Pougnet Richard, Pougnet Laurence, Dewitte Jean-Dominique, Loddé Brice, Lucas David
Centre for Professional and Environmental Pathologies (Centre de Ressource en Pathologie Professionnelle et Environnementale CRPPE), Brest University Hospital (CHRU), Brest, France.
French Society for Maritime Medicine, France.
Int Marit Health. 2020;71(1):71-77. doi: 10.5603/IMH.2020.0014.
In France, the monitoring of professional divers is regulated. Several learned societies (French Occupational Medicine Society, French Hyperbaric Medicine Society and French Maritime Medicine Society) have issued follow-up recommendations for professional divers, including medical follow-up. Medical decisions could be temporary unfitness for diving, temporary fitness with monitoring, a restriction of fitness, or permanent unfitness. The aim of study was to point out the causes of unfitness in our centre.
The divers' files were selected from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P). Only files with a special medical decision were selected, between 2002 and 2019.
Three hundred and ninety-six professional divers are followed-up in our centre and 1371 medical decisions were delivered. There were 29 (7.3%) divers with a special medical decision, during 42 (3.1%) medical visit. Twelve (3.0%) had a permanent unfitness. The leading cause of unfitness was pulmonary diseases: emphysema (3), chronic obstructive pulmonary disorder (2), asthma (2). Sixteen (4.0%) divers had temporary unfitness. The leading causes were cardiovascular (4 times) and neurological (6 times). Twelve (3.0%) divers had had at least one decompression sickness.
Judgments of permanent unfitness for diving were rare (3.0% of divers), but were because of life-threatening disease. Medical follow-up of occupational divers was justified to decrease the risk of fatal event during occupational dives.
在法国,专业潜水员的监测受到规范。几个学术团体(法国职业医学学会、法国高压氧医学学会和法国航海医学学会)已发布针对专业潜水员的随访建议,包括医学随访。医学决定可能是暂时不适宜潜水、在监测下暂时适宜、适宜受限或永久不适宜。本研究的目的是指出我们中心不适宜潜水的原因。
潜水员档案选自法国国家职业病监测与预防网络(RNV3P)。仅选取2002年至2019年间有特殊医学决定的档案。
我们中心对396名专业潜水员进行了随访,并做出了1371项医学决定。在42次(3.1%)就诊期间,有29名(7.3%)潜水员有特殊医学决定。12名(3.0%)潜水员永久不适宜潜水。不适宜潜水的主要原因是肺部疾病:肺气肿(3例)、慢性阻塞性肺疾病(2例)、哮喘(2例)。16名(4.0%)潜水员暂时不适宜潜水。主要原因是心血管疾病(4次)和神经系统疾病(6次)。12名(3.0%)潜水员至少发生过一次减压病。
潜水永久不适宜的判定很少见(占潜水员的3.0%),但都是由于危及生命的疾病。对职业潜水员进行医学随访对于降低职业潜水期间致命事件的风险是合理的。