Diving risk
The risk of dying during recreational, scientific or commercial diving is small, and on scuba, deaths are usually associated with poor gas management, poor buoyancy control, equipment misuse, entrapment, rough water conditions and pre-existing health problems. Some fatalities are inevitable and caused by unforeseeable situations escalating out of control, but the majority of diving fatalities can be attributed to human error on the part of the victim. Equipment failure is rare in open circuit scuba.
According to death certificates, over 80% of the deaths were ultimately attributed to drowning, but other factors usually combined to incapacitate the diver in a sequence of events culminating in drowning, which is more a consequence of the medium in which the accidents occurred than the actual accident. Scuba divers should not drown unless there are other contributory factors as they carry a supply of breathing gas and equipment designed to provide the gas on demand. Drowning occurs as a consequence of preceding problems such as unmanageable stress, cardiac disease, pulmonary barotrauma, unconsciousness from any cause, water aspiration, trauma, environmental hazards, equipment difficulties, inappropriate response to an emergency or failure to manage the gas supply. and often obscures the real cause of death. Air embolism is also frequently cited as a cause of death, and it, too is the consequence of other factors leading to an uncontrolled and badly managed ascent, possibly aggravated by medical conditions. About a quarter of diving fatalities are associated with cardiac events, mostly in older divers. There is a fairly large body of data on diving fatalities, but in many cases the data is poor due to the standard of investigation and reporting. This hinders research which could improve diver safety.
Fatality rates are comparable with jogging (13 deaths per 100,000 persons per year) and are within the range where reduction is desirable by Health and Safety Executive (HSE) criteria, The most frequent root cause for diving fatalities is running out of or low on gas. Other factors cited include buoyancy control, entanglement or entrapment, rough water, equipment misuse or problems and emergency ascent. The most common injuries and causes of death were drowning or asphyxia due to inhalation of water, air embolism and cardiac events. Risk of cardiac arrest is greater for older divers, and greater for men than women, although the risks are equal by age 65.
Several plausible opinions have been put forward but have not yet been empirically validated. Suggested contributing factors included inexperience, infrequent diving, inadequate supervision, insufficient predive briefings, buddy separation and dive conditions beyond the diver’s training, experience or physical capacity.
Decompression sickness and arterial gas embolism in recreational diving have been associated with specific demographic, environmental, and diving behavioural factors. A statistical study published in 2005 tested potential risk factors: age, asthma, body mass index, gender, smoking, cardiovascular disease, diabetes, previous decompression illness, years since certification, number of dives in the previous year, number of consecutive diving days, number of dives in a repetitive series, depth of the previous dive, use of nitrox as breathing gas, and use of a dry suit. No significant associations with risk of decompression sickness or arterial gas embolism were found for asthma, body mass index, cardiovascular disease, diabetes or smoking. Greater dive depth, previous decompression illness, number of consecutive days diving, and male biological gender were associated with higher risk for decompression sickness and arterial gas embolism. The use of dry suits and nitrox breathing gas, greater frequency of diving in the previous year, greater age, and more years since certification were associated with lower risk, possibly as indicators of more extensive training and experience.
Risk management has three major aspects besides equipment and training: Risk assessment, emergency planning and insurance cover. The risk assessment for a dive is primarily a planning activity, and may range in formality from a part of the pre-dive buddy check for recreational divers, to a safety file with professional risk assessment and detailed emergency plans for professional diving projects. Some form of pre-dive briefing is customary with organised recreational dives, and this generally includes a recitation by the divemaster of the known and predicted hazards, the risk associated with the significant ones, and the procedures to be followed in case of the reasonably foreseeable emergencies associated with them. Insurance cover for diving accidents may not be included in standard policies. There are a few organisations which focus specifically on diver safety and insurance cover, such as the international Divers Alert Network
Environmental factors
The underwater environment is alien to humans. When not actively hostile, it is unforgiving of errors, and some errors can escalate rapidly to a fatal conclusion. Many aspects of the underwater environment are static or predictable, others vary and may not be easily or reliably predictable, and must be managed as found. The reasonably predictable factors can be allowed for in the dive planning. Suitable equipment can be selected, personnel can be trained in its use and support provided to manage the foreseeable contingencies. When conditions are found to be other than predicted, plans may have to be changed. Sometimes conditions are better than expected, but other times they may be worse, and may deteriorate during the course of a dive to the extent that recovery becomes an emergency.
Predictable/static environmental factors – conditions which should be considered in the dive plan
Variable environmental factors – conditions can change during a dive – dive contingency plans should take into account the reasonably foreseeable variations based on forecasts and local knowledge. When there is no reliable local knowledge, a wider range of contingencies should be considered.
