Diving with Asthma by Sheldon Hey

Many asthmatics want to dive, but unfortunately, there are a number of concerns about the effect of asthma on dive safety. Dive physicians have traditionally taken a very conservative approach to asthma in dive fitness assessments. Mention of the word "Asthma" and potential divers were ejected from the surgery faster than you could say, "but it wasn't serious and it's gone away now"

More recently, some dive physicians have begun to take a more liberal, informed consent approach in assessing previous or mild asthmatics for diving. Some ex-sufferers previously prevented from diving can now dive, after making an informed choice about the possible risks. To understand this, it is first necessary to understand what asthma actually is. Asthma is a condition affecting medium to small airways in the lungs. In asthmatics, these airways are prone to narrowing, which impedes the flow of air into and, in particular, out of the small air sacs (alveoli) where gas exchange occurs. The trigger for these events is often an allergic response to a specific stimulus.

Some asthmatics also respond to physical stimuli such as exercise or a change from breathing warm air to cold air. The result is that the patient feels short of breath and there may be an audible wheeze due to airway narrowing which can cause severe breathing difficulty, which in severe cases, can certainly be fatal. One of the biggest problems in discussing asthma, and this is particularly true when discussing asthma in the context of diving, is that the spectrum of severity is extraordinarily wide.

There are three main concerns about asthma and diving. First, asthma may make divers more likely to suffer a dive-related illness. We are all taught that the most important rule in diving is to breathe normally and to never hold your breath. If a diver ascends while holding his breath, the expanding air can damage delicate lung tissue, and air may be introduced directly into the blood, travel to the brain and cause an arterial gas embolism (AGE).

There is concern that an asthmatic may suffer narrowing or blocking of small airways during a dive, and that expansion of any trapped air during ascent may lead to the same problem. There is also concern that use of reliever medication, such as Ventolin, prior to diving may cause the lungs to be less efficient at filtering out the venous nitrogen bubbles we all have after dives. These bubbles may then circulate through the lungs and reach arteries where they might, in theory, be more likely to contribute to the development of decompression illness.

Second, it is recognised that an asthma attack in the water may severely compromise the diver's safety by incapacitating him and causing an inability to function effectively. Indeed, it is hard to argue that difficulty breathing would not be a decided disadvantage if you were caught in a current that was sweeping you away from your boat.

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BIO:

Sheldon Hey is the founder of Dive The World (http://www.DiveTheWorldThailand.com)and has been an passionate scuba diving professional for many years. Sheldon and the Dive The World Team would love to share their experience with you to ensure your next diving trip meets all your expectations. Follow this link if you would like to read more about Sheldon’s scuba diving experiences.

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