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Divers face specific physical and health risks when they go underwater (e.g. with scuba or other diving equipment) or use high pressure breathing gases. Some of these conditions also affect people who work in raised pressure environments out of water, e.g. in caissons.

Contents

The ordinary features of diving

Effects of relying on breathing equipment while underwater

Effects of barotrauma or pressure damage

On descent

On ascent

Effects of breathing gas at high pressure

Other risks encountered by people in water

See also

External links

The ordinary features of diving

Click on the boldface links for more information about each topic.

Need to:	Remedy	Comments
Breathe underwater	Open-circuit 'scuba set'	Easy to refill. Safer to use than a rebreather.
	'Rebreather'	Longer duration per weight of set, but needs more training to be safe.
	'Surface supplied diving'	Mostly for work diving
	'Standard diving dress'	Mostly for work diving. Mostly merely of historical interest now.
	'Liquid breathing' system	(In the real world this is at the early experiment stage. It should allow very deep diving when it is developed.)
See underwater. Protect the eyes. (The human eye cannot focus accurately when directly submerged.)	Eyes-and-nose 'diving mask'	Easy to clear if flooded. Easily knocked off.
	'Full face mask '	Allows talking if no mouthpiece inside. Difficult or impossible to go to snorkel on running out of air.
	'Diving helmet'	As fullface mask. Protects the head well.
	Special contact lenses	Occasionally used by commando frogmen instead, to avoid searchlight beams reflecting off a mask window.
Move faster than with unequipped swimming	Fins on feet	Cheap, easy to use. Even without a diving suit, wetsuit bootees let the diver wear bigger fins.
	'Diver Propulsion Vehicles'	Faster but expensive, and heavy and bulky to carry about on land.
Avoid hypothermia (losing body heat to the water)	In cool or cold water, wear an adequately warm 'diving suit' for the conditions.	Much heat can be lost from a head without a hood.
Control buoyancy	'Diving weighting systems'	Usually a weight belt. Some breathing sets have built-in weight pouches.
	Diving suits	The buoyancy of most drysuits can be changed during the dive.
	'Buoyancy compensators'	These make diver's buoyancy control much easier.
Protect the skin from cuts and stings and grazes	Diving suits and diving gloves and diving suit bootees serve this purpose.	In very warm water try diving in a boiler suit, or other strong clothes with long sleeves and legs.
Breathe from atmosphere to save air when on surface	Snorkel	Advisable, despite some naval divers' opinions.

Effects of relying on breathing equipment while underwater

Being unable to breathe fresh air naturally whilst submerged and relying on limited breathing gas supplies and fallible breathing equipment can have these effects. Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type	Cause	How to avoid it
'Drowning'	Being unable to inhale anything but water	See under "anoxia" hereinunder
'Secondary drowning'	Can occur hours after a near drowning	Prompt medical treatment after near drowning
'Oxygen toxicity'	Breathing gas at too high a partial pressure of oxygen; partial pressure depends upon proportion of oxygen and depth	Proper training before using a rebreather or oxygen enriched gases such as nitrox.
'Hypoxia' or 'anoxia' occurs while having gas to breathe, but where the oxygen partial pressure is too low to sustain normal activity or consciousness.	A faulty or misused rebreather can provide the diver with hypoxic gas	Keep rebreathers properly maintained. Proper training before using a rebreather.
	Some deep diving breathing gases such as trimix and heliox can be hypoxic	Don't breathe hypoxic gas in shallow water. Proper training before using mixed gases.
	A full cylinder standing for a long time while the inside of the cylinder rusts, using up oxygen in the contained air, before the diver uses the cylinder	Keep cylinders routinely checked and tested. If a cylinder has stood full for months, empty it and refill it.
'Anoxia' due to having no air or gas to breathe	Equipment failure - particularly in rebreathers that monitor and maintain oxygen content	Keep equipment routinely checked and in good condition
	Running out of air due to poor dive discipline	Better training of divers. More disciplined attitude when underwater.
	Running out of air due to getting trapped by nets	Better awareness underwater. Carry a diver's net cutter, or dive tool/knife.
	Running out of air due to getting trapped or lost in enclosed spaces underwater (e.g. caves and shipwrecks)	Specific training and leadership for such types of diving. See cave diving and wreck diving.
	Running out of air due to getting lost in open water	Better training and leadership, including in using a compass underwater
'Salt water aspiration syndrome'	Inhaling a mist of sea water from a faulty demand valve causing a reaction in the lungs	Keep equipment routinely checked and in good condition
'Carbon monoxide poisoning'	Air cylinder filled by a compressor which sucked in products of combustion, often its own engine's exhaust	Proper precautions when filling cylinders
	Oil getting into the air feed and firing in the air compression cylinder, like in a diesel engine	Proper servicing of the compressor
'Emphysema' caused by inhaling oil mist	This happens gradually over a long time. This is a particular risk with a pumped surface air feed.	Use proper filters in the air pump or air compressor.
'Carbon dioxide poisoning': hypercapnia	Re-inhaling carbon dioxide-laden exhaled gas	Minimise the volume of any enclosed spaces which the diver breathes through. For example, this hazard can happen with diving with a large "bubblehead" helmet.
	With a rebreather, the diver re-inhales carbon dioxide because the soda lime scrubber cannot absorb the exhaled carbon dioxide as fast as the diver produces it. See Rebreather#Carbon dioxide scrubber.	British naval divers called it shallow water blackout. Keep rebreathers properly maintained. Proper training before using a rebreather.
Various effects of breathing a wrong gas	A wrong gas was put in a cylinder	Check conditions where you have your cylinders refilled. Put the proper gas identification markings on cylinders.