Equipment safety
Two basic classes of equipment are used by divers: Equipment necessary to do the planned dive, and equipment required to do the task for which the dive is necessary. Recreational divers may not require equipment for a task, but it is quite common for them to use a camera, and some will survey a dive site, or use a small lift bag to recover an anchor or diving shot. There are no particularly significant risks associated with tools commonly used by recreational divers. Commercial divers usually use tools of some kind while diving, and some of these tools can be very dangerous if used incorrectly, such as high-pressure water-jets, explosive bolts, oxy-arc cutting and welding and heavy lifting equipment and rigging.
Scuba
Open circuit scuba is mechanically robust and reliable, but can malfunction when damaged, misused, poorly maintained, or occasionally due to unplanned circumstances. Provision of a completely independent emergency supply capable of providing sufficient breathing gas to allow the diver to surface safely from any point on the planned dive profile reduces the risk of a non-survivable out of gas incident to an extremely low level. This remains valid only as long as the emergency gas supply is within immediate reach of the diver, which is more reliably achieved by the diver carrying a bailout cylinder than by relying on a buddy or standby diver, who may not be where needed in an emergency.
Rebreathers have an intrinsically much higher risk of mechanical failure than open circuit scuba because of their structural and functional complexity, but this can be mitigated by good design which provides redundancy of critical items and by carrying sufficient alternative breathing gas supplies for bailout including any required decompression in case of failure. Designs that minimize risk of human-machine interface errors, and adequate training in procedures that deal with this area may help reduce the fatality rate. Two thirds of fatalities were associated with high risk behaviour of a high risk dive profile.
Surface-supplied equipment
The essential aspect of surface-supplied diving is that breathing gas is supplied from the surface, either from a specialized diving compressor, high-pressure cylinders, or both. In commercial and military surface-supplied diving, a backup source of breathing gas should always be present in case the primary supply fails. The diver may also wear a cylinder called a “bail-out bottle,” which can provide self-contained breathing gas in an emergency. Thus, the surface-supplied diver is much less likely to have an “out-of-air” emergency than a scuba diver as there are normally two alternative air sources available. Surface-supplied diving equipment usually includes communication capability with the surface, which adds to the safety and efficiency of the working diver.
Surface-supplied equipment is required under the US Navy operational guidance for diving in harsh contaminated environments which was drawn up by the Navy Experimental Diving Unit. Surface-supplied diving equipment is required for a large proportion of the commercial diving operations conducted in many countries, either by direct legislation, or by authorised codes of practice, as in the case of IMCA operations.
Human factors
Human factors are the physical or cognitive properties of individuals, or social behavior which is specific to humans, and influence functioning of technological systems as well as human-environment equilibria. The safety of underwater diving operations can be improved by reducing the frequency of human error and the consequences when it does occur. Human error can be defined as an individual’s deviation from acceptable or desirable practice which culminates in undesirable or unexpected results.
Human error is inevitable and everyone makes mistakes at some time. The consequences of these errors are varied and depend on many factors. Most errors are minor and do not cause significant harm, but others can have catastrophic consequences. Examples of human error leading to accidents are available in vast numbers, as it is the direct cause of 60% to 80% of all accidents. In a high risk environment, as is the case in diving, human error is more likely to have catastrophic consequences. A study by William P. Morgan indicates that over half of all divers in the survey had experienced panic underwater at some time during their diving career. These findings were independently corroborated by a survey that suggested 65% of recreational divers have panicked under water. Panic frequently leads to errors in a diver’s judgment or performance, and may result in an accident. Human error and panic are considered to be the leading causes of dive accidents and fatalities.
Only 4.46% of the recreational diving fatalities in a 1997 study were attributable to a single contributory cause. The remaining fatalities probably arose as a result of a progressive sequence of events involving two or more procedural errors or equipment failures, and since procedural errors are generally avoidable by a well-trained, intelligent and alert diver, working in an organised structure, and not under excessive stress, it was concluded that the low accident rate in commercial scuba diving is due to this factor. The study also concluded that it would be impossible to eliminate absolutely all minor contraindications of scuba diving, as this would result in overwhelming bureaucracy and would bring all diving to a halt.
Humans function underwater by virtue of technology, as our physiology is poorly adapted to the environment. Human factors are significant in diving because of this harsh and alien environment, and because diver life support systems and other equipment that may be required to perform specific tasks depend on technology that is designed, operated and maintained by humans, and because human factors are cited as significant contributors to diving accidents in most accident investigations
Professional diving is a means to accomplish a wide range of activities underwater in a normally inaccessible and potentially hazardous environment. While working underwater, divers are subjected to high levels of physical and psychological stress due to environmental conditions and the limitations of the life support systems, as well as the rigours of the task at hand.
