Diving youngsters on Nitrox

[danceswithoctopus]

As I understand it (in my limited capacity) one of the main concerns with diving is concern for injury to growing tissues, such as the growth plate of bones. In the DAN paper, DAN's Assessment of Medical Issues Associated with Children and Diving, it says, "In growing children . . . bones continue to grow from a region called the phusis, which in long bones (arms and legs) is near each end. This area consists of mostly cartilage and has no blood supply, it depends on diffusion of substances to and from adjacent tissue which has a blood supply. If this area is injured then abnormal bone growth will result, such as one leg being longer than the other." Such an injury, the paper suggests would also be caused by microbubbles in the blood, causing blockage and affecting the blood flow.

It seems to me that the use of nitrox for young divers would reduce this risk by reducing the microbubbles of nitrogen in the blood. Of course, this also brings on the question of whether Oxygen Toxicity in young people occurs earlier than in adults.

Does anyone out there have any informed opinion on this subject?

 

[kelpmermaid]

well, mostly likely not. Not to be inflamatory, but can they do the math that Nitrox certication requires? Is it worth taking any risk with their bone development?

 

[The Chairman]

Hopefully the medical doctors will chime in on this... I am the advisor for a Venture Crew (14 and up) and this concerns me greatly. I have no worries with the kids doing/understanding the math and they are limited in their profiles to rather safe depths anyway. Keeping N2 out of their system sounds only good.

 

[Ontario Diver]

Why use Nitrox at all.

The younger set (10-16) are restricted under PADI rules to 40' depth. Seeing is that is in excess of 2 hours of NDL on air, why bother with the extra expense and math of Nitrox?

 

[danceswithoctopus]

can they do the math that Nitrox certication requires?

I can't speak for all kids, but this one can. He's an excellent math student well in advance of most students his age.

Is it worth taking any risk with their bone development?

why bother with the extra expense and math of Nitrox?

Maybe I should have listed those quotes in the other order. The reason I am asking this question in the first place is that it seems to me that using NitrOx would reduce the nitrogen micorbubbles in the bloodstream thereby decreasing the chance of an adverse affect on bone growth.

Where safety is involved, expense is not a concern.

BTW: Thanks for your replies so far.

 

[The Iceni]

I agree with your thinking, DWO as I am an advocate of the safety of Nitrox but as well as the observation made above bear in mind also;-

1) In the fifties, when neonatal paediatrics was unheard of, a large number of premature babies were blinded by high concentrations of oxygen in their incubators due to an condition known as retrolental fibroplasia. This is because the immature retina is much more senisitive to oxygen than that of a full-term foetus. It took that generation of doctors a long time to work out the cause if this crippling disease. This was with partial pressueres of oxygen less than 1 bar!

2) It is quite possible that the epiphysial growth plate is similarly sensitive to higher that normal partial pressures of oxygen. Certainly children's bones and joints are extremely sensitive to abuse. Look at the Russian olympic gymnast, Olga Corbutt. A heroine at the age of 15, now crippled with arthritis.

3) We live in a litiginous society. I am not sure that you will be able find an adult prepared to take the responsibility of sanctioning an unknown risk on any minors in their charge. Adult divers are always pushing the envelope, but they are entirely at liberty of risking their own necks and lives. A responsible adult is legally responsible for supervising all diving by minors. This is one responsible adult who dares not take the risk of supporting your proposals, with the current state of knowledge, even though they make a great deal of sense to me.

Perhaps if Haldane were still here to dive some baby goats on Nitrox we could get some idea of the relative risks. Unfortunately, I suspect may be few takers for this necessary piece of research, if it has not been done already. My personal view is that if we are to allow any diving by minors we must establish the relative risks. Which is worse excessive ppN2 or ppO2?

I have no doubt high school kids can get to grips with the theory and calculations required for Nitrox diving and decompression, as you seem to have proven, but that's quite irrelevant.

Sometimes being a kid is a real pain but don't rush to grow up too fast, DWO!

 

[danceswithoctopus]

Dr. Thomas,

Excellent information. Thanks for your input: this is exactly the type of information I'm looking for.

(btw: I may be a kid at heart, but it's my son I'm talking about, not me. He's certified PADI Jr. Open Water. I am PADI Divemaster and IANTD Nitrox certified and am wondering if Nitrox might make the dive safer for the Jr. Dancer by decreasing the risk of N2 buildup.)

As for O2 buildup, O2 is metabolized away by the body, while N2 has to off gas through the lungs. Since N2 hangs around longer, doesn't it follow then that the risk of microbubbles from O2 is smaller than from N2?

As for retrolental fibroplasia, it seems there are additional factors of which I am unaware. I'd rather not use the kid as an experimental 'baby goat'. That's why I'm seeking any factual information I can find.

Thanks again.

 

[The Iceni]

My personal opinion is that all adults ought to use Nitrox rather than air for every dive (with a target depth pp O2 of under 1.4 bar). This is because, as you rightly say, inert gasses are the cause of DCI and oxygen is not an inert gas. There is mounting evidence that all dives produce bubbles in the venous system but these are not problematic because they are mopped up by the lungs.

To my mind your thinking is sound and perhaps the powers-that-be will realise that now more minors are diving recreationally they may have a duty to investigate the relative risks to them from high pressure oxygen and nitrogen. After all, there has been little or no research into the effects of a high pressure environment on children. All the decompression tables are based on research on adults.

It may be that children have completely different tolerances to both oxygen and nitrogen. Who knows?

 

[Soggy]

Originally posted by Dr Paul Thomas
Look at the Russian olympic gymnast, Olga Corbutt. A heroine at the age of 15, now crippled with arthritis.

Maybe that's why Darva Conger kicked her butt boxing.