Pulmonary Considerations in Diving
Posted By Divers Alert Network on 12 July 2002
By Dr. Richard Moon, DAN Vice President & Medical Director
(First appeared January 2000 - DAN Divers Alert Journal)
The human body consists of several different body systems, and each serves a specific purpose. For example, the central nervous system carries all our neural messages, from balance to sight and hearing, touch, smell and taste. We could not navigate our environment without our nervous system.Thousands of diseases can affect the systems in our bodies, but remarkably, enough reserve seems to be built into our systems that we can easily survive many traumas. Even with the removal of part of a body system, like part of the intestines, a kidney or even a lung, we can live on.
Today, with modern medicine and science on our side, we change our participation in very few activities to accommodate disease. After disease, people can maintain active lifestyles.
With specific diseases, however, we need to be aware of the systems they affect. If we're involved with scuba diving, for example, we should pay special attention to diseases of the lungs. Although some divers may continue diving actively with little or no limitations after disease or other trauma, scuba diving carries a special risk for those who have suffered some types of lung disorders.
When they're engaged in diving, scuba divers can usually tolerate the small changes that occur in the lung air spaces. In certain lung diseases such as sarcoidosis*, however, lung tissue can stiffen, causing potential problems for scuba divers. For anyone who wants to take up diving or continue diving after illness, any condition that restricts or impedes the flow of air into and out of the lung can be problematic.
"Dr. Richard Moon, DAN's Medical Director and Professor of Anesthesiology at Duke University Medical Center, has explained the basic physiology of the lung and associated diseases we must consider when we choose scuba diving as a recreational activity. Although incomplete, the list of lung diseases does refer to the most commonly asked questions that DAN receives about lung disease. Healthy lungs are essential for safe diving."
— Joel Dovenbarger, Vice President, DAN Medical Services
The human body consumes oxygen to generate energy from foods such as glucose; it also produces carbon dioxide as a byproduct of this activity. The lungs, vital to this process, add oxygen to the blood and remove carbon dioxide.
To accomplish this, gas must move into and out of the lungs (i.e., breathing, or ventilation) at a rate governed by the level of exertion. At rest, in normal breathing, gas moves at a rate of around 5 liters per minute, but during heavy exercise, the body accommodates an increased requirement for oxygen and greater production of carbon dioxide. This may increase the ventilation rate to about 100 liters per minute. Since the muscles of respiration, such as the diaphragm, can move as much as 150 liters of gas into and out of the lungs per minute, a reserve usually exists.
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