Recreational, or sport divers, including technical divers, dive for entertainment, and are usually motivated by a desire to explore and witness, though there is no distinct division between the underwater activities of recreational and professional divers. The primary distinction is that legal obligations and protection are significantly different, and this is reflected in organisational structure and procedures.
Recreational diving has been rated more risky than snow skiing, but less risky than other adventure sports such as rock climbing, bungee jumping, motorcycle racing and sky diving. Improvements in training standards and equipment design and configuration, and increased awareness of the risks of diving, have not eliminated fatal incidents, which occur every year in what is generally a reasonably safe recreational activity.
Both categories of diver are usually trained and certified, but recreational diving equipment is typically limited to freediving and scuba, whereas professional divers may be trained to use a greater variety of diving systems, from scuba to surface supplied mixed gas, saturation systems and atmospheric diving suits. A recreational diver may use some ancillary equipment to enhance the diving experience, but the professional will almost always use tools to perform a specific task.
Since the goal of recreational diving is personal enjoyment, a decision to abort a dive, for whatever reason, normally only affects the diver and his companions. A working diver faced with the same decision, must disappoint a client who needs and expects the diver’s services, often with significant financial consequences. Therefore, the working diver often faces greater pressure to provide the service at the cost of reduced personal safety. An understanding of the human factors associated with diving may help the diving team to strike an appropriate balance between service delivery and safety.
Human factors are the influences on human behavior, and the resulting effects of human performance on a process or system. Safety can be improved by reducing the frequency of human error and the consequences when it does occur. Human error can be defined as an individual’s deviation from acceptable or desirable practice which culminates in undesirable or unexpected results.
Diver performance
Safety of underwater diving operations can be improved by reducing the frequency of human error and the consequences when it does occur. Human error can be defined as an individual’s deviation from acceptable or desirable practice which culminates in undesirable or unexpected results. Human error is inevitable and everyone makes mistakes at some time. The consequences of these errors are varied and depend on many factors. Most errors are minor and do not cause significant harm, but others can have catastrophic consequences. Human error and panic are considered to be the leading causes of dive accidents and fatalities.
Inadequate learning or practice of critical safety skills may result in the inability to deal with minor incidents, which consequently may develop into major incidents.
Overconfidence can result in diving in conditions beyond the diver’s competence, with high risk of accident due to inability to deal with known environmental hazards.
Inadequate strength or fitness for the conditions can result in inability to compensate for difficult conditions even though the diver may be well versed at the required skills, and could lead to over-exertion, overtiredness, stress injuries or exhaustion.
Peer pressure can cause a diver to dive in conditions where they may be unable to deal with reasonably predictable incidents.
Diving with an incompetent buddy can result in injury or death while attempting to deal with a problem caused by the buddy.
Overweighting can cause difficulty in neutralising and controlling buoyancy, and this can lead to uncontrolled descent, inability to establish neutral buoyancy, inefficient swimming, high gas consumption, poor trim, kicking up silt, difficulty in ascent and inability to control depth accurately for decompression.
Underweighting can cause difficulty in neutralising and controlling buoyancy, and consequent inability to achieve neutral buoyancy, particularly at decompression stops.
Diving under the influence of drugs or alcohol, or with a hangover may result in inappropriate or delayed response to contingencies, reduced ability to deal timeously with problems, leading to greater risk of developing into an accident, increased risk of hypothermia and increased risk of decompression sickness.
Use of inappropriate equipment and/or configuration can lead to a whole range of complications, depending on the details.
High task loading due to a combination of these factors can result in a dive that goes well enough until something goes wrong, and the diver’s residual capacity is not enough to cope with the changed circumstances. This can be followed by a cascade of failures, as each problem loads the diver more and triggers the next. In such cases the diver is lucky to survive, even with the assistance of a buddy or team, and there is a significant risk of others becoming part of the accident.
Dive team performance
A dive team can vary from a recreational buddy pair to a professional saturation diving team working 24 hours per day with dive and habitat support personnel on a dynamically positioned vessel. The primary purpose of a professional diving team is to improve safety for the working diver by providing backup and support, and to manage the surface equipment required for the operation. A buddy pair is also intended to improve the safety of recreational divers, and in some circumstances succeeds in this aim, depending on the skills, situational awareness and compliance with procedures of the divers. Technical diving teams can vary between the recreational buddy pair at its worst to expedition teams with structure, competence and planning similar to professional teams.
For many applications, the minimum personnel requirement for a professional diving operation is a working diver, to do the job, a diver’s tender to assist the diver and manage the umbilical or airline, a standby diver, competent and ready to go to the assistance of the working diver, and a supervisor, to co-ordinate the team, ensure that the plan is acceptably safe in terms of the organisational policies coded of practice and applicable legislation, ensure that the operation follows the plan as far as possible, and to manage any contingencies or emergencies that may come up during the operation. The primary responsibility of the supervisor of a professional diving team is the health and safety of the diving team.
