Scuba Diving

Technical terms

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Contents
Articles
Breathing gas Cave diving Coral reef Decompression sickness Decompression stop Deep diving Equivalent air depth Equivalent narcotic depth High-pressure nervous syndrome List of diving hazards and precautions Maximum operating depth Nitrogen narcosis Nitrox Oxygen toxicity Partial pressure Rebreather Recreational diving Scuba diving Scuba set Technical diving Trimix (breathing gas) Wreck diving 1 8 18 38 53 56 60 61 63 65 71 73 82 89 105 110 124 128 142 155 161 166

References
Article Sources and Contributors Image Sources, Licenses and Contributors 171 174

Article Licenses
License 177

Breathing gas

Breathing gas
Breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas. Other artificial gases, either pure gases or mixtures of gases, are used in breathing equipment and enclosed habitats such as SCUBA equipment, surface supplied diving equipment, recompression chambers, submarines, space suits, spacecraft and anaesthetic machines.[1] [2] [3] Most breathing gases are a mixture of oxygen and one or more inert gases.[1] [3] Other breathing gases have been developed to improve on the performance of air by reducing the risk of decompression sickness, reducing the duration of decompression stops, reducing nitrogen narcosis or allowing safer deep diving.[1] [3] A safe breathing gas has three essential features: it must contain sufficient oxygen to support the life, consciousness and work rate of the breather.[1] [2] [3] it must not contain harmful gases. Carbon monoxide and carbon dioxide are common poisons in breathing gases. There are many others.[1] [2] [3] it must not become toxic when being breathed at high pressure such as when underwater. Oxygen and nitrogen are examples of gases that become toxic under pressure.[1] [2] [3] The techniques used to fill diving cylinders with gases other than air are called gas blending.[4] [5]

Common diving breathing gases

Common diving breathing gases are: Air is a mixture of 21% oxygen, 78% nitrogen, and approximately 1% other trace gases; to simplify calculations this last 1% is usually treated as if it were nitrogen. Being cheap and simple to use, it is the most common diving gas.[1] [2] [3] As its nitrogen component causes nitrogen narcosis it is considered to have a safe depth limit of about 40 metres (130feet) for most divers, although the maximum operating depth of air is 66.2 metres (218feet).[1] [3]
[6]

Pure oxygen is mainly used to speed the shallow decompression stops at the end of a military, commercial or technical dive and is only safe down to a depth of 6 meters (maximum operating depth) before oxygen toxicity steps in.[1] [2] [3] [6] It was much used in frogmen's rebreathers.[2] [6] [7] [8] Nitrox is a mixture of oxygen and air, and generally refers to mixtures which are more than 21% oxygen. It can be used as a tool to accelerate in-water decompression stops or to decrease the risk of decompression sickness and thus prolong a dive (a common misconception is that the diver can go deeper, this is not true owing to a shallower maximum operating depth than on conventional air).[1] [2] [3] [9] Trimix is a mixture of oxygen, nitrogen and helium and is often used at depth in technical diving and commercial diving instead of air to reduce nitrogen narcosis and to avoid the dangers of oxygen toxicity.[1] [2] [3] Heliox is a mixture of oxygen and helium and is often used in the deep phase of a commercial deep dive to eliminate nitrogen narcosis.[1] [2] [3] [10] Heliair is a form of trimix that is easily blended from helium and air without using pure oxygen. It always has a 21:79 ratio of oxygen to nitrogen; the balance of the mix is helium.[3] [11] Hydreliox is a mixture of oxygen, helium, and hydrogen and is used for dives below 130 metres in commercial diving.[1] [3] [10] [12] [13] Hydrox, a gas mixture of hydrogen and oxygen is used as a breathing gas in very deep diving.[1] [3] [10] [12] [14] Neox (also called neonox) is a mixture of oxygen and neon sometimes employed for in deep commercial diving. It is rarely used due to its cost. Also, DCS symptoms produced by neon ("neox bends") have a poor reputation, being widely reported to be more severe than those produced by an exactly equivalent dive-table and mix with helium.[1] [3] [10] [15]

Breathing gas

Individual component gases

Oxygen
Oxygen (O2) must be present in every breathing gas.[1] [2] [3] This is because it is essential to the human body's metabolic process, which sustains life. The human body cannot store oxygen for later use as it does with food. If the body is deprived of oxygen for more than a few minutes, unconsciousness and death result. The tissues and organs within the body (notably the heart and brain) are damaged if deprived of oxygen for much longer than four minutes.

NEDU gas analysis lab

Filling a diving cylinder with pure oxygen costs around five times more than filling it with compressed air. As oxygen supports combustion and causes rust in diving cylinders, it should be handled with caution when gas blending.[4] [5] Oxygen has historically been obtained by fractional distillation of liquid air, but is increasingly obtained by non cryogenic technologies such as pressure swing adsorption (PSA) and vacuum-pressure swing adsorption (VPSA) technologies.[16] Fraction of oxygen The fraction of the oxygen component of a breathing gas mixture is sometimes used when naming the mix: hypoxic mixes, strictly, contain less than 21% oxygen, although often a boundary of 16% is used, and are designed only to be breathed at depth as a "bottom gas" where the higher pressure increases the partial pressure of oxygen to a safe level.[1] [2] [3] Trimix, Heliox and Heliair create typical hypoxic mixes and are used in technical diving as deep breathing gases.[1] [3] normoxic mixes have the same proportion of oxygen as air, 21%.[1] [3] The maximum operating depth of a normoxic mix could be as shallow as 47 metres (155feet). Trimix with between 17% and 21% oxygen is often described as normoxic because it contains a high enough proportion of oxygen to be safe to breathe at the surface. hyperoxic mixes have more than 21% oxygen. Enriched Air Nitrox (EANx) is a typical hyperoxic breathing gas.[1] [3] [9] Hyperoxic mixtures, when compared to air, cause oxygen toxicity at shallower depths but can be used to shorten decompression stops by drawing dissolved inert gases out of the body more quickly.[6] [9] The fraction of the oxygen determines the deepest the mixture gas can safely be used to avoid oxygen toxicity. This depth is called the maximum operating depth.[1] [3] [6] [9] Partial pressure of oxygen The concentration of oxygen in a gas mix depends on both the fraction and the pressure of the mixture. It is expressed by the partial pressure of oxygen (ppO2).[1] [3] [6] [9] The partial pressure of any component gas in a mixture is calculated as: partial pressure = total absolute pressure x volume fraction of gas component For the oxygen component: ppO2 = P x FO2

Breathing gas

where: ppO2 P FO2 = partial pressure of oxygen = total pressure = volume fraction of oxygen

The minimum safe partial pressure of oxygen in a breathing gas is commonly held to be 16 kPa (0.16 bar). Below this partial pressure the diver may be at risk of unconsciousness and death due to hypoxia, depending on factors including individual physiology and level of exertion. When a hypoxic mix is breathed in shallow water it may not have a high enough ppO2 to keep the diver conscious. For this reason normoxic or hyperoxic "travel gases" are used at medium depth between the "bottom" and "decompression" phases of the dive. The maximum safe ppO2 in a breathing gas depends on exposure time, the level of exercise and the security of the breathing equipment being used. It is typically between 100 kPa (1 bar) and 160 kPa (1.6 bar) but for dives of less than three hours is commonly considered to be 140 kPa (1.4 bar), although the U.S. Navy has been known to authorize dives with a ppO2 of as much as 180 kPa (1.8 bar).[1] [2] [3] [6] [9] At high ppO2 or longer exposures, the diver risks oxygen toxicity including a seizure.[1] [2] Each breathing gas has a maximum operating depth that is determined by its oxygen content.[1] [2] [3] [6] [9] Oxygen analysers measure the ppO2 in the gas mix.[4] Divox "Divox" is oxygen. In the Netherlands, pure oxygen for breathing purposes is regarded as medicinal as opposed to industrial oxygen, such as that used in welding, and is only available on medical prescription. The diving industry "created" Divox and registered it as a trademark to circumvent the strict rules concerning medicinal oxygen thus making it easier for (recreational) scuba divers to obtain oxygen for blending their breathing gas. In most countries, there is no difference in purity in medical oxygen and industrial oxygen, as they are produced by exactly the same methods and manufacturers, but labeled and tanked differently. The chief difference between them is that the paper record-keeping trail is much more extensive for medical oxygen, in order to more easily identify the exact manufacturing trail of a "lot" of oxygen, in case problems are later found with its purity.

Nitrogen
Nitrogen (N2) is a diatomic gas and the main component of air, the cheapest and most common breathing gas used for diving. It causes nitrogen narcosis in the diver, so its use is limited to shallower dives. Nitrogen can cause decompression sickness.[1] [2] [3] [17] Equivalent air depth is used to estimate the decompression requirements of a nitrox (oxygen/nitrogen) mixture. Equivalent narcotic depth is used to estimate the narcotic potency of trimix (oxygen/helium/nitrogen mixture). Many divers find that the level of narcosis caused by a 30m (100ft) dive, whilst breathing air, is a comfortable maximum.[1] [2] [3] [18] [19] Nitrogen in a gas mix is almost always obtained by adding air to the mix.

Breathing gas

Helium
Helium (He) is an inert gas that is less narcotic than nitrogen at equivalent pressure (in fact there is no evidence for any narcosis from helium at all), so it is more suitable for deeper dives than nitrogen.[1] [3] Helium is equally able to cause decompression sickness. At high pressures, helium also causes High Pressure Nervous Syndrome, which is a CNS irritation syndrome which is in some ways opposite to narcosis.[1] [2] [3] [20] Helium fills typically cost ten times more than an equivalent air fill. Helium is not very suitable for dry suit inflation due to its poor thermal insulation properties helium is a very good conductor of heat (compared to air which is a rather poor, making it more of an insulator).[1] [3] Helium's low molecular weight (monatomic MW=4, compared with diatomic nitrogen MW=28) increases the timbre of the breather's voice, which may impede communication.[1] [3] [21] This is because the speed of sound is faster in a lower molecular weight gas, which increases the resonance frequency of the vocal cords.[1] [21] Helium leaks from damaged or faulty valves more readily than other gases because atoms of helium are smaller allowing them to pass through smaller gaps in seals. Helium is found in significant amounts only in natural gas, from which it is extracted at low temperatures by fractional distillation.

Neon
Neon (Ne) is an inert gas sometimes used in deep commercial diving but is very expensive.[1] helium, it is less narcotic than nitrogen, but unlike helium, it does not distort the diver's voice.
[3] [10] [15]

Like

Hydrogen
Hydrogen (H2) has been used in deep diving gas mixes but is very explosive when mixed with more than about 4 to 5% oxygen (such as the oxygen found in breathing gas).[1] [3] [10] [12] This limits use of hydrogen to deep dives and imposes complicated protocols to ensure that oxygen is cleared from the lungs, the blood stream and the breathing equipment before breathing hydrogen starts. Like helium, it increases the timbre of the diver's voice. The hydrogen-oxygen mix when used as a diving gas is sometimes referred to as Hydrox.

Unwelcome components of breathing gases

Many gases are not suitable for use in diving breathing gases.[5] present in a diving environment:
[22]

Here is an incomplete list of gases commonly

Argon
Argon (Ar) is an inert gas that is more narcotic than nitrogen, so is not generally suitable as a diving breathing gas.[23] Argox is used for decompression research.[1] [3] [24] [25] It is sometimes used for dry suit inflation by divers whose primary breathing gas is helium-based, because of argon's good thermal insulation properties. Argon is more expensive than air or oxygen, but considerably less expensive than helium.

Breathing gas

Carbon dioxide
Carbon dioxide (CO2) is produced by the metabolism in the human body and can cause carbon dioxide poisoning.[22]
[26] [27]

Carbon monoxide
Carbon monoxide (CO) is produced by incomplete combustion.[1] common sources are:
[2] [5] [22]

See carbon monoxide poisoning. Four

Internal combustion engine exhaust gas containing CO in the air being drawn into a diving air compressor. CO in the intake air cannot be stopped by any filter. The exhausts of all internal combustion engines running on petroleum fuels contain some CO, and this is a particular problem on boats, where the intake of the compressor cannot be arbitrarily moved as far as desired from the engine and compressor exhausts. Heating of lubricants inside the compressor may vaporize them sufficiently to be available to a compressor intake or intake system line. In some cases hydrocarbon lubricating oil may be drawn into the compressor's cylinder directly through damaged or worn seals, and the oil may (and usually will) then undergo combustion, being ignited by the immense compression ratio and subsequent temperature rise. Since heavy oils don't burn well - especially when not atomized properly - incomplete combustion will result in carbon monoxide production. A similar process is thought to potentially happen to any particulate material, which contains "organic" (carbon-containing) matter, especially in cylinders which are used for hyperoxic gas mixtures. If the compressor air filter(s) fail, ordinary dust will be introduced to the cylinder, which contains organic matter (since it usually contains humus). A more severe danger is that air particulates on boats and industrial areas, where cylinders are filled, often contain carbon-particulate combustion products (these are what makes a dirt rag black), and these represent a more severe CO danger when introduced into a cylinder.

Hydrocarbons
Hydrocarbons (CxHy) are present in compressor lubricants and fuels. They can enter diving cylinders as a result of contamination, leaks, or due to incomplete combustion near the air intake.[2] [4] [5] [22] [28] They can act as a fuel in combustion increasing the risk of explosion, especially in high-oxygen gas mixtures. Inhaling oil mist can damage the lungs and ultimately cause the lungs to degenerate with severe lipid pneumonia or emphysema.

Moisture content
The process of compressing gas into a diving cylinder removes moisture from the gas.[5] [22] This is good for corrosion prevention in the cylinder but means that the diver inhales very dry gas. The dry gas extracts moisture from the diver's lungs while underwater contributing to dehydration, which is also thought to be a predisposing risk factor of decompression sickness. It is also uncomfortable, causing a dry mouth and throat and making the diver thirsty. This problem is reduced in rebreathers because the soda lime reaction to remove carbon dioxide puts moisture back into the breathing gas.[8] In hot climates, open circuit diving can accelerate heat exhaustion because of dehydration. Another concern with regard to moisture content is the tendency of moisture to condense as the gas is decompressed while passing through the regulator; this coupled with the extreme reduction in temperature, also due to the decompression can cause the moisture to solidify as ice. This icing up in a regulator can cause moving parts to seize and the regulator to fail or free flow. It is for this reason that SCUBA regulators are generally constructed from brass, and chrome plated (for protection). Brass, with its good thermal conductive properties, quickly conducts heat from the surrounding water to the cold, newly decompressed air, helping to prevent icing up.

Breathing gas

Gas detection and measurement

Divers find it difficult to detect most gases that are likely to be present in diving cylinders because they are colourless, odourless and tasteless. Electronic sensors exist for some gases, such as oxygen analysers, helium analyser, carbon monoxide detectors and carbon dioxide detectors.[2] [4] [5] Oxygen analysers are commonly found underwater in rebreathers.[8] Oxygen and helium analysers are often used on the surface during gas blending to determine the percentage of oxygen or helium in a breathing gas mix.[4] Chemical and other types of gas detection methods are not often used in recreational diving.

