title: Airway reactivity and diving in healthy and atopic subjects.
abstract: BACKGROUND
  The short- and long-term effects of self-contained underwater breathing apparatus (SCUBA) dives on airway responsiveness in nonasthmatic atopic subjects have not been systematically investigated.
  
  
  OBJECTIVE
  To compare the effect of SCUBA diving at 50-m depth on lung function and airway responsiveness to methacholine (MCh) in atopic nonasthmatics and healthy subjects.
  
  
  METHODS
  We studied 15 atopic nonasthmatic subjects and 15 controls who underwent the visit for the professional SCUBA-diving license at the Navy Medical Center, La Spezia, Italy. All subjects underwent spirometry and skin-prick test for common environmental allergens. MCh challenge was performed 24 h before, and 20 min and 24 h after a standardized SCUBA-dive test and after hyperbaric-chamber test.
  
  
  RESULTS
  At 20 min, the provocative dose of MCh causing 20% fall of the forced expiratory volume at the first second (MCh PD20 - FEV1) was significantly reduced in atopic, asymptomatic subjects from 1712 x 2.6 microg (mean x geometric standard deviation) to 1202 x 2.2 microg (P < 0.0005) after the hyperbaric-chamber test and to 1204 x 2.3 microg (P < 0.005) after SCUBA diving. In healthy subjects, the baseline value of MCh PD20 was 2977 x 1.1 microg, and this value did not change significantly after the hyperbaric-chamber test (2575 x 1.4 microg) and after SCUBA dives (2553 x 1.4 microg, P > 0.1 for both comparisons). In atopic subjects, the MCh PD20 returned near to the baseline value 24 h after the hyperbaric-chamber test (1776 x 2.4 microg) and after the SCUBA test (1500 x 2.67 microg). No significant change in FEV1 was observed after the tests in both groups.
  
  
  CONCLUSIONS
  SCUBA diving is associated with development of early airway hyperresponsiveness to MCh in atopic subjects.
authors.affiliation: Respiratory Physiopathology, Bronchology, Allergy and Immunology Clinic, Italian Navy Hospital Bruno Falcomatà, La Spezia, Italy.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Cirillo
authors.forename: Andrea
authors.initials: A
authors.lastname: Vizzaccaro
authors.forename: Emanuele
authors.initials: E
authors.lastname: Crimi
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications* / Q000209:etiology; D016535:Bronchial Hyperreactivity / Q000209:etiology* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D016022:Case-Control Studies; D004242:Diving / Q000502:physiology*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications*; D008297:Male; D016210:Methacholine Chloride
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride