Daniel Popa1,2,3, Anthony Medak2, Walter Chin4, Oswaldo Huchim-Lara5, Evelyne Fliszar6, Tudor Hughes6, Ian Grover2. 1. Rush University Department of Emergency Medicine, Chicago IL, USA. 2. UCSD Department of Emergency Medicine, Division of Hyperbaric and Undersea Medicine, San Diego, USA. 3. Corresponding author: Dr Daniel Popa, Rush University Department of Emergency Medicine, 1750 W. Harrison St., Kellogg Suite 108, Chicago, IL 60612, USA, dan_popa@rush.edu. 4. Winship Cancer Institute of Emory University, Atlanta GA, USA. 5. La Universidad Marista de Mérida School of Medicine, Mérida, Yucátan, Mexico. 6. UCSD Department of Radiology, San Diego CA, USA.
Abstract
INTRODUCTION: Artisanal diving fishermen in Yucatán, Mexico have high rates of decompression sickness as a result of frequently unsafe diving practices with surface supplied compressed air. In this study, we investigated the prevalence of dysbaric osteonecrosis (DON), a type of avascular necrosis, in the most susceptible joints in a cohort of these fishermen. METHODS: We performed radiographs of bilateral shoulders, hips, and knees of 39 fishermen in Mexico and surveyed them about their medical and diving histories. We performed pairwise correlations to examine if the fishermen's diving behaviours affected the numbers of joints with DON. RESULTS: The radiographs revealed Grade II or higher DON in 30/39 (76.9%) of the fishermen. Twenty-two of 39 fishermen (56.4%) had at least two affected joints. The number of joints with DON positively correlates with the lifetime maximum diving depth and average bottom time. CONCLUSIONS: These findings represent among the highest prevalence rates of DON in divers and reflect the wide-spread scale of decompression sickness among these fishermen. Through this work, we hope to further educate the fishermen on the sequelae of their diving with the aim of improving their diving safety. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: Artisanal diving fishermen in Yucatán, Mexico have high rates of decompression sickness as a result of frequently unsafe diving practices with surface supplied compressed air. In this study, we investigated the prevalence of dysbaric osteonecrosis (DON), a type of avascular necrosis, in the most susceptible joints in a cohort of these fishermen. METHODS: We performed radiographs of bilateral shoulders, hips, and knees of 39 fishermen in Mexico and surveyed them about their medical and diving histories. We performed pairwise correlations to examine if the fishermen's diving behaviours affected the numbers of joints with DON. RESULTS: The radiographs revealed Grade II or higher DON in 30/39 (76.9%) of the fishermen. Twenty-two of 39 fishermen (56.4%) had at least two affected joints. The number of joints with DON positively correlates with the lifetime maximum diving depth and average bottom time. CONCLUSIONS: These findings represent among the highest prevalence rates of DON in divers and reflect the wide-spread scale of decompression sickness among these fishermen. Through this work, we hope to further educate the fishermen on the sequelae of their diving with the aim of improving their diving safety. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Entities:
Keywords:
Surface supplied diving; Bone necrosis; Decompression sickness; Diving at work; Indigenous divers
Authors: Walter Chin; Oswaldo Huchim; Grace H Wegrzyn; Susan E Sprau; Silvia Salas; Gerald H Markovitz Journal: Undersea Hyperb Med Date: 2015 Jul-Aug Impact factor: 0.698