Neuman T S, Bove A A, O'Connor R D, Kelsen S G
University of California, San Diego School of Medicine.
Ann Allergy. 1994 Oct;73(4):344-50.
Approximately 10 to 15 million Americans are scuba divers. The prevalence of scuba diving and asthma makes it likely some asthmatics will be interested in scuba diving and some scuba divers will have asthma. Conditions present during scuba diving may provoke airway obstruction in asthmatic patients. Further, asthmatic patients may, in theory, face a greater than normal risk of pulmonary barotrauma from lung overdistension on ascent through the water column.
The purpose of this paper is to review the theoretical issues underlying the prohibition against scuba diving for asthmatic patients as advanced by most major diving organizations in the United States and critically examine the relevant accident data.
All reports that dealt with asthma and diving, and all available American accident data including both fatal and nonfatal accidents were reviewed.
Actuarial data on the risk of scuba accidents attributable to asthma do not define several important variables likely to affect accident risk during scuba diving. Despite these limitations, careful review indicates the risks of serious morbidity or mortality during scuba diving appears to be inconsequentially elevated in subjects whose asthma was not characterized.
Additional data are needed to define accurately risks of diving in subjects with different forms of asthma, however, the available data suggest asthmatic patients with normal airway function at rest, and with little airway reactivity in response to exercise or cold air inhalation, have a risk of pulmonary barotrauma similar to that of normal subjects.
约1000万至1500万美国人是水肺潜水员。水肺潜水的流行程度以及哮喘的存在使得一些哮喘患者可能对水肺潜水感兴趣，而一些水肺潜水员可能患有哮喘。水肺潜水期间出现的情况可能会引发哮喘患者的气道阻塞。此外，理论上哮喘患者在通过水柱上升过程中因肺部过度扩张而面临肺气压伤的风险可能高于正常水平。
本文旨在回顾美国大多数主要潜水组织提出的禁止哮喘患者进行水肺潜水的潜在理论问题，并严格审查相关事故数据。
查阅了所有涉及哮喘与潜水的报告，以及所有可用的美国事故数据，包括致命和非致命事故。
关于哮喘导致水肺事故风险的精算数据并未明确几个可能影响水肺潜水事故风险的重要变量。尽管存在这些局限性，但仔细审查表明，在未对哮喘进行特征描述的受试者中，水肺潜水期间严重发病或死亡的风险似乎仅略有升高。
需要更多数据来准确界定不同类型哮喘患者的潜水风险，然而，现有数据表明，静息时气道功能正常、对运动或吸入冷空气反应时气道反应性较小的哮喘患者，其肺气压伤风险与正常受试者相似。
