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Can I get hold of the paper referred to in the UK Sports Diving Medical Committee's proposal?

This was published in the British Journal of Sports Medicine 2000;34:375-378, "Medical supervision of sport diving in Scotland: reassessing the need for routine medical examinations" Glen S, White S and Douglas J. Reprints are available from the British Journal of Sports Medicine, BMJ Publishing Group, BMA House, Tavistock Square, London, WC1H 9JR, UK.

See the article abstract.

If a diver signs the form stating that all is OK, but is hiding a past illness…

The form is a legal declaration. If a diver is found to have been untruthful and an accident occurs then that diver will be uninsured and may be held individually liable for the consequences.

What if I have had DCI but been cleared to dive? or What if I have a condition listed on the medical form and have to tick yes- but have been cleared to dive by a medical referee?

Simply include details of your previous assessment when completing the form. This certificate may be given for a certain time period or be a clearance that self-declaration forms can be completed by the diver for the future. Provided you have been given the all clear then there will not be a problem.

Who do I speak to if I am unsure about whether an illness in the past will stop me diving?

Telephone your local medical referee. Check the UK Sports Diving Medical Committee's website or your Diving Organisation for the most up-to-date list of referees. The telephone enquiry to a medical referee may result in:

  1. From the information you give, the referee may say that you can complete the self declaration form yourself.
  2. The referee may need to contact your own doctor for further information and on this result may need to endorse your self-declaration form. All this will involve is sending the form the the Referee with a stamped addressed envelope for return of the endorsed form to you.
  3. The referee will require you to visit for a medical examination before a certificate of fitness to dive can be issued.

What about the body mass index (BMI)?

There is no longer a cut-off. If you are able to complete the pool training then this is used as an indication of your fitness to dive. A high BMI does not necessarily reflect a poor level of fitness, just as a low BMI does not guarantee good fitness.

Isn't this just a means of medical referees now being able to charge?

The medical referees have diving medicine expertise and incur significant expense maintaining their knowledge, and also performing medicals or arranging investigation. Until recently many referees did not charge for their time, but this is impossible to sustain because of the increasing number of referrals. As an approximate guide, the British Medical Association suggested an initial consultation fee for this type of examination of £61.50 in 2000.

How does the self declaration affect my Diving insurance?

This change has been approved by the diving organisation insurance companies.

At least I was seen by a doctor for my diving medical?

You can continue to have medicals if you choose to do so, but you should not be falsely reassured by their screening value for diving fitness.

Where can I seek general medical advice?

Check the medical standards on the website, or contact your local medical referee.

If I have a condition that warrants a visit to a medical referee, does that referee keep my own doctor up to date?

Copies of correspondence or investigation results are usually sent to your own doctor.

Supposing different advice has been given from another medical source compared to a medical referee, who do I go to seek advice or clarification?

The UK Sport Diving Medical Committee is the final court of appeal for divers, and referees are able to refer to the committee for advice

My DO doesn't agree with the new proposal, will anyone from BSAC or SAA be able to help with updating and giving them more information?

The DO should contact their respective organisation for a further response by their UK Sports Diving Medical Committee representative.

Isn't this decision because everyone else is looking at or accepting self declarations?

The UKSDMC continually monitors the safety of diving in the UK and it is because of the ongoing research programme that this change has been proposed. Other organisations use questionnaires but the proposed system is based on published evidence.

Why do I have to go through a medical for a job, but not for diving which is perceived as more dangerous?

Employment medicals are a different situation entirely because of the concern of employer liability. Although some employers insist on screening medicals there may be little supporting evidence for this for most types of employment.

What about medical conditions such as high blood pressure, mental problems or substance abuse that may be missed by going onto self declarations?

We have had instances of hypertensive divers developing acute pulmonary oedema (fluid on the lungs) from left ventricular failure when diving in cold water. This was mostly in the days of the neoprene wet suit. Now that dry suits are more common, this is no longer such a problem. The current medical system does not prevent the occasional diver developing pulmonary oedema.
Mental problems significant in a diving context would normally be detected during training.
Substance abuse is a fact of life these days and a medical examination would not normally detect it. Do not forget that by far the commonest drug to be abused is alcohol, and the night in the pub before diving is often a silent contributing factor to diving accidents the following day.