seeking comments on mortality studies

[Pork Whisperer]

I apologize up front for not spending much time checking the literature on SCUBA Diving mortality studies, but thought it might be easier and best to check with folks that seem to be current on the diving world.

I have followed ScubaBoard for about 18 months and it seems like a surprising number of middleaged men are having fatal complications with diving. Being 57 and in my 4th year as a novice diver, these cases are interesting to me. Reading about these sad events brings up a few questions. However, to start with I know there is a certain percentage of people dying every day, so from a numbers game, the mortality reported on ScubaBoard may just be the normal mortality rate. It certainly could be the guy was just in the water when his time was up.

However, I am curious if there is any linkage between a new class of cardiovascular drug and some issue with diving. I know there has been research done in this area, but wonder if it is a bit dated. It seems possible that as new drugs are made that are more specific for a certain receptor in vascular cells, then there may be new problems that occur when diving. Of course, there is an alternative hypothesis that drugs have not changed, there are just that many more folks diving which accounts for most of the issues discussed on ScubaBoard.

Now, I am considered healthy by my physician and take no cardiovascular drugs. However, one day I am sure I will be on some ubiquitous hypertension drug and would like to know more about their interactions.

I will search more in the literature, but so far not seeing much for recent critical discussion about the root cause of diving mortality that seems (in my opinion) related to vascular events. For example, is it known if the folks that have died were taking the same medications? How many people dive on heart drugs without problems? These are simple questions, but I realize there may be limited funding for such studies. I also realize that there may be many causes for SCUBA diving related mortality, but just looking for simple answers first.

Thanks

 

[Duke Dive Medicine]

Hi Pork,

Another way of looking at this is to look at the diving population in general, which is aging, and consider how many safe dives are made by this population every day. If your physician considers you healthy and you keep yourself in good physical condition, you should be at a very low risk of sudden death under water.

Best regards,
DDM

 

[DocVikingo]

I have followed ScubaBoard for about 18 months and it seems like a surprising number of middleaged men are having fatal complications with diving.

Hey Pork Whisperer,

I really do not believe that this is the case.

The various statistics involved in a discussion of this topic depend upon which studies are referenced. However, the general consensus appears to be that scuba-related deaths are very uncommon, indeed. Per the National Sporting Goods Association (NSGA), based on the US Census for 2000, scuba fatalities are estimated at 0.02% of all annual sports-related deaths. For comparison, the estimated fatality rate for non-scuba related drownings is about 2%. Using NSGA estimates & DAN fatality records, the death rate among US divers is only about a tiny 3-6 per 100,000.

According to DAN's Annual Diving Report 2012-2015, it received notification of 561 deaths worldwide involving recreational scuba diving during 2010-2013. Only the deaths of 334 US & Canadian recreational divers were actively investigated by DAN. High blood pressure, cardiovascular disease & diabetes, in that order, were the three most common causes of diver deaths in this group. While the true prevalence of these among scuba victims is uncertain as the medical history was incomplete or not known for many of the deceased, I suspect that this ordering (and the associated percentages of fatalities) is roughly accurate. And of course some of those deceased who were reportedly healthy may have had undiagnosed hypertension, heart disease or diabetes, as is often the case in the general population. Of the deceased, 78% of males & 90% of females were 40 yrs of age or older; 58% of males & 59% of females were 50 yrs or older. Based on the totality of research that I have read, it seems reasonable to estimate that about 25% of diving fatalities are related to these three diseases, with the majority of these in divers aged 40-45 & above.

However, I am curious if there is any linkage between a new class of cardiovascular drug and some issue with diving.

Unless the Medical Moderators know what class of drugs you are referring to, we cannot reasonably & succinctly respond to this part of your inquiry.

At this point in the exchange, I am quite inclined to agree with DDM regarding your risk of sudden cardiovascular-related death u/w.

Regards,

DocVikingo

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.

 

[Pork Whisperer]

Thank you DDM and DocVikingo for comments. I would certainly agree with statistics that diving is safe, and afterall, I drive a car, so I am certainly accepting of mortal threats from one's choices.

I am just interested in some of the diving events reported on ScubaBoard where someone is an experienced diver, seems healthy in all respects, and then dies one day while diving. I know there can be many factors, but was just wondering if any recent changs in medications, and how well such information might be tracked. I have no assumption about any specific medication, just a general thought.

Although I have forgotten a lot of physiology, and I need to review recent diving physiology literature, I can attest from personal experience that I have a moderate to robust immersion diuresis response to diving. I would not be surprised at all if such a response causes issues in some folks when taking some drugs. Since that comment is quite vague, I respond to DDM and DocVikingo do not waste your time responding. I will do some reading and will be back when I have specific questions to ask of you.

Thank you and others for your responses on this section of the SCUBAboard.

 

[Duke Dive Medicine]

Hi Pork,

Immersion diuresis happens in every healthy individual who is appropriately hydrated. It's a function of fluid redistribution with immersion in water. Some medications can alter blood pressure and renal function and may change the dynamics of the immersion diuresis response. Is there a specific drug that you had a question about?

Best regards,
DDM

 

[dreamdive]

You might find this helpful. It is a link to a PDF file that contains various recent (2000-now) dive related scientific articles.

Add Helium - The Rebreather Epicenter

Claudia