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Acclimatization to diving: a systematic review.

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Summary
This summary is machine-generated.

Multiday hyperbaric exposure likely acclimatizes workers, reducing decompression sickness (DCS). Further research is needed to understand the mechanisms, extent of protection, and optimal procedures for this beneficial effect.

Keywords:
acclimatizationdecompression sicknessdivinghealthreview articlesystematic reviewvenous gas embolism

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Area of Science:

  • Hyperbaric Medicine
  • Occupational Health
  • Physiology

Background:

  • Multiday hyperbaric exposure is known to reduce decompression sickness (DCS) incidence in compressed-air workers.
  • This phenomenon, termed acclimatization, lacks a comprehensive systematic review.
  • Existing studies suggest a protective effect but require synthesis.

Purpose of the Study:

  • To systematically review and synthesize findings on acclimatization to multiday hyperbaric exposure.
  • To assess the impact of multiday diving on decompression sickness (DCS) and venous gas embolism (VGE).
  • To identify gaps in knowledge regarding the mechanisms and optimal procedures for hyperbaric acclimatization.

Main Methods:

  • Systematic literature search of PubMed, Ovid Embase, The Cochrane Library, and Rubicon Research Repository.
  • Inclusion of studies reporting DCS incidence, VGE, or subjective health in humans and animals after multiday hyperbaric exposure.
  • Analysis of 29 studies meeting the inclusion criteria.

Main Results:

  • Three epidemiological studies showed significant acclimatization to DCS in compressed-air workers.
  • Experimental studies reported reduced DCS incidence and itching after multiday diving.
  • Acclimatization to DCS was observed in six animal species; effects on VGE were inconsistent in humans.

Conclusions:

  • Multiday hyperbaric exposure likely provides acclimatization and protection against DCS.
  • No evidence suggests a sensitizing effect or benefit from mandatory days off after consecutive diving days.
  • Mechanisms, extent of protection, and optimal acclimatization procedures require further investigation.