open access
Evolution of the respiratory function of professional divers over 15 years
Affiliations- ORPHY Laboratory, University Brest, Brest, France
- French Society for Maritime Medicine, Brest, France
- Hôpital d’Instruction des Armées, Clermont-Tonnerre, Brest, France
- CHRU Brest, Hyperbaric Medicine Unit, Brest, France
- CHRU Brest, Hyperbaric Medicine Unit, Brest, France
open access
Abstract
Background: The study was aimed at assessing changes in respiratory function after 15 years of profes- sional diving, among scientific divers.
Materials and methods: A retrospective study was performed on divers who underwent an initial visit and a visit 15 years later at the same medical centre, among divers who had a scientific activity (monitoring the coastline, fauna and flora). Pulmonary function tests were performed in the same laboratory with the same operating standards and using a Jaeger MasterBody plethysmograph. Each subject acted as his or her own control. The data were analysed by Student’s t-test and Spearman’s correlation coefficient.
Results: Twenty-six divers were included. Changes over 15 years included: a decrease in the forced expired volume in 1 second/functional vital capacity (FEV1/FVC) ratio (–6 for absolute value, p < 0.01; and –5% for theoretical value, p = 0.02); a decrease in forced expiratory flow (FEF)25% (–1.1 for absolute value, p < 0.01; and –21% for theoretical value, p < 0.01); a decrease in transfer factor for carbon monoxide (TLCO) (–0.7 for absolute value, p = 0.04); and an increase in vital capacity (VC) (+8% for theoretical value, p = 0.03). A significant correlation was found between the consumption of tobacco in packs per year (PY) and the variations in VC (r = 0.89; p < 0.01) and the variations in the theoretical FEV1 (r = 0.76; p = 0.03). There was a significant relationship between the number of dives and the variations in the percentage of the theoretical FEV1/FVC ratio (r = –0.42; p = 0.04). The same relationship was found for the average of dive duration (r = –0.59; p < 0.01)
Conclusions: With increasing length of diving activities service, the pulmonary function displays a trend toward both a decrease in TLCO and a decrease in FEF25%.
Abstract
Background: The study was aimed at assessing changes in respiratory function after 15 years of profes- sional diving, among scientific divers.
Materials and methods: A retrospective study was performed on divers who underwent an initial visit and a visit 15 years later at the same medical centre, among divers who had a scientific activity (monitoring the coastline, fauna and flora). Pulmonary function tests were performed in the same laboratory with the same operating standards and using a Jaeger MasterBody plethysmograph. Each subject acted as his or her own control. The data were analysed by Student’s t-test and Spearman’s correlation coefficient.
Results: Twenty-six divers were included. Changes over 15 years included: a decrease in the forced expired volume in 1 second/functional vital capacity (FEV1/FVC) ratio (–6 for absolute value, p < 0.01; and –5% for theoretical value, p = 0.02); a decrease in forced expiratory flow (FEF)25% (–1.1 for absolute value, p < 0.01; and –21% for theoretical value, p < 0.01); a decrease in transfer factor for carbon monoxide (TLCO) (–0.7 for absolute value, p = 0.04); and an increase in vital capacity (VC) (+8% for theoretical value, p = 0.03). A significant correlation was found between the consumption of tobacco in packs per year (PY) and the variations in VC (r = 0.89; p < 0.01) and the variations in the theoretical FEV1 (r = 0.76; p = 0.03). There was a significant relationship between the number of dives and the variations in the percentage of the theoretical FEV1/FVC ratio (r = –0.42; p = 0.04). The same relationship was found for the average of dive duration (r = –0.59; p < 0.01)
Conclusions: With increasing length of diving activities service, the pulmonary function displays a trend toward both a decrease in TLCO and a decrease in FEF25%.
Keywords
diving/physiology; pulmonary ventilation/physiology; occupational exposure; retrospective study
About this articleTitle
Evolution of the respiratory function of professional divers over 15 years
Journal
Issue
Article type
Original article
Pages
119-124
Published online
2019-06-25
Page views
1508
Article views/downloads
814
DOI
10.5603/IMH.2019.0019
Pubmed
Bibliographic record
IMH 2019;70(2):119-124.
Keywords
diving/physiology
pulmonary ventilation/physiology
occupational exposure
retrospective study
Authors
Richard Pougnet
Laurence Pougnet
Anne Henckes
David Lucas
Jean-Dominique Dewitte
Philippe Mialon
Brice Loddé
References (25)- Tetzlaff K, Thomas PS. Short- and long-term effects of diving on pulmonary function. Eur Respir Rev. 2017; 26(143).
