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March 2006 Vol. 21, No. 3   RSS Feed for Undercurrent Issues
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With DCI, Age Matters

from the March, 2006 issue of Undercurrent   Subscribe Now

Recent studies confirm that older divers may be more susceptible to severe decompression illness (DCI) than younger ones, and less able to recover.

Divers Alert Network (DAN) compared cases of diving fatalities with divers from Project Dive Exploration to explore potential risk factors in diving.1

Potential risk factors tested included: age, gender, body mass, smoking, asthma, diabetes, cardiovascular disease, years since certification, dives last year, last dive depth, Nitrox use, and dry suit use.

Those factors that suggested an increased risk were: a significant increase in body mass, smoking, diving 50 ft. deeper than on ones last dive, and a 20- year increase in age. (Risks of deaths from asthma, diabetes, and cardiovascular disease also increased with age.)

Divers with reduced risk were those diving less than 10 years since certification, making more than 30 dives in the last year, and using dry suits. DAN pointed out that these factors showed an association, not causality.

The University of Hawaii reviewed 889 cases treated for DCS at the schools Hyperbaric Treatment Center. The preponderance of injuries occurred in divers 21-40 year old. Of 889 cases, 250 were severe and 58 (23.2%) of those did not achieve complete functional recovery as compared with 0.5% of mild to moderately severe cases. 2

Age
% of Severe Cases
Incomplete recovery
under 20 31.9% 20.0%,
21-30 21.9% 19.3%
31-40 26.0% 21.6%
41-50 31.4% 30.6%
51-60 45.0% 29.6%
over 60 60.0% 44.0%

Researchers concluded that the degree of DCI severity portends poorer outcomes, and it becomes more pronounced with advancing age. While it appears that older divers are no more likely to incur DCI because of their age, their cases may be more severe and they are less apt to recover completely.

1. Case Control Analysis of Diving Fatalities, Dear GD, Caruso JLA, Denoble PJ, Department of Anesthesiology, Duke University; Freiberger JJ, Pieper CF, Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC; Vann RD, Divers Alert Network (DAN), Durham, NC.

2. Effect of Aging on Prevalence and Recovery from DCI, Smerz RW, Hyperbaric Treatment Center, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii.

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