Screening for oxygen intolerance in U.S. Navy divers.

All U.S. Navy diving candidates are screened for their tolerance to hyperbaric oxygen by taking an oxygen tolerance test (OTT). During a recent experimental oxygen dive series at the U.S. Navy Experimental Diving Unit, three divers were noted to be reproducibly oxygen sensitive. These three divers were then given additional OTTs to see if any evidence of central nervous system oxygen toxicity would be detected by these multiple tests. The additional OTTs did not produce any signs or symptoms of oxygen toxicity in these already proven susceptible divers. A subsequent review of the records of the Naval Safety Center yielded a total of 1347 OTTs from 1 January 1972 to 31 December 1981. A review of diving accidents reported during this period revealed that 26 episodes of oxygen toxicity were noted during OTTs for a derived failure rate of 1.9%. Analysis of oxygen toxicity episodes encountered during operational Navy diving for this period found that 9 episodes of nonconvulsive oxygen toxicity were seen in mixed gas diving and 3 episodes of nonconvulsive oxygen toxicity were noted in closed circuit oxygen diving. Conclusions from this paper are: Screening for oxygen intolerance is complicated by intraindividual variation in oxygen tolerance; U.S. Navy diving using 100% oxygen during the period studied has had an acceptable safety record according to the data on record at the Naval Safety Center; the OTT as currently administered by the U.S. Navy does not identify all individuals who are relatively susceptible to oxygen toxicity; those individuals who do fail the OTT are unusually susceptible to oxygen toxicity; and because of the need to continue to identify these unusually susceptible individuals, the OTT should continue to be administered to U.S. Navy diver candidates.