References
[1] Brubakk, A. O.; T. S. Neuman (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed.. United States: Saunders Ltd.. pp.800. ISBN0702025712. [2] US Navy Diving Manual, 6th revision (http:/ / www. supsalv. org/ 00c3_publications. asp?destPage=00c3& pageID=3. 9). United States: US Naval Sea Systems Command. 2006. . Retrieved 2008-08-29. [3] Tech Diver. "Exotic Gases" (http:/ / www. techdiver. ws/ exotic_gases. shtml). . Retrieved 2008-08-29. [4] Harlow, V (2002). Oxygen Hacker's Companion. Airspeed Press. ISBN0967887321. [5] Millar IL; Mouldey PG (2008). "Compressed breathing air the potential for evil from within." (http:/ / archive. rubicon-foundation. org/ 7964). Diving and Hyperbaric Medicine. (South Pacific Underwater Medicine Society) 38: 14551. . Retrieved 2009-02-28. [6] Acott, Chris (1999). "Oxygen toxicity: A brief history of oxygen in diving" (http:/ / archive. rubicon-foundation. org/ 6014). South Pacific Underwater Medicine Society Journal 29 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-08-29. [7] Butler FK (2004). "Closed-circuit oxygen diving in the U.S. Navy" (http:/ / archive. rubicon-foundation. org/ 3986). Undersea Hyperb Med 31 (1): 320. PMID15233156. . Retrieved 2008-08-29. [8] Richardson, Drew; Menduno, Michael; Shreeves, Karl. (eds). (1996). "Proceedings of Rebreather Forum 2.0." (http:/ / archive. rubicon-foundation. org/ 7555). Diving Science and Technology Workshop.: 286. . Retrieved 2008-08-29. [9] Lang, M.A. (2001). DAN Nitrox Workshop Proceedings (http:/ / archive. rubicon-foundation. org/ 4855). Durham, NC: Divers Alert Network. pp.197. . Retrieved 2008-08-29. [10] Hamilton Jr Robert W, Schreiner Hans R (eds) (1975). Development of Decompression Procedures for Depths in Excess of 400 feet (http:/ / archive. rubicon-foundation. org/ 4498). 9th Undersea and Hyperbaric Medical Society Workshop. Bethesda, MD: Undersea and Hyperbaric Medical Society. pp.272. . Retrieved 2008-08-29. [11] Bowen, Curt. "Heliair: Poor man's mix" (http:/ / www. advanceddivermagazine. com/ ezinefreearticles/ HeliairPoorMansMix. pdf). DeepTech. . Retrieved 2010-01-13. [12] Fife, William P (1979). "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". Texas A&M University Sea Grant TAMU-SG-79-201. [13] Rostain, J. C.; M. C. Gardette-Chauffour; C. Lemaire; R. Naquet. (1988). "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw." (http:/ / archive. rubicon-foundation. org/ 2487). Undersea Biomed. Res. 15 (4): 25770. ISSN0093-5387. OCLC2068005. PMID3212843. . Retrieved 2008-08-29. [14] Brauer RW (ed). (1985). "Hydrogen as a Diving Gas." (http:/ / archive. rubicon-foundation. org/ 4862). 33rd Undersea and Hyperbaric Medical Society Workshop. (Undersea and Hyperbaric Medical Society) (UHMS Publication Number 69(WS-HYD)3-1-87): 336 pages. . Retrieved 2008-09-16. [15] Hamilton Jr, Robert W; Powell, Michael R; Kenyon, David J; Freitag, M (1974). "Neon Decompression" (http:/ / archive. rubicon-foundation. org/ 3778). Tarrytown Labs LTD NY CRL-T-797. . Retrieved 2008-08-29. [16] Universal Industrial Gases, Inc. (2003). "Non-Cryogenic Air Separation Processes" (http:/ / www. uigi. com/ noncryo. html). . Retrieved 2008-08-29. [17] Fowler, B; Ackles, KN; Porlier, G (1985). "Effects of inert gas narcosis on behavior--a critical review." (http:/ / archive. rubicon-foundation. org/ 3019). Undersea Biomed. Res. 12 (4): 369402. ISSN0093-5387. OCLC2068005. PMID4082343. . Retrieved 2008-08-29. [18] Logan, JA (1961). "An evaluation of the equivalent air depth theory" (http:/ / archive. rubicon-foundation. org/ 3835). United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. . Retrieved 2008-08-29. [19] Berghage TE, McCraken TM (December 1979). "Equivalent air depth: fact or fiction" (http:/ / archive. rubicon-foundation. org/ 2835). Undersea Biomed Res 6 (4): 37984. PMID538866. . Retrieved 2008-08-29. [20] Hunger Jr, W. L.; P. B. Bennett. (1974). "The causes, mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. rubicon-foundation. org/ 2661). Undersea Biomed. Res. 1 (1): 128. ISSN0093-5387. OCLC2068005. PMID4619860. . Retrieved 2008-08-29. [21] Ackerman MJ, Maitland G (December 1975). "Calculation of the relative speed of sound in a gas mixture" (http:/ / archive. rubicon-foundation. org/ 2738). Undersea Biomed Res 2 (4): 30510. PMID1226588. . Retrieved 2008-08-29. [22] NAVSEA (2005). "Cleaning and gas analysis for diving applications handbook." (http:/ / archive. rubicon-foundation. org/ 7563). NAVSEA Technical Manual (NAVAL SEA SYSTEMS COMMAND) SS521-AK-HBK-010. . Retrieved 2008-08-29.

Breathing gas
[23] Rahn H, Rokitka MA (March 1976). "Narcotic potency of N2, A, and N2O evaluated by the physical performance of mouse colonies at simulated depths" (http:/ / archive. rubicon-foundation. org/ 2768). Undersea Biomed Res 3 (1): 2534. PMID1273982. . Retrieved 2008-08-28. [24] D'Aoust BG, Stayton L, Smith LS (September 1980). "Separation of basic parameters of decompression using fingerling salmon" (http:/ / archive. rubicon-foundation. org/ 2869). Undersea Biomed Res 7 (3): 199209. PMID7423658. . Retrieved 2008-08-29. [25] Pilmanis AA, Balldin UI, Webb JT, Krause KM (December 2003). "Staged decompression to 3.5 psi using argon-oxygen and 100% oxygen breathing mixtures" (http:/ / www. ingentaconnect. com/ content/ asma/ asem/ 2003/ 00000074/ 00000012/ art00004). Aviat Space Environ Med 74 (12): 124350. PMID14692466. . Retrieved 2008-08-29. [26] Lambertsen, C. J. (1971). "Carbon Dioxide Tolerance and Toxicity" (http:/ / archive. rubicon-foundation. org/ 3861). Environmental Biomedical Stress Data Center, Institute for Environmental Medicine, University of Pennsylvania Medical Center (Philadelphia, PA) IFEM Report No. 2-71. . Retrieved 2008-08-29. [27] Glatte Jr H. A., Motsay G. J., Welch B. E. (1967). "Carbon Dioxide Tolerance Studies" (http:/ / archive. rubicon-foundation. org/ 6045). Brooks AFB, TX School of Aerospace Medicine Technical Report SAM-TR-67-77. . Retrieved 2008-08-29. [28] Rosales, KR; Shoffstall, MS; Stoltzfus, JM (2007). "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems." (http:/ / archive. rubicon-foundation. org/ 4861). NASA, Johnson Space Center Technical Report NASA/TM-2007-213740. . Retrieved 2008-08-29.

External links
altitude.org. "Altitude oxygen calculator" (http://www.altitude.org/oxgyen_levels.php). altitude.org. Retrieved 2008-08-29. Westfalen (2004). "Fact sheet on Divox" (http://www.westfalengassen.nl/technischegassen/divox/divox.pdf) (in Dutch). Westfalen. Retrieved 2008-08-29. Taylor, L. "A Brief History Of Mixed Gas Diving" (http://www-personal.umich.edu/~lpt/mixhistory.htm). Retrieved 2008-08-29. OSHA. "Commercial Diving Regulations (Standards - 29 CFR) - Mixed-gas diving. - 1910.426" (http://www. osha.gov/pls/oshaweb/owadisp.show_document?p_id=9986&p_table=STANDARDS). U.S. Department of Labor, Occupational Safety & Health Administration. Retrieved 2008-08-29.

Cave diving

Cave diving
Cave diving is a type of technical diving in which specialized equipment is used to enable the exploration of caves which are at least partially filled with water. In the United Kingdom it is an extension of the more common sport of caving, and in the United States an extension of the more common sport of SCUBA diving. Compared to caving and SCUBA diving, there are relatively few practitioners of cave diving. This is due in part to the specialized equipment (such as rebreathers, diver propulsion vehicles and dry suits) and skill sets required, and in part because of the high potential risks, including decompression sickness and drowning.

Entrance to Peacock Springs Cave System

Despite these risks, water-filled caves attract SCUBA divers, cavers, and speleologists due to their often unexplored nature, and present divers with a technical diving challenge. Caves often have a wide range of unique physical features (such as stalactites, stalagmites and other speleothems), and can contain unique fauna (including trogloxenes, troglophiles and troglobites) not found elsewhere.

Hazards
Cave diving is one of the most challenging and potentially dangerous kinds of diving or caving and presents many hazards. Cave diving is a form of penetration diving, meaning that in an emergency a diver cannot swim vertically to the surface due to the cave's ceilings, and so must swim horizontally or diagonally to escape. The underwater navigation through the cave system may be difficult and exit routes may be at considerable distance, requiring the diver to have sufficient breathing gas to make the journey. The dive may also be deep, resulting in potential deep diving risks. Visibility can vary from nearly unlimited to low, or non-existent, and can go from one extreme to the other in a single dive. While a less-intensive kind of diving called cavern diving does not take divers beyond the reach of natural light, true cave diving can involve penetrations of many thousands of feet, well beyond the reach of sunlight. The level of darkness experienced creates an environment impossible to see in without an artificial form of light. Caves often contain sand, mud, clay, silt, or other sediment that can further reduce underwater visibility in seconds when stirred up. Caves can carry strong water currents. Most caves emerge on the surface as either springs or siphons. Springs have out flowing currents, where water is coming up out of the Earth and flowing out across the land's surface. Siphons have in-flowing currents where, for example, an above-ground river is going underground. Some caves are complex and have some tunnels with out-flowing currents, and other tunnels with in-flowing currents. If currents are not properly managed, they can cause serious problems for the diver. Cave diving is perceived [1] as one of the more dangerous sports in the world. This perception is arguable because the vast majority of divers who have lost their lives in caves have either not undergone specialized training or have had inadequate equipment for the environment.[1] Cave divers have suggested that cave diving is in fact statistically much safer than recreational diving due to the much larger barriers imposed by experience, training, and equipment cost.[1] There is no reliable worldwide database listing all cave diving fatalities. Such fractional statistics as are available, however, suggest that very few divers have ever died while following accepted protocols and while using equipment configurations recognized as acceptable by the cave diving community.[1] In the very rare cases of exceptions to this rule there have typically been unusual circumstances.[1]

Cave diving

Safety
Most cave divers recognize five general rules or contributing factors for safe cave diving, which were popularized, adapted and became generally accepted from Sheck Exley's 1977 publication Basic Cave Diving: A Blueprint for Survival.[1] In this book, Exley included accounts of actual cave diving accidents, and followed each one with a breakdown of what factors contributed to the accident. Despite the uniqueness of any individual accident, Exley found that at least one of a small number of major factors contributed to each one. This technique for breaking down accident reports and finding common causes among them is now called Accident Analysis, and is taught in introductory cave diving courses. Exley outlined a number of these resulting cave diving rules, but today these five are the most recognized: Training: A safe cave diver never exceeds the boundaries of his/her training.[1] Cave diving is normally taught in segments, each successive segment focusing on more complex aspects of cave diving. Furthermore, each segment of training must be coupled with real world experience before moving to a more advanced level. Accident analysis of recent cave diving fatalities has proven that academic training without sufficient real world experience is not enough in the event of an underwater emergency. Only by slowly building experience can one remain calm enough to recall their training should a problem arise, whereas an inexperienced diver (who may be recently trained) will tend to panic when confronted with a similar situation. Guide line: A continuous guide line is maintained at all times between the leader of a dive team and a fixed point selected outside the cave entrance in open water.[1] Often this line is tied off a second time as a backup directly inside the cavern zone.[2] As the dive leader lays the guideline he takes great care to ensure there is sufficient tension on the line.[2] Should a silt out occur, divers can find the taut line and successfully follow it back to the cave entrance.[2] It is important to note that not using a guide line is the number one cause of fatality among untrained, non-certified divers who venture into caves.[1]

A cave diver running a reel with guide line into the overhead environment

Depth rules: Gas consumption and decompression obligation increase with depth, and it is critical that no cave diver exceeds the dive plan or the maximum operating depth (MOD) of the gas mixture used.[1] Also, the effects of nitrogen narcosis are possibly greater in a cave, even for a diver who has the same depth experience in open water. Cave divers are advised not to dive to "excessive depth," and to keep in mind this effective difference between open water depth and cave depth. It should be noted that among fully trained cave divers, not paying sufficient attention to depth is a major cause of fatalities.[1] Air (gas) management: The most common protocol is the 'rule of thirds,' in which one third of the initial gas supply is used for ingress, one third for egress, and one third to support another team member in the case of an emergency.[1] [3] UK practice is to adhere to the rule of thirds, but with an added emphasis on keeping depletion of your separate air systems "balanced," so that the loss of a complete air system will still leave you with sufficient air to return safely. Note that the rule of thirds makes no allowance for the increased air consumption that the loss of an air system will induce. Dissimilar tank sizes among the divers are also not included and the proper amount of air reserve must be calculated for each dive (if tanks are dissimilar). UK practice is to assume that anyone else diving with you does not exist, as in a typical UK sump there is absolutely nothing that you can do to assist him/her. Most UK cave divers dive solo. US sump divers follow a similar protocol. Note that the rule of thirds was devised as an approach to diving Florida's caves - they typically have high outflow currents, which help to reduce air consumption when exiting. In a cave system with little (or no) outflow it is mandatory to reserve more air than is dictated by the rule of thirds.

Cave diving Lights: All cave divers must have three independent sources of light.[1] One is considered the primary and the other two are considered backup lights. If any one of the three light sources fail for one diver, the dive is called off and ended for all members of the dive team. These five rules may be remembered with the mnemonic The Good Divers Are Living, the first letter of each word referring to the first letter of the corresponding rule. An alternative mnemonic taught in the United States is Thank Goodness All Divers Live, requiring a rearrangement of the rules. In recent years new contributing factors were considered after reviewing accidents involving solo diving, diving with incapable dive partners, video or photography in caves, complex cave dives and cave diving in large groups. With the establishment of technical diving, the usage of mixed gasessuch as trimix for bottom gas, and nitrox and oxygen for decompressionreduces the margin for error. Accident analysis informs us that breathing the wrong gas at the wrong depth and/or not analyzing the breathing gas properly has led to cave diving accidents. Cave diving requires a wide variety of very specialized techniques. Divers who do not adhere strictly to these techniques, as well as equipment specifications, greatly increase the amount of risk they undertake. The cave diving community works hard to educate the public on the risks they assume when they enter water-filled caves. Warning signs with the likenesses of the Grim Reaper have been placed just inside the openings of many popular caves in the US, and others have been placed in nearby parking lots and local dive shops. Many cave diving sites around the world contain basins, which are also popular open-water diving sites. These sites try to minimize the risk of untrained divers being tempted to venture inside the cave systems. With the support of the cave diving community, many of these sites enforce a "no-lights rule" for divers who lack cave trainingthey may not carry any lights into the water with them. It is easy to venture into an underwater cave with a light and not realize how far away from the entrance (and daylight) one has swum; this rule is based on the theory that, without a light, divers will not venture beyond daylight.

