Fock Andrew W
Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Victoria, Australia.
Diving Hyperb Med. 2013 Jun;43(2):78-85.
Since the introduction of recreational closed-circuit rebreathers (CCRs) in 1998, there have been many recorded deaths. Rebreather deaths have been quoted to be as high as 1 in 100 users.
Rebreather fatalities between 1998 and 2010 were extracted from the Deeplife rebreather mortality database, and inaccuracies were corrected where known. Rebreather absolute numbers were derived from industry discussions and training agency statistics. Relative numbers and brands were extracted from the Rebreather World website database and a Dutch rebreather survey. Mortality was compared with data from other databases. A fault-tree analysis of rebreathers was compared to that of open-circuit scuba of various configurations. Finally, a risk analysis was applied to the mortality database.
The 181 recorded recreational rebreather deaths occurred at about 10 times the rate of deaths amongst open-circuit recreational scuba divers. No particular brand or type of rebreather was over-represented. Closed-circuit rebreathers have a 25-fold increased risk of component failure compared to a manifolded twin-cylinder open-circuit system. This risk can be offset by carrying a redundant 'bailout' system. Two-thirds of fatal dives were associated with a high-risk dive or high-risk behaviour. There are multiple points in the human-machine interface (HMI) during the use of rebreathers that can result in errors that may lead to a fatality.
While rebreathers have an intrinsically higher risk of mechanical failure as a result of their complexity, this can be offset by good design incorporating redundancy and by carrying adequate 'bailout' or alternative gas sources for decompression in the event of a failure. Designs that minimize the chances of HMI errors and training that highlights this area may help to minimize fatalities.
自1998年引入休闲用封闭式循环呼吸器（CCR）以来，已有多起死亡记录。据报道，呼吸器死亡人数高达每100名使用者中有1人死亡。
从Deeplife呼吸器死亡率数据库中提取1998年至2010年期间的呼吸器死亡案例，并在已知的情况下纠正不准确之处。呼吸器的绝对数量来自行业讨论和培训机构的统计数据。相对数量和品牌则从呼吸器世界网站数据库和一项荷兰呼吸器调查中提取。将死亡率与其他数据库的数据进行比较。对呼吸器进行故障树分析，并与各种配置的开路式水肺进行比较。最后，对死亡率数据库进行风险分析。
记录在案的181起休闲用呼吸器死亡案例的发生率约为开路式休闲水肺潜水员死亡发生率的10倍。没有哪种特定品牌或类型的呼吸器的死亡率过高。与歧管式双气瓶开路系统相比，封闭式循环呼吸器组件故障的风险增加了25倍。携带冗余的“备用”系统可以抵消这种风险。三分之二的致命潜水与高风险潜水或高风险行为有关。在使用呼吸器的过程中，人机界面（HMI）存在多个可能导致错误并进而导致死亡的点。
虽然由于其复杂性，呼吸器本质上具有更高的机械故障风险，但通过采用包含冗余设计的良好设计以及携带足够的“备用”或替代气源以在发生故障时进行减压，可以抵消这种风险。将人机界面错误的可能性降至最低的设计以及突出这一领域的培训可能有助于将死亡人数降至最低。
