[FONT=Arial, Helvetica, sans-serif]Heat Regulation[/FONT]
[FONT=Arial, Helvetica, sans-serif]Due to a relatively large skin mass to body mass ratio, children do not regulate body heat as well as adults. Until the mid-teens or so, youth are far more vulnerable to hypothermia. And, alarmingly, a child may be hypothermic yet have no complaints, and still feel warm to the touch.[/FONT]
[FONT=Arial, Helvetica, sans-serif]Eustachian Tube Development[/FONT]
[FONT=Arial, Helvetica, sans-serif]In younger children, the Eustachian tube is narrower and more horizontal than later in development. While this is unlikely to be problematic in children over age 12, it has implications for equalizing, including potentially damaging reverse squeeze, for children closer to age 8. Furthermore, young divers with immature Eustachian tubes may be subject to more frequent middle ear infections. Since a diver must be able to clear his ears safely and comfortably, a person with a middle ear infection should not dive. So, a child must recognize it, tell someone, and not dive.[/FONT]
[FONT=Arial, Helvetica, sans-serif]The Response of the Dive Training Community [/FONT]
[FONT=Arial, Helvetica, sans-serif] The positions of several agencies are based on conclusions expressed by John Kinsella, Director, Training and Quality Management of PADI America, in his article entitled “Kids and Diving” (The PADI Undersea Journal — First Quarter, 2001). After reviewing the evidence for potential medical concerns expressed by DAN, he concluded: “There is insufficient information available to make any evidence-based medical judgment for or against children in scuba diving.”[/FONT]
[FONT=Arial, Helvetica, sans-serif]SSI allows children as young as age 8 to have a shallow water scuba experience in their “Scuba Rangers” program. Children 10 to 12 may receive a junior open water certification with certain limitations. Once they turn 12, they may upgrade to a regular open water diver. Those 12 and older are eligible to become a Nitrox specialty diver. [/FONT]
[FONT=Arial, Helvetica, sans-serif]When we asked Dennis M. Pulley, SSI Director of Training, about their program, he told us that “SSI is aware of medical and psychological concerns in divers as young as 12.” However, he cited the RSTC position that medical experts are unable to provide any documentation or proof why an individual must be at least 12 years of age to begin scuba training. Pulley also remarked that, “Psychologically, one could argue that many young males between the ages of 16 and 30 could have the same attitude of being invincible.”[/FONT]
[FONT=Arial, Helvetica, sans-serif]It is true that many theoretical medical and behavioral concerns have not been subjected to controlled studies on humans. And may never. The ethical issues are obvious. For those issues that may be studied, it will be a long and painstaking process, as evidenced by how difficult gathering useful data on DCS has been.[/FONT]
[FONT=Arial, Helvetica, sans-serif]It seems, then, to drop the training age with no longitudinal, hard data about the effect on children is questionable at best. Historically, the response of training agencies to incomplete knowledge has been to err on the side of safety. Think about how the agencies have treated dive tables for all gases, how they fought against Nitrox because it was unsafe and unstudied, how conservative they have been on dive-to-fly estimations, depth limits, and clearance to dive for medical disorders that may pose a risk to scuba divers. Yet the leadership in this conservative industry has taken a “relaxed” attitude regarding the diving safety of children. [/FONT]
[FONT=Arial, Helvetica, sans-serif]However, while there may be no formal studies of the effect of diving on children, PADI and European-based CMAS have long offered swimming pool scuba to children as young as age 4, and restricted open water certification for those to age 8. To date, the results cause no alarm. Even allowing for the extent to which good PR may influence disclosure of adverse events, if children were sustaining harm in significant numbers, liability issues would presumably force this information into the open. [/FONT]
[FONT=Arial, Helvetica, sans-serif]To their credit, PADI and SSI have taken sensible steps to address medical and developmental concerns. For example, the Seal Team, Bubblemaker and Scuba Rangers programs are restricted to a pool or pool-like environment. Both agencies require that certified divers ages 10-11 be accompanied by a certified parent, legal guardian, or professional dive leader, and limit maximum depth to 40 feet. We should note, however, that while these depth limits do control the partial pressures of nitrogen and oxygen, an embolism can occur in as little as four feet of water. PADI has taken special educational efforts to alert instructors to the safety issues. And while current instructors haven’t been trained to certify children but still can, future instructors will find extensive material incorporated into upcoming revised Instructor Development Courses.[/FONT]
[FONT=Arial, Helvetica, sans-serif]Nonetheless, not all agencies have been willing to embrace scuba experiences for kids. Neither NAUI nor the YMCA — both nonprofit organizations in contrast with PADI and SSI — offer scuba programs for children less than 12 years of age. Frank Toal, of the NAUI training office, told Undercurrent that the agency found the medical and developmental concerns sufficiently compelling to preclude consideration of scuba for those less than age 12. Additionally, NAUI’s junior scuba certification, for ages 12-14, imposes a 60-foot maximum depth limit and requires supervision by a certified diver age 18 or older.[/FONT]
[FONT=Arial, Helvetica, sans-serif]Such reservations are not limited to these two training agencies and many experts have been outspoken in their opposition (see sidebar). World-recognized dive medicine expert Dr. Ernest Campbell has expressed misgivings about allowing his children to be certified at a young age, and said that he probably would have waited until their midteens if he had it to do again.[/FONT]
[FONT=Arial, Helvetica, sans-serif]So, What’s A Parent To Do? [/FONT]
[FONT=Arial, Helvetica, sans-serif] Admittedly the issues are complex. Yet it is clear, children face greater risks than adults. Parents or guardians must be thorough and responsible when considering whether to enroll in a PADI or SSI program.[/FONT]
[FONT=Arial, Helvetica, sans-serif]Any child being considered for a compressed air at depth experience or scuba certification should receive a pediatric examination with the expressed purpose of clearance for diving. The child’s psychological maturity for diving should be evaluated through open and honest discussions between the child, parent or guardian, and a knowledgeable instructor. If any party has substantial reservations, wait until these resolve. Under no circumstances should an unwilling child be coerced into scuba. If all signs are go, make sure the youngster has gear he or she can manage, wears adequate thermal protection, and is enrolled in a class of similar aged children. Finally, for those children receiving certifications with restrictions, ensure that all conditions are scrupulously observed. Attend the classes with your child and if you have any doubts about the child, the instructor, or the class, work them out or consider other classes later. [/FONT]
[FONT=Arial, Helvetica, sans-serif]© Doc Vikingo 2001[/FONT]