Skogstad M, Thorsen E, Haldorsen T
National Institute of Occupational Health, PO Box 8149, N-0033 Oslo, Norway.
Occup Environ Med. 2000 Jun;57(6):390-5. doi: 10.1136/oem.57.6.390.
To characterise diving exposure and pulmonary function in professional divers at the start of their formal education and during the first 3 years of their professional career.
The study included 87 men at the start of their education as professional divers. At follow up 1 and 3 years after the school 83 and 81 divers respectively were re-examined. Assessment of lung function included dynamic lung volumes and flows and transfer factor for carbon monoxide (Tl(CO)).
69 Divers had preschool SCUBA diving experience and had a median number of 70 dives (range 2-3000) to a median maximal depth of 40 (range 10-73) metres. During the 15 week introductory diving course, they had 44 dives (range 38-50) in the depth range 10-50 metres. The median number of dives over the follow up period was 95 (range 0-722) to a maximal median depth of 38 (range 0-98) metres. At the start of the diving course there were no differences in forced vital capacity (FVC), forced expired volume in 1 second (FEV(1)), and in Tl(CO) between the 69 pre-exposed divers and the 18 never exposed divers. The FVC was significantly larger than predicted in both groups. At follow up at 3 years there was a significant reduction in mean (SD) FEV(1) of 1.8% (6.5), in forced mid-expiratory flow rate (FEF(25-75%)) of 6.5% (11.7) and in forced expiratory flow at 75% of FVC expired (FEF(75%)) of 10.4% (16. 8). There was no change in FVC. The Tl(CO) was significantly decreased by 4.6% (8.8). No significant effects were found of cumulative diving exposure, including the number of dives, on the relative changes of any of the lung function variables.
The results indicate that divers initially belong to a selected group with large FVC. Exposure to diving may contribute to changes in pulmonary function, mostly affecting small airways conductance.
描述职业潜水员在正规教育开始时及其职业生涯的前3年中的潜水暴露情况和肺功能。
该研究纳入了87名刚开始接受职业潜水员教育的男性。在毕业后1年和3年进行随访时，分别对83名和81名潜水员进行了重新检查。肺功能评估包括动态肺容量和流速以及一氧化碳转运因子（Tl(CO)）。
69名潜水员有学前水肺潜水经验，潜水次数中位数为70次（范围2 - 3000次），最大深度中位数为40米（范围10 - 73米）。在为期15周的入门潜水课程中，他们在10 - 50米深度范围内潜水44次（范围38 - 50次）。随访期间潜水次数中位数为95次（范围0 - 722次），最大深度中位数为38米（范围0 - 98米）。在潜水课程开始时，69名有潜水经验的潜水员和18名无潜水经验的潜水员在用力肺活量（FVC）、第1秒用力呼气量（FEV(1)）和Tl(CO)方面没有差异。两组的FVC均显著大于预测值。在3年随访时，平均（标准差）FEV(1)显著降低了1.8%（6.5），用力呼气中期流速（FEF(25 - 75%)）降低了6.5%（11.7），FVC呼出75%时的用力呼气流量（FEF(75%)）降低了10.4%（16.8）。FVC没有变化。Tl(CO)显著降低了4.6%（8.8）。未发现累积潜水暴露（包括潜水次数）对任何肺功能变量的相对变化有显著影响。
结果表明，潜水员最初属于FVC较大的特定群体。潜水暴露可能导致肺功能变化，主要影响小气道传导。
