By Steve Guglielmo and Dr. Brian Bourgeois
In an ideal world, all divers will come to the work site feeling completely healthy. However, just as with any other job, divers are human. They get sick. Unlike with a desk job, however, when a diver isn’t feeling their best, safety becomes an issue. Commonly, three different illnesses can affect divers and the general population. Those are the common cold, the flu and bronchitis.
The common cold is caused by a virus. It is not caused by bacteria and antibiotics will not cure the common cold. The symptoms associated with the illness; congestion of the nasal passages, sinus and ears, runny nose, non-productive cough and a feeling of tiredness are common and are best treated with over the counter remedies such as decongestants and non-sedating anti-histamines. For a diver, the normal function of the eustachian tubes and sinuses are very important. A diver who is congested may not be able to clear or respond to pressure changes. They may develop barotrauma of the ear or sinus structures, suffer vestibular symptoms and subsequently compromise their safety. The diver suffering from a cold or having these symptoms should be appropriately managed prior to diving. Furthermore, sharing helmets and personal equipment is a sure way to get others sick.
Bronchitis is an inflammatory condition of the airways of the lung. It directly affects the lungs ability to move air and may affect the normal gas exchange.
The flu is also a virus, influenza. It mutates and every year the strain is different. Hence, the success of the flu vaccine varies year over year. Despite this, vaccination is highly beneficial. Influenza causes high fever, lethargy, and body aches. This triad of symptoms is classic. The flu is a contraindication to diving. The illness is highly contagious and produces a severe, systemic inflammatory response in the affected individual. Complete rest and recovery is the only option. Any diver with the flu should be specifically kept from diving during that period of time and must be seen by a dive medical officer prior to returning to diving.
Bronchitis is often a result of a viral illness or a lingering symptom from a cold or the flu. Bronchitis is an inflammatory condition of the airways of the lung. It directly affects the lungs ability to move air and may affect the normal gas exchange. Furthermore, it can lead to a bacterial pneumonia. For a diver, the optimal function of the pulmonary system is of paramount importance to his or her safety and ability to dive. At no time should an individual with bronchitis dive without first being treated and cleared by an appropriate diving medical officer. Bronchitis is treatable but will often last several days and may last longer.
Other common illnesses such as gastroenteritis, upset stomach, or other illnesses of the intestinal system primarily produce problems with dehydration. Avoiding dehydration is very important to a diver. It is a definite risk to a diver to be diving or exposed to hyperbaric pressure when dehydrated. This can cause a much higher risk of decompression illness.
Divers that present for work with lingering symptoms from common illnesses should have specific evaluation and treatment from someone who is knowledgeable both about medicine and the diving implications of an illness. Specifically a dive medical officer or somebody who is equally familiar. Things like bronchitis or the flu affect the ability of the lung to transmit gas or air and exchange gas or air. This is very important to the safety of the diver, because the diver is incumbent on having a normal functioning pulmonary system while in the water. It is essentially his lifeline.
Diving can be affected by many common over the counter medications, many of which cause somnolence, lethargy, or just decreased general cognitive ability. When somebody is diving they need to have all of their mental faculties and they have to be on point. Medications, over the counter, despite not being a prescription have effects that can be compounded by other medications that you may be taking. It is my generally my recommendation that a diver be taking no medication when diving.