Cardiovascular risk assessment in divers: Toward safer diving.

Autor:	Rienks R; University Medical Center Utrecht, The Netherlands.; CardioExpert Clinic for Sports and Occupational Cardiology, Amsterdam, The Netherlands., Buwalda M; Medical and Educational Services, Odijk, The Netherlands., Bucx J; CardioExpert Clinic for Sports and Occupational Cardiology, Amsterdam, The Netherlands., Dubois E; Hyperbaric Medical Center, Rijswijk, The Netherlands., Wingelaar T; Royal Netherlands Navy Diving and Submarine Medical Center, Den Helder, The Netherlands.; Amsterdam University Medical Center, Academic Medical Center, Department of Hyperbaric Medicine and Experimental Anaesthesiology, Amsterdam, the Netherlands., van Hulst R; Amsterdam University Medical Center, Academic Medical Center, Department of Hyperbaric Medicine and Experimental Anaesthesiology, Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc [Undersea Hyperb Med] 2022 Third Quarter; Vol. 49 (3), pp. 355-365.
Abstrakt:	Similar to aviation, diving is performed in an environment in which acute incapacitation may lead to a fatal outcome. In aeromedicine, a pilot is considered "unfit to fly" when the cardiovascular event risk exceeds one percent per annum, the so-called 1% rule. In diving no formal limits to cardiovascular risk have been established. Cardiovascular risk of divers can be calculated using the modified Canadian Cardiovascular Society (CCS) Risk of Harm formula: risk of harm (RH: cardiovascular fatality rate per year during diving: number × 10-⁵/divers/year) = time diving (TD: number of dives × 10-⁴) × sudden cardiac incapacitation (SCI: cardiovascular diver event rate per year (number × 10-⁵/year). The SCI and thus the RH are strongly dependent on age. Using the CCS criterion for RH, 5 × 10-⁵ divers/year, and considering an average of 25 dives per year per diver, the calculated maximum acceptable SCI is 2%/year, consistent with current practice for dive medical examinations. If the SCI were to exceed 2%/year, a diver could be considered "unfit to dive," which could particularly benefit older (≥ 50 years) divers, in whom cardiovascular risk factors are often not properly treated. For the prevention of fatal diving accidents due to atherosclerotic cardiovascular disease, a dive medical examination is of limited value for young (≺ 50 years) divers who have no cardiovascular risk factors. Introducing a cardiovascular risk management system for divers may achieve a reduction in fatal diving accidents that result from cardiovascular disease in older divers engaged in both recreational and professional diving. Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission. (Copyright© Undersea and Hyperbaric Medical Society.)
Databáze:	MEDLINE
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