Diving with Asthma

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CMH777

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I have a medical question. I have a freind that is interested in getting his OW certification who has Asthma. He uses an inhaler. My friend can take a hit off his inhaler and then play basket ball, snowboard, wakeboard and not have any attacks for a couple of hours. Does anyone here have Asthma and dive. Or know if a person with Asthma can be certified to dive.

Thanks,
Chris
 
CMH777 once bubbled...
I have a medical question. I have a freind that is interested in getting his OW certification who has Asthma. He uses an inhaler. My friend can take a hit off his inhaler and then play basket ball, snowboard, wakeboard and not have any attacks for a couple of hours. Does anyone here have Asthma and dive. Or know if a person with Asthma can be certified to dive.

Thanks,
Chris
Many divers have asthma, it depends a lot on the type, severity and triggers. Some people consider any asthma a complete contra-indication for diving but that is not backed up by the research. Severe or uncontrolled asthma, or asthma with trigger conditions you will encounter during a dive are no gos. I have friends who wanted to dive and have mild asthma and some where cleared and some where not. The important thing is to get checked by a respirologist who understands the issues that diving presents and is not simply going to repeat a "party line". Your friend should contact DAN, research, and finally ask many questions.
Also be aware that diving vacations can be a problem even if a doctor clears you. Dive operators in most southern locations have medical forms and if you indicate you have astma on the question sheet you may be barred from diving.
I am not a doctor and I may have all of this wrong, check with a doctor for your friends individual case.
Good luck.
 
I am an asthmatic diver. There are a variety of viewpoints on diving and asthma, and it varies from country to country. But experts in the US now seem to agree that some asthmatics can dive.

One of the things that you will hear is that asthmatics are more prone to AGE than other divers. In asthma, an allergic reaction causes the tiny air sacs in your lungs to contract, making it difficult to breathe. The theory used to be that if this happened at depth, the sacs could rupture as you surfaced. This sounds logical, but as far as I can tell, it has never happened.

The other concern, obviously, is that if you had an attack underwater, there would be nothing you could do about it until you surfaced.

I used to use a Ventolin inhaler as necessary to treat my asthma. If my chest was feeling tight, or if I was about to engage in heavy exercise, I would take a blast off the inhaler and I would be fine. It sounds like your friend is in a similar situation.

In order to dive, I had to update my medication regimen a bit. I am now on Azmacort and Serevent, with the Ventolin available if I still need it. I never do. My doctor recommends that I take a blast of the Ventolin just before a dive to give me added protection. I use a peak flow meter to see how I am doing the night before and day of a dive, and I should scrub the dive if the number is too low, but this has yet to happen.

So, the short answer is, have your friend get his medication regimen looked at by a specialist and get a referral from DAN so he can talk to a doctor who knows diving. Also, the YMCA has a very extensive and rigorous program available specifically for asthmatic divers; it may be worth looking into.

Hope that helps.
 
A girl in our dive club has asthma, I only found out two years ago after knowing her six or seven years. Obviously her symptoms are mild, since I never saw her use a pump.

She dives in pretty extreme conditions, low viz, cold, current, deep (100 ft+), she even did the club ice dive once.

I'm no doctor, but as you can see, there's hope for your friend. I hope it all works out for him.

K.
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The following article, which also can be found by searching the board archives at http://www.scubaboard.com/search.php?s=, may prove informative:

Here's a piece on asthma & diving that appeared in my Dec '00 "Dive Workshop" column in "Rodale's Scuba Diving" magazine:

"Can I Dive With Asthma?

Asthma is a chronic but often largely controllable obstructive pulmonary disease that affects about eight to 10 percent of children and five to eight percent of adults in the U.S. Signs and symptoms include shortness of breath, wheezing, tightness in the chest and lasting cough. The potential adverse impact of a severe attack under water is obvious, and could be fatal. Arterial gas embolism (AGE) as a result of air trapping from the constriction and plugging characteristic of this disease has also been a frequent, but as yet inconclusive, concern.

