A Doppler ultrasound self-monitoring approach for detection of relevant individual decompression stress in scuba diving

Observing modern decompression protocols alone cannot fully prevent diving injuries especially in repetitive diving. Professional audio Doppler bubble measurements are not available to sports scuba divers. If those non-professionals were able to learn audio Doppler self-assessment for bubble grading, such skill could provide significant information on individual decisions with respect to diving safety. We taught audio Doppler self-assessment of subclavian and precordial probe position to 41 divers in a 45-min standardized, didactically optimized training. Assessment before and after air dives within sports diving limits was made through 684 audio Doppler measurements in dive-site conditions by both trained divers and a medical professional, plus additional 2D-echocardiography reference. In all dives (average maximum depth 22 m; dive time 44 min), 33% of all echocardiography measurements revealed bubbles. The specificity of audio bubble detection in combination of both detection sites was 95%, and sensitivity over all grades was 40%, increasing with higher bubble grades. Dive-site audio-Doppler-grading underestimated echo-derived bubble grades. Bubble detection sensitivity of audio Doppler self-assessments, compared to an experienced examiner, was 62% at subclavian and 73% at precordial position. 6 months after the training and 4.5 months after the last measurement, the achieved Doppler skill level remained stable. Audio Doppler self-assessment can be learned by non-professionals in a single teaching intervention. Despite accurate bubble grading is impossible in dive-site conditions, relevant high bubble grades can be detected by non-professionals. This qualitative information can be important in self-evaluating decompression stress and assessing measures for increased diving safety.

Dysbaric osteonecrosis (DON) among the artisanal diving fishermen of Yucatán, Mexico

Popa D, Medak A, Chin W, Huchim-Lara O, Fliszar E, Hughes T, Grover I. Dysbaric osteonecrosis (DON) among the artisanal diving fishermen of Yucatán, Mexico. Diving and Hyperbaric Medicine. 2020 December 20;50(4):391–398. doi: 10.28920/dhm50.4.391-398. PMID: 33325021.) Introduction: Artisanal diving fishermen in Yucatán, Mexico have high rates of decompression sickness as a result of frequently unsafe diving practices with surface supplied compressed air. In this study, we investigated the prevalence of dysbaric osteonecrosis (DON), a type of avascular necrosis, in the most susceptible joints in a cohort of these fishermen. Methods: We performed radiographs of bilateral shoulders, hips, and knees of 39 fishermen in Mexico and surveyed them about their medical and diving histories. We performed pairwise correlations to examine if the fishermen’s diving behaviours affected the numbers of joints with DON. Results: The radiographs revealed Grade II or higher DON in 30/39 (76.9%) of the fishermen. Twenty-two of 39 fishermen (56.4%) had at least two affected joints. The number of joints with DON positively correlates with the lifetime maximum diving depth and average bottom time. Conclusions: These findings represent among the highest prevalence rates of DON in divers and reflect the wide-spread scale of decompression sickness among these fishermen. Through this work, we hope to further educate the fishermen on the sequelae of their diving with the aim of improving their diving safety.

"I Would Die to See One": A Study to Evaluate Safety Knowledge, Attitude, and Behavior Among Shark Scuba Divers

Shark diving tourism is an activity that can contribute significantly to coastal economies, while also offering tremendous help to shark conservation efforts. Nevertheless, like any form of wildlife-based tourism, shark diving poses management challenges revolving around ethical and safety considerations. Safety in shark diving normally focuses on operational self-efficacy and adherence to shark diving codes of conduct to prevent incidents such as shark bites and to minimize ecological harm. However, safety issues in shark diving can arise from personal choices to exceed standard certification limits. Any detrimental results are capable of casting doubts on the sustainability of shark diving, thus jeopardizing its future as well as shark conservation. This study addressed compliance with shark diving codes of conduct and standard diving safety by examining the knowledge, attitude, and behavior of people who engage in free scuba diving with predatory sharks. The research made use of mixed methods of data collection, including interviews with shark divers at two popular shark diving destinations in Southeast Africa (n = 86) and an online questionnaire survey among shark divers (n = 89). The results showed that divers had positive attitudes towards sharks and shark diving. However, a notable proportion declared that they had exceeded certification limits and broken codes of conduct during shark diving. In particular, diving experience and being a professional diver were correlated significantly with poor safety attitudes and behavior. The results highlight the need to create an understanding among scuba divers of the connection between shark diving safety and conservation, including the negative implications of safety breaches, whether big or small, for the future of shark diving tourism and of sharks.

The Effect of High Pressures on the Radiological Image of the Maxillary Sinuses in Divers

The barofunction of paranasal sinuses is of great significance in terms of diving safety and comfort. The paper aimed at determining the changes in the aeration of maxillary sinuses as a result of diving activities on the basis of a radiological image. Inter alia, it was observed that individuals who frequently practise diving show persistent changes in the radiological image of sinuses, however, usually they do not influence the diving capacity.