- Bove A. Diving Medicine. American Journal of Respiratory and Critical Care Medicine. 2014; 189(12): 1479–1486.
- Lippmann J, Baddeley A, Vann R, et al. An analysis of the causes of compressed-gas diving fatalities in Australia from 1972-2005. Undersea Hyperb Med. 2013; 40(1): 49–61.
- Pougnet R, Pougnet L, Lucas D, et al. Longitudinal change in professional divers' lung function: literature review. Int Marit Health. 2014; 65(4): 223–229.
- Tetzlaff K, Thorsen E. Breathing at depth: physiologic and clinical aspects of diving while breathing compressed gas. Clin Chest Med. 2005; 26(3): 355–80, v.
- Thorsen E, Segadal K, Kambestad B, et al. Divers' lung function: small airways disease? Br J Ind Med. 1990; 47(8): 519–523.
- Skogstad M, Skare O. Pulmonary function among professional divers over 12 years and the effect of total number of dives. Aviat Space Environ Med. 2008; 79(9): 883–887.
- Skogstad M, Thorsen E, Haldorsen T, et al. Lung function over six years among professional divers. Occup Environ Med. 2002; 59(9): 629–633.
- Skogstad M, Thorsen E, Haldorsen T. Lung function over the first 3 years of a professional diving career. Occup Environ Med. 2000; 57(6): 390–395.
- Tetzlaff K, Friege L, Theysohn J, et al. Lung function in military oxygen divers: a longitudinal study. Aviat Space Environ Med. 2005; 76(10): 974–977.
- Voortman M, Ooij PJ, Hulst RA, et al. Pulmonary function changes in Navy divers during their professional careers. Undersea Hyperb Med. 2016; 43(6): 649–657.
- Lucas D, Loddé B, Choucroun P, et al. 5-tears fellow up study of respiratory function in a cohort of 31 professional divers. Medicina Maritima. 2005; 5(1): 17–28.
- Pougnet R, Henckes A, Mialon P, et al. Evolution of the ventilatory function of professional divers over 10 years. Undersea Hyperb Med. 2013; 40(4): 339–43.
- Cotes JE, Chinn DJ, Quanjer PH, et al. Standardization of the measurement of transfer factor (diffusing capacity). Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993; 16: 41–52.
- Quanjer PH, Tammeling GJ, Cotes JE, et al. [Lung volumes and forced ventilatory flows. Work Group on Standardization of Respiratory Function Tests. European Community for Coal and Steel. Official position of the European Respiratory Society]. Rev Mal Respir. 1994; 11 Suppl 3: 5–40.
- No authors listed]. Standardized lung function testing. Official statement of the European Respiratory Society. Eur Respir J. ; 16(Suppl 1993): 1–100.
- Dakin J, Kourteli E, Winter R, Housset B. Maîtriser les épreuves fonctionnelles respiratoires: de la théorie à la Clinique. Elsevier-Masson, Paris 2007.
- Sames C, Gorman DF, Mitchell SJ, et al. Long-term changes in spirometry in occupational divers: a 10-25 year audit. Diving Hyperb Med. 2018; 48(1): 10–16.
- Fitzpatrick DT, Conkin J. Improved pulmonary function in working divers breathing nitrox at shallow depths. Aviat Space Environ Med. 2003; 74(7): 763–767.
- Chong SiJ, Tan TW, Lim JY. Changes in lung function in Republic of Singapore Navy divers. Diving Hyperb Med. 2008; 38(2): 68–70.
- Davey IS, Cotes JE, Reed JW. Relationship of ventilatory capacity to hyperbaric exposure in divers. J Appl Physiol Respir Environ Exerc Physiol. 1984; 56(6): 1655–1658.
- Lemaître F, Tourny-Chollet C, Lemouton MC. Ventilatory function in experienced recreational scuba divers: Evidence of small airways disease? Int J Sports Med. 2006; 27(11): 875–879.
- Tetzlaff K, Reuter M, Leplow B, et al. Risk factors for pulmonary barotrauma in divers. Chest. 1997; 112(3): 654–659.
- Mijacika T, Dujic Z. Sports-related lung injury during breath-hold diving. Eur Respir Rev. 2016; 25(142): 506–512.
- Aquila I, Pepe F, Manno M, et al. Scuba diving death: Always due to drowning? Two forensic cases and a review of the literature. Med Leg J. 2018; 86(1): 49–51.