Asthma Triggers

Asthma is a chronic irritation & hypersensitivity of the respiratory tract, and attacks can be triggered as a reaction to a variety of conditions including stress, cold or exercise, or allergens such as pollen and certain foods and medications. The asthmatic’s body reacts to these triggers, in varying order and severity, by constriction of smooth muscle in the bronchi and bronchioles, inflammation of the airway and increased mucous production. Attacks tend to be recurrent rather than continuous, and there is often much that can be done medically to reverse breathing difficulties when they do occur. In addition, since many of the precipitants of an attack are known, they can be avoided or controlled.

Diving with Asthma

Until the mid-1990s, asthma was largely considered an absolute contraindication to diving. However, thinking in the medical and professional dive community has rather radically altered since then, and those with asthma can now be certified under certain circumstances. Although they differ somewhat, the YMCA, BASC and Undersea and Hyperbaric Medicine Society each offer protocols guiding medical clearance to dive.

For example, the YMCA* criteria include a requirement that all asthmatics have normal resting and exercise pulmonary function tests with no degradation after exercise. The criteria allow those taking routine preventative medications to be evaluated while continuing their treatment. Also required is the ability to exercise and tolerate stress without becoming symptomatic while on maintenance medications, and the absence of a need for “rescue” inhalers during times of stress or exertion.

If you suffer from asthma, it’s clearly unwise to deny or minimize this condition to yourself, or hide it from your instructor or the operators with whom you dive. Scuba can involve some of the asthma triggers discussed above, such as cold and exercise, not mention hyperdry scuba cylinder gas. If you have asthma and want to dive, or are already diving without medical clearance, it is critical that you consult a physician to obtain an appropriate pulmonary workup and permission to dive."

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Hope you found this helpful.

DocVikingo

* The YMCA protcol & some background info on diving with asthma can be found here---> http://www.ymcascuba.org/ymcascub/asthmatc.html
 
"One of the things that you will hear is that asthmatics are more prone to AGE than other divers. In asthma, an allergic reaction causes the tiny air sacs in your lungs to contract, making it difficult to breathe. The theory used to be that if this happened at depth, the sacs could rupture as you surfaced. This sounds logical, but as far as I can tell, it has never happened."

The answer on this is not yet in. While researech to date certainly suggests that it is not a major issue in asthmatic divers, the risk may be somewhat elevated.

From Sports Med 2003;33(2):109-16.

"Asthma and Recreational SCUBA Diving : A Systematic Review.

Koehle M, Lloyd-Smith R, McKenzie D, Taunton J.

Allan McGavin Sports Medicine Centre, Department of Family Practice and the School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada.

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."

Seems that meta-analysis suggests that you may be at some slight level of increased risk of DCS & pulmonary barotrauma, but nothing compelling to date.

Dive carefully out there.

DocVikingo



The answer on this is not yet in, but researech to date certainly suggets that it is not a major issue of asthmatic divers.
 
I have asthma, and I have dived a couple of years now.
First of all, it´s important to get your lungs x-rayed, or even go through a MRI(magnetic resonance imaging).
Secondly, the effects of asthma medication under pressure are not completely known (yet).
If the asthma is allergy-related(as in my case), it´s possible to dive that time of the year when those little things that cause the allergy are not flying around in the air :)
good luck for your friend,


norppa
 
diving for 24 years, ZERO instances of asthma-related problems while underwater. Anecdotal evidence, but it's all I have.

I find it helpful to consult a respiratory specialist who also dives.
 
cyklon_300 once bubbled...
diving for 24 years, ZERO instances of asthma-related problems while underwater. Anecdotal evidence, but it's all I have.

I find it helpful to consult a respiratory specialist who also dives.

Each agency is going to have different standards on this. Its one of those issues where there is little agreement right now.
 

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