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Diving ability of Anopheles gambiae (Diptera: Culicidae) larvae.

Anopheles gambiae Giles larvae usually live near the surface of shallow and temporary aquatic habitats. How deep the larvae can dive and how long they can submerge may be related to feeding efficiency and predator avoidance. This study examined diving behavior of An. gambiae larvae in the laboratory. We recorded diving depths and larval mortality of second and fourth instars in clean water and muddy water by using deep water (32-cm) and shallow water (20-cm) columns. In deep water columns with clean water, we found that 2% of second instars and 6% of fourth instars died from diving, whereas 3% of second instars and 11% of fourth instars died in muddy water. The fourth instars dived deeper in muddy water than in clean water. The mortality rates of the fourth instars subjected to diving stimulations were significantly higher than those in the shallow water columns. Therefore, larval diving behavior may offer the benefits of predator avoidance and food acquisition but also incur energetic costs and increased mortality.

Animals↗

Simulated high altitude diving experiment for the underwater construction operation.

The simulated dive experiments were conducted at the high altitude of 4500 meters and 5000 meters, for the requirement of diving operation in the lakes at the altitude of 4442 meters for the construction of large-scale hydroelectric power station. The high & low pressure chamber-complex was used, and 15 professional divers participated in the experiment. The divers were stayed at the altitude of 4500 and 5000 meters for 7-9 days. Totally 85 persons-times of dives to the depths of 30-50 meters were operated; they stayed under the water for 30-90 minutes while processing physical activities. During the experiment, we studied the pressurization procedure, decompression table, and physiological functions of the divers. The results indicate that, although the relative pressure differences between the surface and underwater was larger at high altitude than at sea level, the appropriate prolongation of the compression time was able to prevent the difficulty in pressure regulation for the divers to avoid the injury of middle ear. Four tables of the decompression A, B, C and D was calculated with Haldane's theory, and the speed of decompression increased in the order from A to D. The safest procedure was C, and there was no decompression sickness and bubbles in body of the divers. The methods of decompression included underwater stage decompression, surface decompression, oxygen-breathing decompression, and repetitive diving decompression. The surface decompression was the most suitable method for the high altitude, as it could greatly decrease the time in the cold water for the divers. The power spectrum analysis of EEG (electroencephalogram) indicated that, when the divers were exposed to the altitude of 5000 meters, the delta activity in EEG increased, alpha and beta activity decreased. And the delta activity decreased, the alpha and beta activity increased while diving during a dry condition. According to the diving and decompression procedure studied under simulated conditions, 272 person-times of diving training and underwater operations were processed in a high altitude hydroelectric power station at the altitude of 4442 meters, including photographing, video-recording, measuring, and drilling. There were no signs and symptoms of decompression sickness and bubbles.

Adaptation, Physiological↗

Asthma and recreational SCUBA diving: a systematic review.

Asthma has traditionally been a contraindication to recreational self-contained underwater breathing apparatus (SCUBA) diving, although large numbers of patients with asthma partake in diving. The purpose of this paper is to review all the research relevant to the issue of the safety of asthma in divers. MEDLINE and MDConsult were searched for papers between 1980-2002. Keywords used for the search were 'asthma', 'SCUBA' and 'diving'. Additional references were reviewed from the bibliographies of received articles.A total of fifteen studies were identified as relevant to the area. These included three surveys of divers with asthma, four case series and eight mechanistic investigations of the effect of diving on pulmonary function. The survey data showed a high prevalence of asthma among recreational SCUBA divers, similar to the prevalence of asthma among the general population. There was some weak evidence for an increase in rates of decompression illness among divers with asthma. In healthy participants, wet hyperbaric chamber and open-water diving led to a decrease in forced vital capacity, forced expired volume over 1.0 second and mid-expiratory flow rates. In participants with asymptomatic respiratory atopy, diving caused a decrease in airway conductivity.There is some indication that asthmatics may be at increased risk of pulmonary barotrauma, but more research is necessary. Decisions regarding diving participation among asthmatics must be made on an individual basis involving the patient through informed, shared decision making.

Asthma↗

[Asthma and scuba diving Absolute contraindication? in all asthma patients?].

