Per-capita claims rates for decompression sickness among insured Divers Alert Network members

Decompression sickness (DCS) in recreational diving is a rare and usually self-limiting injury, but permanent disability can occur. Incidence rate estimates are difficult to establish because the number of divers at risk is usually unknown in population samples with well-documented DCS. We estimated the annual per-capita DCS incidence rates for 2000-2007 based on insurance claims submitted by members of the Divers Alert Network (DAN), Durham, N.C., with dive accident insurance. The overall per-capita DCS claims rate (DCR) was 20.5 per 10,000 member-years. Based on the age-adjusted DCR, males submitted 28% more claims than females. Male-to-female difference was greatest between 35 and 40 years of age and disappeared by the mid-50s. Highest rates were observed in the 30- to 39-year age category, after which DCR declined with increasing age. Highest yearly DCR was estimated in 2002. Insurance dropout rate was greater among those who had DCS in the first year of their insurance compared to those who did not have DCS in their first year.