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Training
Cave diving training includes equipment selection and configuration, guideline protocols and techniques, gas management protocols, communication techniques, propulsion techniques, emergency management protocols, and psychological education. As cave diver training stresses the importance of safety it does point out cave conservation ethics as well. Most training programs contain various stages of certification and education. Cavern training explains the basic skills needed to enter into the overhead environment. Training will generally consist of gas planning, propulsion techniques needed to deal with the silty environments in many caves, reel and handling, and communication. Once certified as a cavern diver, a diver may undertake cavern diving with a cavern (or greater) certified "buddy," as well as advance into cave diving training. Introduction into cave training builds off of the techniques learned during cavern training and includes the training needed to penetrate beyond the cavern zone and working with permanent guidelines that exist in many caves. Once intro to cave certified, a diver may penetrate much further into a cave, usually limited by 1/3 of a single cylinder, or in the case of a basic cave certification, 1/6 of double cylinders. An intro cave diver is usually not certified to do complex navigation. Apprentice cave training serves as the building block from intro to full certification and includes the training needed to penetrate deep into caves working from both permanent guide lines as well as limited exposure to side lines that exist in many caves. Training covers complex dive planning and decompression procedures used for longer dives. Once apprentice certified, a diver may penetrate much further into a cave, usually limited by 1/3 of double cylinders. An apprentice diver is also allowed to do a single jump or gap (a break in the guideline from two sections of mainline or between mainline and sideline) during the dive. An apprentice diver typically has one year to finish full cave or must repeat the apprentice stage.

Cave diving Full cave training serves final level of basic training and includes the training needed to penetrate deep into the cave working from both permanent guidelines as well as sidelines and may plan and complete complex dives deep into a system using decompression to stay longer. Once cave certified, a diver may penetrate much further into a cave, usually limited by 1/3 of double cylinders. A cave diver is also allowed to do multiple jumps or gaps (a break in the guideline from two sections of mainline or between mainline and sideline) during the dive.

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International differences
The cave diving community is a global one, partly due to the highly specialised nature with the resulting small numbers of practitioners at a local level. However, cave diving practice can differ markedly by locality. One such difference is the use of a floating polypropylene guide line. Most cave divers in the U.S. balk at the use of any sort of floating guide line, 6mm polypropylene line is the norm in UK precisely because it does float - the line is regularly anchored to stones, lead weights, or whatever is needed and the floating keeps it clear of mud and silt. In Europe, thinner yet slightly buoyant line is typical. Cave diving practices in some localities may be different than those in other parts of the world because those caves require specialized techniques. It is always recommended that individuals contact someone familiar with a cave before venturing inside a cave. Regularity in signs and warnings may also differ around the world. For example, warnings signs are rare in the UK.

History
Jacques-Yves Cousteau, co-inventor of the first SCUBA equipment, was both the world's first SCUBA diver and the world's first SCUBA cave diver. However, many cave divers penetrated caves prior to the advent of SCUBA with surface supplied UBA through the use of umbilical hoses and compressors. SCUBA diving in all its forms, including cave diving, has advanced in earnest since he introduced the aqua-Lung in 1943.

UK history
The Cave Diving Group (CDG) was established informally in the United Kingdom in 1935 to organise training and equipment for the exploration of flooded caves in the Mendip Hills of Somerset. The first dive was made by Jack Sheppard on 4 October 1936,[4] using a home-made drysuit surface fed from a modified bicycle pump, which allowed Shepard to pass Sump 1 of Swildon's Hole. Swildon's is an upstream feeder to the Wookey Hole resurgence system. The difficulty of access to the sump in Swildon's prompted operations to move to the resurgence, and the larger cave there allowed use of conventional "hard Cave diving equipment from 1935 in the museum hat" equipment which was secured from the Siebe Gorman company. at Wookey Hole Caves The left photograph on the standard diving dress page will give some indication of the scale of operations this entailed. In UK cave diving, the term "Sherpa" is used without a drop of irony for the people who carry the diver's gear although recently this has gone out of fashion; support is now more normally used, and before the development of SCUBA equipment such undertakings could be monumental operations. Diving in the spacious third chamber of Wookey Hole led to a rapid series of advances, each of which was dignified by being given a successive number, until an air surface was reached at what is now known as "Chamber 9." Some of these dives were broadcast live on BBC radio, which must have been a quite surreal experience for both diver and audience.

Cave diving

12 The number of sites where standard diving dress could be used is clearly limited and there was little further progress before the outbreak of World War II reduced the caving community considerably. However, the rapid development of underwater warfare through the war made a lot of surplus equipment available. The CDG re-formed in 1946 and progress was rapid. Typical equipment at this time was a frogman rubber diving suit for insulation (water temperature in the UK is typically 4C), an oxygen diving cylinder, soda lime absorbent canister and counter-lung comprising a rebreather air system and an "AFLOLAUN," meaning "Apparatus For Laying Out Line And Underwater Navigation." The AFLOLAUN consisted of lights, line-reel, compass, notebook (for the survey), batteries, and more.

Cave diving equipment in the museum at Wookey Hole Caves

Progress was typically by "bottom walking", as this was considered less dangerous than swimming (note the absence of buoyancy controls). The use of oxygen put a depth limit on the dive, which was considerably mitigated by the extended dive duration. This was the normal diving equipment and methods until approximately 1960 when new techniques using wetsuits (which provide both insulation and buoyancy compensation), twin open-circuit SCUBA air systems the development of side mounting cylinders, helmet-mounted lights and free-swimming with fins. The increasing capacity and pressure rating of air bottles also extended dive durations.[5]

U.S. History
In the 1970s, cave diving greatly increased in popularity among divers in the United States. However, there were very few experienced cave divers and almost no formal classes to handle the surge in interest. The result was a large number of divers trying to cave dive without any formal training. This resulted in more than 100 fatalities over the course of the decade. The state of Florida came close to banning SCUBA diving around the cave entrances. The cave diving organizations responded to the problem by creating training programs and certifying instructors, in addition to other measures to try to prevent these fatalities. This included posting signs, adding no-lights rules, and other enforcements. In the United States, Sheck Exley was a pioneering cave diver who first explored many Florida underwater cave systems, and many other underwater cave systems throughout the US and the world. On February 6, 1974, Exley became the first chairman of the Cave Diving Section of the National Speleological Society.[6] Since the 1980s, cave diving education has greatly reduced diver fatalities, and it is now rare for an agency trained diver to perish in an underwater cave. Also in the 1980s, refinements were made to the equipment used for cave diving, most importantly better lights with smaller batteries. In the 1990s, cave diving equipment configurations became more standardized, due mostly to the adaptation and popularization of the "Hogarthian Rig", developed by several North Florida cave divers (named in honor of William "Hogarth" Main) which promotes equipment choices that "keep it simple and streamlined". Today, the cave community is most focused on training, exploration, public awareness, and cave conservation. Documentary films made by Wesley C. Skiles and Jill Heinerth cave diving in the early 21st century.
[7]

have contributed to the increasing popularity of

Cave diving

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Cave diving venues

Grand Bahama Island
The caves and caverns of Grand Bahama contain an immense underwater cavern with a vast flooded labyrinth of caverns, caves and submerged tunnels that honeycomb the entire island of Grand Bahama and the surrounding sea bed. The inland caves are not abundant with life, but do contain creatures living in the caves other than the migrating gray snappers. Residents of these caves include a type of blind cave fish and remipedia that don't pose any threat to cave divers. The caves in the Bahamas were formed during the last ice age. With much of the Earth's water held in the form of glacial ice, the sea level fell hundreds of feet, leaving most of the Bahama banks, which are now covered in water, high and dry. Rain falling on the most porous limestone slowly filtered down to sea level forming a lens where it contacted the denser salt water of the ocean permeating the spongy lime stone. The water at the interface was acidic enough to dissolve away the limestone and form the caves. Then, as more ice formed and the sea level dropped even further, the caves became dry and rainwater dripping through the ceiling over thousands of years created the incredible crystal forests of stalagmites which now decorate the caves. Finally, when the ice melted and the sea level rose, the caves were reclaimed by the sea.

Central and Northern Florida, U.S.

The largest and most active cave diving community in the United States is in north-central Florida. The North Floridan Aquifer expels groundwater through numerous first-magnitude springs, each providing an entrance to the aquifer's labyrinthine cave system. These high-flow springs have resulted in Florida cave divers developing special techniques for exploring them, since some have such strong currents that it is impossible to swim against them. The longest known underwater cave system in the USA, The Leon Sinks cave system, near Tallahassee, Florida, has multiple interconnected sinks and springs spanning two counties (Leon & Wakulla).[8] One main resurgence of the system, Wakulla Springs, is explored exclusively by a very successful and pioneering project called the Woodville Karst Plain Project (WKPP), although other individuals and groups like the US Deep Cave Diving Team, have explored portions of Wakulla Springs in the past. One of the deepest known underwater caves in the USA is Weeki Wachee Spring. Due to its strong outflow, divers have had limited success penetrating this first magnitude spring until 2007, when drought conditions eased the out-flowing water allowing team divers from Karst Underwater Research to penetrate to depths of 400ft (120m)[9] The Florida caves are formed from geologically young limestone with moderate porosity. The absence of speleothem decorations which can only form in air filled caves, indicates that the flooded Florida caves have a single genetic phase origin, having remained water filled even during past low sea levels. In plan form, the caves are relatively linear with a limited number of side passages allowing for most of the guidelines to be simple paths with few permanent tees. It is common practice for cave divers in Florida to joint a main line with a secondary line using a jump reel when exploring side passages, in order to maintain a continuous guideline to the surface.

Yucatan Peninsula, Mexico

While there is great potential for cave diving in the continental karst throughout Mexico, the vast majority of cave diving in Mexico occurs in the Yucatn Peninsula. While there are thousands of deep pit cenotes throughout the Yucatn Peninsula including in the states of Yucatn and Campeche, the extensive sub-horizontal flooded cave networks for which the peninsula is known are essentially limited to a 10km wide strip of the Caribbean coastline in the state of Quintana Roo extending south from Cancun to the Tulum Municipality and the Sian Ka'an Biosphere Reserve, although some short segments of underwater cave have been explored on the north-west coast (Yucatn State).

Cave diving In the Yucatn Peninsula, any surface opening where groundwater can be reached is called cenote, which is a Spanish form of the Maya word dzonot. The cave systems formed as normal caves underwater, but upper sections drained becoming air filled during past low sea levels. During this vadose, or air filled state, abundant speleothem deposits formed. The caves and the vadose speleothem were subsequently reflooded and became hydraulically reactivated as rising sea levels also raised the water table. These caves are therefore polygenetic, having experienced more than one cycle of formation below the water table. Polygenetic coastal cave systems with underwater speleothem are globally common, with notable examples being on the Balearic Islands (Mallorca, Menorca) of Spain, the islands of the Bahamas, Bermuda, Cuba, and many more. As with all cave speleothems, the underwater speleothems in the Yucatn Peninsula are fragile. If a diver accidentally breaks off a stalactite from the ceiling or other speleothem formation, it will not reform as long as the cave is underwater so active cave conservation diving techniques are paramount. In plan form, the Quintana Roo caves are extremely complex with anastomotic interconnected passages. When cave diving through the caves, the pathways then appear to have many offshoots and junctions, requiring careful navigation with permanent tees or the implementation of jumps in the guideline. The beginning of the 1980s brought the first cave divers from the U.S. to the Yucatn Peninsula, Quintana Roo to explore cenotes such as Carwash, Naharon and Maya Blue, but also to central Mexico where resurgence rivers such as Rio Mante, sinkholes such as Zacaton were documented. In the Yucatn, the 1980s ended with the discoveries of the Dos Ojos and Nohoch Nah Chich cave systems which lead into a long ongoing competition of which exploration team had the longest underwater cave system in the world at the time, with both teams vying for first place. The beginning of the 1990s led into the discovery of underwater caves such as Aereolito on the island of Cozumel, ultimately leading to the 5th biggest underwater cave in the world. By the mid 1990s a push into the central Yucatn Peninsula by dedicated deep cave explorers discovered a large number of deep sinkholes, or pit cenotes, such as Sabak Ha, Utzil and deep caves such as Chacdzinikche, Dzibilchaltun, Karkirixche that have been explored and mapped. To this day these deep caves of the central Yucatn remain largely unexplored due to the sheer number of cenotes found in the State of Yucatn, as well as the depth involved that can be only tackled using technical diving techniques or rebreathers. In the end of the last millennium closed circuit rebreather (CCR) cave diving techniques were employed in order to explore these deep water filled caves. By the end of the 1990s, "The Pit" in the Dos Ojos cave system located 5.8km from the Caribbean coast had been discovered, and it is presently (2008) 119m deep. At that time, technical diving and rebreather equipment and techniques became common place. By the turn of the millennium the longest underwater cave system at that time, Ox Bel Ha was established by cave diving explorers whose combined efforts and information helped join segments of previously explored caves. The use of hand held GPS technology and aerial and satellite images for reconnaissance during exploration became common. New technology such as rebreathers and diver propulsion vehicles (DPVs) became available and were utilized for longer penetration dives. As of October 2010, Ox Bel Ha includes 182km of underwater passage (See QRSS for current statistics). Active exploration continues in the new millennium. Most cave diving exploration is now conducted on the basis of "mini projects" lasting 1 7 days, and occurring many times a year, and these may include daily commutes from home to jungle dive base camps located within 1 hour from road access. Starting in 2006 a number of large previously explored and mapped cave systems have been connected utilizing sidemount cave diving techniques and many times no-mount cave diving techniques in order to pass through these tight cave passages, creating the largest connected underwater cave system on the planet, Sac Actun, which presently has a length extent of 215km (See QRSS for current statistics).

14

Cave diving Many cave maps have been published by the Quintana Roo Speleological Survey (QRSS).

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United Kingdom
UK requirements are generally that all people wishing to take up cave diving must be competent cavers before they start cave diving. This is primarily because most British cave dives are at the far end of dry caves. There are individuals that begin cave diving directly from the recreational diving, but they represent a minority in the UK, and represent only a few percent of the Cave Diving Group (CDG).

