Pulmonary Function in Divers following SARS-CoV-2 (COVID-19)Infection
One of the aims at DDRC Healthcare is to improve diver safety and we always use the most up to date evidence to advise divers and enable safer diving. COVID-19 is a novel infectious disease that has affected millions of people worldwide and we need to consider how it could impact the health of the diving community, but at present there is very limited scientific evidence to guide doctors and divers. There are concerns that COVID-19 infection can cause changes to the lungs, even when few symptoms were noticed by the patient, and that these changes could cause problems for diving.
What is this study? This study aims to look at the lung function of divers before and after COVID-19 infection, to see if there is a significant difference. At DDRC we already have the lung function (spirometry) test results of many commercial and recreational divers who attended the service for medicals before the emergence of COVID-19. Some of these divers may have since had suspected or confirmed infection with COVID-19. By re-testing their lung function we will gain insight into post-infection lung recovery which has implications not only for divers but for survivors of COVID-19 worldwide.
Can I take part? We are looking for divers who:
- Have undergone a fitness to dive or HSE medical at DDRC Healthcare in the last 5 years, and…
- Have had suspected or confirmed coronavirus (COVID-19) infection, including symptoms consistent with coronavirus. These symptoms include cough, fever, anosmia (loss of smell) or shortness of breath.
- Be asked to visit DDRC (Plymouth, UK) for a consultation and examination, very similar to a sports diver medical. This will include a heart tracing, spirometry (lung function test) and an exercise test.
- Be assessed by a qualified diving doctor who can sign you off as fit to dive at the end of the study, providing you fulfil the UKDMC criteria. We are offering this fitness to dive medical free of charge to participants.
- Have the opportunity to be involved in research which has the potential to benefit the dive community and millions of survivors of COVID-19!
How do I take part? If you meet the above requirements and are interested in taking part, please click here to download the Participant information sheet or for more information email [email protected]
DDRC ‘Health of Divers’ Research Programme?
The ‘Health of Divers’ diving research studies explore health issues that might affect recreational divers. The concept has been to try and shed some light on what divers are really doing – in the imperfect world – as opposed to what they should be doing – in the perfect world!
Below you will find an introductory overview of many of the individual diving research studies which we have more recently undertaken, together with links to any published research papers.
Can I participate in a diving research project? We could not carry out these studies without the active participation of recreational divers and the support of various diving organisations and clubs. We are immensely grateful to all of you who support our research through your participation.
How can I share the learning from the ‘Health of Divers’ research? You will find a range of downloadable leaflets and resources such as Powerpoint presentations over on our Diving Education page. These have been created especially for divers and dive clubs.
The very first element of the “Health of Divers” project in 2010 showed us that 22% (105/479) of the respondents had used some kind of illicit drug since learning to dive, with 3.5% using drugs in the last 12 months, and 3.3% within the last month of the survey. This was compared with the national data of the time where 36% of non-divers in the national population had used illicit drugs in their life-time, and 9.3% of the population in the previous 12 months, and 5.3% in the last month. Divers in our study were using a whole range of illicit drugs, from all classes, stimulants, hallucinogens and opiates. In line with national data, cannabis was cited as the most frequently used illicit drug, followed by cocaine and magic mushrooms. Additionally 40% of the illicit drug users admitted to using a class A drug since learning to dive. Also reported was the shortest time between a dive and taking a specific illicit drug. It showed that class A or B drugs had been used by 21% of the drug users from 5 minutes to 24 hours before diving, with cannabis, cocaine, and ecstasy all reported between 5 and 6 hours before a dive. The use of hallucinogens was reported by 67% of the illicit drug users, with 25% having used both hallucinogens and stimulants since learning to dive, and 10% using in the last month of the survey. In total, barbiturates, tranquillisers, amphetamines, cocaine, ecstasy, LSD, cannabis, heroin, and magic mushrooms were all reported in the survey. Because the study also asked many questions about a divers’ health in general there was a great deal of other fascinating and valuable facts gathered, enabling DDRC Healthcare to replicate the findings in other non-diving peer review studies. This showed a relationship between illicit drug use and anxiety and depression. In other words, in our study more divers suffered from anxiety or depression who were using illicit drugs, than divers who did not use illicit drugs. This in itself was an interesting result from the study because it also showed that a number of respondents were diving suffering from depression, and at the same time taking prescribed medications for the condition. Regular use of cannabis is associated with an increased risk of developing psychotic illnesses later in life, including schizophrenia. Also a family background of mental illness can increase the risk of developing a psychotic illness by using cannabis. It is possible that frequent use of cannabis might affect the fertility of men and women! Read the full paper and learn more about the subject: Diving Research paper Illicit drugs & diving
