Can You Still Have Asthma And Dive?
Can you still have asthma and dive? The answer is potentially yes, but it requires careful medical assessment and management to minimize risks associated with asthma and the underwater environment, making it safe to dive.
Understanding Asthma and Its Impact
Asthma is a chronic respiratory disease characterized by inflammation and narrowing of the airways, leading to symptoms like wheezing, coughing, shortness of breath, and chest tightness. These symptoms can be triggered by various factors, including allergens, exercise, cold air, and irritants. When considering scuba diving, the potential for bronchospasm (sudden airway constriction) becomes a significant concern.
The Risks of Diving with Asthma
Diving inherently presents unique physiological challenges, and combining these with asthma poses additional risks. The primary concern is the increased risk of lung barotrauma, particularly during ascent. This occurs when trapped air in the lungs expands as pressure decreases, potentially causing lung rupture. In asthmatics, pre-existing airway narrowing increases the likelihood of air trapping.
Here’s a summary of the key risks:
- Lung Barotrauma: Air trapping due to airway narrowing increases the risk of lung over-expansion and rupture during ascent.
- Bronchospasm Underwater: An asthma attack underwater can lead to panic, rapid ascent, and increased risk of barotrauma and drowning.
- Reduced Exercise Tolerance: Asthma can limit exercise capacity, potentially making it difficult to cope with currents, long swims, or emergency situations underwater.
- Unpredictable Symptoms: Asthma symptoms can be unpredictable and difficult to manage underwater.
Medical Evaluation and Clearance
The cornerstone of safe diving with asthma is a thorough medical evaluation by a physician knowledgeable about both asthma and diving medicine. This evaluation typically includes:
- Detailed Medical History: Focusing on asthma severity, frequency of attacks, triggers, and medication use.
- Pulmonary Function Testing (PFTs): Measuring lung volumes, airflow rates, and responsiveness to bronchodilators.
- Exercise Challenge Test: Evaluating asthma control during and after exercise, often simulating diving conditions.
- Consideration of Co-morbidities: Assessing for other medical conditions that may affect diving safety.
Guidelines for Safe Diving with Asthma
If cleared to dive, asthmatics must adhere to strict guidelines to minimize risks:
- Excellent Asthma Control: Asthma must be well-controlled with minimal symptoms and normal or near-normal pulmonary function.
- Stable Medication Regimen: Medication use should be stable, with no recent changes.
- Avoidance of Triggers: Identify and avoid known asthma triggers.
- Dive Within Limits: Dive in calm conditions, shallow depths, and within established buddy system protocols.
- Emergency Plan: Have a clear plan for managing asthma symptoms underwater, including communication signals and ascent procedures.
- Regular Medical Review: Periodic medical evaluations are essential to reassess diving suitability.
Common Mistakes and Misconceptions
One of the biggest mistakes is self-assessment and diving without proper medical clearance. Another common error is neglecting preventative medication or not adhering to prescribed treatment plans. Believing that mild asthma poses no risk is also a dangerous misconception.
Medications and Diving
The use of asthma medications, particularly inhaled bronchodilators, is generally permitted while diving, provided they are used as prescribed and do not cause significant side effects that could impair diving safety. Inhaled corticosteroids are also typically acceptable. However, oral steroids may raise concerns and require careful evaluation. It’s essential to discuss all medications with a diving medical professional.
Frequently Asked Questions (FAQs)
Can I dive if I only have exercise-induced asthma?
While exercise-induced asthma might seem less severe, it still presents risks when diving. A thorough evaluation, including an exercise challenge test, is crucial to determine if you can safely manage your asthma while underwater. The ability to consistently achieve peak flow rates during and after exercise is critical.
What if I haven’t had an asthma attack in years?
Even if your asthma is well-controlled and you haven’t had an attack in years, you still need medical clearance before diving. Pulmonary function can change over time, and a recent assessment is essential to ensure your lungs are healthy enough for the stresses of diving.
Are there specific types of diving that are safer for asthmatics?
Generally, shallow, calm-water diving is considered safer than deep or strenuous diving. Avoid diving in cold water or areas with strong currents, as these can trigger asthma symptoms. Maintaining excellent buoyancy control also helps reduce exertion.
Can I use my inhaler underwater?
While there are specialized underwater inhaler delivery systems available, they are not commonly used and require specialized training. The primary goal is prevention and management before the dive. If you experience asthma symptoms underwater, signaling your buddy and initiating a controlled ascent is the priority.
What pulmonary function test values are considered safe for diving with asthma?
There is no single universally accepted PFT value, but generally, an FEV1 (forced expiratory volume in one second) of at least 80% of predicted and a normal or near-normal FEF25-75% (forced expiratory flow between 25% and 75% of vital capacity) are desirable. Your physician will assess your results in the context of your overall medical history.
Is it okay to dive if I only use a rescue inhaler occasionally?
Occasional use of a rescue inhaler still warrants a full medical evaluation. It indicates that your asthma is not perfectly controlled, and the underlying causes need to be investigated. Diving with uncontrolled asthma significantly increases the risk of complications.
What happens if I have an asthma attack underwater?
If you experience asthma symptoms underwater, immediately signal your buddy, initiate a controlled ascent, and terminate the dive. Do not panic or attempt to continue the dive. Once on the surface, use your rescue inhaler and seek medical attention if necessary.
Does the depth of the dive matter in relation to asthma?
Yes, depth matters. Deeper dives involve higher partial pressures of nitrogen, which can potentially exacerbate airway hyperreactivity in some individuals. Shallower dives minimize this risk.
Are there any medications that are absolutely prohibited for divers with asthma?
While most asthma medications are considered safe, oral steroids, particularly long-term use, raise concerns due to potential side effects like bone density loss and increased risk of infection. These must be carefully evaluated by a diving medical professional.
How often should I get re-evaluated by a doctor after being cleared to dive with asthma?
Annual medical evaluations are generally recommended, or more frequently if your asthma control changes or you experience any new symptoms. Regular check-ups ensure that your diving suitability is reassessed as your condition evolves.
What if my doctor isn’t familiar with diving medicine?
It’s crucial to see a physician who has specific training or experience in diving medicine. Organizations like the Divers Alert Network (DAN) can help you find qualified medical professionals in your area.
If my child has asthma, can they start scuba diving?
The risks associated with asthma and diving are generally considered too high for children with asthma. Most diving medical professionals would advise against it, particularly due to the potential for lung barotrauma and the child’s developing respiratory system. Alternative water sports with lower risks are recommended.