Australian cave diving and the CDAA

Australia has many spectacular water filled caves and sinkholes, but unlike the UK, most Australian cave divers come from a general ocean-diving background. The "air-clear" water of the sinkholes and caves can be found in the Mount Gambier area of south-eastern Australia. The first cave and sinkhole dives here took place in the very late 1950s, and until the mid 1980s divers generally used single diving cylinders and homemade torches, and reels, resulting in most of their explorations being limited. A series of tragedies between 1969 and 1973 in which 11 divers drowned (including a triple and a quadruple fatality) in just four karst features - "Kilsbys Hole", "Piccaninnie Ponds", "Death Cave" and "The Shaft" - created much public comment and led to the formation of the Cave Divers Association of Australia (CDAA) Inc. in September 1973. As a consequence of the CDAA's assessment programs, divers are rated at various levels, and today they comprise Deep Cavern, Cave, and Advanced Cave. During the 1980s the Nullarbor Plain was recognized as a major cave-diving area, with one cave, Cocklebiddy, being explored for more than 6 kilometers, involving the use of large sleds to which were attached numerous diving cylinders and other paraphernalia, and which were then laboriously pushed through the cave by the divers. In more recent years divers have been utilizing compact diver-towing powered scooters, but the dive is still technically extremely challenging. A number of other very significant caves have also been discovered during the past 10 years or so; the 10+ (Lineal) kilometre long Tank Cave near Mount Gambier, other very large features on the Nullarbor and adjacent Roe Plain as well as a number of specific sites elsewhere, and nowadays the cave diving community utilizes many techniques, equipment and standards from the U.S. and elsewhere. The CDAA is one of a number of organisations responsible for the administration of cave diving certification in Australia. Mixed-gas and rebreather technologies can now be used in many sites. All cave diving in the Mount Gambier area as well as at some New South Wales sites and the Nullarbor requires divers to be members of the CDAA, whether in the capacity of a visitor or a trained and assessed member.

Cave diving

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Brazil
In Brazil there is cavern diving in Chapada da Diamantina, in Bahia state; Bonito, in Mato Grosso do Sul state; and Mariana, where there is also cave diving (visiting Mina da Passagem), in Minas Gerais state. For cave diving in Mariana a cave diver certification will be required.

Sardinia Italy
In the north west of Sardinia, close to Porto Conte bay, Alghero territory, there is the most important cave diving site in the Mediterranean Sea. Thanks to the huge limestone cliffs of Capo Caccia and Punta Giglio there are more than 300 caves above and below water, with about 30 large, and many smaller, underwater sea caves. The Nereo Cave is the most important and it is considered also the largest in the Mediterranean Sea. On the east side of Sardinia there are many underwater cave systems starting from the Gennargentu Mountains, with underwater rivers which arrive at the sea by different, lengthy routes. Here one of the deepest fresh water caves exits at more than 110m (360ft) depth.

The Nereo Cave "Belvedere" watching terrace, south upside entrance

References
[1] Sheck Exley (1977). Basic Cave Diving: A Blueprint for Survival. National Speleological Society Cave Diving Section. ISBN9994663372. [2] Devos, Fred; Le Maillot, Chris; Riordan, Daniel (2004). "Introduction to Guideline Procedures - Part 2: Methods" (http:/ / www. gue. com/ files/ page_images/ expeditions/ Mexico/ guideline2. pdf). DIRquest (Global Underwater Explorers) 5 (4). . Retrieved 2009-04-05. [3] Bozanic, JE (1997). "AAUS Standards for Scientific Diving Operations in Cave and Cavern Environments: A Proposal." (http:/ / archive. rubicon-foundation. org/ 4634). In: SF Norton (ed). Diving for Science...1997. Proceedings of the American Academy of Underwater Sciences (17th Annual Scientific Diving Symposium). . Retrieved 2008-07-05. [4] "Jack Sheppard" (http:/ / www. cavedivinggroup. org. uk/ Articles/ Sheppard. html). Cave Diving Group. . Retrieved 2007-12-29. [5] Farr, Martyn (1991). The Darkness Beckons. London: Diadem Books. ISBN0939748320. [6] Staff. "Cave Diving Section of the National Speleological Society was founded" (http:/ / www. cavedivinghistory. com/ forums/ showthread. php?t=84). cavedivinghistory.com. . Retrieved 2009-06-01. [7] http:/ / www. intotheplanet. com [8] Kernagis DN, McKinlay C, Kincaid TR (2008). "Dive Logistics of the Turner to Wakulla Cave Traverse" (http:/ / archive. rubicon-foundation. org/ 8011). In: Brueggeman P, Pollock NW, eds. Diving for Science 2008. Proceedings of the American Academy of Underwater Sciences 27th Symposium. Dauphin Island, AL: AAUS;. . Retrieved 2009-06-01. [9] Neill, Logan; Anderson, Joel (2009-04-20). "Cave divers explore deepest parts of Weeki Wachee Springs" (http:/ / www. tampabay. com/ news/ humaninterest/ article993502. ece). St. Petersburg Times. . Retrieved 2009-06-01.

Cave diving

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Sources
"Skin Diver Killed in Submerged Cave", The New York Times, May 16, 1955, Page 47. Basic Cave Diving: A Blueprint for Survival, Sheck Exley 1977.

External links
Florida Cave & Cavern List (http://caves.tampadiving.com) An article from the CDG (http://www.cavedivinggroup.org.uk/Essays/History/JBArticle.html) Woodville Karst Plain Project (http://www.wkpp.org/) Books and DVDs about cave diving (http://www.cavedivingbook.com/) Wakulla system (http://research.gg.uwyo.edu/kincaid/Modeling/Wakulla/wakhydro.htm) International Underwater Cave Rescue and Recovery (IUCRR) (http://www.iucrr.org) Article in Divetime.com (http://www.divetime.com/articles/Scuba_Diving_Information/Cave_Diving_189. html) A cavern dive video (http://www.youtube.com/watch?v=BM_oH3f_Xc8&feature=channel_page) Cave Diving Group manual (http://www.cavedivinggroup.org.uk/Zen-CDG/index. php?main_page=product_info&cPath=5&products_id=43&zenid=5hu5ggrmoi91510c7bu7ocdoq3) Cave Diving Down Under (Australia) (http://www.cavediving.net.au) Dominican Republic Speleological Society (http://www.dr-ss.com/)

Training organizations
National Association for Cave Diving(NACD) (http://www.safecavediving.com/) (U.S.) National Speleological Society, Cave Diving Section(NSS/CDS) (http://www.nsscds.com/) (U.S.) Professional Scuba Association International (PSAI) (http://www.psai.com/) International Association of Nitrox and Technical Divers(IANTD) (http://www.iantd.com/) Technical Diving International(TDI) (http://www.tdisdi.com/) Cave Diving Group (CDG) (http://www.cavedivinggroup.org.uk/Membership.html) (UK) French Diving Federation (FFESSM) Cave Diving Committee (http://souterraine.ffessm.fr/) (France) Cave Divers Association of Australia (CDAA) (http://www.cavedivers.com.au/) (Australia) Global Underwater Explorers (GUE) (http://www.gue.com/) (U.S.) Unified Team Diving (UTD) (http://www.unifiedteamdiving.com/) (U.S.) Cave Diving and Research Group (MADAG) (http://www.madag.org/) (Turkey) Underwater Technical Research (UTR) (http://www.utrtek.it/) (Italy) German Exploration Cave Diving (Germany) (http://www.germancavediving.de) NAUI - National Association of Underwater Instructors (http://www.naui.org)

Coral reef

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Coral reef
Coral reefs are underwater structures made from calcium carbonate secreted by corals. Corals are colonies of tiny living animals found in marine waters that contain few nutrients. Most coral reefs are built from stony corals, which in turn consist of polyps that cluster in groups. The polyps are like tiny sea anemones, to which they are closely related. But unlike sea anemones, coral polyps secrete hard carbonate exoskeletons which support and protect their bodies. Reefs grow best in warm, shallow, clear, sunny and agitated waters. Often called rainforests of the sea, coral reefs form some of the most diverse ecosystems on Earth. They occupy less than one tenth of one percent of the world's ocean surface, about half the area of France, yet they provide a home for twenty-five percent of all marine species,[1] including fish, molluscs, worms, crustaceans, echinoderms, sponges, tunicates and other cnidarians.[2] Paradoxically, coral reefs flourish even though they are surrounded by ocean waters that provide few nutrients. They are most commonly found at shallow depths in tropical waters, but deep water and cold water corals also exist on smaller scales in other areas. Coral reefs deliver ecosystem services to tourism, fisheries and shoreline protection. The annual global economic value of coral reefs has been estimated at $US375 billion. However, coral reefs are fragile ecosystems, partly because they are very sensitive to water temperature. They are under threat from climate change, ocean acidification, blast fishing, cyanide fishing for aquarium fish, overuse of reef resources, and harmful land-use practices, including urban and agricultural runoff and water pollution, which can harm reefs by encouraging excess algae growth.[3] [4] [5]

Formation
Most coral reefs were formed after the last glacial period when melting ice caused the sea level to rise and flood the continental shelves. This means that most coral reefs are less than 10,000 years old. As communities established themselves on the shelves, the reefs grew upwards, pacing rising sea levels. Reefs that rose too slowly could become drowned reefs, covered by so much water that there was insufficient light.[6] Coral reefs are also found in the deep sea away from the continental shelves, around oceanic islands and as atolls. The vast majority of these islands are volcanic in origin. The few exceptions have tectonic origins where plate movements have lifted the deep ocean floor on the surface. In 1842 in his first monograph, The Structure and Distribution of Coral Reefs[7] Charles Darwin set out his theory of the formation of atoll reefs, an idea he conceived during the voyage of the Beagle. He theorized uplift and subsidence of the Earth's crust under the oceans formed the atolls.[8] Darwins theory sets out a sequence of three stages in atoll formation. It starts with a fringing reef forming around an extinct volcanic island as the island and ocean floor subsides. As the subsidence continues, the fringing reef becomes a barrier reef, and ultimately an atoll reef.

Darwins theory starts with a volcanic island which becomes extinct

As the island and ocean floor subside, coral growth builds a fringing reef, often including a shallow lagoon between the land and the main reef.

As the subsidence continues, the fringing reef becomes a larger barrier reef further from the shore with a bigger and deeper lagoon inside.

Ultimately, the island sinks below the sea, and the barrier reef becomes an atoll enclosing an open lagoon.

Darwin predicted that underneath each lagoon would be a bed rock base, the remains of the original volcano. Subsequent drilling proved this correct. Darwin's theory followed from his understanding that coral polyps thrive in the clean seas of the tropics where the water is agitated, but can only live within a limited depth range, starting just

Coral reef below low tide. Where the level of the underlying earth allows, the corals grow around the coast to form what he called fringing reefs, and can eventually grow out from the shore to become a barrier reef. Where the bottom is rising, fringing reefs can grow around the coast, but coral raised above sea level dies and becomes white limestone. If the land subsides slowly, the fringing reefs keep pace by growing upwards on a base of older, dead coral, forming a barrier reef enclosing a lagoon between the reef and the land. A barrier reef can encircle an island, and once the island sinks below sea level a roughly circular atoll of growing coral continues to keep up with the sea level, forming a central lagoon. Barrier reefs and atolls do not usually form complete circles, but are broken in places by storms. Like sea level rise, a rapidly subsiding bottom subside can overwhelm coral growth, killing the animals and the reef.[8] [10]

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A fringing reef can take ten thousand years to form, and an atoll can take up to 30 million [9] years.

The two main variables determining the geomorphology, or shape, of coral reefs are the nature of the underlying substrate on which they rest, and the history of the change in sea level relative to that substrate. The approximately 20,000 year old Great Barrier Reef offers an example of how coral reefs formed on continental shelves. Sea level was then 120 metres (390ft) lower than in the 21st century.[11] [12] As sea level rose, the water and the corals encroached on what had been hills of the Australian coastal plain. By 13,000 years ago, sea level had risen to 60 metres (200ft) lower than at present, and many hills of the coastal plains had become continental islands. As the sea level rise continued, water topped most of the continental islands. The corals could then overgrow the hills, forming the present cays and reefs. Sea level on the Great Barrier Reef has not changed significantly in the last 6,000 years,[12] and the age of the modern living reef structure is estimated to be between 6,000 and 8,000 years.[13] Although the Great Barrier Reef formed along a continental shelf, and not around a volcanic island, Darwin's principles apply. Development stopped at the barrier reef stage, since Australia is not about to submerge. It formed the world's largest barrier reef, 3001000 metres (9803300 ft) from shore, stretching for 2000 kilometres (1200mi).[14] Healthy tropical coral reefs grow horizontally from 1 to 3 centimetres (0.39 to 1.2 in) per year, and grow vertically anywhere from 1 to 25 centimetres (0.39 to 9.8 in) per year; however, they grow only at depths shallower than 150 metres (490ft) due to their need for sunlight, and cannot grow above sea level.[15]

Types
The three principal reef types are: Fringing reef this type is is directly attached to a shore, or borders it with an intervening shallow channel or lagoon. Barrier reef a reef separated from a mainland or island shore by a deep channel or lagoon Atoll reef this more or less circular or continuous barrier reef extends all the way around a lagoon without a central island.

Coral reef

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Other reef types or variants are: Patch reef this type is an isolated, comparatively small reef outcrop, usually within a lagoon or embayment, often circular and surrounded by sand or seagrass. Patch reefs are common. Apron reef a short reef resembling a fringing reef, but more sloped; extending out and downward from a point or peninsular shore Bank reef a linear or semicircular shaped-outline, larger than a patch reef Ribbon reef a long, narrow, possibly winding reef, usually associated with an atoll lagoon Table reef an isolated reef, approaching an atoll type, but without a lagoon Habili - this is a reef in the Red Sea that does not reach the surface near enough to cause visible surf, although it may be a hazard to ships (from the Arabic for "unborn"). Microatoll certain species of corals form communities called microatolls. The vertical growth of microatolls is limited by average tidal height. By analysing growth morphologies, microatolls offer a Inhabited cay in the Maldives low-resolution record of patterns of sea level change. Fossilized microatolls can also be dated using radioactive carbon dating. Such methods have been used to reconstruct Holocene sea levels.[16] Cays are small, low-elevation, sandy islands formed on the surface of coral reefs. Material eroded from the reef piles up on parts of the reef or lagoon, forming an area above sea level. Plants can stabilize cays enough to become habitable by humans. Cays occur in tropical environments throughout the Pacific, Atlantic and Indian Oceans (including the Caribbean and on the Great Barrier Reef and Belize Barrier Reef), where they provide habitable and agricultural land for hundreds of thousands of people. When a coral reef cannot keep up with the sinking of a volcanic island, a seamount or guyot is formed. The tops of seamounts and guyots are below the surface. Seamounts are rounded at the top and guyots are flat. The flat top of the guyot, also called a tablemount, is due to erosion by waves, winds, and atmospheric processes.
A small atoll in the Maldives

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Zones
Coral reef ecosystems contain distinct zones that represent different kinds of habitats. Usually, three major zones are recognized: the fore reef, reef crest, and the back reef (frequently referred to as the reef lagoon). All three zones are physically and ecologically interconnected. Reef life and oceanic processes create opportunities for exchange of seawater, sediments, nutrients, and marine life among one another. Thus, they are integrated components of the coral reef ecosystem, each playing a role in the support of the reefs' abundant and diverse fish assemblages.

