Occupational and Environmental Aspects of Diving and Compressed-Air Work
Fitness to dive and occupational setting
Fitness-to-dive decisions ask whether a condition could cause sudden incapacitation underwater, impair gas exchange or bubble handling, or be worsened by pressure. Key systems are cardiovascular, respiratory, neurologic, ENT, endocrine, and musculoskeletal. Commercial diving and compressed-air work add regulatory duties: medical surveillance, dive planning, equipment inspection, accident reporting, and decompression procedures. Caisson and tunnel workers can develop decompression sickness from compressed-air exposure, so compression and decompression must be controlled occupationally.
Traps and special cases
Questions often present absolutes that are not absolute. Well-controlled asthma may allow diving after specialist assessment, but active asthma with air trapping is a concern; a history of spontaneous pneumothorax raises recurrence risk. Insulin-treated diabetes requires individualized assessment for hypoglycemia risk. Pregnancy is generally disqualifying because of fetal risk. Medications with sedating, arrhythmic, or hypoglycemic effects matter. A normal resting examination does not exclude patent foramen ovale, coronary disease, or seizure risk.
Worked example and rule of thumb
A young diver with a prior spontaneous pneumothorax should not dive without specialist clearance, because pneumothorax recurrence underwater can cause tension physiology and arterial gas embolism. Rule of thumb: evaluate functional risk and the consequence of failure in the water, not just the diagnostic label.