900 times more deadly than OC?

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Rhone Man

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I know there are lies, damn lies and statistics, but I read this stat that divers using rebreathers are 900 times more likely to suffer a fatal diving accident that divers using open circuit (see page 3 of http://www.deeplife.co.uk/files/How_Rebreathers_Kill_People.pdfhttp://www.deeplife.co.uk/files/How_Rebreathers_Kill_People.pdf).

Some statistics seem so skewed as to strike me as instictively "must be b****cks". But the rebreather world is complete alien to me. Does anyone with more knowledge have any views?
 
I know there are lies, damn lies and statistics, but I read this stat that divers using rebreathers are 900 times more likely to suffer a fatal diving accident that divers using open circuit (see page 3 of http://www.deeplife.co.uk/files/How_Rebreathers_Kill_People.pdfhttp://www.deeplife.co.uk/files/How_Rebreathers_Kill_People.pdf).

Some statistics seem so skewed as to strike me as instictively "must be b****cks". But the rebreather world is complete alien to me. Does anyone with more knowledge have any views?

Couldn't access the link, but I've read enough similar statistics to have a pretty good idea of what it says. Either way, here's what I have to say on the subject.

I've lived in South Florida my entire life and have been diving for over 23 years. I was certified as a PADI Instructor in 1986...I was certified as a TDI Trimix Diver in 1995, and I've logged thousands of dives throughout the years. In September of 2007, I purchased a Dive Rite Optima Rebreather and completed the course required to attain my IANTD Optima Rebreather Diver certification. Since then, I've exclusively been diving my rebreather practically every weekend and have logged in excess of 80 hours underwater, none of which was logged on long dive trips where it's easier to rack up the hours. I've also unfortunately been on a dive boat this year when a rebreather related fatality occurred.

Please bear in mind that my experience has exclusively been using the Optima, which is a fully closed circuit electronic rebreather. However, I do regularly dive with several other rebreather divers who use different rebreathers. So here are my observations on the subject:

If you ask me whether I feel as though the probability of suffering a fatal accident while diving a rebreather is greater than while diving open circuit, I would have to unequivocally say yes. However, if I’m provided the opportunity to expand on my answer, you might be surprised at the answer.

Rebreathers are riskier, yet in many ways they are safer. Here's what I mean:

Traditional open circuit equipment provides the average diver with no emergency recourse in the event of a gas restricting emergency, other than their buddy's air supply or an emergency ascent. However, all rebreather divers I know enter the water with some type of independent open circuit gas supply or bailout system, exclusively dedicated for emergency gas restricting or gas altering emergencies. Furthermore, most divers have their bailout gas supply system directly plugged in to a b.o.v. (bailout out valve), which is built into the same mouthpiece they are breathing, and only need to flip a switch to be immediately connected to their bailout system, so is that particular difference less safer than a pure open circuit diver, I think not.

Open circuit divers are supplied with a gas source of consistent composition, which is very inefficient at most depths, and they either have it supplied to them or they do not. However, rebreather divers breathe on a loop which is composed of a multiple gases, one being pure oxygen and the other being a carefully selected diluent, often air. The diluent is injected manually into the loop by the user or can be set to be injected upon negative loop pressure or breathing demand via the ADV, which is usually what is done on the descent portion of the dive. The O2 can be injected manually by the user as well, or can be injected electronically, based on the constant partial pressure selected by the user within the controlling electronics of the rebreather. The effect of the injecting of these gases contributes to making up the composition of the breathing loop and are monitored via the use of multiple independent oxygen sensors, usually at least three, but sometimes more. The monitoring of the users oxygen sensors at all times is the number one rule for a rebreather diver, because oxygen is what sustains life, and by monitoring it closely, you will have ample time to deal with any problems which might lead to a either deprivation or excess of oxygen in the breathing loop, which can both be bad. Consequently, in the event of a oxygen depriving or excess oxygen emergency, which would normally be spotted by the user long before it ever became a problem, the user has several options for dealing with the situation (i.e., manual addition of O2, electronic addition of O2, manual addition of diluent, flush the loop out and replace it with diluent, bailout to open circuit, etc.) Furthermore, many rebreathers come with backup systems that will further alert the user to a problem or a life threatening drop or increase of the partial pressure of the oxygen within the breathing loop, by way of flashing lights and vibrating mouthpieces. In addition to that, many rebreathers will automatically inject oxygen into the breathing loop, if the partial pressure of the loop approaches non-life sustaining levels. So therefore, are rebreathers more complex than open circuit, sure they are, but also they do provide the user with multiple ways in which to deal with any drop or increase in the life sustaining oxygen content of the breathing loop, which if checked, maintained and monitored, is actually extremely safe.

