title: Does self-certification reflect the cardiac health of UK sport divers?
abstract: BACKGROUND
  Since 2009, the United Kingdom diving incident data show an increasing number of fatalities in the over-50s age group. Previous studies also suggest some divers take cardiac medications. Since 2001, diving medicals have not been mandatory for UK sport divers. Instead, an annual medical self-certification form, submitted to their club/school or training establishment, is required. We documented in a survey of UK sport divers the prevalence of cardiac events and medications and the frequency of medical certifications.
  
  
  METHODS
  An anonymous on-line questionnaire was publicised. Measures included diver and diving demographics, prescribed medications, diagnosed hypertension, cardiac issues, events and procedures, other health issues, year of last diving medical, diagnosed persistent foramen ovale (PFO), smoking and alcohol habits, exercise and body mass index.
  
  
  RESULTS
  Of 672 completed surveys, hypertension was reported by 119 (18%) with 25 of these (21%) having not had a diving medical. Myocardial infarction 6 (1%), coronary artery bypass grafting 3 (< 1%), atrial fibrillation 19 (3%) and angina 12 (2%) were also reported. PFOs were reported by 28 (4%), with 20 of these opting for a closure procedure. From 83 treated incidences of decompression illness (DCI), 19 divers reported that a PFO was diagnosed.
  
  
  CONCLUSIONS
  Divers inevitably develop health problems. Some continue to dive with cardiac issues, failing to seek specialised diving advice or fully understand the role of the diving medical. Physicians without appropriate training in diving medicine may inform a diver they are safe to continue diving with their condition without appreciating the potential risks. The current procedure for medical screening for fitness to dive may not be adequate for all divers.
authors.affiliation: DDRC Healthcare, Hyperbaric Medical Centre, Plymouth Science Park, Research Way, Plymouth PL6 8BU, Devon, United Kingdom Phone: +44 (0) 1752 209999, E-mail: mstld@btinternet.com.
authors.forename: Marguerite
authors.initials: M
authors.lastname: St Leger Dowse
authors.affiliation: Diving Diseases Reasearch Centre Healthcare, Plymouth, United Kingdom.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Waterman
authors.affiliation: Diving Diseases Reasearch Centre Healthcare, Plymouth, United Kingdom.
authors.forename: Christine El
authors.initials: CE
authors.lastname: Penny
authors.affiliation: Diving Diseases Reasearch Centre Healthcare, Plymouth, United Kingdom.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Smerdon
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000787:Angina Pectoris / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000453:epidemiology; D015992:Body Mass Index; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000628:therapy; D002568:Certification / Q000379:methods*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003665:Decompression Sickness / Q000453:epidemiology; D004242:Diving / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D054092:Foramen Ovale, Patent / Q000453:epidemiology / Q000601:surgery; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000601:surgery; D011998:Recreation; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D002317:Cardiovascular Agents
keywords: Health surveys; cardiovascular; fitness to dive; medicals − diving; recreational divers