Physical and psychological fitness are required for scuba diving, leading to medical contraindications in certain subjects. Asthma, a condition exhibiting increasing prevalence in the general population is currently considered an absolute contraindication for scuba diving by the French Federation for Submarine Sports and Education (FFESSM). There is however no documented evidence demonstrating a higher risk in asthmatic divers. Our English-speaking colleagues have suggested that certain asthmatic subjects could participate in scuba diving sports under certain conditions without any higher risk compared with non-asthmatic divers. We recall here the impact of diving on respiratory function and potential consequences in asthmatic subjects, proposing that the formal contraindication against scuba diving should be maintained for asthmatic patients who experience frequent symptoms (step 2 or more of the International Consensus Report on Diagnosis and Treatment of Asthma) and/or have a baseline obstructive syndrome. It would appear reasonable to discuss the contraindication concerning patients with rare acute episodes and who have a perfectly normal respiratory function. The question of bronchodilator inhalation prior to diving may be a question to debate. However, such a proposal cannot be considered to be valid unless well-conducted studies of the clinical manifestations are available (frequency and severity of the acute episodes, triggering factors) for the diver candidate. Because of the highly restrictive nature of the contraindication notification and the absence of arguments backing up the decision, the question should be put to competent authorities (sports federations, learned societies) in order to ascertain the pathophysiological mechanisms involved and collect reliable epidemiological data before proposing a consensus discussion. This process may lead to the delivery of scuba diving authorizations for selected asthmatic subjects without a higher risk than non-asthmatic subjects.

Acute Disease↗

Factors in 171 navy diving decompression accidents occurring between 1960-1969.

Comparisons were made between the incidence of specific factors in U.S. Navy decompression accidents and the incidence of these factors in routine (nonexperimental) U.S. Navy operational dives. It was found that decompression accidents are disproportionately high among a) air dives less than 140 ft which have bottom times of 30 min or less and air dives greater than 140 ft which have bottom times of more than 15 min, b) Divers First Class, c) older divers, and d) dives which do not involve work or divers which require heavy work. Repetitive dives have a lower decompression accident rate than expected. Decompression accidents were not disproportionately high for any category of body build. These results indicate that the present U.S. Navy decompression tables are extremely safe (5 decompression accidents/10,000 dives), and do not appear to require modification. Future decompression research may be directed toward analyzing the relationship of work and aging to physiological processes involved in decompression. In addition, the present findings should be cross-validated using more recent accident and operational diving data.

Accidents↗

Diving methods and decompression sickness incidence of Miskito Indian underwater harvesters.

Diving conditions, dive profiles, and symptoms of decompression sickness (DCS) in a group of Miskito Indian underwater seafood harvesters are described. Dive profiles for 5 divers were recorded with dive computers, and DCS symptoms were assessed by neurological examination and interview. Divers averaged 10 dives a day over a 7-day period with a mean depth of 67 +/- 7 FSW (306 +/- 123 kPa) and average in-water time of 20.6 +/- 6.3 minutes. Limb pain was reported on 10 occasions during 35 man-days of diving. Symptoms were typically managed with analgesic medication rather than recompression. Indices of the decompression stress were estimated from the recorded profiles using a probabilistic model. We conclude that the dives were outside the limits of standard air decompression tables and that DCS symptoms were common. The high frequency of limb pain suggests the potential for dysbaric bone necrosis for these divers.

Adult↗

[Health fitness assessment for recreational diving requires special medical competence].

Recreational diving has become increasingly popular in Sweden over the last years and about half a million dives are made each year. During the same time the health requirements for diving have changed and today we allow asthmatics and diabetics to dive under certain conditions. Chest X-ray, that earlier was compulsory, is not required in the fitness to dive examination, and in the future Europe the minimal requirements will be a health declaration rather than a FTD examination by a doctor. Despite this there will be a need for doctors with competence in diving medicine to handle medical problems in connection to diving and to evaluate all the questions generated by the divers' answers in the health declarations.

Clinical Competence↗

Exercise effects during diving and decompression on postdive venous gas emboli.

