title: Dysbaric osteonecrosis among professional divers: a literature review.
abstract: OBJECTIVE
  Dysbaric osteonecrosis (DON) continues to be a significant occupational hazard that has significant medical and social consequences for professional divers. This review aims to evaluate the prevalence and risk factors of DON among professional divers and to summarize the scientific knowledge regarding distribution of the lesions as well as disease prognosis and treatment.
  
  
  METHODS
  A literature review using the Medline database.
  
  
  RESULTS
  The prevalence of DON varies between 0 and 70.6% in professional divers, and its prevalence is highest in Turkey, Hawaii, Korea and Japan but is dependent on activity and medical monitoring. The risk of DON is very low for military divers who strictly obey the decompression rules and who undergo periodic medical examination. DON pre- dominately occurs in the proximal part of the femur and humerus. In a majority of cases, DON will progress despite the absence of further dysbaric exposure.
  
  
  CONCLUSIONS
  The pathophysiology of the disease is incompletely understood and other etiological factors are perhaps being overlooked.
authors.affiliation: Occupational and Environmental Diseases Center CHRU Morvan, Brest, France. marie.guillou-uguen@chu-brest.fr
authors.forename: M
authors.initials: M
authors.lastname: Uguen
authors.forename: R
authors.initials: R
authors.lastname: Pougnet
authors.forename: A
authors.initials: A
authors.lastname: Uguen
authors.forename: B
authors.initials: B
authors.lastname: Loddé
authors.forename: J D
authors.initials: JD
authors.lastname: Dewitte
mesh_terms: D003430:Cross-Sectional Studies; D004242:Diving / Q000009:adverse effects*; D005269:Femur; D006801:Humans; D006811:Humerus; D064887:Observational Studies as Topic; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D010020:Osteonecrosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors