Information for asthma patients who choose to dive

Asthma had traditionally been a contraindication to recreational scuba diving, but according to Sourasky Medical Center findings under the right circumstances patients with asthma could safely participate in recreational diving without any apparent increased risk of an asthma-related event

Self-contained underwater breathing apparatus (scuba) diving has grown in popularity, with millions of divers enjoying the sport worldwide. This activity presents unique physical and physiological challenges to the respiratory system, raising numerous concerns about individuals with asthma who choose to dive.

Asthma had traditionally been a contraindication to recreational diving, although this caveat has been ignored by large numbers of such patients. Herein we review the currently available literature to provide evidence-based evaluation of the risks associated with diving that are posed to asthmatics. Although there is some indication that asthmatics may be at an increased risk of pulmonary barotrauma, the risk seems to be small.

Thus, under the right circumstances, patients with asthma can safely participate in recreational diving without any apparent increased risk of an asthma-related event. Decisions on whether or not diving is hazardous must be made on an individual basis and be founded upon an informed decision shared by both patient and physician.

Sade K, Wiesel O, Kivity S, Levo Y., Department of Medicine 'T', Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel. kobi-sa@inter.net.il

More opinions:

Diving: what to tell the patient with asthma and why?

Until a decade ago, divers with asthma were uniformly barred from diving with compressed air. This prohibition was based more on theoretical concerns for barotrauma than on actual data. Follow-up studies, although retrospective, do not support a ban on recreational or commercial diving for divers with stable asthma. These studies have noted that, despite the prohibition on diving, many divers with asthma have logged multiple dives without negative consequences. When those who have suffered diving-related barotrauma have undergone physiologic testing, measurements of small airways dysfunction (maximal mid-expiratory flow rates) have been lower than measurements for comparable divers who have never suffered diving accidents. Follow-up studies with long-term commercial divers have shown that a small percentage of individuals who have sufferred diving-related barotrauma also develop abnormal maximal mid-expiratory flow rates and even some airway hyperreactivity. These latter findings correlate with the changes that occur in chronic asthmatic patients, especially those who are not well treated. The decision as to whether an asthmatic patient should be allowed to dive rests on the individual's physiologic function, maturity, and insight into the consequences of poorly managed airway inflammation and bronchospasm.

Curr Opin Pulm Med. 2001 Jan;7(1):32-8. Diving: what to tell the patient with asthma and why? Krieger BP. University of Miami at Mount Sinai Medical Center, Miami Beach, Florida 33140, USA. bronchobruce@pol.net

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