The three major zones of a coral reef: the fore reef, reef crest, and the back reef

Most coral reefs exist in shallow waters less than fifty metres deep. Some inhabit tropical continental shelves where cool, nutrient rich upwelling does not occur, such as Great Barrier Reef. Others are found in the deep ocean surrounding islands or as atolls, such as in the Maldives. The reefs surrounding islands form when islands subside into the ocean, and atolls form when an island subsides below the surface of the sea. Alternatively, Moyle and Cech distinguish six zones, though most reefs possess only some of the zones.[17] The reef surface is the shallowest part of the reef. It is subject to the surge and the rise and fall of tides. When waves pass over shallow areas, they shoal, as shown in the diagram at the right. This means the water is often agitated. These are the precise condition under which corals flourish. Shallowness means there is plenty of light for photosynthesis by the symbiotic zooxanthellae, and agitated water promotes the ability of coral to feed on plankton. However, other organisms must be able to withstand the robust conditions to flourish in this zone. The off-reef floor is the shallow sea floor surrounding a reef. This zone occurs by reefs on continental shelves. Reefs around tropical islands and atolls drop abruptly to great depths, and do not have a floor. Usually sandy, the floor often supports seagrass meadows which are important foraging areas for reef fish.

Water in the reef surface zone is often agitated. This diagram represents a reef on a continental shelf. The water waves at the left travel over the off-reef floor until they encounter the reef slope or fore reef. Then the waves pass over the shallow reef crest. When a wave enters shallow water it shoals, that is, it slows down and the wave height increases.

The reef drop-off is, for its first 50 metres, habitat for many reef fish who find shelter on the cliff face and plankton in the water nearby. The drop-off zone applies mainly to the reefs surrounding oceanic islands and atolls. The reef face is the zone above the reef floor or the reef drop-off. "It is usually the richest habitat. Its complex growths of coral and calcareous algae provide cracks and crevices for protection, and the abundant invertebrates and epiphytic algae provide an ample source of food."[17] The reef flat is the sandy-bottomed flat can be behind the main reef, containing chunks of coral. "The reef flat may be a protective area bordering a lagoon, or it may be a flat, rocky area between the reef and the shore. In the former case, the number of fish species living in the area often is the highest of any reef zone."[17]

Coral reef The reef lagoon "many coral reefs completely enclose an area, thereby creating a quiet-water lagoon that usually contains small patches of reef."[17] However, the "topography of coral reefs is constantly changing. Each reef is made up of irregular patches of algae, sessile invertebrates, and bare rock and sand. The size, shape and relative abundance of these patches changes from year to year in response to the various factors that favour one type of patch over another. Growing coral, for example, produces constant change in the fine structure of reefs. On a larger scale, tropical storms may knock out large sections of reef and cause boulders on sandy areas to move."[18]

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Locations
Coral reefs are estimated to cover 284300 square kilometers ( sqmi),[19] just under one tenth of one percent of the oceans' surface area. The Indo-Pacific region (including the Red Sea, Indian Ocean, Southeast Asia and the Pacific) account for 91.9% of this total. Southeast Asia accounts for 32.3% of that figure, while the Pacific including Australia accounts for 40.8%. Atlantic and Caribbean coral reefs account for 7.6%.[20] Although corals exist both in temperate and tropical waters, shallow-water reefs form only in a zone extending from 30N to 30S of the equator. Tropical corals do not grow at depths of over 50 meters (160ft). The optimum temperature for most coral reefs is 2627 C (7981F), and few reefs exist in waters below 18 C (64F).[21] However, reefs in the Persian Gulf have adapted to temperatures of 13 C (55F) in winter and 38 C (100F) in summer.[22]

Locations of coral reefs

Boundary for 20C isotherms. Most corals live within this boundary. Note the cooler waters caused by upwelling on the southwest coast of Africa and off the coast of Peru.

Deep water coral can exist at greater depths and colder temperatures at much higher latitudes, as far north as Norway.[23] Although deep water corals can form reefs, very little is known about them. Coral reefs are rare along the American and African west coasts. This is due primarily to upwelling and strong cold coastal currents that reduce water temperatures in these areas (respectively the Peru, Benguela and Canary streams).[24] Corals are seldom found along the coastline of South Asia from the eastern tip of India (Madras) to the Bangladesh and

Coral reef Myanmar borders.[20] They are also rare along the coast around northeastern South America and Bangladesh due to the freshwater release from the Amazon and Ganges Rivers, respectively. The Great Barrier Reeflargest, comprising over 2,900 individual reefs and 900 islands stretching for over 2600 kilometers (1600mi) off Queensland, Australia The Mesoamerican Barrier Reef Systemsecond largest, stretching 1000 kilometers (620mi) from Isla Contoy at the tip of the Yucatn Peninsula down to the Bay Islands of Honduras

23

This map shows areas of upwelling in red. Coral reefs are not found in coastal areas where colder and nutrient-rich upwellings occur.

The New Caledonia Barrier Reefsecond longest double barrier reef, covering 1500 kilometers (930mi) The Andros, Bahamas Barrier Reefthird largest, following the east coast of Andros Island, Bahamas, between Andros and Nassau The Red Seaincludes 6000-year-old fringing reefs located around a 2000km (1240mi) coastline Pulley Ridgedeepest photosynthetic coral reef, Florida Numerous reefs scattered over the Maldives The Raja Ampat Islands in Indonesia's West Papua province offer the highest known marine diversity.[25]

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Biology
Live coral are small animals embedded in calcium carbonate shells. It is a mistake to think of coral as plants or rocks. Coral heads consist of accumulations of individual animals called polyps, arranged in diverse shapes.[26] Polyps are usually tiny, but they can range in size from a pinhead to 12 inches (30cm) across. Reef-building or hermatypic corals live only in the photic zone (above 50metres), the depth to which sufficient sunlight penetrates the water, allowing photosynthesis to occur. Coral polyps do not themselves photosynthesize, but have a symbiotic relationship with zooxanthellae; these organisms live within the tissues of polyps and provide organic nutrients that nourish the polyp. Because of this relationship, coral reefs grow much faster in clear water, which admits more sunlight. Without their symbionts, coral growth would be too slow for the corals to form significant reef structures. Corals get up to 90% of their nutrients from their symbionts.[27] Reefs grow as polyps and other organisms deposit calcium carbonate,[28] [29] the basis of coral, as a skeletal structure beneath and around themselves, pushing the Anatomy of a coral polyp coral head's top upwards and outwards.[30] Waves, grazing fish (such as parrotfish), sea urchins, sponges, and other forces and organisms act as bioeroders, breaking down coral skeletons into fragments that settle into spaces in the reef structure or form sandy bottoms in associated reef lagoons. Many other organisms living in the reef community contribute skeletal calcium carbonate in the same manner.[31] Coralline algae are important contributors to reef structure in those parts of the reef subjected to the greatest forces by waves (such as the reef front facing the open ocean). These algae strengthen the reef structure by depositing limestone in sheets over the reef surface. The colonies of the one thousand coral species assume a characteristic shape such as wrinkled brains, cabbages, table tops, antlers, wire strands and pillars. Corals reproduce both sexually and asexually. An individual polyp uses both reproductive modes within its lifetime. Corals reproduce sexually by either internal or external fertilization. The reproductive cells are found on the mesentery membranes that radiate inward from the layer of tissue that lines the stomach cavity. Some mature adult corals are hermaphroditic; others are exclusively male or female. A few species change sex as they grow. Internally fertilized eggs develop in the polyp for a period ranging from days to weeks. Subsequent development produces a tiny larva, Table coral known as a planula. Externally fertilized eggs develop during synchronized spawning. Polyps release eggs and sperm into the water en masse, simultaneously. Eggs disperse over a large area. The timing

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of spawning depends on time of year, water temperature, and tidal and lunar cycles. Spawning is most successful when there is little variation between high and low tide. The less water movement, the better the chance for fertilization. Ideal timing occurs in the spring. Release of eggs or planula usually occurs at night, and is sometimes in phase with the lunar cycle (three to six days after a full moon). The period from release to settlement lasts only a few days, but some planulae can survive afloat for several weeks. They are vulnerable to predation and environmental conditions. The lucky few planulae which successfully attach to substrate next confront competition for food and space.

Close up of polyps are arrayed on a coral, waving their tentacles. There can be thousands of polyps on a single coral branch.

Brain coral

Staghorn coral

Spiral wire coral

Pillar coral

Darwin's paradox
Darwin's paradox Coral... seems to proliferate when ocean waters are warm, poor, clear and agitated, a fact which Darwin had already noted when he passed through Tahiti in 1842. This constitutes a fundamental paradox, shown quantitatively by the apparent impossibility of balancing input and output of the nutritive elements which control the coral polyp metabolism. Recent oceanographic research has brought to light the reality of this paradox by confirming that the oligotrophy of the ocean euphotic zone persists right up to the swell-battered reef crest. When you approach the reef edges and atolls from the quasidesert of the open sea, the near absence of living matter suddenly becomes a plethora of life, without transition. So why is there something rather than nothing, and more precisely, where do the necessary nutrients for the functioning of this extraordinary coral reef machine come from ? Francis Rougerie
[32]

During his voyage on the Beagle, Darwin described tropical coral reefs as oases in the desert of the ocean. He reflected on the paradox that tropical coral reefs, which are among the richest and most diverse ecosystems on earth, flourish surrounded by tropical ocean waters that provide hardly any nutrients. Coral reefs cover less than one tenth of one percent of the surface of the worlds ocean, yet they support over one-quarter of all marine species. This diversity results in complex food webs, with large predator fish eating smaller forage fish that eat yet smaller zooplankton and so on. However, all food webs eventually depend on plants, which are the primary producers. Coral reefs' primary productivity is very high, typically producing 5-10g C m2 day1 biomass.[33] One reason for the unusual clarity of tropical waters is they are deficient in nutrients and drifting plankton. Further, the sun shines year round in the tropics, warming the surface layer, making it less dense than subsurface layers. The warmer water is separated from deeper, cooler water by a stable thermocline, where the temperature makes a rapid change. This keeps the warm surface waters floating above the cooler deeper waters. In most parts of the ocean, there is little exchange between these layers. Organisms that die in aquatic environments generally sink to the bottom, where they decompose, which releases nutrients in the form of nitrogen (N), phosphorus (P) and potassium (K).

Coral reef These nutrients are necessary for plant growth, but in the tropics, they do not directly return to the surface.[10] Plants form the base of the food chain, and need sunlight and nutrients to grow. In the ocean, these plants are mainly microscopic phytoplankton which drift in the water column. They need sunlight for photosynthesis, which powers carbon fixation, so they are found only relatively near the surface. But they also need nutrients. Phytoplankton rapidly use nutrients in the surface waters, and in the tropics, these nutrients are not usually replaced because of the thermocline.[10] Around coral reefs, lagoons fill in with material eroded from the reef and the island. They become havens for marine life, providing protection from waves and storms. Most importantly, reefs recycle nutrients, which happens much less in the open ocean. In coral reefs and lagoons, producers include phytoplankton, as well as seaweed and coralline algae, especially small types called turf algae, which pass nutrients to corals.[34] The phytoplankton are eaten by fish and crustaceans, who also pass nutrients along the food web. Recycling ensures fewer nutrients are needed overall to support the community. Coral reefs support many symbiotic relationships. In particular, zooxanthellae provide energy to coral in the form of glucose, glycerol, and amino acids.[35] Zooxanthellae can provide up to 90% of a corals energy requirements.[36] In return, as an example of mutualism, the corals shelter the zooxanthellae, averaging one million for every cubic centimetre of coral, and provide a constant supply of the carbon dioxide they need for photosynthesis.
Coral polyps

26

Corals also absorb nutrients, including inorganic nitrogen and phosphorus, directly from water. Many corals extend their tentacles at night to catch zooplankton that brush them when the water is agitated. Zooplankton provide the polyp with nitrogen, and the polyp shares some of the nitrogen with the zooxanthellae, which also require this element.[34] The varying pigments in different species of zooxanthellae give them an overall brown or golden-brown appearance, and give brown corals their colours. Other pigments such as reds, blues, greens, etc. come from colored proteins made by the coral animals. Coral which loses a large fraction of its zooxanthellae becomes white (or sometimes pastel shades in corals that are richly pigmented with their own colorful proteins) and is said to be bleached, a condition which, unless corrected, can kill the coral.

The colour of corals depends on the combination of brown shades provided by their zooxanthellae and pigmented proteins (reds, blues, greens, etc.) produced by the corals themselves.

Sponges are another key to explaining Darwins paradox. They live in crevices in the coral reefs. They are efficient filter feeders, and in the Red Sea they consume about 60% of the phytoplankton that drifts by. The sponges eventually excrete nutrients in a form the corals can use.[37]

Coral reef

27 The roughness of coral surfaces is the key to coral survival in agitated waters. Normally, a boundary layer of still water surrounds a submerged object, which acts as a barrier. Waves breaking on the extremely rough edges of corals disrupt the boundary layer, allowing the corals access to passing nutrients. Turbulent water thereby promotes reef growth and branching. Without the nutritional gains brought by rough coral surfaces, even the most effective recycling would leave corals wanting in nutrients.[38]

Most coral polyps are nocturnal feeders. Here, in the dark, polyps have extended their tentacles to feed on zooplankton.

Cyanobacteria provide soluble nitrates for the reef via nitrogen fixation.[39]

Coral reefs also often depend on surrounding habitats, such as seagrass meadows and mangrove forests, for nutrients. Seagrass and mangroves supply dead plants and animals which are rich in nitrogen and also serve to feed fish and animals from the reef by supplying wood and vegetation. Reefs, in turn, protect mangroves and seagrass from waves and produce sediment in which the mangroves and seagrass can root.[40]

Biodiversity
Coral reefs form some of the world's most productive ecosystems, providing complex and varied marine habitats that support a wide range of other organisms.[41] Fringing reefs just below low tide level also have a mutually beneficial relationship with mangrove forests at high tide level and sea grass meadows in between: the reefs protect the mangroves and seagrass from strong currents and waves that would damage them or erode the sediments in which they are rooted, while the mangroves and sea grass protect the coral from large influxes of silt, fresh water and pollutants. This additional level of variety in the environment is beneficial to many types of coral reef animals, which, for example, may feed in the sea grass and use the reefs for protection or breeding.[42] Reefs are home to a large variety of organisms, including fish, seabirds, sponges, cnidarians (which includes some types of corals and jellyfish), worms, crustaceans (including shrimp, cleaner shrimp, spiny lobsters and crabs), Tube sponges attracting cardinal fishes, glassfishes and wrasses molluscs (including cephalopods), echinoderms (including starfish, sea urchins and sea cucumbers), sea squirts, sea turtles and sea snakes. Aside from humans, mammals are rare on

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coral reefs, with visiting cetaceans such as dolphins being the main exception. A few of these varied species feed directly on corals, while others graze on algae on the reef.[20] [34] Reef biomass is positively related to species diversity.[43]

Fish
Over 4,000 species of fish inhabit coral reefs.[20] The reasons for this diversity remain controversial. Hypotheses include the "lottery", in which the first (lucky winner) recruit to a territory is typically able to defend it against latecomers, "competition", in which adults compete for territory, and less-competitive species must be able to survive in poorer habitat, and "predation", in which population size is a function of postsettlement piscivore mortality.[44] Healthy reefs can produce up to 35 tons of fish per square kilometre each year, but damaged reefs produce much less.[45] Reef species include: Fish that influence the coral feed either on Organisms can cover every square inch of a coral reef. small animals living near the coral, seaweed/algae, or on the coral itself. Fish that feed on small animals include Labridae (cleaner fish) who notably feed on organisms that inhabit larger fish, bullet fish and sea-urchin-eating Balistidae (triggerfish), while seaweed-eating fish include the Pomacentridae (damselfishes). Serranidae (groupers) cultivate the seaweed by removing creatures feeding on it (such as sea urchins), and they remove inedible seaweeds. Fish that eat coral itself include Scaridae (parrotfish) and Chaetodontidae (butterflyfish). Fish that cruise the boundaries of the reef or nearby seagrass meadows include predators, such as Trachinotus(pompanos), groupers, horse mackerels, certain types of shark, barracudas and Lutjanidae (snappers). Herbivorous and plankton-eating fish also populate reefs. Seagrass-eating fish include horse mackerel, snapper, Pagellus (porgies) and Conodon (grunts). Plankton-eating fish include Caesio (fusilier), ray, chromis, and the nocturnal Holocentridae (squirrelfish), Apogonidae (cardinalfish) and Myctophidae (lanternfish). Fish that swim in coral reefs can be as colorful as the reef. Examples are the parrotfish, Pomacanthidae (angelfish), damselfish, Clinidae (blennies) and butterflyfish. At night, some change to a less vivid color.