BACKGROUND: Exercise and diving have generally been associated with an increased risk of decompression sickness (DCS), thus accounting for the lack of studies involving exercise during decompression. However, theoretical and observational evidence contrary to this association motivated the present investigation on the effects of moderate, intermittent exercise during diving and/or during decompression on venous gas emboli (VGE) activity following a dive. HYPOTHESIS: VGE observed at both the precordium and subclavian vein sites after diving should be reduced if moderate exercise is performed during decompression vs. remaining inactive. METHODS: In a water-filled hyperbaric chamber, 39 healthy male subjects were compressed to a pressure of 450 kPa (45 msw) for 30 min followed by 55 min of staged decompression. Subjects were either active or inactive at the bottom phase (450 kPa) and/or during the decompression. Activity comprised three 5-min intervals of moderate arm or leg exercise at the bottom and five such intervals during decompression. After decompression, VGE were monitored at the precordium and subclavian vein sites using Doppler detection. Bubble activity scores were converted to various indices and analyzed using non-parametric statistics. RESULTS: VGE activity was invariant as to whether subjects were active or sedentary during the bottom phase of the dive. However, it was significantly lower for all indices examined (p < 0.05) after dives in which exercise was performed during decompression vs. inactive decompression. CONCLUSION: Moderate, intermittent physical activity during decompression decreases VGE activity after diving.

Adult↗

Influence of body posture and ear clearing on body buoyancy during diving.

The amount of gas introduced into the gastrointestinal (GI) tract during diving was studied by underwater weighing. The influence of body posture and ear clearing methods was determined. Ten subjects were studied in wet simulated dives to a 30-m depth. Clearing the ears by swallowing and descending head first gave a mean weight reduction (before dive-after dive) of 0.29 kg; descending in the upright position gave a mean weight reduction of 0.16 kg. Swallowing during descent (upright posture) caused a 0.11 kg greater weight reduction than blowing against the clamped nose. The greatest weight reduction (1.34 kg) occurred in a head-first dive (swallowing) with 7 cycles of depth changes between 30 and 25 m. During the ascent the subject experienced considerable abdominal discomfort. It was concluded that swallowing during diving, particularly in the head-down position, may introduce large amounts of gas into the GI tract and that during diving one should try to eliminate ingested gas by belching.

Aerophagy↗

Experimental trials to assess the risks of decompression sickness in flying after diving.

We conducted experimental trials of flying after diving using profiles near the no-decompression exposure limits for recreational diving. The objective was to determine the dependence of DCS occurrence during or after flight on the length of the preflight surface intervals (PFSI). One to three dives were conducted during a single day with dry, resting subjects in a hyperbaric chamber at depths of 40, 60, or 100 fsw (224, 286, 408 kPa). The dives were followed by PFSI of 3 to 17 hrs and a four-hour altitude exposure at 8,000 ft (75 kPa), the maximum permitted cabin altitude for pressurized commercial aircraft. Forty DCS incidents occurred during or after flight in 802 exposures of 495 subjects. The DCS incidence decreased as PFSI increased, and repetitive dives generally required longer PFSI to achieve low incidence than did single dives (p = 0.0159). No DCS occurred in 52 trials of a 17 hr PFSI, the longest PFSI tested. The results provide empirical information for formulating guidelines for flying in commercial aircraft after recreational diving.

Adult↗

Exercise ending 30 min pre-dive has no effect on bubble formation in the rat.

INTRODUCTION: We have previously shown that exercise performed 20 h before a dive significantly reduces bubble formation in both rats and humans. Furthermore, exercise performed closer to the dive did not prevent bubble formation. HYPOTHESIS: The present study was designed to determine whether exercise 30 min prior to a dive promotes bubble formation. The occurrence of many bubbles is linked to a higher risk of developing decompression sickness. METHODS: A total of 58 Sprague-Dawley rats were randomly divided into a sedentary control group (n = 29) and an exercise group (n = 29). Rats in the exercise group ran on a treadmill for a total of 90 min at variable intensity up to 85-90% of VO2max. Then, 30 min after exercise, one rat from each group rested in a pressure chamber at 700 kPa (7 atm) breathing air, performing a simulated dive. Bottom time was 45 min; decompression rate was 50 kPa x min(-1) (0.5 atm x min(-1)). Immediately after surfacing (100 kPa, 1 atm), the rats were anesthetized and bubbles were measured discontinuously for the next 60 min. RESULTS: There were no significant differences in survival (p = 0.55), median bubble grade (p = 0.67), survival time (p = 0.53), or the number of rats getting a bubble score > or = 2 (p = 0.79) between the groups. CONCLUSION: The same type and intensity of exercise that reduces bubble formation when performed 20 h prior to a dive neither promotes nor reduces bubble formation if performed 30 min before a dive. The present data indicate that exercise completed 30 min before a dive does not increase the risk of developing decompression sickness in the rat.

