John Lippmann1,2,3,4, Christopher Lawrence5,6, Michael Davis7. 1. Department of Public Health and Preventive Medicine, Monash University, Victoria, Australia. 2. Australasian Diving Safety Foundation, Canterbury, Victoria, Australia. 3. Royal Life Saving Society Australia, Sydney, Australia. 4. Corresponding author: Dr John Lippmann, Australasian Diving Safety Foundation, PO Box 478, Canterbury, VIC 3126, Australia, johnl@adsf.org.au. 5. Department of Pathology, Christchurch Hospital, Christchurch, New Zealand. 6. Statewide Forensic Medical Services, Royal Hobart Hospital, Tasmania, Australia. 7. Department of Anaesthesiology, School of Medicine, The University of Auckland, Auckland, New Zealand.
Abstract
INTRODUCTION: New Zealand (NZ) diving-related fatalities have been reported since the 1960s. The aim is to identify contributing risk factors, including medical, and to inform appropriate preventative strategies. METHODS: NZ scuba diving fatalities from 2007 to 2016 were searched from multiple sources - the National Coronial Information System (NCIS); the NZ Chief Coroner's office; Water Safety NZ Drownbase™ and the NZ Police National Dive Squad records. For inclusion, a victim must have been wearing a scuba set (which may include a rebreather). A key word search of the NCIS was made and the results matched to the other databases. An Excel® database was created and a chain of events analysis (CEA) conducted. RESULTS: Forty-eight scuba diving fatalities were identified, 40 men and eight women, average age 47 years (range 17-68), 20 of Māori ethnicity. Thirty-five were classified as overweight (14) or obese (21). Pre-existing medical risk factors were identified, either pre dive or at autopsy, in 37 divers, the commonest being ischaemic heart disease (IHD, 20), left ventricular hypertrophy (LVH, 18) and hypertension (seven). IHD, LVH and obesity were variously associated with each other. The likely commonest disabling conditions, identified in 32 cases, were asphyxia (15), cardiac (nine) and pulmonary barotrauma/cerebral arterial gas embolism (five). Multiple environmental and diving practice breaches and poor planning were identified in the CEA, similar to those seen in other studies. Thirty-eight divers had not released their weight belt. Information on resuscitation was limited. CONCLUSIONS: Obesity and cardiovascular disease were common and Māori appear to be over-represented, both as previously reported. 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: New Zealand (NZ) diving-related fatalities have been reported since the 1960s. The aim is to identify contributing risk factors, including medical, and to inform appropriate preventative strategies. METHODS: NZ scuba diving fatalities from 2007 to 2016 were searched from multiple sources - the National Coronial Information System (NCIS); the NZ Chief Coroner's office; Water Safety NZ Drownbase™ and the NZ Police National Dive Squad records. For inclusion, a victim must have been wearing a scuba set (which may include a rebreather). A key word search of the NCIS was made and the results matched to the other databases. An Excel® database was created and a chain of events analysis (CEA) conducted. RESULTS: Forty-eight scuba diving fatalities were identified, 40 men and eight women, average age 47 years (range 17-68), 20 of Māori ethnicity. Thirty-five were classified as overweight (14) or obese (21). Pre-existing medical risk factors were identified, either pre dive or at autopsy, in 37 divers, the commonest being ischaemic heart disease (IHD, 20), left ventricular hypertrophy (LVH, 18) and hypertension (seven). IHD, LVH and obesity were variously associated with each other. The likely commonest disabling conditions, identified in 32 cases, were asphyxia (15), cardiac (nine) and pulmonary barotrauma/cerebral arterial gas embolism (five). Multiple environmental and diving practice breaches and poor planning were identified in the CEA, similar to those seen in other studies. Thirty-eight divers had not released their weight belt. Information on resuscitation was limited. CONCLUSIONS: Obesity and cardiovascular disease were common and Māori appear to be over-represented, both as previously reported. 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.
Authors: John Lippmann; Christopher Stevenson; David McD Taylor; Jo Williams; Mohammadreza Mohebbi Journal: Diving Hyperb Med Date: 2017-09 Impact factor: 0.887