title: Scuba diving injuries among Divers Alert Network members 2010-2011.
abstract: BACKGROUND
  Scuba diving injuries vary greatly in severity and prognosis. While decompression sickness (DCS) and arterial gas embolism can be tracked easily, other forms of diving injury remain unaccounted for.
  
  
  OBJECTIVE
  The purpose of this paper is to assess rates of overall self-reported scuba-diving-related injuries, self-reported DCS-like symptoms, and treated DCS and their association with diver certification level, diving experience and demographic factors.
  
  
  METHODS
  We analyzed self-reported data from a Divers Alert Network membership health survey conducted during the summer of 2011. Poisson regression models with scaled deviance were used to model the relative rates of reported injuries. Models were adjusted for sex, age, body mass index (BMI) and average annual dives, based on the bias-variance tradeoff.
  
  
  RESULTS
  The overall rate of diving-related injury was 3.02 per 100 dives, self-reported DCS symptoms was 1.55 per 1,000 dives and treated DCS was 5.72 per 100,000 dives. Diving-related injury and self-reported DCS symptom rates decreased for higher diver certification levels, increasing age, increasing number of average annual dives and for men; they increased for increasing BMI.
  
  
  CONCLUSIONS
  Diving injury rates may be higher than previously thought, indicating a greater burden on the diving community. Self-reported DCS-like symptoms are a small fraction of all dive-related injuries and those receiving treatment for DCS are an even smaller fraction. The small number of divers seeking treatment may suggest the mild nature and a tendency towards natural resolution for most injuries.
authors.affiliation: Divers Alert Network, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA, Divers Alert Network, 6 West Colony Place, Durham, NC 27705, USA, E-mail: shabbarkaid@gmail.com.
authors.forename: Shabbar I
authors.initials: SI
authors.lastname: Ranapurwala
authors.affiliation: Duke Urgent Care, Duke University Health System, Durham, NC, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bird
authors.affiliation: Divers Alert Network, Durham, NC, USA.
authors.forename: Pachabi
authors.initials: P
authors.lastname: Vaithiyanathan
authors.affiliation: Divers Alert Network, Durham, NC, USA.
authors.forename: Petar J
authors.initials: PJ
authors.lastname: Denoble
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002568:Certification; D019058:Community Networks / Q000706:statistics & numerical data; D003665:Decompression Sickness / Q000453:epidemiology* / Q000628:therapy; D004242:Diving / Q000009:adverse effects / Q000293:injuries* / Q000592:standards / Q000706:statistics & numerical data; D004618:Embolism, Air / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D011998:Recreation; D012189:Retrospective Studies; D057566:Self Report; D012737:Sex Factors; D055815:Young Adult
keywords: DAN - Divers Alert Network; Injuries; decompression sickness; epidemiology; health survey; recreational diving