Effects of barotrauma or pressure damage

See barotrauma and pressure for more information.

On descent

Air spaces within the body provide no support against greater outside pressure. This can happen from losing control of buoyancy causing excessive vertical speed during descent. Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type	Cause	How to avoid it
Eardrum damage. Cold water in the middle ear chills the inner ear, causing dizziness and disorientation etc.	Failing to equalize the pressure in the middle ear with surrounding pressure.	Do not dive if the eustachian tube is congested, e.g. with the common cold. Proper diver training in clearing the ears.
	The pressure in the outer ear not equalizing with surrounding pressure	Make sure that your hood does not make an airtight seal over the outside ear hole; never wear earplugs.
Damage to other body air spaces, such as the paranasal sinuses.	Obstruction to the sinus ducts	Do not dive with conditions such as the common cold
Squeeze damage to blood vessels around the eyes	Caused by suction from the air space inside a mask ("mask squeeze") which is not a fullface mask	Let air into the mask through the nose. Do not dive with eyes-only goggles.
Squeeze damage to skin under folds in a drysuit	Suction into the space inside the fold	Modern drysuits have a tube connection to inflate the drysuit from the cylinder
Lung squeeze: blood in lungs	Extreme depth when snorkelling	Use an underwater breathing set
Helmet squeeze, with the old standard diving dress. This does not happen with scuba where there is no solid pressure-tight helmet	A valve in the helmet failing. In severe cases much of the diver's body could be mangled and compacted inside the helmet	Keep equipment in good order and inspected. Proper training in its use.

On ascent

Air spaces within the body expand when the outside pressure decreases. This can happen from holding the breath on ascent, or from losing control of buoyancy causing excessive vertical speed during ascent. Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type	Cause	How to avoid it
Pulmonary barotrauma: "burst lung"	Holding the breath while ascending	Never hold your breath while diving with breathing apparatus
This can cause:
'Pneumothorax'	Collapsed lung, air loose in the pleural cavity
'Interstitial emphysema'	Gas trapped in the chest after burst lung
'Subcutaneous emphysema'	Gas loose under the skin.
'Gas embolism'	Air or other gas in the blood stream. Its effects can be very similar to decompression sickness.
Pain in a sinus	Blockage of the sinus's duct	Do not dive with nasal congestion, e.g. the common cold.
Eardrum bursting outwards	Blocked Eustachian tube

Effects of breathing gas at high pressure

Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type	Cause	How to avoid it
'Decompression sickness ("the bends")'	Gas dissolves in blood under pressure according to Henry's Law over time. After dive, ascending too quickly will cause gas to supersaturate and form bubbles in tissues according to time and depth of the dive.	Plan your dive. Know how long you can stay at the planned depth and still make a normal ascent. If stops are necessary, do not miss or cut short decompression stops. Training in using diving tables and a dive computer. See 'decompression sickness' for a detailed list of the symptoms. Provide something for the diver to hold onto while decompressing.
Bends in snorkellers. Uncommon but known.	Many deep dives in succession. See 'taravana'.	Use an underwater breathing set
'Nitrogen narcosis'	Breathing a high partial pressure of nitrogen (or other inert gas, to varying degrees)	Do not dive too deep on ordinary air. With mixture diving, use the correct breathing gas.
'Oxygen toxicity'	Breathing a high partial pressure of oxygen	This hazard is well known with rebreathers. This can happen in very deep diving with open-circuit scuba.
'HPNS': High Pressure Nervous Syndrome or Helium Tremors	Breathing a high partial pressure of helium	Use another diving technique, such as an ROV; or add a little nitrogen as described at HPNS.

The term dysbarism describes Decompression sickness, arterial gas embolism, and barotrauma.
Divers face specific physical and health risks when they go underwater (e.g. with scuba) or use high pressure breathing gases. Some of these conditions also affect people who work in raised pressure environments out of water, e.g. in caissons.

Other risks encountered by people in water

Types of this class of diving disorder, and how to avoid them. Click on the boldface links to find symptoms and more information for each topic.
Where it says "Avoid diving with bare skin", a boilersuit could be worn in very warm water.

Type	Cause	How to avoid it
'Hypothermia'	Losing body heat to the water. Water carries heat away far better than air.	In cool or cold water, wear an adequately warm diving suit for the conditions. Also, much heat can be lost from a head without a hood.
Cuts, sometimes with coral tissue left in them	Coral	Do not get too close to coral. Avoid diving with bare skin.
Cuts	Rock, metal, etc	Avoid diving in bare skin, particularly in caves or shipwrecks.
Stings	Fire coral	It is yellow. Learn to identify it.
Stings, some dangerous	Some 'jellyfish'	Learn about the dangerous species. Avoid diving with bare skin.
A deep cut which leaves poison in the wound	'sting ray' (its self-defence reaction)	Do not poke about in sand where they live. Care when wading.
Poison-injecting spines	'lionfish', 'stonefish', 'crown of thorns starfish', some 'sea urchins' in warm seas	Learn to identify them. Keep away from them. Care when wading.
Poison injection	'Blue ringed octopus', in parts of the Pacific Ocean
'Shark' bites	Sharks, likelihood of risk is location dependent	Consult location-specific information to determine risk; never molest even seemingly-tame sharks underwater.
'Crocodile' attack	Crocodiles, in some tropical waters	Get proper information on them
Attack by an unusually large grouper.	''Epinephelus lanceolatus'' can grow very big in tropical waters, where protected from attack by sharks.	Get proper information on them. A throat inlet that can expand to 2 feet square can swallow a scuba diver.
'Electrocution'	'Electric eel', in some South American fresh water	Get proper information on them
	'Electric ray', in some warm seas
	It is said that some naval anti-frogman defences use electric shock	Keep out of armed forces areas
Powerful ultrasound	It is said that some naval anti-frogman defences use powerful ultrasound. Also used for long-range communication with submarines	Keep out of armed forces areas. Avoid large ships' ordinary sonar. See Underwater Port Security System.
Exposure to disease carried by in-water organisms	'Weil's disease' (in rat's urine) 'Bilharzia' (in some warm fresh water) Various bacteria found in sewage	In affected water, dive in watertight drysuit and full face diving mask
Exposure to harmful chemicals in the water	May be found in water polluted by industrial waste outfalls or by natural sources. For example hydrogen sulfide in some lakes and caves can be absorbed through the skin.
Broken bones, bleeding wounds and other trauma	Colliding with a boat or its propellor. Wave action on the shore.	Use Surface detection aids or a diving shot to mark surfacing position and aid searchers. Plan a safe exit point and check weather and tidal conditions.
Diver lost at sea after a boat dive	Separated from boat cover due to poor visibility at surface or strong underwater currents.
Diver lost at sea after a shore dive	Big waves made it unsafe to leave the water; currents moved the diver away from a safe exit; surface weather on the shore make the sea too rough to safely exit.

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See also

★ Alternobaric_vertigo

★ diver rescue

★ Diving equipment

★ Rubicon Foundation

External links

★ Diving Diseases Research Centre