I am traveling to the Caribbean on vacation and plan to go scuba diving, but my husband says it’s not safe since I have asthma. What guidance can you give us?
In the past, asthma of any type and of any severity was viewed as an absolute contraindication to scuba diving.
Scuba diving requires inhalation of dry, compressed air through a mouthpiece, which many people find uncom-fortable. The biggest concern for a diver with asthma is of course, having an exacerbation under water. Studies suggest that asthma increases a diver’s risk of developing complications, such as arterial gas embolism, barotrauma, and decompression sickness.
Asthma places an individual at increased risk of diving complications because of the potential for air trapping, bronchospasm, and mucous plugging in asthmatic airways. Persons with asthma were thus issued a total prohibition and always advised that scuba diving was off limits, although snorkeling on the surface was acceptable.
Today, with careful medical screening and medical preparation, some individuals with well-controlled, stable asthma who have normal spirometry and who understand the increased risks can go scuba diving, after a detailed medical evaluation and clearance by a physician familiar with diving and asthma. Studies per-formed by physicians with a specialty in diving medicine in the United States and abroad have yielded specific recommendations and guidelines. For example, people with exercise-induced bronchospasm (EIB) or cold-induced bronchospasm should not dive.
Similarly, any person with asthma who requires inhalation of an inhaled β2 agonist, quick-relief inhaler should be prohibited from diving until at least 48 hours have elapsed without a need for a dose of the bronchodilator medication.
I would need to know more about your asthma, your overall level of health and fitness, as well as your swimming and diving skills. Common sense suggests that if you have never had scuba diving instruction, vacation is not a good time to start diving with asthma. Similarly, if your asthma is not controlled on vacation, you should not dive. An alternative approach would be to first consult with your physician and undergo any appropriate testing and evaluation.
Then, with your physician’s approval, you could enroll in scuba classes taught by certified professionals.
The Professional Association of Diving Instructors (PADI) maintains a Web site, http:// www.padi.com/scuba/, where you can locate classes in your hometown. You can also learn more about diving with asthma and its risks at DAN, the Divers Alert Net-work, at http://www.diversalertnetwork.org. Physicians (myself included!) take the approach that safety always comes first. At the risk of appearing to side with your spouse, if pressed for an answer, I would advise you not to scuba dive on your Caribbean trip and enjoy another sport instead.