ORPHY Laboratory, EA 4324, Western Brittany University (UBO), 29238 Brest, France.
Occupational Diseases Center, Brest University Hospital, 29609 Brest, France.
Int J Environ Res Public Health. 2023 Aug 3;20(15):6516. doi: 10.3390/ijerph20156516.
Long-term alterations of pulmonary function (mainly decreased airway conductance and capacity of the lungs to diffuse carbon monoxide (DLCO)) have been described after hyperbaric exposures. However, whether these alterations convey a higher risk for divers' safety has never been investigated before. The purpose of the present pilot study was to assess whether decreased DLCO is associated with modifications of the physiological response to diving. In this case-control observational study, 15 "fit-to-dive" occupational divers were split into two groups according to their DLCO measurements compared to references values, either normal (control) or reduced (DLCO group). After a standardized 20 m/40 min dive in a sea water pool, the peak-flow, vascular gas emboli (VGE) grade, micro-circulatory reactivity, inflammatory biomarkers, thrombotic factors, and plasmatic aldosterone concentration were assessed at different times post-dive. Although VGE were recorded in all divers, no cases of decompression sickness (DCS) occurred. Compared to the control, the latency to VGE peak was increased in the DLCO group (60 vs. 30 min) along with a higher maximal VGE grade ( < 0.0001). P-selectin was higher in the DLCO group, both pre- and post-dive. The plasmatic aldosterone concentration was significantly decreased in the control group (-30.4 ± 24.6%) but not in the DLCO group. Apart from a state of hypocoagulability in all divers, other measured parameters remained unchanged. Our results suggest that divers with decreased DLCO might have a higher risk of DCS. Further studies are required to confirm these preliminary results.
长期以来，高压暴露后肺部功能（主要是气道传导率和一氧化碳弥散能力（DLCO）下降）发生了改变。然而，这些改变是否会给潜水员的安全带来更高的风险，以前从未被研究过。本研究的目的是评估 DLCO 下降是否与潜水生理反应的改变有关。在这项病例对照观察性研究中，根据他们的 DLCO 测量值与参考值的比较，将 15 名“适合潜水”的职业潜水员分为两组，即正常（对照组）或降低（DLCO 组）。在海水池内进行 20 米/40 分钟的标准潜水后，在潜水后不同时间点评估最大峰流速、血管气体栓塞（VGE）分级、微血管反应性、炎症生物标志物、血栓形成因子和血浆醛固酮浓度。尽管所有潜水员都记录了 VGE，但没有发生减压病（DCS）病例。与对照组相比，DLCO 组的 VGE 峰值潜伏期延长（60 分钟比 30 分钟），最大 VGE 分级也更高（<0.0001）。DLCO 组在潜水前和潜水后 P-选择素均升高。对照组的血浆醛固酮浓度显著下降（-30.4±24.6%），但 DLCO 组没有。除了所有潜水员处于低凝状态外，其他测量参数均无变化。我们的结果表明，DLCO 降低的潜水员可能有更高的 DCS 风险。需要进一步的研究来证实这些初步结果。
