No abstract

We compared changes in spirometric parameters over long periods of occupational diving with normative data and found no clinically significant differences that could be attributed to diving. We found no justification for routine spirometry in asymptomatic divers.

A case of severe hasmoperitoneum following spontaneous rupture of a granulosa-cell tumour is reported, and the treatment discussed.

The utility of regular medical fitness-for-diving examinations of occupational divers is unknown. The aim of this audit was to investigate the impact on the employment of occupational divers of a 5-yearly medical examination and an annual health surveillance questionnaire administered in intervening years. The medical records of all New Zealand occupational divers registered with the Department of Labour for at least 5 years were audited (n= 336). Each record included at least two full medical examinations (mean spacing of 5.6 years). An impact on career was defined as the diver being issued with either a conditional certificate of fitness or being graded as temporarily or permanently unfit for diving. The means by which the relevant medical issue was identified was recorded. Ten (3%) of 336 divers had an assessment outcome, which had a career impact. One was considered permanently unfit, four were temporarily unfit, and five were issued with conditional certification. Two were identified by respiratory function testing and eight by way of their responses to the questionnaire; none was found by the medical interview and examination process. The questionnaire system did not 'miss' any divers who developed a critically important health problem, and detected most of those with less important problems. Five yearly medical examinations have a low detection rate for important health problems, but remain useful for discussion of risk understanding, acceptance and mitigation.

Surveillance of professional divers' hearing is routinely undertaken on an annual basis despite lack of evidence of benefit to the diver. The aim of this study was to determine the magnitude and significance of changes in auditory function over a 10−25 year period of occupational diving with the intention of informing future health surveillance policy for professional divers. Methods: All divers with adequate audiological records spanning at least 10 years were identified from the New Zealand occupational diver database. Changes in auditory function over time were compared with internationally accepted normative values. Any significant changes were tested for correlation with diving exposure, smoking history and body mass index. Results: The audiological records of 227 professional divers were analysed for periods ranging from 10 to 25 years. Initial hearing was poorer than population norms, and deterioration over the observation period was less than that predicted by normative data. Changes in hearing were not related to diving exposure, or smoking history. Conclusion: Audiological changes over 10 to 25 years of occupational diving were not found to be significantly different from age-related changes. Routine annual audiological testing of professional divers does not appear to be justifiable.