Cialoni Danilo, Pieri Massimo, Balestra Costantino, Marroni Alessandro
DAN Europe Research Division, DAN Europe FoundationRoseto degli Abruzzi, Italy.
Environmental, Occupational and Ageing (Integrative) Physiology Lab, Haute Ecole Bruxelles-BrabantBrussels, Belgium.
Front Psychol. 2017 Sep 19;8:1587. doi: 10.3389/fpsyg.2017.01587. eCollection 2017.
The popularity of SCUBA diving is steadily increasing together with the number of dives and correlated diseases per year. The rules that govern correct decompression procedures are considered well known even if the majority of Decompression Sickness (DCS) cases are considered unexpected confirming a bias in the "mathematical ability" to predict DCS by the current algorithms. Furthermore, little is still known about diving risk factors and any individual predisposition to DCS. This study provides an in-depth epidemiological analysis of the diving community, to include additional risk factors correlated with the development of circulating bubbles and DCS. An originally developed database (DAN DB) including specific questionnaires for data collection allowed the statistical analysis of 39,099 electronically recorded open circuit dives made by 2,629 European divers (2,189 males 83.3%, 440 females 16.7%) over 5 years. The same dive parameters and risk factors were investigated also in 970 out of the 39,099 collected dives investigated for bubble formation, by 1-min precordial Doppler, and in 320 sea-level dives followed by DCS symptoms. Mean depth and GF high of all the recorded dives were 27.1 m, and 0.66, respectively; the average ascent speed was lower than the currently recommended "safe" one (9-10 m/min). We found statistically significant relationships between higher bubble grades and BMI, fat mass, age, and diving exposure. Regarding incidence of DCS, we identified additional non-bubble related risk factors, which appear significantly related to a higher DCS incidence, namely: gender, strong current, heavy exercise, and workload during diving. We found that the majority of the recorded DCS cases were not predicted by the adopted decompression algorithm and would have therefore been defined as "undeserved." The DAN DB analysis shows that most dives were made in a "safe zone," even if data show an evident "gray area" in the "mathematical" ability to predict DCS by the current algorithms. Some other risk factors seem to influence the possibility to develop DCS, irrespective of their effect on bubble formation, thus suggesting the existence of some factors influencing or enhancing the effects of bubbles.
随着潜水次数以及每年与潜水相关疾病数量的增加，水肺潜水的受欢迎程度正在稳步上升。尽管大多数减压病（DCS）病例被认为是意外发生的，这证实了当前算法在预测DCS的“数学能力”方面存在偏差，但人们认为正确的减压程序规则是广为人知的。此外，关于潜水风险因素以及任何个体对DCS的易感性，我们仍然知之甚少。本研究对潜水群体进行了深入的流行病学分析，以纳入与循环气泡和DCS发生相关的其他风险因素。一个最初开发的数据库（DAN数据库），包括用于数据收集的特定问卷，使得对2629名欧洲潜水员（2189名男性，占83.3%；440名女性，占16.7%）在5年期间进行的39099次电子记录的开路潜水进行统计分析成为可能。在39099次收集的潜水中，有970次通过1分钟的心前区多普勒检查研究了气泡形成情况，还有320次海平面潜水随后出现了DCS症状，对这些潜水的相同潜水参数和风险因素也进行了调查。所有记录潜水的平均深度和梯度因子（GF）高分别为27.1米和0.66；平均上升速度低于目前推荐的“安全”速度（9 - 10米/分钟）。我们发现较高的气泡等级与体重指数（BMI）、脂肪量、年龄和潜水暴露之间存在统计学上的显著关系。关于DCS的发病率，我们确定了其他与气泡无关的风险因素，这些因素似乎与较高的DCS发病率显著相关，即：性别、强水流、剧烈运动和潜水期间的工作量。我们发现，大多数记录的DCS病例未被采用的减压算法预测到，因此本可被定义为“不应发生的”。DAN数据库分析表明，即使数据显示当前算法在预测DCS的“数学”能力方面存在明显的“灰色区域”，大多数潜水仍处于“安全区”。其他一些风险因素似乎会影响发生DCS的可能性，而不论其对气泡形成的影响如何，这表明存在一些影响或增强气泡作用的因素。
