Recently on a trip to Mildura part of the regulator on the DLCO gas bottle was damaged. Thankfully it was still operational on the day. On return Vanessa went to visit some local dive experts to make sure it was fixed correctly.
They were very interested in our Respiratory Lab. In return, the visit generated some interest amongst our staff in what part Respiratory testing plays in Dive Medical Examinations.
Australia apparently has some of the strictest dive guidelines in the world and the Australian Standards 4005.1 need to be adhered to when assessing a diver for a medical examination.
A survey conducted in Queensland a few years ago attempted to assess the variability of opinion regarding fitness to dive among doctors doing dive medical examinations. There was a 64% response rate. Fifteen hypothetical cases were presented. They were asked to classify the cases as either fit to proceed with dive training, unfit to proceed, requiring a referral to specialist and fit after investigation.
Opinion varied greatly. There was a 70% consensus about unfitness in only 4 cases (one of which should have been referred according to AS guidelines) and fitness in only two cases (both should have been referred). For each case that the AS guidelines firmly state as unfit to dive at least one doctor passed as fit.
How does this relate to respiratory disease? Absolute contraindications for diving are Asthma, Lung cysts, obstructive lung disease, lungs that empty unevenly and previous thoracotomy. Relative contraindication are FEV1/FVC ratio of less than 75% and poor physical condition.
Jessica
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