Shreeves Karl, Buzzacott Peter, Hornsby Al, Caney Mark
Professional Association of Diving Instructors.
Int Marit Health. 2018;69(2):94-98. doi: 10.5603/IMH.2018.0014.
Diving is a popular recreation with an excellent safety record, with an estimated 1.8 deaths per 1 million dives. This study investigated the relationship between intentional deviation from accepted diving practices (violations) and diver fatalities.
The authors examined 119 incidents/122 diver fatalities that did not involve diver training in North America and the Caribbean, and identified the presence of violations of accepted diving safety practices, as well as if the death was associated with an acute medical event such as heart attack.
Of the 122 fatalities, 57% (n = 70) were associated with a medical event and 43% (n = 52) were non-medical. Violations were found in 45% of fatalities (n = 55) overall. Violations were recorded for 23% of the 70 medical and 75% of the 52 non-medical fatalities. Divers who died from something other than a medical cause were 7 times as likely to have one or more violations associated with the fatality (OR 7.3, 95% CI 2.3-23.2). The odds of dying from something other than a medical condition increased approximately 60% for each additional 10 metres of depth. The odds of a death being associated with a medical condition increased approximately 9% per year of age, or 2.4 times for every 10 years older a diver was.
Medical events are associated with over half of the non-training related diver fatalities in North America and the Caribbean, with the odds of death being associated with a medical condition doubling each decade of additional age. These data support recommendations that divers stay physically fit and have regular medical checkups, particularly as they get older. They also strongly support the safety benefit of adhering to established safe diving practices.
潜水是一项广受欢迎的娱乐活动，有着出色的安全记录，估计每100万次潜水中有1.8人死亡。本研究调查了故意偏离公认潜水规范（违规行为）与潜水者死亡之间的关系。
作者检查了北美和加勒比地区119起不涉及潜水者培训的事件/122例潜水者死亡案例，确定是否存在违反公认潜水安全规范的情况，以及死亡是否与心脏病发作等急性医疗事件有关。
在122例死亡案例中，57%（n = 70）与医疗事件有关，43%（n = 52）与非医疗事件有关。总体而言，45%（n = 55）的死亡案例存在违规行为。在70例与医疗事件相关的死亡案例中有23%记录到违规行为，在52例非医疗死亡案例中有75%记录到违规行为。非因医疗原因死亡的潜水者与死亡相关的违规行为有一项或多项的可能性是其他潜水者的7倍（比值比7.3，95%置信区间2.3 - 23.2）。深度每增加10米，非因医疗状况死亡的几率大约增加60%。与医疗状况相关的死亡几率随年龄每增加一岁大约增加9%，即潜水者每年长10岁，死亡几率增加2.4倍。
在北美和加勒比地区，超过一半的与非培训相关的潜水者死亡与医疗事件有关，与医疗状况相关的死亡几率每增加一个十年就会翻倍。这些数据支持了潜水者应保持身体健康并定期进行体检的建议，尤其是随着年龄增长。它们还有力地支持了遵守既定安全潜水规范的安全益处。