Animals↗

Aerobic exercise 2 hours before a dive to 30 msw decreases bubble formation after decompression.

BACKGROUND: A single bout of aerobic exercise 24 h before a dive significantly reduces the formation of circulating venous gas emboli (VGE) on decompression. The purpose of this investigation was to determine the effect of aerobic exercise 2 h before a dive. METHODS: There were 16 trained military divers who were compressed to 30 msw (400 kPa) for 30 min breathing air in a dry hyperbaric chamber at rest, then decompressed at a rate of 10 m x min(-1) with a 9-min stop at 3 msw. Each diver performed two dives 3 d apart, one with and one without exercise that consisted of running for 45 min at 60-80% of maximum heart rate (estimated as 220 - age). VGE were graded according to the Spencer scale using a pulsed Doppler detector on the precordium at 30 min (T30) and 60 min (T60) after surfacing. RESULTS: Mean bubble grades at T60 were 1.25 for control dives and 0.44 for dives preceded by exercise, the difference being highly significant. None of the divers showed an increase in venous bubble grade after exercise. CONCLUSION: Like exercise 24 h ahead, 45 min of running 2 h before a dive decreases bubble formation after diving, suggesting a protective effect of aerobic exercise against DCS. The threshold of exercise intensity and duration necessary to change venous circulating bubbles is unknown. Mechanisms underlying the protective effect of exercise remain unclear. Rather than altering the nitrogen elimination rate, exercise may affect the population of gaseous nuclei from which bubbles form.

Adult↗

CNS oxygen toxicity in closed-circuit diving: signs and symptoms before loss of consciousness.

INTRODUCTION: There is a dearth of information regarding CNS oxygen toxicity accidents in closed-circuit oxygen diving. The aims of the present study were to report the sensations and symptoms that accompany CNS oxygen toxicity accidents, and to evaluate whether loss of consciousness can occur without any warning signs. METHODS: We documented 36 CNS oxygen toxicity accidents in closed-circuit oxygen diving. The full accident inquiry included the first report from the diving unit, an interview of the victim and his buddy by the researchers, and an examination of the diving equipment. RESULTS: The symptoms that appeared before termination of a dive, as reported by the victim or his buddy, were as follows (in descending order of frequency): limb convulsions; hyperventilation; difficulty maintaining a steady depth; headache; and visual disturbances. The symptoms that appeared after detachment from the mouthpiece were, in descending order of frequency: headache; loss of consciousness; confusion; weakness; dizziness; and facial muscle twitching and limb convulsions. A high inspired CO2 [mean 4.2 kPa (29.9 mmHg)] was connected with loss of consciousness. No dive was terminated before at least two symptoms (mean 3.4) had been noted a minimum of 5 min before termination. DISCUSSION: Symptoms that are accepted as being related to CNS oxygen toxicity, as well as others such as headache, difficulty maintaining a steady depth, hyperventilation, weakness, and a choking sensation, were more frequent among the O2 accident victims compared with divers who did not interrupt their dives. CONCLUSION: Awareness of any unusual sensation can prevent a potentially dangerous situation from arising.

Accidents↗

[The heart and underwater diving].

Cardiovascular examination of a certain number of candidates for underwater diving raises justifiable questions of aptitude. An indicative list of contraindications has been proposed by the French Federation of Underwater Studies and Sports but a physiopathological basis gives a better understanding of what is involved. During diving, the haemodynamic changes due not only to the exercise but also to cold immersion, hyperoxaemia and decompression impose the absence of any symptomatic cardiac disease. Moreover, the vasoconstriction caused by the cold and hyperoxaemia should incite great caution in both coronary and hypertensive patients. The contraindication related to betablocker therapy is controversial and the debate has not been settled in France. The danger of drowning makes underwater diving hazardous in all pathologies carrying a risk of syncope. Pacemaker patients should be carefully assessed and the depth of diving limited. Finally, the presence of right-to-left intracardiac shunts increases the risk of complications during decompressionand contraindicates underwater diving. Patent foramen ovale is a special case but no special investigation is required for its detection. The cardiologist examining candidates for underwater diving should take all these factors into consideration because, although underwater diving is a sport associated with an increased risk, each year there are more and more people, with differing degrees of aptitude, who wish to practice it.

