of immersed objects and requiring more weight to descend. Dive training typically begins in freshwater environments such as pools, quarries or lakes, so new divers should consider that even if they are wearing the same exposure protection they will need to add weight for ocean diving. The exact amount of additional weight needed will vary from person to person. Performing a buoyancy check in each situation will help determine the correct amount of weight to add.

SECURE IT There are several options available for how and where to secure your weights. A weight belt is the most common method of wearing weights; there are belts that accept slide-on weights as well as pocket belts that can accommodate either solid weights or soft weights (bags filled with lead shot). Weight belts are easy to ditch in an emergency as long as you keep other gear clear of the belt. A shoulder harness is sometimes used when the buoyancy of a thermal protective suit requires more weight than can comfortably be worn around the waist. Integrated weight pockets and harness systems offer a couple of advantages over belts: They can be considerably more comfortable, and they How to Perform a Buoyancy Check offer improved ability to adjust trim. But unlike Start in water too deep to stand in, weight to offset the potentially belts, which have a single point of release, and release all the air from your positive buoyancy of a partially BC. Inhale a normal breath, and the emptied aluminium cylinder at the harnesses and integrated systems may have water should be at eye level. When end of the dive. more than one release point. This is crucial you exhale, you should sink so that If you are properly weighted, information for the diver and dive buddy to the water is just over your head and you should be able to hover then rise to eye level as you inhale effortlessly at five metres at the discuss prior to diving – and to remember in the normally again. end of your dive with 50 bar in event of an emergency. A downside to using weight Adjust your weights in small your aluminium tank and no air in increments (e.g., one kilo at a your BC. pockets is that it may be more difficult to add or time). Consider adding a little extra remove weights if adjustments need to be made.

23 In addition STAY TRIM Fins can be positively, neutrally or to wearing the In addition to wearing the right amount of negatively buoyant, and each type may require right amount weight, make sure it’s positioned to optimise compensation. Ankle weights can help offset a of weight, underwater trim. Creating a level profile in the more buoyant lower body half, but they may be make sure water makes you more hydrodynamic. Distribute a challenge to ditch, because you have to reach it’s positioned the weights as equally as possible from side to to release them. If your fins are negative and to optimise side; you should never feel as though you are create a downward pull on the lower half of your underwater listing to one side while diving. You should also body, moving weights higher on your body or trim consider the weight of your scuba tank and the shifting your tank higher in the band can move style of your BC when placing your weights. up your centre of gravity to promote a more The tank can be moved up or down in the tank level profile. Reviewing where and how your band to facilitate optimal body positioning in the buddy’s dive weights are placed is an essential water. Back-inflation BCs have a tendency to component of every pre-dive check. Each buddy push the diver forward (face down) in the water, needs to know how to jettison the other buddy’s so placing weights toward the back can help to weights in an emergency. counter some of this forward pitch, especially at Learning to determine proper weighting will the surface. While weight pockets on the back enhance your enjoyment of dives and your safety. of your BC can help with trim, they also present Having a good understanding of your baseline a in an emergency because buddy weighting needs and the factors influencing your assistance is required to remove them if ditching buoyancy will aid you in adjusting to a variety of weight becomes necessary. environments and conditions.

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