Acute otitis externa in divers working in the North Sea: a microbiological survey of seven saturation dives

Abstract

SUJMMARYSaturation diving is an important and widely used technique in the Offshore Oil Industry. During 1974-5 two saturation dives in the North Sea were terminated because of outbreaks of incapacitating otitis externa, and others were disrupted. P8eudomona8 aeruginosa was consistently isolated from the ears of affected divers.Because complex work schedules were threatened seven subsequent dives were subjected to microbiological monitoring and control. Colonization of the ear canal with P. aeruginosa or with other gram-negative bacilli occurred in 39 (67 %) of the 58 divers studied, usually within 7 days of starting the dive. Data obtained by serotyping the isolations ofP. aeruginosa suggested that a single infected diver may be the source of organisms which rapidly spread to his colleagues and throughout the living chambers, that the living chambers may constitute a reservoir of infection during and between dives, and that certain serotypes of P. aeruginosa are more likely than others to colonize the ear canal in the conditions of a saturation dive. The control measures used during the dives were only partially effective, but none of the divers suffered severe pain and all the dives were an operational success.

Upper respiratory tract and aural flora of saturation divers.

“…Although the same changes have been observed when contact with water was also involved (Wright and Alexander, 1974;Alcock, 1977), our findings, in the absence of any operational diving, confirm that such changes in the aural flora are unavoidably associated with the saturation technique itself. It is this change to a Gram-negative flora in the external auditory meatus that would predispose to the development of otitis externa.…”

Coincidental Radiographic Findings in Severe External Otitis in Nonimmunocompromised Patients

“…In 30% of patients suffering from external otitis, P. aeruginosa can be isolated from the external auditory canal [6], Epidemiological studies have shown that P. aeruginosa is highly infectious under favorable circum stances, and its virulence accumulates, with serious epidemics as a result [11]. This may explain the fulminant infections in our otherwise healthy, young patients.…”

Auditory Complaints in Scuba Divers: an Overview

“…Muth et al [12] in their study observed that SCUBA divers are the most commonly affected by this condition especially in warmer climates. Specifically, saturation divers are a commonly affected category of working divers because they maintain little cerumen due to the constant flushing of the EAC, [10,13,14]. These divers spend days, sometimes weeks, underwater at a great depth, living within a helium-filled confined space to carry out study on a commercial or industrial basis.…”