Hazards
Divers operate in an environment for which the human body is not well suited. They face special physical and health risks when they go underwater or use high pressure breathing gas. The consequences of diving incidents range from merely annoying to rapidly fatal, and the result often depends on the equipment, skill, response and fitness of the diver and diving team. The hazards include the aquatic environment, the use of breathing equipment in an underwater environment, exposure to a pressurised environment and pressure changes, particularly pressure changes during descent and ascent, and breathing gases at high ambient pressure. Diving equipment other than breathing apparatus is usually reliable, but has been known to fail, and loss of buoyancy control or thermal protection can be a major burden which may lead to more serious problems. There are also hazards of the specific diving environment, and hazards related to access to and egress from the water, which vary from place to place, and may also vary with time. Hazards inherent in the diver include pre-existing physiological and psychological conditions and the personal behaviour and competence of the individual. For those pursuing other activities while diving, there are additional hazards of task loading, of the dive task and of special equipment associated with the task.
Professional divers may be exposed to a wider range of hazards, some of which are inherent in the equipment used to reduce the risk of other hazards. Saturation diving is intended to reduce a relatively high risk of decompression sickness, but introduces other health and safety hazards of living at a high ambient pressure for extended periods, and transfer between pressurised spaces. Failure of a saturation system can be catastrophic and fatal to the occupants and bystanders. Such failures are seldom engineering failures, they are more often ergonomic design and operation failures, and usually systems are corrected after analysis of such failures.
Consequences
Diving related medical conditions, are conditions associated with underwater diving, and include both conditions unique to underwater diving, and those that also occur during other activities. This second group further divides into conditions caused by exposure to ambient pressures significantly different from surface atmospheric pressure, and a range of conditions caused by general environment and equipment associated with diving activities.
Disorders particularly associated with diving include those caused by variations in ambient pressure, such as barotraumas of descent and ascent, decompression sickness and those caused by exposure to elevated ambient pressure, such as some types of gas toxicity. There are also non-dysbaric disorders associated with diving, which include the effects of the aquatic environment, such as drowning, which also are common to other water users, and disorders caused by the equipment or associated factors, such as carbon dioxide and carbon monoxide poisoning. General environmental conditions can lead to another group of disorders, which include hypothermia and motion sickness, injuries by marine and aquatic organisms, contaminated waters, man-made hazards, and ergonomic problems with equipment. Finally there are pre-existing medical and psychological conditions which increase the risk of being affected by a diving disorder, which may be aggravated by adverse side effects of medications and other drug use.
Treatment depends on the specific disorder, but often includes oxygen therapy, which is standard first aid for most diving accidents, and is hardly ever contra-indicated for a person medically fit to dive, and hyperbaric therapy is the definitive treatment for decompression sickness. Screening for medical fitness to dive can reduce some of the risk for some of the disorders.
Risk
The labels used to classify dives are not sufficiently precise for analysing risk. Terms like “recreational”, “technical”, “commercial”, “military”, “scientific” and “professional” are used but are not precisely defined, particularly for risk analysis as they do not identify specific contributors to diving risk. Categorisation by depth and obligation for decompression stops are also insufficient to classify risk.
The diving mode has a large influence on risk, and choice of diving mode is commonly based on the outcome of a risk assessment for the diving operation.
Hazard Identification and Risk Assessment: HIRA is a procedure applied to a project, and the results would be used to inform the planners on safety related issues such as choosing the appropriate diving mode, selection of equipment and dive team members, specialised training that may be required, and contingency and emergency planning.
Job Safety Analysis: A (JSA) is a procedure which helps integrate accepted safety and health principles and practices into a particular task or job operation. In a JSA, each basic step of the analysis is to identify potential hazards and to recommend the safest way to do the job. In professional diving a JSA would be done for the planned task for a specific dive, and the result would be included in the dive briefing.
Risk management
Risk management has three major aspects besides equipment and training: Risk assessment, emergency planning and insurance cover. The risk assessment for a dive is primarily a planning activity, and may range in formality from a part of the pre-dive buddy check for recreational divers, to a safety file with professional risk assessment and detailed emergency plans for professional diving projects. Some form of pre-dive briefing is customary with organised recreational dives, and this generally includes a recitation by the divemaster of the known and predicted hazards, the risk associated with the significant ones, and the procedures to be followed in case of the reasonably foreseeable emergencies associated with them. Insurance cover for diving accidents may not be included in standard policies. There are a few organisations which focus specifically on diver safety and insurance cover, such as the international Divers Alert Network
Source from Wikipedia