Untreated DCS stats

[crispos]

I read the DAN Report on DCI, Diving Fatalities and PDE, 2002 Edition. They provide short case studies of only 10 of the 728 reported injuries, but all the 91 dive fatalities. Makes for interesting and sobering reading.

DAN obtains its Dive Injury data from reporting Hyperbaric Chambers so the sample consists of chamber-treated divers only. Does anyone know any source that has attempted to measure the incidence of Untreated (at least by chamber) DCS in recreational diving anywhere in the world?

 

[Arnaud]

Don't mean to be rude, but why would a doctor diagnose a case of DCS, not treat it and take the time to report it?

 

[Saturation]

crispos once bubbled...
I read the DAN Report on DCI, Diving Fatalities and PDE, 2002 Edition. They provide short case studies of only 10 of the 728 reported injuries, but all the 91 dive fatalities. Makes for interesting and sobering reading.

DAN obtains its Dive Injury data from reporting Hyperbaric Chambers so the sample consists of chamber-treated divers only. Does anyone know any source that has attempted to measure the incidence of Untreated (at least by chamber) DCS in recreational diving anywhere in the world?

Quite a large number, but this is 'old' information. A recent summary of the effects of untreated bends episodes is in Bennett and Elliott's current textbook, Physiology and Medicine of Diving, 2003, 5th Edition.

 

[crispos]

Do I have to go to a doctor to have a condition of high blood pressure? Or a slipped disc? If someone was clever, they could impute the number of probable untreated DCS cases in sport diving, that's all. But to refine the question, let's say, DCS that was diagnosed and therefore untreated more than 31 days after an incident. In my case, it was about 60 days.


Saturation, what is "old" data? The studies on untreated DCS, or my question, or the DAN report? I am sure I cannot lift that textbook, let alone afford it. But if you have any references from the Net, please tell.

 

[Saturation]

crispos once bubbled...
Do I have to go to a doctor to have a condition of high blood pressure? Or a slipped disc? If someone was clever, they could impute the number of probable untreated DCS cases in sport diving, that's all. But to refine the question, let's say, DCS that was diagnosed and therefore untreated more than 31 days after an incident. In my case, it was about 60 days.


Saturation, what is "old" data? The studies on untreated DCS, or my question, or the DAN report? I am sure I cannot lift that textbook, let alone afford it. But if you have any references from the Net, please tell.

Old data refers to the complications of untreated DCI.

Below is one recent study of DCI in pilots:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8775396&dopt=Abstract

Bennett and Elliott has an entire chapter of the results of chronic DCI exposure among divers in southeast Asia and other 3rd world regions, were divers dive indefinitely, surfacing only when their gas runs out.

 

[pufferfish]

Saturation once bubbled...


Old data refers to the complications of untreated DCI.

Bennett and Elliott has an entire chapter of the results of chronic DCI exposure among divers in southeast Asia and other 3rd world regions, were divers dive indefinitely, surfacing only when their gas runs out.

Here is some of that evidence from the Miskito region of Nicaragua

Untreated DCI

 

[crispos]

Pufferfish, I am shaken after seeing those fotos. Especially as the favorite playground of my diver friends is San Andres Island, due East of the Mosquito Coast. What can we do to stop this misery?

Saturation, interesting journal abstract. However, they say their is no statistically significant (ie causal) relationship to the DCS of the pilots, and their arthritic symptoms afterwards. Hard to believe.

The BSAC Accident report makes for interesting reading, as it differs from the DAN report, in that the Coast Guard is the main data soure. They dive abit deeper in the UK I think, and the report admits that many more incidents of DCI probably occur than are reported. Which is the source of my question.

By the way, I should have asked for, Untreated DCS STUDIES, not STATS. That is the whole point, that these are neglected cases.

Any other Untreated DCS study references are much appreciated.

 

[pufferfish]

crispos once bubbled...
Pufferfish, I am shaken after seeing those fotos. Especially as the favorite playground of my diver friends is San Andres Island, due East of the Mosquito Coast. What can we do to stop this misery?

Good question but tough one to answer. Remember these divers are the investment bankers in their communities and if they don't get bent or die they have the biggest houses in town and largest families. The only thing that will touch that kind of income is the drug trade. People have talked about boycotting Darden Foods (Red Lobster) which buys much of the diver caught lobster although it is sent through a middle man so it isn't labelled as such. People have tried getting a union together for the divers. People have tried educating them. Nothing seems to have worked basically as this is a poor area with the only law being that of the jungle. The biggest gun rules the land. The boat owners know if one kid dies or is paralysed there are another hundred ready to replace him.

Men's Journal should have a very revealing article out before the year is out on this. National Geographic ran a show about a year ago on the subject. The new government in Nica because of this bad PR seems to be finally looking into the DCS epidemic.

The easiest thing to do is send money to SOS. Bob is looking to bring a donated chamber from the Bahamas to the Miskito coast and needs some $$ for transport. This guy will live in a tent and eat rice and beans for a month to help these folks. He is always looking for people to help him on his trips so if you can the time to spare look him up. He is quite the individual, ex-commercial diver.

 

[crispos]

An article about the Miskito lobster divers in the Summer 2002 UHMS Journal, you probably have seen it, by Dunford et alia, or is one of them you or your buddy? It indicates the diving habits of these guys (don't know if the women participate). I'd call it a study, but it collects data on only 5 divers for a 7 day "normal" fishing trip, and they were paid to participate. Don't know if it could be normal if there were gringos around pushing, prodding and measuring them. But anyways...makes for an unsettling read.

What stands out is that they dive frequently (like 6-7 dives to average 65 feet each, and they suck the tanks dry), they dive in pain (15% of man days, most reporting joint injuries self medicated with pain killers) and they all dive pretty stoned.

Unbelievably there was no O2 or chamber on board the study vessel, the object was not to treat them, so basically, the experimenters watched and measured these guys inflict multiple DCS hits on themselves. Wow.

I think this must be a social phenomenon revolving around abject poverty, money and dope and it would be hard to unravel just what is going to change it for the better the way they see it, if anything. Not my area of expertise. So you get a chamber down there, they get bent all day, you treat them, they go out and get bent again. Apparently they understand what is causing the DCS. According to the study conclusion "they accept these risks and discomfor as a tradeoff for economic and social reasons beyond what a modern diver must consider".

 

[pufferfish]

Yes the largest income earners are drug runners and lobster fishermen. The drug of choice is cocaine as far as trafficking goes and they can earn big $$. Lobster fishing is seen then as the big legal money earner and attracts the young men despite the risks.

You are probably correct in that a chamber or two alone is not going to fix the problem as they will just return to the same conditions that got them bent in the first place. If you are able to read Spanish and go to the SOS web site forum you will see that the Nica government has finally addressed the issue from a occupational health and safety standpoint. Lots of new lobster diver regulations like max depth, max number of dives per day, obligatory use of computers, etc. Of course someone has to teach them about DCS and how to use computers. The real issue though will be compliance and enforcement in an area where there is no or very little central government presence. I think one of the regs is that should a diver become injured the boat owner will be responsible for paying the chamber costs. This might have the effect of forcing the owners and captains to monitor what their divers are doing instead of turning a blind eye as they know if a diver dies they can just give the family some money to buy silence and get another diver the next day.

On the surface a diving medicine problem but the longterm answers are political, social, and economic reform.

Thanks for reminding me about that 'study' as I had seen it previously but forgot to have a closer look. Having been to the area a few times not too much would surprise me though.