As part of the illicit drug survey we also collected data to see what divers were taking by way of physician prescribed drugs, and over the counter drugs. 23% (121/531) of the respondents were taking physician prescribed drugs, with 10% (53/531) taking some type of cardiovascular drug. Physician prescribed pain killers were also reported with some taking opiate based pain killers that could potentially affect a diver’s alertness, judgement, and decision making abilities, calling into question the divers’ fitness to dive. Over the counter drugs were reported by 57% (303/531), taking them within 4 to 6 hours of a dive. Painkillers were the most commonly reported, with decongestants the next most regularly reported over the counter drug. A small number of divers, 13%, were taking a combination of both physician and over the counter drugs at the time of a dive. Read the full paper and learn more about the subject: Diving Research paper Medicines & diving
By conducting a series of surveys over time and drilling down into different aspects of a diver’s health, trends start to become apparent. What we saw from this ‘Health of Divers’ research project into ‘Alcohol and Diving’ was a similar percentage of divers were taking physician prescribed medications, and a similar number were taking cardiac medications as in the previous drugs study. The data also showed that 35% (288/818) of the respondents had never had a diving medical of any kind. With regard to alcohol it seemed that older divers were more likely to exceed the UK government recommended weekly amount of units compared to younger divers. But, binge drinking was associated with younger divers. Binge drinking was defined as consuming more than double the daily recommended units of alcohol in one session. Only 39% (313/818) of the respondents reported a responsible attitude to alcohol by their dive clubs – both under normal circumstances and whilst on a dive trip. When it came to diving incidents – 23% (187/818) reported they had witnessed a diving incident which they felt was attributable to alcohol, added to which 19% (151/818) of the respondents had dived when considering themselves unfit to drive a car! Perhaps the take home message here should be if you aren’t fit to drive a car – then you aren’t fit to dive. Find out more by downloading the full research paper: Diving Research paper Alcohol and UK recreation divers
Dental health is often overlooked by divers, but the majority of the 416 divers (78%) in this study did report having dental checks every 6 or 12 months, but 22% said they never attended a dentist at all, or only when something was wrong. Importantly, overall 38% reported their dentist was not aware they dived, with a further 10% unsure. Some respondents also reported dentists were unaware of the implications of scuba diving on dental health. So the advice should be that it might be wise to let your dentist know you dive and remind him of diving physics! Facial, jaw, tooth or sinus pain was experienced by 57% whilst diving with 19% having aborted a dive due to pain. There were also reports of surfacing with blood in the mask by 28% of respondents. Sinus pain whilst diving with a cold was reported by 21%. Dental hygiene left a bit to be desired with 42% reporting bleeding gums when cleaning their teeth. Fillings, crowns and root canal work were the most reported elements of dental work.
Because we had noticed in the previous ‘Health of Divers’ surveys that a percentage of divers were taking some kind of cardiac medications, and there was a certain amount of debate around cardiac health in divers generally, we decided to have a closer look at the subject. Some 672 divers participated in this study, and the results were very interesting! Of the group as a whole 9% were taking some kind of cardiac medication, and 38% had no diving medical at all or had not undertaken a medical for more than 10 years. Considering overall health, two or more of the following cardiac risk factors – current cigarette smoking, exceeding recommended upper weekly limit for alcohol consumption, exercising less than 3 to 4 times a week, and BMI greater than 24.9 – were reported by 34% of the respondents. High blood pressure was reported by 18% (119), with 21% of that group having no diving medical at all. Still with the 119 high blood pressure group, 29% were technical divers. Heart attacks (6), coronary artery bypass grafting (3), atrial fibrillation (19) and angina (12), were all reported by respondents since learning to dive. A total of 28 PFOs were reported, with 20 opting for a closure procedure. Of the 83 treated incidences of decompression illness (DCI), 19 divers had a PFO. And finally, a 1st degree relative age under 60 with history of cardiac problems was reported by 22%. The full research paper on Diving and Cardiac Health can be downloaded here: Diving Research paper Cardiac Health
Our survey on Mental Health and Diving is now closed. Thank you to everyone who participated. We are now analysing the data provided and will publish the findings in due course.
Our survey on Ears and Diving is now closed. Thank you to everyone who participated. We are now analysing the data provided and will publish the findings in due course.
Our survey on Flying and Diving is now closed. Thank you to everyone who participated. We are now analysing the data provided and will publish the findings in due course.