Fit as recreation Diver or FIT to work as Diver

Fit To DIVE or FIT to work as Diver

1. Fit to Dive Vs Fit for work as Diver dr.Eddy , MKK PERHIMPUNAN DOKTER KESEHATAN KERJA / IDKI

2. Data on fatalities Date drawn from the last 9 years Total UK fatalities in this time 147 Bodies still not recovered 25 Leaving 122 Medical cause 20 Nearly all of these are heart attacks

3. Current situation Self-declaration for medical fitness Referral to diving medical referees Movement away from tough fitness tests Diving a sport for all Simple swimming test to learn to dive Advanced Life saver required for First Class National exam - an exam of instructional technique

4. BSCA Fit to dive? Trends in recreational diving History of fitness tests in Incident report analysis BSAC role as educators on fitness to dive BSAC Diver Training Programme comprised a number of fitness tests Medical performed by local GP

5. BSCA Learning to dive- the A test Swim 200 metres freestyle (not backstroke) without a stop. Swim 100 metres backstroke without a stop. Swim 50 metres wearing a 5kg weight belt Float on back for 5 minutes (hand and leg movement permitted). Tread water with hands above head for one minute Recover 6 objects from the deep end of training pool (one object per dive).

6. BSAC perspective New trainee divers Seasonal peaks New trends in diving Fitness to dive on the day..

7. New trainee divers Additional stresses Normally shore diving Weight of equipment Buoyancy issues Lack of familiarity with equipment Anxiousness failure to ventilate properly Dive fitness muscles to do the work From 2007 - BSAC will be training these trainee divers to use Nitrox - option to minimise risk

8. Trends in Recreational Diving Deeper longer dives more frequent Cylinder numbers and equipment has developed Closed circuit rebreathers improving decompression 60 branches in BSAC have 2 or more rebreather divers New physiological problems Oxygen toxicity CO2 toxicity

9. What is Commercial Diving? Commercial diving is a broad term that describes a variety of occupations. Some commercial divers work offshore on oil rigs, while others dive in local lakes and rivers. Here are some of the most common commercial diving jobs: Drinking Water Assessment HAZMAT : Diving in polluted water Inspection : Checking underwater cables, pipelines or bridge pylons for signs of damage Public Safety Diving Salvage : Recovering items or entire vessels Underwater Construction and Maintenance : Including bridges, dams and other infrastructure Underwater Demolition

10. Commercial D ivers Wear specialized equipment Receive different training Dive places recreational divers should never go Is lack of medical fitness to dive a burning issue?

11. National Instructor Exam- historyPacked full of stamina tests The long swim.. Examiners pose rescue scenarios

12. Justification Needed to be fit to dive Required in rescue situations Poor performance of demand valves required a high level of fitness Diving often involved long snorkels to wreck sites Shore dives with demanding entries and exits Diving an extreme sport

13. Age factor Average age of 20 subjects 48 (29-67) Average age in incident database 38 Probably an age trend in medical fatalities Divers are currently an ageing population!

14. Fitness to dive on the day Previous dive history unreported or unrecognised decompression illness Recent dives missed stops fast ascents repetitive deep diving over several days Fatigue Infection ears, sinuses, chest. Body core temperature Dehydration Blood alcohol levels

15. Fitness to Dive Certificates – EDTC 2003 I. "Medical examiner of divers" − Competent to perform the periodic "Fitness to dive assessments" of working and recreational divers and compressed air workers, except the initial assessment of novice professional divers . IIa . "Diving medicine physician" − Competent to perform the initial and all other assessments of working and recreational divers or compressed air workers . − Can manage diving accidents and advise diving contractors and others on diving medicine and physiology* (with the back-up of a hyperbaric expert or consultant). − Should have knowledge in relevant aspects of occupational health. (He or she does not need to be certified specialist in occupational medicine to be in accordance with the standards). IIb. "Hyperbaric oxygen physician" − Responsible for HBO sessions at the treatment site (with backup of a hyperbaric expert or consultant) − Should have appropriate experience in anaesthesia and intensive care in order to manage the HBO patients (he or she does not need to be certified specialist in anaesthesia to be in accordance with the standards) − Competent to assess and manage clinical patients for HBO treatment III "Hyperbaric expert or consultant (hyperbaric and diving medicine)" − Competent as chief of a hyperbaric facility (HBO centre ) and/or to manage the medical and physiological aspects of complex diving activities* . − Competent to manage research programs. − Competent to supervise his team (HBO doctors and personnel, health professionals and others). − Competent to teach relevant aspects of hyperbaric medicine and physiology to all members of staff . IV. "Associated specialists" This title is not a job qualification , but rather a function. It covers experts, consultants and specialists of other clinical specialities who can be nominated as competent to advise within their own speciality upon specific problems in the diving and hyperbaric field.

16. EDTC 2003

17. HSE-UK

18. Fit to dive? Fit to dive on the day? Fit to dive in the conditions? BSAC role to educate divers to make informed decisions Medically fit to dive? In your capable hands.