title: Experienced scuba divers in Australia and the United States suffer considerable injury and morbidity.
abstract: OBJECTIVE
  Scuba diving-specific injuries have been well described. However, the injury experiences of individual divers over long diving careers have rarely been investigated. Our objective was to study the acute and chronic injuries of experienced, recreational scuba divers.
  
  
  METHODS
  This was an international, cross-sectional, descriptive postal survey of experienced, recreational scuba divers belonging to diving clubs in Australia and the United States.
  
  
  RESULTS
  Seven hundred nine divers were enrolled (346 Australian divers and 363 US divers). Most participants were experienced (mean number of dives, 262) male divers (488; 68.8%) aged 31 to 50 years (425; 59.9%). Mild barotrauma was common. Ear, sinus, and tooth "squeeze" had been experienced on > or = 1 occasion by 369 (52.1%), 245 (34.6%), and 66 (9.2%) divers, respectively. Tympanic membrane (TM) rupture, round/oval window rupture, and subcutaneous emphysema had been experienced by 38 (5.4%), 8 (1.1%), and 5 (0.7%) divers, respectively. No diver reported pneumothorax or arterial gas embolism (AGE); however, 31 divers (4.4%) had suffered decompression sickness (DCS). A wide range of other injuries were reported. Sixteen divers (2.3%) reported permanent disabilities, which largely consisted of hearing loss, tinnitus, and balance disorder.
  
  
  CONCLUSIONS
  The majority of experienced divers who responded to the survey had suffered diving-related injuries, mainly barotrauma. Further research and diver education are needed to better document injury rates and minimize serious diving-related injuries and permanent disabilities.
authors.affiliation: Emergency Department, Royal Melbourne Hospital, Parkville, Victoria, Australia. david.taylor@mh.org.au
authors.forename: David McD
authors.initials: DM
authors.lastname: Taylor
authors.forename: Kevin S
authors.initials: KS
authors.lastname: O'Toole
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Ryan
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000328:Adult; D017677:Age Distribution; D001265:Athletic Injuries / Q000453:epidemiology* / Q000209:etiology; D001315:Australia / Q000453:epidemiology; D001469:Barotrauma / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D003665:Decompression Sickness / Q000453:epidemiology / Q000209:etiology; D004242:Diving / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014432:Tympanic Membrane / Q000293:injuries; D014481:United States / Q000453:epidemiology