Temporary and permanent unfitness of occupational divers. Brest Cohort 2002–2019 from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P)
Abstract
Background: In France, the monitoring of professional divers is regulated. Several learned societies (French Occupational Medicine Society, French Hyperbaric Medicine Society and French Maritime Medicine Society) have issued follow-up recommendations for professional divers, including medical follow-up. Medical decisions could be temporary unfitness for diving, temporary fitness with monitoring, a restriction of fitness, or permanent unfitness. The aim of study was to point out the causes of unfitness in our centre.
Materials and methods: The divers’ files were selected from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P). Only files with a special medical decision were selected, between 2002 and 2019.
Results: Three hundred and ninety-six professional divers are followed-up in our centre and 1371 medical decisions were delivered. There were 29 (7.3%) divers with a special medical decision, during 42 (3.1%) medical visit. Twelve (3.0%) had a permanent unfitness. The leading cause of unfitness was pulmonary diseases: emphysema (3), chronic obstructive pulmonary disorder (2), asthma (2). Sixteen (4.0%) divers had temporary unfitness. The leading causes were cardiovascular (4 times) and neurological (6 times). Twelve (3.0%) divers had had at least one decompression sickness.
Conclusions: Judgments of permanent unfitness for diving were rare (3.0% of divers), but were because of life-threatening disease. Medical follow-up of occupational divers was justified to decrease the risk of fatal event during occupational dives.
Keywords: divingoccupational medicinedecompression sicknessFrancecontraindications
References
- Pougnet R, Uguen M, Verdier G, et al. Predicted nine-year risk of diabetes among professional divers: a prospective study. Int Marit Health. 2015; 66(2): 87–92.
- Epp T, Waldner C. Occupational health hazards in veterinary medicine: zoonoses and other biological hazards. Can Vet J. 2012; 53(2): 144–150.
- Maestre FT. Ten simple rules towards healthier research labs. PLoS Comput Biol. 2019; 15(4): e1006914.
- Gempp E, Louge P, de Maistre S. Predictive factors of dysbaric osteonecrosis following musculoskeletal decompression sickness in recreational SCUBA divers. Joint Bone Spine. 2016; 83(3): 357–358.
- Sharareh B, Schwarzkopf R. Dysbaric osteonecrosis: a literature review of pathophysiology, clinical presentation, and management. Clin J Sport Med. 2015; 25(2): 153–161.
- Azizi MH. Ear disorders in scuba divers. Int J Occup Environ Med. 2011; 2(1): 20–26.
- Tseng WS, Huang NC, Huang WS, et al. Brown-Séquard syndrome: a rare manifestation of decompression sickness. Occup Med (Lond). 2015; 65(9): 758–760.
- Chantre C, Morin J, Le Hot H, et al. [Hyperbaric medicine and emergency medicine, an example of decompression sickness in diving]. Rev Infirm. 2018; 67(242): 16–17.
- 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.
- Casadesús JM, Aguirre F, Carrera A, et al. Diving-related fatalities: multidisciplinary, experience-based investigation. Forensic Sci Med Pathol. 2019; 15(2): 224–232.
- Uguen M, Pougnet R, Uguen A, et al. Dysbaric osteonecrosis among professional divers: a literature review. Undersea Hyperb Med. 2014; 41(6): 579–587.
- Kot J, Sićko Z. New Polish occupational health and safety regulations for underwater works. Int Marit Health. 2007; 58(1-4): 149–156.
- Giovagnoli P, Bianco P, Ragusa F, et al. [Safety and health protection of professional divers in the context of the European Diver Technology Committee (EDTC): technical training and diver competence, role of the "examining" physician]. G Ital Med Lav Ergon. 2003; 25 Suppl(3): 249–251.
- Lodde B, Meliet JL, Pougnet R, et al. Recommandations de bonne pratique pour le suivi en santé au travail des travailleurs exposés aux contraintes hyperbares. Arch Mal Pro Env. 2016; 77(3): 414.
- Sames C, Gorman DF, Mitchell SJ, et al. The impact of health on professional diver attrition. Diving Hyperb Med. 2019; 49(2): 107–111.
- Sames C, Gorman D, Mitchell S, et al. An evidence-based system for health surveillance of occupational divers. Intern Med J. 2016; 46(10): 1146–1152.
- Huchim-Lara O, Chin W, Salas S, et al. Decompression sickness among diving fishermen in Mexico: observational retrospective analysis of DCS in three sea cucumber fishing seasons. Undersea Hyperb Med. 2017; 44(2): 149–156.
- Muller A, Rochoy M. [Diving and asthma: Literature review]. Rev Pneumol Clin. 2018; 74(6): 416–426.
- Ustrup AS, Ulrik CS. Are recreational SCUBA divers with asthma at increased risk? J Asthma. 2017; 54(8): 784–791.
- Adir Y, Bove AA. Can asthmatic subjects dive? Eur Respir Rev. 2016; 25(140): 214–220.
- 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.
- Pougnet R, Pougnet L, Henckes A, et al. Evolution of the respiratory function of professional divers over 15 years. Int Marit Health. 2019; 70(2): 119–124.
- 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.
- Åsmul K, Irgens Å, Grønning M, et al. Diving and long-term cardiovascular health. Occup Med (Lond). 2017; 67(5): 371–376.
- Henzel J, Rudziński PN, Kłopotowski M, et al. Transcatheter closure of patent foramen ovale for the secondary prevention of decompression illness in professional divers: a single-centre experience with long-term follow-up. Kardiol Pol. 2018; 76(1): 153–157.
- Germonpré P. Persistent (patent) foramen ovale (PFO): implications for safe diving. Diving Hyperb Med. 2015; 45(2): 73–74.
- Anderson G, Ebersole D, Covington D, et al. The effectiveness of risk mitigation interventions in divers with persistent (patent) foramen ovale. Diving Hyperb Med. 2019; 49(2): 80–87.
- Morin J, de Maistre S, Druelle A, et al. [Is it possible to dive again after decompression sickness?]. Rev Infirm. 2018; 67(242): 25–26.
- Van Wijk CH. Personality profiles of divers: integrating results across studies. Int Marit Health. 2018; 69(4): 297–303.
- van Wijk CH. Personality and behavioural outcomes in diving: current status and recommendations for future research. Diving Hyperb Med. 2017; 47(4): 248–252.
- Lafère P, Balestra C, Caers D, et al. Patent Foramen Ovale (PFO), Personality Traits, and Iterative Decompression Sickness. Retrospective Analysis of 209 Cases. Front Psychol. 2017; 8: 1328.
- Sames C, Gorman D, Mitchell S. Postal survey of fitness-to-dive opinions of diving doctors and general practitioners. Diving Hyperb Med. 2012; 42(1): 24–29.
![](https://journals.viamedica.pl/plugins/generic/popups/images/icons/close.png)