Ranapurwala Shabbar I, Wing Steve, Poole Charles, Kucera Kristen L, Marshall Stephen W, Denoble Petar J
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
Divers Alert Network, Durham, NC, USA.
Inj Epidemiol. 2017 Dec;4(1):16. doi: 10.1186/s40621-017-0113-z. Epub 2017 Jun 5.
Recreational scuba diving involves the use of complex instruments and specialized skills in an unforgiving environment. Errors in dive preparation in such an environment may lead to unsafe conditions, mishaps, injuries and fatalities. Diving mishaps can be major and minor based on their potential to cause injury and the severity of the resulting injury. The objective of this study is to assess the incidence of diving mishaps and unsafe conditions, and their associations with the participants' routine use of their own checklists.
Between June and August 2012, 426 divers participated in the control group of a randomized trial to evaluate the effectiveness of an intervention pre-dive checklist. The current nested analysis prospectively follows the control participants, who did not receive the intervention checklist. Poisson regression models with generalized estimating equations were used to estimate rate ratios comparing written checklist use with memorized and no checklist use.
The overall incidence of major mishaps and minor mishaps was 11.2 and 18.2 per 100 dives, respectively. Only 8% participants reported written checklist use, 71% reported using memorized checklists, and 21% did not use any checklist. The rate ratio for written checklist use as compared to using a memorized or no checklist was 0.47 (95%CI: 0.27, 0.83) for all mishaps (major and minor combined), and 0.31 (95% CI: 0.10, 0.93) for major mishaps. The rate of mishaps among memorized checklist users was similar to no checklist users.
This study reinforces the utility of written checklists to prevent mishaps and, potentially, injuries and fatalities.
休闲水肺潜水需要在恶劣环境中使用复杂仪器和专业技能。在这种环境下，潜水准备过程中的失误可能导致不安全状况、事故、受伤甚至死亡。潜水事故根据其造成伤害的可能性和伤害的严重程度可分为重大事故和轻微事故。本研究的目的是评估潜水事故和不安全状况的发生率，以及它们与参与者日常使用自己的检查清单之间的关联。
2012年6月至8月期间，426名潜水员参与了一项随机试验的对照组，以评估潜水前干预检查清单的有效性。当前的嵌套分析对未接受干预检查清单的对照组参与者进行前瞻性跟踪。使用带有广义估计方程的泊松回归模型来估计比率比，比较使用书面检查清单与记忆检查清单及不使用检查清单的情况。
重大事故和轻微事故的总体发生率分别为每100次潜水11.2起和18.2起。只有8%的参与者报告使用书面检查清单，71%报告使用记忆检查清单，21%未使用任何检查清单。对于所有事故（重大和轻微事故合并），使用书面检查清单与使用记忆检查清单或不使用检查清单相比的比率比为0.47（95%置信区间：0.27，0.83），对于重大事故为0.31（95%置信区间：0.10，0.93）。使用记忆检查清单的参与者的事故发生率与不使用检查清单的参与者相似。
本研究强化了书面检查清单在预防事故以及潜在的伤害和死亡方面的作用。