Invertebrates
Sea urchins, Dotidae and sea slugs eat seaweed. Some species of sea urchins, such as Diadema antillarum, can play a pivotal part in preventing algae from overrunning reefs.[46] Nudibranchia and sea anemones eat sponges. A number of invertebrates, collectively called cryptofauna, inhabit the coral skeletal substrate itself, either boring into the skeletons (through the process of bioerosion) or living in pre-existing voids and crevices. Those animals boring into the rock include sponges, bivalve mollusks, and sipunculans. Those settling on the reef include many other species, particularly crustaceans and polychaete worms.[24]

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Algae
Reefs are chronically at risk of algal encroachment. Overfishing and excess nutrient supply from onshore can enable algae to outcompete and kill the coral.[47] [48] In surveys done around largely uninhabited US Pacific islands, algae inhabit a large percentage of surveyed coral locations.[49] The algae population consists of turf algae, coralline algae, and macroalgae.

Seabirds
Coral reef systems provide important habitats for seabird species, some endangered. For example, Midway Atoll in Hawaii supports nearly three million seabirds, including two-thirds (1.5 million) of the global population of Laysan albatross, and one-third of the global population of black-footed albatross.[50] Each seabird species has specific sites on the atoll where they nest. Altogether, 17 species of seabirds live on Midway. The short-tailed albatross is the rarest, with fewer than 2,200 surviving after excessive feather hunting in the late19th century.[51]

Other
Sea snakes feed exclusively on fish and their eggs. Tropical birds, such as herons, gannets, pelicans and boobies, feed on reef fish. Some land-based reptiles intermittently associate with reefs, such as monitor lizards, the marine crocodile and semiaquatic snakes, such as Laticauda colubrina. Sea turtles eat sponges.

Schooling reef fish

Caribbean reef squid

Banded coral shrimp

The whitetip reef shark almost exclusively inhabits coral reefs.

Green turtle

Giant clam

Soft coral, cup coral, sponges and ascidians

Banded sea krait

Economic value
Coral reefs deliver ecosystem services to tourism, fisheries and coastline protection. The global economic value of coral reefs has been estimated at as much as $US375 billion per year.[52] Coral reefs protect shorelines by absorbing wave energy, and many small islands would not exist without their reef to protect them. According to the environmental group World Wide Fund for Nature, the economic cost over a 25 year period of destroying one kilometre of coral reef is somewhere between $137,000 and $1,200,000.[53] About six million tons of fish are taken each year from coral reefs. Well-managed coral reefs have an annual yield of 15 tons seafood on average per square kilometre. Southeast Asia's coral reef fisheries alone yield about $ 2.4 billion annually from seafood.[53] To improve the management of coastal coral reefs, another environmental group, the World Resources Institute (WRI) developed and published tools for calculating the value of coral reef-related tourism, shoreline protection and

Coral reef fisheries, partnering with five Caribbean countries. As of April2011, published working papers covered St. Lucia, Tobago, Belize, and the Dominican Republic, with a paper for Jamaica in preparation. The WRI was also "making sure that the study results support improved coastal policies and management planning".[54] The Belize study estimated the value of reef and mangrove services at 395559 million dollars annually.[55]

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Threats
Coral reefs are dying around the world.[56] In particular, coral mining, agricultural and urban runoff, pollution (organic and inorganic), overfishing, blast fishing, disease, and the digging of canals and access into islands and bays are localized threats to coral ecosystems. Broader threats are sea temperature rise, sea level rise and pH changes from ocean acidification, all associated with greenhouse gas emissions. In El Nino-year 2010, preliminary reports show global coral bleaching [56] reached its worst level since another El Nino year, 1998, when 16 Island with fringing reef off Yap, Micronesia percent of the world's reefs died as a result of increased water temperature. In Indonesia's Aceh province, surveys showed some 80 percent of bleached corals died. In July, Malaysia closed several dive sites where virtually all the corals were damaged by bleaching.[57] [58] To find answers for these problems, researchers study the various factors that impact reefs. The list includes the ocean's role as a carbon dioxide sink, atmospheric changes, ultraviolet light, ocean acidification, viruses, impacts of dust storms carrying agents to far flung reefs, pollutants, algal blooms and others. Reefs are threatened well beyond coastal areas. General estimates show approximately 10% of the world's coral reefs are dead.[59] [60] [61] About 60% of the world's reefs are at risk due to destructive, human-related activities. The threat to the health of reefs is particularly strong in Southeast Asia, where 80% of reefs are endangered.

Protection
Marine Protected Areas (MPAs) have become increasingly prominent for reef management. MPAs promote responsible fishery management and habitat protection. Much like national parks and wildlife refuges, and to varying degrees, MPAs restrict potentially damaging activities. MPAs encompass both social and biological objectives, including reef restoration, aesthetics, biodiversity, and economic benefits. Conflicts surrounding MPAs involve lack of participation, clashing views, effectiveness, and funding. In some situations, as in the Phoenix Islands Protected Area, MPAs can also provide revenue, potentially equal to the income they would have generated without controls, as Kiribati did for its Phoenix Islands.[62]

A diversity of corals

Biosphere reserve, marine park, national monument and world heritage status can protect reefs. For example, Belize's Barrier reef, Chagos archipelago, Sian Ka'an, the Galapagos islands, Great Barrier Reef, Henderson Island, Palau and Papahnaumokukea Marine National Monument are world heritage sites. In Australia, the Great Barrier Reef is protected by the Great Barrier Reef Marine Park Authority, and is the subject of much legislation, including a biodiversity action plan. Inhabitants of Ahus Island, Manus Province, Papua New Guinea, have followed a generations-old practice of restricting fishing in six areas of their reef lagoon. Their cultural traditions allow line fishing, but not net or spear

Coral reef fishing. The result is both the biomass and individual fish sizes are significantly larger than in places where fishing is unrestricted.[63] [64]

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Artificial reefs
Efforts to expand the size and number of coral reefs generally involve supplying substrate to allow more corals to find a home. Substrate materials include discarded vehicle tires, scuttled ships, subway cars, and formed concrete, such as reef balls. Reefs also grow unaided on marine structures such as oil rigs. In large restoration projects, propagated hermatypic coral on substrate can be secured with metal pins, superglue or milliput.[65] Needle and thread can also attach A-hermatype coral to substrate.[66]

Coral nubbins growing on nontoxic concrete

Low-voltage electrical currents applied through seawater crystallize dissolved minerals onto steel structures. The resultant white carbonate (aragonite) is the same mineral that makes up natural coral reefs. Corals rapidly colonize and grow at accelerated rates on these coated structures. The electrical currents also accelerate formation and growth of both chemical limestone rock and the skeletons of corals and other shell-bearing organisms. The vicinity of the anode and cathode provides a high-pH environment which inhibits the growth of competitive filamentous and fleshy algae. The increased growth rates fully depend on the accretion activity.[67] During accretion, the settled corals display an increased growth rate, size and density, but after the process is complete, growth rate and density return to levels comparable to natural growth, and are about the same size or slightly smaller.[67]

Origins
Beginning a few thousand years after marine organisms developed hard skeletons, coral reefs emerged. The times of maximum development were in the Middle Cambrian (513501 Ma), Devonian (416359 Ma) and Carboniferous (359299 Ma), due to Order Rugosa extinct corals, and Late Cretaceous (10065 Ma) and all Neogene (23 Mapresent), due to Order Scleractinia corals. Not all reefs in the past were formed by corals: Early Cambrian (542513 Ma) reefs resulted from Ancient coral reefs calcareous algae and archaeocyathids (small animals with conical shape, probably related to sponges), and rudists, a type of bivalve, built Late Cretaceous (10065 Ma) reefs.

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Organizations
Organizations which currently undertake coral reef/atoll restoration projects using simple methods of plant propagation: Coral Cay [68] Counterpart International[69] U.S. Coral Reef Task Force (CRTF) National Coral Reef Institute (NCRI) [70] US Department of Commerces National Oceanic and Atmospheric Administration (NOAA): Coral Reef Conservation Program National Center for Coral Reef Research (NCORE) Reef Ball Southeast Florida Coral Reef Initiative (SEFCRI) Foundation of the peoples of the South Pacific [71] WorldFishCenter: promotes sustainable mariculture techniques to grow reef organismsas tridacnidae Coral Restoration Foundation (CRF) : Adopt a Coral [72]

Organizations which promote interest, provide knowledge bases about coral reef survival, and promote activities to protect and restore coral reefs: Australian Coral Reef Society Biosphere Foundation[73] Chagos Conservation Trust Conservation Society of Pohnpei Coral Cay Conservation Coral Reef Care Coral Reef Alliance (CORAL) Coral Reef Alliance (CORAL) [74] Coral Reef Targeted Research and Capacity Building for Management Coral Triangle Initiative Cousteau Society Crusoe Reef Society CEDAM International Earthwatch Environmental Defense Fund Environmental Solutions International Friends of Saba Marine Park Global Coral Reef Alliance (GCRA) Global Coral Reef Alliance (GCRA) [75] Global Coral Reef Monitoring Network[76] Great Barrier Reef Marine Park Authority Green Fins ICRAN Mesoamerican Reef Alliance International Coral Reef Initiative (ICRI)[77] International Marinelife Alliance International Society for Reef Studies Intercoast Network Kosrae Conservation and Safety Organization Marine Conservation Group

Marine Conservation Society Mesoamerican Reef Tourism Initiative (MARTI)

Coral reef NSF Moorea Coral Reef Long-term Ecological Research site[78] Nature Conservancy Ocean Voice International PADI Planetary Coral Reef Foundation[79] Practical Action[80] Project Reefkeeper ReefBase Reef Check Reef Relief[81] Reefwatch Save Our Seas Foundation[82] Seacology SECORE Singapore Underwater Federation Society for Andaman and Nicobar Ecology Tubbataha Foundation

33

Wildlife Conservation International WWF

Notes
[1] Mulhall M (2007) Saving rainforests of the sea: An analysis of international efforts to conserve coral reefs (http:/ / www. law. duke. edu/ shell/ cite. pl?19+ Duke+ Envtl. + L. + & + Pol'y+ F. + 321+ pdf) Duke Environmental Law and Policy Forum 19:321351. [2] Hoover, John (November, 2007). Hawaii's Sea Creatures. Mutual. ISBN1-5854702902. [3] "Corals reveal impact of land use" (http:/ / www. coralcoe. org. au/ news_stories/ landimpacts. html). ARC Centre of Excellence for Coral Reef Studies. . Retrieved 12 July 2007. [4] Minato, Charissa (July 1, 2002). "Urban runoff and coastal water quality being researched for effects on coral reefs" (http:/ / www. hcri. ssri. hawaii. edu/ files/ media/ pr-water_quality. pdf). . Retrieved December, 2010. [5] "Coastal Watershed Factsheets - Coral Reefs and Your Coastal Watershed" (http:/ / water. epa. gov/ type/ oceb/ fact4. cfm). Environmental Protection Agency Office of Water. July 1998. . Retrieved December, 2010. [6] Kleypas, Joanie (September 21, 2010). "Coral reef" (http:/ / www. eoearth. org/ article/ Coral_reef#Types_of_Coral_Reefs). The Encyclopedia of Earth. . Retrieved April 4, 2011. [7] Darwin, Charles (1842). The Structure and Distribution of Coral Reefs. Being the first part of the geology of the voyage of the Beagle, under the command of Capt. Fitzroy, R.N. during the years 1832 to 1836 (http:/ / darwin-online. org. uk/ content/ frameset?viewtype=text& itemID=F271& pageseq=1). London: Smith Elder and Co. [8] Gordon Chancellor (2008). Introduction to Coral reefs (http:/ / darwin-online. org. uk/ EditorialIntroductions/ Chancellor_CoralReefs. html). Darwin Online. . Retrieved 2009-01-20 [9] Animation of coral atoll formation (http:/ / oceanservice. noaa. gov/ education/ kits/ corals/ media/ supp_coral04a. html) NOAA Ocean Education Service. Retrieved 9 January 2010. [10] Anderson, Genny (2003). "htm Coral Reef Formation" (http:/ / www. marinebio. net/ marinescience/ 04benthon/ crform. ). Marinebio.net. . Retrieved April 5, 2011. [11] Great Barrier Reef Marine Park Authority (2006). "A "big picture" view of the Great Barrier Reef" (http:/ / www. gbrmpa. gov. au/ __data/ assets/ pdf_file/ 0017/ 12437/ Reef-Facts-01. pdf) (PDF). Reef Facts for Tour Guides. . Retrieved 18 June 2007. [12] Tobin, Barry (1998, revised 2003). "How the Great Barrier Reef was formed" (http:/ / www. aims. gov. au/ pages/ research/ project-net/ reefs/ apnet-reefs00. html). Australian Institute of Marine Science. . Retrieved 22 November 2006. [13] CRC Reef Research Centre Ltd. "What is the Great Barrier Reef?" (http:/ / www. reef. crc. org. au/ discover/ coralreefs/ coralgbr. html). . Retrieved 28 May 2006. [14] Four Types of Coral Reef (http:/ / www. stanford. edu/ group/ microdocs/ typesofreefs. html) Microdocs, Stanford Education. Retrieved 10 January 2010. [15] MSN Encarta (2006). "Great Barrier Reef" (http:/ / encarta. msn. com/ encyclopedia_761575831/ Great_Barrier_Reef. html). Great Barrier Reef. . Retrieved 11 December 2006. [16] Smithers, S.G. and Woodroffe, C.D. (August 2000). "Microatolls as sea-level indicators on a mid-ocean atoll." (http:/ / www. sciencedirect. com/ science?_ob=ArticleURL& _udi=B6V6M-40WDSPX-4& _user=10& _coverDate=08/ 15/ 2000& _rdoc=1& _fmt=summary&

