title: Scuba decompression illness and diving fatalities in an overseas military community.
abstract: A retrospective study of scuba decompression illness (DCI) and fatalities in the U.S. military community on Okinawa Island, Japan, was performed for 1989-95. Some 94 cases of diving DCI, including 10 cases of cerebral air-gas embolism (CAGE), and 9 diving fatalities were reported, for an annual incidence of 13.4 DCI events and 1.3 fatalities per 100,000 dives. The overall estimated incidence of scuba DCI was estimated to be 1/7400 dives, with an annual incidence of undeserved DCI of 1/37,300, and a fatality rate of 1/76,900. A review of treatment dives revealed a 10% overdiagnosis rate in cases treated for presumed DCI. A bimodal distribution of DCI accidents was observed for depths deeper or shallower than 24.6m/80FSW (feet of sea water). Increased risk of DCI in diving deeper than 24.6m/80FSW was associated with violations of no-decompression limits (NDL), while other risk factors were associated with diving to less than 24.6m/80FSW. NDL violations accounted for only 24/94 (26%) of all DCI accidents. Treatment of divers with hyperbaric oxygen (HBOT) led to complete recovery in 91% of cases, but of those divers requiring retreatment with HBOT, 67% had chronic residua of DCI. Selected illustrative and interesting cases are discussed.
authors.affiliation: Kadena Air Base, Okinawa Island, Japan.
authors.forename: M K
authors.initials: MK
authors.lastname: Arness
mesh_terms: D000328:Adult; D003665:Decompression Sickness / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D003951:Diagnostic Errors; D004242:Diving / Q000293:injuries*; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008889:Military Personnel; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000208:ethnology