Which brings me to what in my opinion is the cause of the data pointing out the statistical difference between fatalities in rebreathers as compared to open circuit. Here's the bottom line - EXISTING REBREATHERS ARE NOT FOR EVERYONE.

I say rebreathers are not for everyone, because all the advantages that come with the efficiency gained by using a rebreather, also come with a cost, and I'm absolutely not talking about a financial cost. The cost I'm referring to is the increased time and diligence that must be applied to the use of a rebreather. Most divers probably spend, on average, one hour preparing their rebreather each time they are going diving. That preparation time includes assembly of the unit, packing of the scrubber, lubing and testing the seals and o-rings associated with the breathing loop, calibrating oxygen sensors, changing and or testing batteries, adjusting the rebreather's computer(s), etc. Much of this preparation is performed at home and some is performed at the dock or on the boat. Also, most divers perform some manner of last minute testing or double checking of all systems, once they've donned the rebreather and are ready to hit the water. And as previously mentioned, underwater, the user is constantly monitoring his oxygen supply and adding gas to his loop. This level of attention and self-disciplined diligence that is required to safely dive a rebreather is not something that everyone possesses the ability to keep up on a consistent basis, which leads to short-cuts. Unfortunately, short-cuts with rebreathers can be life threatening, which is why the current generation of rebreathers should only be used by those that have the self-discipline and diligence to take all the required steps to ensure safe operation of their rebreather.

I think if you took a detailed look at each of the fatal accidents comprising the statistical data used to derive the comparison within the link you've provided, you'll most likely find that the use of the rebreather didn't lead to the fatality, but instead, the user's inability to approach the preparation and use of the rebreather in the diligent and detailed manner in which each user was trained was most likely the primary contributing factor causing the fatality.

It is my humble opinion that if the use of a rebreather is consistently approached according to the training each user receives from their respective instructor/training agency, then the probability of suffering a fatal accident while diving a rebreather is no greater, and in many cases even less than diving open circuit.

Just my 0.02 cents!
 
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Outstanding 0.02 sense SFLDiver3445. Thanks for the very articulate and informative perspective.
 
I agree with everything that SFLDiver said except that it only takes me about 15-20 minutes to prepare my unit for diving. It takes about 45 minutes to clean the unit at home after the dive, but part of this time is spent waiting while the disinfectant that the diver adds to clean the loop does its job (about 10-15 minutes). After a while, you become pretty efficient with the process.

As to the statistics, some of them are valid while others are old news that are no longer an issue. Training and then following the training teaches the diver how to deal with all of these situations. Also, you might want to run searches on the author of the slides before accepting the information presented as fact.
 
I think SFLDiver3445 said it perfectly. I have lots of hours underwater on my Inspiration CCR and couldn't agree more with what he said.
 
SFLDiver3445, thanks for posting this valuable response. I'm impressed when people take the time to post such quality thought.

there is a "chicken and egg" conundrum here. rebreathers, compared to OC, are vastly more complicated, and thus are vastly more prone to malfunction but depending on design seem to increase the divers potential for human error leading up to fatal consequences. It would seem that some folks take comfort in identifying the element of human error in each case, as if they think simply preparing more will assure they don't become susceptible to the same fate, yet many of the fatalities have befallen the most experienced of them all. I see it as an issue of their being a lot more stupid mistakes that can be made, and everyone, regardless of skill level is prone to error at some point. I take no solace in the fact that human error is at the root of many, if not all of the fatalities and I do think design has a great deal of bearing in ones propensity to make fatal mistakes.

