Diving medicine, also known as hyperbaric medicine or underwater medicine, is a specialised field that focuses on the medical aspects of diving and the effects of the underwater environment on the human body. It covers the prevention, diagnosis, and treatment of diving-related injuries, illnesses, and medical conditions.

Diving medicine deals with understanding the unique physiological changes and challenges that occur in the body when diving, particularly due to the increased pressure and changes in gas composition experienced underwater. It addresses the unique challenges and risks associated with diving. Diving medicine professionals play a significant role in educating divers, diagnosing and treating diving-related illnesses, and promoting safe practices to minimize the risk of these conditions.

Let’s look closer at some of the diving illnesses:

Diving illnesses, often referred to as "diving disorders," are health conditions that can affect individuals who participate in scuba diving, free diving, or other underwater activities. These conditions typically result from changes in pressure, exposure to specific gases, or other factors related to diving. There are two primary categories of diving illnesses: decompression sickness (DCS) and barotrauma.

Decompression Sickness (DCS): DCS, commonly known as "the bends", occurs when a diver ascends to the surface too quickly after spending time at significant depths. The condition is characterised by the formation of nitrogen gas bubbles in the body due to the rapid reduction in pressure. Symptoms of DCS can vary widely but may include joint pain, fatigue, dizziness, numbness, and even life-threatening complications affecting the central nervous system or lungs. Treatment involves hyperbaric oxygen therapy to help eliminate nitrogen bubbles and alleviate symptoms.

Barotrauma: Barotrauma includes various pressure-related injuries that can affect different parts of the body. One common form is ear barotrauma, which occurs when pressure imbalances between the inner and outer ear result in discomfort, pain, or even damage to the eardrum. Another type is sinus barotrauma, which affects the sinuses and can cause pain and sinus congestion. Lung barotrauma, often associated with breath-hold diving, can lead to lung over-expansion injuries. Proper techniques and equalisation can help prevent barotrauma.

In addition to decompression sickness (DCS) and barotrauma, there are several other diving-related illnesses and conditions that divers should be aware of:

Nitrogen Narcosis: also known as "rapture of the deep" or "nitrogen narcosis," this condition occurs when a diver descends to significant depths. It is characterised by symptoms similar to alcohol intoxication, including impaired judgment, confusion, and loss of coordination. Nitrogen narcosis is reversible upon ascending to shallower depths, and it typically does not leave any long-term effects.

Oxygen Toxicity: oxygen toxicity can result from breathing high partial pressures of oxygen at depth, particularly in technical diving or the use of mixed gases. It can lead to seizures and other neurological symptoms. Proper gas mixtures, exposure limits, and training are essential for preventing oxygen toxicity.

Carbon Monoxide Poisoning: divers using compressed air or scuba tanks must be vigilant about the quality of the air they breathe. Contaminants such as carbon monoxide can cause poisoning and impair cognitive and physical function underwater. Regular tank inspections and proper fill procedures help mitigate this risk.

Seafood Poisoning: consuming certain seafood within 24 hours before diving can lead to ciguatera poisoning, which can result in gastrointestinal and neurological symptoms. It's essential to avoid high-risk seafood before diving in regions where ciguatera is prevalent.

Jellyfish Stings and Marine Life Injuries: encounters with marine life can result in injuries or stings. For example, contact with venomous jellyfish or coral can lead to pain, swelling, and other symptoms. Proper first aid and knowledge of local hazards are critical for avoiding and managing such injuries.

Hypothermia: prolonged exposure to cold water can cause hypothermia, which may lead to confusion, shivering, and eventually loss of consciousness. Appropriate exposure protection, like wetsuits or drysuits, is essential to prevent hypothermia.

Infectious Diseases: in some regions, divers may be at risk of waterborne infectious diseases. Avoiding ingestion of contaminated water and practicing good hygiene can reduce the risk of these illnesses.

Professionals in diving medicine, such as diving medical officers or hyperbaric physicians, play a crucial key role in ensuring the safety and well-being of divers. Some key aspects of what they do are:

Pre-Dive Medical Assessments: diving medicine professionals evaluate divers' medical fitness to dive and screen for any pre-existing conditions that may pose risks. They review medical histories, perform physical examinations, and assess an individuals' ability to withstand the physiological stresses of diving

Diving Safety Guidelines: they provide guidance on safe diving practices, including proper ascent and descent rates, decompression procedures, use of diving equipment, and appropriate gas mixtures for different diving depths

Treatment of Diving Injuries: during diving accidents or injuries, diving medicine professionals are trained to provide immediate medical assistance; they manage conditions such as decompression sickness, arterial gas embolism, and other diving-related emergencies

Hyperbaric Oxygen Therapy: hyperbaric physicians administer hyperbaric oxygen therapy, a treatment technique that involves breathing pure oxygen in a pressurised chamber; it is used to treat decompression sickness, non-healing wounds, carbon monoxide poisoning, and other conditions

Research and Education: they contribute to research efforts aimed at improving understanding of diving physiology, developing safer diving practices, and advancing medical treatments; they also educate divers, dive instructors, and healthcare providers about diving-related medical issues and safety measures.

Fitness to Return to Diving Assessments: after a diving-related injury or illness, diving medicine professionals assess when individuals are fit to resume diving activities and provide recommendations for a safe return

Dive Accident Prevention: they play an important role in promoting dive safety through education, awareness campaigns, and advocacy for adherence to diving guidelines and regulations

Regulatory Compliance: diving doctors help establish and update diving safety protocols and guidelines, ensuring compliance with international diving standards and regulations

CONCLUDING REMARKS: The unique environmental conditions encountered during diving expeditions can pose significant health risks. Diving doctors combine their medical expertise with a deep understanding of the unique physiological challenges and risks associated with diving and provide guidance on preventing and managing these issues, ensuring the expedition's safety. The presence therefore of medical support in expeditions is not just a convenience; it's a lifeline that can mean the difference between a successful adventure and a life-threatening crisis. Finally, it is also crucial for divers to be knowledgeable about the potential diving-related illnesses, take preventive measures, and seek medical attention if symptoms develop. Regular training, safe diving practices, and diving within one's training and experience level are essential for minimising the risks associated with underwater activities.