Coral reef
_orig=browse& _sort=d& view=c& _acct=C000050221& _version=1& _urlVersion=0& _userid=10& md5=844934e86d603e4aa8f0c42faa6b42ef). Marine Geology 168 (14): 6178. doi:10.1016/S0025-3227(00)00043-8. . [17] Moyle & Cech 2003, p.556 [18] Connell, Joseph H. (March 24, 1978). "Diversity in Tropical Rain Forests and Coral Reefs". Science 199 (4335): 13021310. doi:10.1126/science.199.4335.1302. [19] UNEP (2001) UNEP-WCMC World Atlas of Coral Reefs (http:/ / coral. unep. ch/ atlaspr. htm) Coral Reef Unit [20] Spalding, Mark, Corinna Ravilious, and Edmund Green. 2001. World Atlas of Coral Reefs. Berkeley, CA: University of California Press and UNEP/WCMC. [21] Achituv, Y. and Dubinsky, Z. 1990. Evolution and Zoogeography of Coral Reefs Ecosystems of the World. Vol. 25:1-8. [22] The Greenpeace Book of Coral Reefs [23] Gunnerus, Johan Ernst (1768). Om Nogle Norske Coraller. [24] Nybakken, James. 1997. Marine Biology: An Ecological Approach. 4th ed. Menlo Park, CA: Addison Wesley. [25] NGM.natinalgeographic.com (http:/ / ngm. nationalgeographic. com/ 2007/ 09/ indonesia/ doubilet-text), Ultra Marine: In far eastern Indonesia, the Raja Ampat islands embrace a phenomenal coral wilderness, by David Doubilet, National Geographic, September 2007 [26] Sherman, C.D.H. " The Importance of Fine-scale Environmental Heterogeneity in Determining Levels of Genotypic Diversity and Local Adaption (http:/ / www. library. uow. edu. au/ adt-NWU/ uploads/ approved/ adt-NWU20060726. 114643/ public/ 02Whole. pdf)." University of Wollongong Ph.D. Thesis. 2006. Accessed 2009-06-07. [27] Paul Marshall and Heidi Schuttenberg.; Marshall, Paul; Schuttenberg, Heidi. (2006). A Reef Managers Guide to Coral Bleaching (http:/ / www. gbrmpa. gov. au/ corp_site/ info_services/ publications/ misc_pub/ a_reef_managers_guide_to_coral_bleaching). Townsville, Australia: Great Barrier Reef Marine Park Authority,. ISBN1 876945 40 0. . [28] Stacy, J., Marion, G., McCulloch, M. and Hoegh-Guldberg, O. " changes to Mackay Whitsunday water quality and connectivity between terrestrial, mangrove and coral reef ecosystems: Clues from coral proxies and remote sensing records -Synthesis of research from an ARC Linkage Grant (2004-2007) (http:/ / www. marine. uq. edu. au/ mackayarc/ Reports & publications/ Mackay_ARC_2007_lowres. pdfLong-term)." University of Queensland - Centre for Marine Studies. May 2007. Accessed 2009-06-07. [29] Nothdurft, L.D. " Microstructure and early diagensis of recent reef building scleractinian corals, Heron Reef, Great Barrier Reef: Implications for palaeoclimate analysis (http:/ / eprints. qut. edu. au/ 16690/ 2/ 02whole. pdf)." Queensland University of Technology Ph.D. Thesis. 2007. Accessed 2009-06-07. [30] Wilson, R.A. " The Biological Notion of Individual (http:/ / plato. stanford. edu/ entries/ biology-individual/ )."Stanford Encyclopedia of Philosophy. August 9, 2007. Accessed 2009-06-07. [31] Jennings S, Kaiser MJ and Reynolds JD (2001) Marine fisheries ecology (http:/ / books. google. co. nz/ books?id=oTVyeNQyoiMC& printsec=frontcover& dq=Marine+ fisheries+ ecology& hl=en& ei=6kNGTrP1Mq7MmAW8qcDFBg& sa=X& oi=book_result& ct=result& resnum=1& ved=0CCoQ6AEwAA#v=onepage& q& f=false) Wiley-Blackwell, pp. 291293. ISBN 9780632050987. [32] Rougerier, F The functioning of coral reefs and atolls: from paradox to paradigm (http:/ / horizon. documentation. ird. fr/ exl-doc/ pleins_textes/ pleins_textes_7/ b_fdi_53-54/ 010020202. pdf) ORSTOM, Papeete. [33] Sorokin, Yuri I. (1993). Coral Reef Ecology. Germany: Sringer-Herlag, Berlin Heidelberg. ISBN978-0387564272. [34] Castro, Peter and Michael Huber. 2000. Marine Biology. 3rd ed. Boston: McGraw-Hill. [35] Zooxanthellae What's That? (http:/ / oceanservice. noaa. gov/ education/ kits/ corals/ coral02_zooxanthellae. html) [36] A Reef Managers Guide to Coral Bleaching (http:/ / www. gbrmpa. gov. au/ corp_site/ info_services/ publications/ misc_pub/ a_reef_managers_guide_to_coral_bleaching). Townsville, Australia: Great Barrier Reef Marine Park Authority,. 2006. ISBN1 876945 40 0. . [37] Roach, John (November 7, 2001). "Rich Coral Reefs in Nutrient-Poor Water: Paradox Explained?" (http:/ / news. nationalgeographic. com/ news/ 2001/ 11/ 1107_keyholecoral. html). National Geographic News. . Retrieved April 5, 2011. [38] "Corals play rough over Darwin's paradox" (http:/ / www. newscientist. com/ article/ mg17523612. 100-corals-play-rough-over-darwins-paradox. html). New Scientist date=21 September 2002 (2361). . [39] Wilson E (2004). "Coral's Symbiotic Bacteria Fluoresce, Fix Nitrogen" (http:/ / pubs. acs. org/ cen/ news/ 8233/ 8233notw7. html). Chemical and engineering news 82 (33): 7. . [40] Wells, Sue; Hanna, Nick (1992). Greenpeace Book of Coral Reefs. Sterling Publishing Company. ISBN0806987952. [41] Barnes, R.S.K., and Mann, K.H. (1991). Fundamentals of Aquatic Ecology (http:/ / books. google. com/ ?id=mOZZlzgdTrwC& pg=PA227& dq="Coral+ Reef"+ productivity). Blackwell Publishing. pp.217227. ISBN0632029838. . Retrieved 2008-11-26. [42] Hatcher, B.G. Johannes, R.E., and Robertson, A.J. (1989). "Conservation of Shallow-water Marine Ecosystems" (http:/ / books. google. com/ ?id=XpmNqFaDZ7cC& pg=PA320& dq="Coral+ Reef"+ mangrove+ "seagrass"). Oceanography and Marine Biology: An Annual Review: Volume 27. Routledge. p.320. ISBN0080377181. . Retrieved 2008-11-21. [43] "World's Reef Fishes Tussling With Human Overpopulation" (http:/ / www. sciencedaily. com/ releases/ 2011/ 04/ 110405130347. htm). ScienceDaily. Apr. 5, 2011. . Retrieved April 25, 2011. [44] Buchheim, Jason. "Coral Reef Fish Ecology" (http:/ / www. marinebiology. org/ fishecology. htm). marinebiology.org. . Retrieved April 5, 2011. [45] McClellan, Kate; Bruno, John (2008). "Coral degradation through destructive fishing practices" (http:/ / www. eoearth. org/ article/ Coral_degradation_through_destructive_fishing_practices). Encyclopedia of Earth. . Retrieved October 25, 2008. [46] Osborne, Patrick L. (2000). Tropical Ecosystem and Ecological Concepts. Cambridge: Cambridge University Press. pp.464. ISBN0 521 64523 9.

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[47] "Coral Reef Biology" (http:/ / www. coral. noaa. gov/ component/ content/ article/ 138. html). NOAA. . Retrieved April 6, 2011. [48] Glynn, P.W. (1990). Dubinsky, Z.. ed. Ecosystems of the World v. 25-Coral Reefs. New York, NY: Elsevier Science. ISBN978-0444873927. [49] Vroom, Peter S.; Page, Kimberly N.; Kenyon, Jean C.; Brainard, Russell E. (2006). "Algae-Dominated Reefs". American Scientist 94 (5): 430437. doi:10.1511/2006.61.1004. [50] The.honoluluadvertiser.com (http:/ / the. honoluluadvertiser. com/ article/ 2005/ Jan/ 17/ ln/ ln23p. html) [51] "U.S. Fish & Wildlife Service - Birds of Midway Atoll" (http:/ / www. fws. gov/ midway/ midwaywildlifebirds. html). . Retrieved August 19, 2009. [52] "Heat Stress to Caribbean Corals in 2005 Worst on Record" (http:/ / www. noaanews. noaa. gov/ stories2010/ 20101115_coralbleaching. html). National Oceanic and Atmospheric Administration. 15 November 2010. . Retrieved April 7, 2011. [53] "The Importance of Coral to People" (http:/ / www. worldwildlife. org/ what/ wherewework/ coraltriangle/ importance-of-coral. html). World Wildlife Fund. . Retrieved April 7, 2011. [54] "Coastal Capital: Economic Valuation of Coastal Ecosystems in the Caribbean" (http:/ / www. wri. org/ project/ valuation-caribbean-reefs). World Resources Institute. . [55] Cooper, Emily; Burke, Lauretta; Bood, Nadia (2008). "Coastal Capital: Belize: The Economic Contribution of Belizes Coral Reefs and Mangroves" (http:/ / pdf. wri. org/ coastal_capital_belize_brochure. pdf). . Retrieved April 6, 2011. [56] "Coral reefs around the world" (http:/ / www. guardian. co. uk/ environment/ interactive/ 2009/ sep/ 02/ coral-world-interactive). Guardian.co.uk. 2 September 2009. . [57] Ritter, Karl (December 8, 2010). goal-coral-reefs.html "Climate goal may spell end for some coral reefs" (http:/ / www. physorg. com/ news/ 2010-12-climate). Associated Press. goal-coral-reefs.html. Retrieved December, 2010. [58] Markey, Sean (May 16, 2006). "Global Warming Has Devastating Effect on Coral Reefs, Study Shows". National Geographic News. [59] Kleypas, J.A.; Feely, R.A.; Fabry, V.J.; Langdon, C.; Sabine, C.L. (2006), Impacts of Ocean Acidification on Coral Reefs and Other Marine Calcifiers: A guide for Future Research (http:/ / www. ucar. edu/ communications/ Final_acidification. pdf), National Science Foundation, NOAA, & United States Geological Survey, , retrieved April 7, 2011 [60] Save Our Seas, 1997 Summer Newsletter, Dr. Cindy Hunter and Dr. Alan Friedlander [61] Tun, K.; Chou, L.M.; Cabanban, A.; Tuan, V.S.; Philreefs; Yeemin, T.; Suharsono; Sour, K. et al. (2004). "Status of Coral Reefs, Coral Reef Monitoring and Management in Southeast Asia, 2004". In Wilkinson, C.. Status of Coral Reefs of the world: 2004. Townsville, Queensland, Australia: Australian Institute of Marine Science. pp.235276. [62] "Phoenix Rising" (http:/ / ngm. nationalgeographic. com/ 2011/ 01/ phoenix-islands/ stone-text). National Geographic Magazine. January 2011. . Retrieved April 30, 2011. [63] Cinner, Joshua E.; MARNANE, Michael J.; McClanahan, Tim R. (2005). "Conservation and community benefits from traditional coral reef management at Ahus Island, Papua New Guinea" (http:/ / onlinelibrary. wiley. com/ doi/ 10. 1111/ j. 1523-1739. 2005. 00209. x-i1/ abstract). Conservation Biology 19 (6): 17141723. doi:10.1111/j.1523-1739.2005.00209.x-i1. . [64] "Coral Reef Management, Papua New Guinea" (http:/ / earthobservatory. nasa. gov/ Newsroom/ NewImages/ images. php3?img_id=17182). Nasa's Earth Observatory. . Retrieved 2 November 2006. [65] Superglue used for placement of coral (http:/ / coralgarden. co. uk/ plate. html) [66] Needle and thread use with soft coral (http:/ / coralgarden. co. uk/ puls. html) [67] Sabater, Marlowe G.; Yap, Helen T. (2004). "Long-term effects of induced mineral accretion on growth, survival, and corallite properties of Porites cylindrica Dana" (http:/ / people. uncw. edu/ szmanta/ 2006 pdfs/ 21 Mineral accretion/ Sabater and Yap 2004 long term growth w mineral accretion. pdf) (PDF). Journal of Experimental Marine Biology and Ecology 311: 355374. doi:10.1016/j.jembe.2004.05.013. . [68] http:/ / www. coralcay. org/ expeditions/ marine/ fj1/ [69] 'The Coral Gardener'-documentary about Counterpart scientist Austin Bowden-Kerby (http:/ / www. bbc. co. uk/ programmes/ b009jsjv) [70] http:/ / www. nova. edu/ ncri [71] http:/ / www. fspi. org. fj/ programs. htm [72] http:/ / www. coralrestoration. org [73] Biosphere Foundation (http:/ / www. biospherefoundation. org) [74] http:/ / www. coral. org/ [75] http:/ / globalcoral. org/ [76] Global Coral Reef Monitoring Network Status of Coral Reefs of the World 2008 (http:/ / www. reefbase. org/ resource_center/ publication/ main. aspx?refid=27173& referrer=GCRMN) [77] International Coral Reef Initiative (http:/ / www. icriforum. org) [78] NSF Moorea Coral Reef Long-term Ecological Research site (http:/ / mcr. lternet. edu) [79] Planetary Coral Reef Foundation (http:/ / www. pcrf. org) [80] Action coral reef restoration Practical Action (http:/ / practicalaction. org/ docs/ technical_information_service/ coral_reefs. pdfPractical) [81] Reef Relief (http:/ / reefrelieffounders. com) [82] Save Our Seas Foundation (http:/ / saveourseas. com)

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References
Butler, Steven. 1996. "Rod? Reel? Dynamite? A tough-love aid program takes aim at the devastation of the coral reefs". U.S. News and World Report, 25 November 1996. Christie, P. 2005a. University of Washington, Lecture. 18 May 2005. Christie, P. 2005b. University of Washington, Lecture. 4 May 2005. Clifton, Julian (2003). "Prospects for Co-Management in Indonesia's Marine Protected Areas". Marine Policy 27 (5): 389395. Courtney, Catherine and Alan White. 2000. Integrated Coastal Management in the Philippines. Coastal Management; Taylor and Francis. Fox, Helen. 2005. Experimental Assessment of Coral Reef Rehabilitation Following Blast Fishing. The Nature Conservancy Coastal and Marine Indonesia Program. Blackwell Publishers Ltd, February 2005. Gjertsen, Heidi. 2004. Can Habitat Protection Lead to Improvements in Human Well-Being? Evidence from Marine Protected Areas in the Philippines. Moyle, PB; Cech, JJ (2003). Fishes, An Introduction to Ichthyology (5 ed.). Benjamin Cummings. ISBN978-0131008472. Sadovy, Y.J. Ecological Issues and the Trades in Live Reef Fishes, Part 1 USEPA (http://www.epa.gov/awow/oceans/coral/about.html). UNEP. 2004. Coral Reefs in the South China Sea. UNEP/GEF/SCS Technical Publication No. 2. (http://www. unepscs.org/SCS_Documents/Download/13_-_Habitat_Booklets/ UNEP_or_GEF_Review_of_Coral_Reefs_in_the_South_China_Sea.html) UNEP. 2007. Coral Reefs Demonstration Sites in the South China Sea. UNEP/GEF/SCS Technical Publication No. 5. (http://www.unepscs.org/SCS_Documents/Download/19_-_Technical_Publications_and_Guidelines/ Technical_Publication_05_-_Coral_Reef_Demonstration_Sites_in_the_South_China_Sea.html) UNEP, 2007. National Reports on Coral Reefs in the Coastal Waters of the South China Sea. UNEP/GEF/SCS Technical Publication No. 11. (http://www.unepscs.org/SCS_Documents/Download/ 19_-_Technical_Publications_and_Guidelines/ Technical_Publication_11_-_National_Reports_on_Coral_Reefs_in_the_Coastal_Waters_of_the_South_China_Sea. html)

External links
External images
Coral Reefs: Rainforests of the Sea (http://www.oceanicresearch.org/education/films/crrain_qt.htm) ORG Educational films.