It will probably be a while before we truly understand the difference in OC vs eCCR vs mCCR risk though, as there is not a convenient parallel of apples to apples comparison to be made. The average number of hours of bottom time being made by each is likely different as is the challenge level of the average dives being performed on each. Much more demanding dives are being attempted with rebreathers in general because they allow people to push the envelope more... it's really no surprise that the risk factors are higher when riskier dives are being performed and you can't blame that on the unit.

That said, I am puzzled by such reports, as they fail to point out that there are virtually no fatalities associated with manual rebreathers, even as they increase dramatically in use each year. Virtually all rebreather fatalities happen on Automated systems (all but one!). while the sample group of mCCR's is still quite small, it's getting harder and harder to shrug this off. if the objective, as stated in this report really is "To make using a rebreather no more dangerous than getting on a Boeing 737 shuttle from Edinburgh to London" I don't understand why this and other studies don't focus more on looking objectively at why mCCR's continue to be so fatality free. If we really want to improve safety, this seems to me to be a very fruitful place to to start asking questions. Getting to the bottom of what the key differences are in m vs eCCR just might turn out to be crucial in lowering the fatalities associated with eCCR's. I'm afraid that there are interests in the industry that are threatened by what the truth may be and frankly I think it's irresponsible not to look at this more openly.
 
Gill, the egg came first BTW.

as has the chicken and egg, design and habit evolve together.:wink:

but seriously, i'm not out to see only manual rebreathers in the market some day, I just think a serious look at what is behind the near zero fatality rate of mCCR divers by an objective third party may just help to reduce the high fatality rate in the eCCR realm. I think design can have a huge impact on involuntary habit patterns. perhaps hybrids are the wave of the future, I don't know, but denying that this trend could actually be real and not just a statistical anomaly, IMHO, is keeping our head in the sand.
 
Rhone,
To address your question with a few numbers.
The database I've been compiling has approx 165 deaths when the diver was using or had been on a rebreather. With my first case in the early 1950's.
There have been over 600 deaths while Cave diving most of them on OC.

Also when tracking the deaths, causes on a timeline relative to training and new technology (ADVs were a big improvement) different looks and perceptions of the data are seen.

I don't track OC related deaths, but its safe to say that its a fair number and I think its safe to say there have been over 1000 since the same time frame.

Now like any statistic you have to use some sort of reference. If you take all RB divers / RB deaths and compare it to all OC divers / OC deaths then compare those two fractions one could state that RB deaths are more. But lets take a look at the OC diver base. If agencies are to be believed, then about 80% of all OC divers are "vacation" divers. Go on semi-guided tours with DMs and other lower risk type dives. But as pointed out by GillEnvy, most RB divers are doing deeper, longer dives hence higher risk environments. If your OC data set is reduced to get a more matched set of diver profiles the difference in statistical danger may be considerably less. One of the problems with these statistics is that determining the base of users is very hard especially for RBs. A few folks have tried using various methods to try to come up with a baseline of users, but at best is still an estimate/guess.

Are there a significantly higer number of people diving RBs then diving Caves? (yes there many who do both, but RB deaths in caves is still very low). Looking at that set of numbers you may note that OC diving in a risker environment (caves, wrecks etc) may be more dangerous then on an RB. But without base numbers everything is just a guess/perception.

As pointed out by several folks, RBs are not for everyone, they do not tolerate the abuse and casual care that modern OC gear can. The current state of the art of RBs is still evolving. The constant flow orifice and the training done for mCCRs does indeed appear to challenge the eCCR when looking at just the death rate. There are now two manufacturers that offer a combined system and the technology continues to evolve.

But as so well said by SFLdiver many of us think that RB diving is actually safer then OC diving when in these risker environments, or that the benefits out weigh the risks.

Being wary is a good thing when considering an RB.

All that said, I still prefer diving an RB then OC for most any dive.
 
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