Many people participate in recreational scuba diving and freediving, yet humans are not made to be underwater. Although the technical development of scuba diving equipment certainly made it easier and safer to explore the wonderful underwater environment, the medical factor needs special attention.
The effect of the pressure on the body as well, as many other related conditions that are present during diving, makes diving an activity that has an impact on the human body in ways that we might not expect. Certain physical conditions, and the relationship to diving could make a person temporary or permanently unfit to dive.
There therefore is a need to screen divers for the conditions that could impact their health and could potentially lead to an accident. To screen divers and declare them fit to dive physicians need to understand the effect of pressure on the body and consider other factors present during a dive, which can influence the physical condition of the person participating in underwater activities.
A diving physical examination should for example concentrate on identifying those medical conditions that could increase a diver’s risk of accidents such as decompression sickness, pulmonary overexpansion leading to arterial gas embolism, or problems that could result in loss of consciousness, which underwater can easily result in drowning. Also issues such as Divers must also thermal stress and the physiological effects of immersion should be fully understood and assessed by the physician.
These effects on the body and the relationship between certain medical conditions and underwater activities are, however, not part of normal medical education and a physician might find himself in a difficult position when he/she needs to establish if a person can safely participate in any kind of underwater activity.
Back in 1976, a group of Dutch physicians understood there was a need to increase the knowledge of underwater or diving medicine amongst other physicians and the Scott Haldane Foundation was established.
The need for further, specialized education was also recognized by the European Committee for Hyperbaric Medicine (ECHM) in the early ‘90s, who developed consensus statements, recommendations, and guidelines in hyperbaric and diving medicine.
Consequently, The European College of Baromedicine (ECB) “translated” these guidelines into training standards and became responsible for the accreditation, examinations, and certification of physicians in diving and hyperbaric medicine, ensuring harmonized recognition of qualifications across European countries.