Decompression Sickness↗

The effect of microinjection of amino acids into the nucleus tractus solitarius on the diving bradycardia in the rat.

The role of nucleus tractus solitarius (NTS) in the diving bradycardia was studied in anesthetized rats. The floor of the 4th ventricle of the medulla was exposed and 0.1 microliters of the test agent was injected into NTS bilaterally. The simulated diving (head immersion) for 30 sec was performed before and after the injection. Blood pressure and heart rate were monitored. Before the treatment, heart rate decreased by 51% and blood pressure rose by 23% during the diving in the pooled data (n = 35). Injection of glutamate (0.1-1 mM) or CaCl2 (100 mM) into NTS attenuated the diving bradycardia, but that of GABA (0.1 mM), glycine (0.1 mM), KCl (100 mM) or saline solution did not affect the diving bradycardia significantly. Lesions of NTS also attenuated the diving bradycardia. These data suggest that NTS may play a role in modulation of the diving response.

Amino Acids↗

Flying after diving guidelines: a review.

Recreational divers face a difficult choice when trying to select the appropriate surface interval between diving and flying. Differences in diving techniques and lack of readily available hyperbaric treatment make guidelines for commercial and military divers inappropriate for recreational divers. A literature review revealed that proposed surface intervals ranged from zero to 24 h, but few were human-tested. On 24 February 1989, the Undersea and Hyperbaric Medical Society (UHMS) Workshop formalized guidelines for recreational divers. Do not push the tables, i.e., do not go to the maximum exposures allowed by the tables. For no-decompression dives: (1) With less than 2 h total dive time (surface to surface) during the previous 48 h, divers should wait 12 h before flying; (2) With multiday, unlimited diving, wait 24 h before flying. Recreational divers should not make dives that require decompression stops, but if such dives should occur, delay flying for at least 24 h and, if possible, for 48 h. Divers with DCS symptoms should not fly, unless it is required to obtain hyperbaric treatment. The UHMS guideline is based on current scientific information and expert opinion, and is anticipated to be conservative, safe surface intervals for the vast majority of divers.

Aerospace Medicine↗

U.S. Navy saturation diving and diver neuropsychologic status.

The neuropsychologic status of 25 male U.S. Navy saturation divers was assessed before and after saturation dives conducted at the Navy Experimental Diving Unit. Between 1982 and 1986, 5 dives to simulated depths of 198 to 335 msw were accomplished. Eighteen divers completed 1 dive, and 7 divers completed 2 saturation dives during this period. Dive durations ranged from 26 to 31 d, with helium-oxygen used as the breathing medium. On each dive the men engaged in strenuous, meaningful, in-water work on the bottom. Comparison of neuropsychologic assessment battery results pre- and postdives did not reveal permanent changes in neuropsychologic status. Transient alterations in affect, visual focusing, and physical activity level presented upon surfacing but resolved within 10 d.

Adult↗

Diving pattern of Tsushima male breath-hold divers (Katsugi).

The present study was undertaken to investigate the diving pattern, buoyancy-mass relationship, and some respiratory functions in professional male breath-hold divers in Tsushima Island, Japan. These divers always wear neoprene wet suits and use fins and 4-kg counterweights. They usually dive to 3-10 m depths. The rate of descent was 1.12 m/s for deeper dives (greater than 10 m), which is nearly twofold greater than that of Korean female divers also wearing wet suits and fins. However, the rate of ascent (0.8 m/s) was comparable to that of Korean women divers. On a typical summer day, they spend nearly 4 h in the water and perform 175 dives. The average dive and surface time were 39 and 42 s, respectively. The total bottom time was estimated to be 67 min/d, nearly twice that of Korean women divers. These divers do not adjust the counterweight and all are using a 4-kg weight. Nevertheless, the buoyancy-mass relationship revealed that they maintain the same degree of positive buoyancy (approximately 10% above the neutral level) at surface as do Korean women divers who adjust counterweights. The vital capacity was significantly greater in the diver than in the control (P less than 0.05), which was largely due to the greater expiratory reserve volume in the diver. The end-tidal O2 and CO2 pressures of the diver resting in air were not different from those of the control. These results indicate that, while the basic diving pattern is similar in both male and female breath-hold divers, the overall efficiency of diving (in terms of the rate of descent and the bottom time) appears to be superior in male divers.

Adult↗