Expiratory flow limitation in compressed air divers and oxygen divers

Divers are exposed to dense gases under hyperbaric and hyperoxic conditions and, therefore, may be at risk of developing respiratory disease. Long-term effects on respiratory function have been found in commercial divers who perform deep dives. This study was conducted to detect possible lung function changes in scuba divers who dive in shallow water using compressed air or oxygen as a breathing gas. A cross-sectional sample of 180 healthy male divers (152 air divers and 28 oxygen divers) and 34 healthy male controls underwent a diving medical examination including body plethysmography, diffusion capacity measurement and a cold-air isocapnic hyperventilation test (CAIH). Air divers and oxygen divers had a lower mid-expiratory flow at 25% of vital capacity (MEF25) than controls (p<0.01 and p<0.05, respectively). Oxygen divers also had a decreased mid-expiratory flow at 50% of vital capacity (MEF50) (p<0.05). Divers' groups and controls did not differ with respect to age, smoking or medical history. The prevalence of airway hyperresponsiveness to CAIH was 1.4% (n=3 divers). MEF25 and MEF50 were inversely related to years of diving (p<0.01 and p<0.001, respectively). The pattern of lung function changes obtained in scuba divers is consistent with small airways dysfunction and the association between diving exposure and lung function changes may indicate long-term effects on respiratory function.