STATUS PERIKANAN PANAH DI KEPULAUAN KARIMUNJAWA KABUPATEN JEPARA JAWA TENGAH BERDASARKAN CCRF (CCRF Perspective on Spearfisheries in Karimunjawa Islands, Jepara District Central Java)

<p>ABSTRACT<br />Speargun is productive fishing gear,spearfishermen catch numerous reef fishes such as yellow tail, snapper grouper,andother fish species.Spearfishermen dive to spear fishes. Air supply diving is common in spearfishing, therefore spearfishermen facing a huge health risk. Diving safety standard should be applied by spearfishermen to prevent various diving diseases.Research objectives wereto determine the Karimunjawa spearfishing status by the CCRF perspective and describe job safety analysis.Fishing gear used by fishermen consists of a gun made of wood with a rubber strap to hurl an arrow made of rust resistant metal.Coral reef is spear fisheries main fishing ground, which is vulnerable ecosystem therefore spearfishing has to carry out carefully. Spearfishing operations is a high-risk activities, fishermen have to be very careful and perform diving safety standards so that the potential risks can be avoided. Karimunjawa spear fisheries, in the CCRF perspective point of view, denote fisheries that support the CCRF concept, despite of several aspects that need to take notice of seriously. Among them isthe fishermen awareness to comply and perform code of conduct and safety standards in the fishing operations and prudence in carrying out fishing operations in the coral reef ecosystems.<br />Key words: CCRF, Karimunjawa, safety standard and spearfishing</p><p>------</p><p><br />ABSTRAK<br />Panah adalah alat tangkap yang cukup produktif. Nelayan panah menangkap berbagai jenis ikan karang, seperti ekor kuning, kakap dan kerapu serta jenis ikan lainnya. Nelayan panah menyelam untuk menombak ikan. Pasokan udara dipompakan dari kompresor yang biasa digunakan untuk mengisi udara ban kendaraan. Oleh karena itu nelayan menghadapi risiko bahaya yang besar. Standar keselamatan penyelaman harus diterapkan oleh nelayan untuk mencegah berbagai penyakit penyelaman. Tujuan penelitian ini untuk menentukan status perikanan panah di Karimunjawa dengan perspektif CCRF dan analisis keselamatan kerja. Penelitian dilaksanakan di perairan Kepulauan Karimunjawa, Kabupaten Jepara, Jawa Tengah, antara bulan Oktober – November 2011. Metode survei digunakan sebagai metode penelitian. Metode analisis yang digunakan dalam penelitian ini meliputi deskripsi unit tangkap panah, analisis perikanan panah berdasarkan CCRF dan analisis keselamatan kerja (Job Safety Analysis – JSA). Alat tangkap yang digunakan oleh nelayan terdiri dari senapan yang terbuat dari kayu dengan tali karet untuk melontarkan panah yang terbuat dari besi tahan karat. Ekosistem terumbu karang adalah daerah penangkapan utama perikanan panah. Sementara itu, terumbu karang merupakan ekosistem yang rentan. Operasi perikanan panah adalah kegiatan berisiko tinggi. Oleh karena itu nelayan harus sangat berhati-hati dan mengikuti standar keselamatan penyelaman, sehingga potensi risiko dapat dihindari. Perikanan panah di Karimunjawa, dari perspektif CCRF, merupakan kegiatan perikanan yang mendukung konsep CCRF, meskipun terdapat beberapa aspek yang perlu diperhatikan secara serius. Aspek tersebut diantaranya adalah kesadaran nelayan untuk mematuhi dan melaksanakan standar CCRF dan aspek keselamatan dalam operasi penangkapan ikan serta kehati-hatian dalam melaksanakan operasi penangkapan ikan di ekosistem terumbu karang.</p><p><br />Kata kunci: CCRF, Karimunjawa, perikanan panah dan standar keselamatan</p>

The significance of health selection among divers and its effect on diving safety

Diving is a kind of human activity that requires special health predispositions due to the nature of an aquatic environment. The environment of an increased atmospheric pressure imposes a significantly greater burden on the respiratory and circulatory system as compared with normobaric conditions. Due to their health status, not everyone among those that wish to take up diving should undergo diving training, as diving can have an adverse effect on their condition while staying under water and considerably raise the risk of an occurrence of a diving accident. As regards diving activities performed within the Armed Forces, individuals with particular health burdens are eliminated via the medical checks conducted at the time of recruitment to the diving service. The checks, based on detailed parameters and described in legal acts, minimise the risk of an occurrence of a diving accident. This problem is quite different when it comes to recreational diving, where quite often, by presenting a health certificate, an interested diver candidate begins a training course and further individual diving activities while being aware of a medical condition that may affect their future safety under water. An analysis of the effect of health selection on the level of diving safety was performed.