Is it safe to SCUBA dive with asthma?

ABSTRACT

Introduction: Internationally it is estimated that six million people participate in self-contained underwater breathing apparatus (SCUBA) diving each year. Registries suggest a significant proportion of divers have a current or historical diagnosis of asthma. Previously individuals with asthma were prohibited from diving, however, several contemporary guidelines suggest a select population of patients with asthma may be able to dive with an acceptable degree of risk.

Areas covered: Divers with asthma may be at an increased risk of a variety of diving-related medical injuries including; pulmonary barotrauma (PBT), pneumothorax, pneumomediastinum, arterial gas embolism (AGE), reduction in pulmonary function, bronchospasm and decompression sickness (DCS). This article will discuss the latest evidence on the incidence of adverse events in diving with a focus on those caused by asthma.

Expert opinion: Physicians can be faced with the difficult task of counseling patients with asthma who wish to dive. This review article will aim to explore the current guidelines which can assist a physician in providing a comprehensive dive safety assessment.

KEYWORDS:

• Asthma
• diving
• dive assessment

Article highlights

• Historically patients with asthma were advised against participating in self-contained underwater breathing apparatus (SCUBA) diving

• Current clinical practice guidelines suggest a select proportion of patients with asthma may be safe to dive

• The risk of diving with asthma is not clearly defined

• Individuals with cold-, emotion-, or exercise induced bronchoconstriction should be advised against diving

• Physicians should follow a guideline based approach when assessing a patient with asthma who intends to dive

Acknowledgments

The authors would like to thank the Faraway Medicine team for their guidance and teaching during The University of Bristol external student selected component on the Island of Gozo, Malta, 2017.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.