Coral Reefs (http://ocean.si.edu/ocean-life-ecosystems/coral-reefs)- At the Smithsonian Ocean Portal How Coral Reefs Work (http://animals.howstuffworks.com/marine-life/coral-reef.htm) International Coral Reef Initiative (http://www.icriforum.org) International Year of the Reef in 2008 (http://www.iyor.org) Moorea Coral Reef Long Term Ecological Research Site (US NSF) (http://mcr.lternet.edu) ARC Centre of Excellence for Coral Reef Studies (http://www.coralcoe.org.au/index.html) NOAA's Coral-List Listserver for Coral Reef Information and News (http://coral.aoml.noaa.gov/mailman/ listinfo/coral-list/) NOAA's Coral Reef Conservation Program (http://www.coralreef.noaa.gov/) Exhibition of the Mexican Caribbean coral reef biodiversity aquarium in Xcaret Mexico (http://www.xcaret. com/Exhibitions/Coral_Reef_Aquarium.html) NOAA's Coral Reef Information System (http://www.coris.noaa.gov/)

Coral reef ReefBase: A Global Information System on Coral Reefs (http://www.reefbase.org/) National Coral Reef Institute (http://www.nova.edu/ncri/) Nova Southeastern University Marine Aquarium Council (http://www.aquariumcouncil.org) NCORE National Center for Coral Reef Research (http://www.ncoremiami.org/) University of Miami Science and Management of Coral Reefs in the South China Sea and Gulf of Thailand (http://www.unepscs. org/index.php?option=com_content&task=view&id=51&Itemid=83) NBII portal on coral reefs (http://coralreefs.nbii.gov/portal/server.pt) Microdocs (http://www.stanford.edu/group/microdocs/): 4 kinds of Reef (http://www.stanford.edu/group/ microdocs/typesofreefs.html) & Reef structure (http://www.stanford.edu/group/microdocs/reefstructure. html) Reefrelieffounders.com (http://www.reefrelieffounders.com): Coral reef resources, images, education, threats, solutions Images Coral Reef of Gulf of Kutch (http://gallery.wildone.in/gallery/marine-creatures/ coral-reef-of-gulf-of-kutch/) "In The Turf War Against Seaweed, Coral Reefs More Resilient Than Expected" (http://www.sciencedaily. com/releases/2009/06/090601111932.htm). Science Daily. June 3, 2009. Retrieved February, 2011.

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Decompression sickness

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Decompression sickness
Caisson disease [decompression sickness]
Classification and external resources

Two United States Navy sailors prepare for training inside a decompression chamber. ICD-10 ICD-9 DiseasesDB eMedicine MeSH T70.3 993.3 3491 [1] [2] [3] [4] [5]

emerg/121

C21.866.120.248

Decompression sickness (DCS; also known as divers' disease, the bends or caisson disease) describes a condition arising from dissolved gases coming out of solution into bubbles inside the body on depressurization. DCS most commonly refers to a specific type of scuba diving hazard but may be experienced in other depressurisation events such as caisson working, flying in unpressurised aircraft, and extra-vehicular activity from spacecraft. Since bubbles can form in or migrate to any part of the body, DCS can produce many symptoms, and its effects may vary from joint pain and rashes to paralysis and death. Individual susceptibility can vary from day to day, and different individuals under the same conditions may be affected differently or not at all. The classification of types of DCS by its symptoms has evolved since its original description over a hundred years ago. Although DCS is not a common event, its potential severity is such that much research has gone into preventing it, and scuba divers use dive tables or dive computers to set limits on their exposure to pressure and their ascent speed. Treatment is by hyperbaric oxygen therapy in a recompression chamber. If treated early, there is a significantly higher chance of successful recovery.

Classification
DCS is classified by symptoms. The earliest descriptions of DCS used the terms: "bends" for joint or skeletal pain; "chokes" for breathing problems; and "staggers" for neurological problems.[6] In 1960, Golding et al. introduced a simpler classification using the term "Type I ('simple')" for symptoms involving only the skin, musculoskeletal system, or lymphatic system, and "Type II ('serious')" for symptoms where other organs (such as the central nervous system) are involved.[6] Type II DCS is considered more serious and usually has worse outcomes.[7] This system, with minor modifications, may still be used today.[8] Following changes to treatment methods, this classification is now much less useful in diagnosis,[9] since neurological symptoms may develop after the initial presentation, and both Type I and Type II DCS have the same initial management.[10]

Decompression sickness

39

Decompression illness and dysbarism

The term dysbarism encompasses decompression sickness, arterial gas embolism, and barotrauma, whereas decompression sickness and arterial gas embolism are commonly classified together as decompression illness when a precise diagnosis cannot be made.[11] DCS and arterial gas embolism are treated very similarly because they are both the result of gas bubbles in the body.[10] The U.S. Navy prescribes identical treatment for Type II DCS and arterial gas embolism.[12] Their spectra of symptoms also overlap, although those from arterial gas embolism are generally more severe because they often arise from an infarction (blockage of blood supply and tissue death).

Signs and symptoms

While bubbles can form anywhere in the body, DCS is most frequently observed in the shoulders, elbows, knees, and ankles. Joint pain ("the bends") accounts for about 60% to 70% of all altitude DCS cases, with the shoulder being the most common site. Neurological symptoms are present in 10% to 15% of DCS cases with headache and visual disturbances the most common symptom. Skin manifestations are present in about 10% to 15% of cases. Pulmonary DCS ("the chokes") is very rare in divers and has been observed much less frequently in aviators since the introduction of oxygen pre-breathing protocols.[13] The table below shows symptoms for different DCS types.[14]

Signs and symptoms of decompression sickness

DCS type Bubble location Signs & symptoms (clinical manifestations) Localized deep pain, ranging from mild to excruciating. Sometimes a dull ache, but rarely a sharp pain. Active and passive motion of the joint aggravates the pain. The pain may be reduced by bending the joint to find a more comfortable position. If caused by altitude, pain can occur immediately or up to many hours later. Itching, usually around the ears, face, neck, arms, and upper torso Sensation of tiny insects crawling over the skin (formication) Mottled or marbled skin usually around the shoulders, upper chest and abdomen, with itching Swelling of the skin, accompanied by tiny scar-like skin depressions (pitting edema) Altered sensation, tingling or numbness paresthesia, increased sensitivity hyperesthesia Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures, unconsciousness Ascending weakness or paralysis in the legs Girdling abdominal or chest pain Urinary incontinence and fecal incontinence Headache Unexplained fatigue Generalised malaise, poorly localised aches Loss of balance Dizziness, vertigo, nausea, vomiting Hearing loss Dry persistent cough Burning chest pain under the sternum, aggravated by breathing Shortness of breath

Musculoskeletal Mostly large joints

(elbows, shoulders, hip, wrists, knees, ankles) Cutaneous Skin Neurologic Brain Neurologic Spinal cord

Constitutional

Whole body

Audiovestibular Inner ear [15] [16]

Pulmonary

Lungs

Decompression sickness

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Frequency
Symptoms local joint pain arm symptoms leg symptoms dizziness paralysis shortness of breath extreme fatigue collapse/unconsciousness Frequency 89% 70% 30% 5.3% 2.3% 1.6% 1.3% 0.5%

Onset
Time to onset within 1 hour within 3 hours within 8 hours within 24 hours within 48 hours Percentage of cases 42% 60% 83% 98% 100%

The distribution of symptoms of DCS observed by the U.S. Navy are as [17] follows:

Although onset of DCS can occur rapidly after a dive, in extreme cases even before a dive has been completed, in more than half of all cases symptoms do not begin to present until over an hour following the dive. The U.S. Navy and Technical Diving International, a leading technical diver training organization, have published a table that indicates onset of first symptoms. The table does not differentiate between types of DCS, [18] [19] or types of symptom.

Causes
DCS is caused by a reduction in ambient pressure that results in the formation of bubbles of inert gases within tissues of the body. It may happen when leaving a high-pressure environment, ascending from depth, or ascending to altitude.

Ascent from depth

DCS is best known as a diving disorder that affects divers having breathed gas that is at a higher pressure than the surface pressure, owing to the pressure of the surrounding water. The risk of DCS increases when diving for extended periods or at greater depth, without ascending gradually and making the decompression stops needed to slowly reduce the excess pressure of inert gases dissolved in the body. The specific risk factors are not well understood and some divers may be more susceptible than others under identical conditions.[20] [21] DCS has been confirmed in rare cases of breath-holding divers who have made a sequence of many deep dives with short surface intervals; and it may be the cause of the disease called taravana by South Pacific island natives who for centuries have dived by breath-holding for food and pearls.[22] Two principal factors control the risk of a diver suffering DCS: 1. the rate and duration of gas absorption under pressure the deeper or longer the dive the more gas is absorbed into body tissue in higher concentrations than normal (Henry's Law); 2. the rate and duration of outgassing on depressurization the faster the ascent and the shorter the interval between dives the less time there is for absorbed gas to be offloaded safely through the lungs, causing these gases to come out of solution and form "micro bubbles" in the blood.[23] Even when the change in pressure causes no immediate symptoms, rapid pressure change can cause permanent bone injury called dysbaric osteonecrosis (DON). DON can develop from a single exposure to rapid decompression.[24]

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Leaving a high-pressure environment

When a worker comes out of a pressurized caisson or out of a mine that has been pressurized to keep water out, they will experience a significant reduction in ambient pressure.[20] [25] A similar pressure reduction occurs when an astronaut exits a space vehicle to perform a space-walk or extra-vehicular activity, where the pressure in his spacesuit is lower than the pressure in the vehicle.[20] [26] [27] [28] The original name for DCS was "caisson disease"; this term was used in the 19th century, in large engineering excavations below the water table, such as bridge supports and tunnels, where caissons under pressure were used to keep water from The principal features of a caisson are the workspace, pressurised by an external air flooding the excavations. Workers spending supply, and the access tube with an airlock time in high-pressure atmospheric pressure conditions are at risk when they return to the lower pressure outside the caisson if the pressure surrounding them was not reduced slowly. DCS was a major factor during construction of Eads Bridge, when 15 workers died from what was then a mysterious illness, and later during construction of the Brooklyn Bridge, where it incapacitated the project leader Washington Roebling.[29]

Ascent to altitude
Passengers may be at risk of DCS when an unpressurized aircraft ascends to high altitude.[20] [26] [27] [30] Likewise, there is increased risk for divers flying in any aircraft shortly after diving, since even in a pressurized aircraft the cabin pressure is not maintained at sea-level pressure but may drop to as low as 73% of sea level pressure.[20] [26] [31] Altitude DCS became a common problem in the 1930s with the development of high-altitude balloon and aircraft flights. Today, cabin pressurization systems maintain commercial aircraft cabin pressure at the equivalent altitude of 2400m (7900ft) or less, allowing safe flights at 12000m (39000 ft) or more. DCS is very rare in healthy individuals who experience pressures equivalent to this altitude. However, since the pressure in the cabin is not actually maintained at sea-level pressure, there is still a risk of DCS in individuals having dived recently. Also, cabin pressurization systems still fail occasionally, and some people may be predisposed to the drop in pressure that occurs even in pressurized aircraft.[32] [33] There is no specific altitude threshold that can be considered safe for everyone and below which no one will develop altitude DCS. Nevertheless, there is very little evidence of altitude DCS occurring among healthy individuals who have not been scuba diving at pressure altitudes below 5500m (18000ft). The higher the altitude of exposure the greater is the risk of developing altitude DCS. Although exposures to incremental altitudes above 5500m (18000ft) show an incremental risk of altitude DCS, they do not show a direct relationship with the severity of the various types of DCS. Individual exposures to pressure altitudes between 5500m (18000ft) and 7500m (24600 ft) have shown a low occurrence of altitude DCS. A US Air Force study of altitude DCS cases reported that 87% of incidents occurred at 7500m (24600 ft) or higher.[34] High altitude parachutists performing a HALO jump may develop altitude DCS if they do not flush nitrogen from the body by pre-breathing pure oxygen.[35]

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Predisposing factors
Although the occurrence of DCS is not easily predictable, many predisposing factors are known. They may be considered as either environmental or individual.

Environmental
The following environmental factors have been shown to increase the risk of DCS: the magnitude of the pressure reduction ratio a large pressure reduction ratio is more likely to cause DCS than a small one.[26] [31] [36] repetitive exposures repetitive dives within a short period of time (a few hours) increase the risk of developing DCS. Repetitive ascents to altitudes above 5500 metres (18000ft) within similar short periods increase the risk of developing altitude DCS.[26] [36] the rate of ascent the faster the ascent the greater the risk of developing DCS. The US Navy Dive Manual indicates that ascent rates greater than about 20m/min (66ft/min) when diving increase the chance of DCS, while recreational dive tables such as the Bhlmann tables require an ascent rate of 10m/min (33ft/min) with the last 6m (20ft) taking at least one minute.[37] An individual exposed to a rapid decompression (high rate of ascent) above 5500 metres (18000ft) has a greater risk of altitude DCS than being exposed to the same altitude but at a lower rate of ascent.[26] [36] the duration of exposure the longer the duration of the dive, the greater is the risk of DCS. Longer flights, especially to altitudes of 5500m (18000ft) and above, carry a greater risk of altitude DCS.[26] scuba diving before flying divers who ascend to altitude soon after a dive increase their risk of developing DCS even if the dive itself was within the dive table safe limits. Dive tables make provisions for post-dive time at surface level before flying to allow any residual excess nitrogen to outgas. However, the pressure maintained inside even a pressurized aircraft may be as low as the pressure equivalent to an altitude of 2400m (7900ft) above sea level. Therefore, the assumption that the dive table surface interval occurs at normal atmospheric pressure is invalidated by flying during that surface interval, and an otherwise-safe dive may then exceed the dive table limits.[38] [39] [40] diving before travelling to altitude DCS can occur without flying if the person moves to a high-altitude location on land immediately after scuba diving, for example, scuba divers in Eritrea who drive from the coast to the Asmara plateau at 2400m (7900ft) increase their risk of DCS.[41] diving at altitude diving in water whose surface altitude is above 300m (980ft) for example, Lake Titicaca is at 3800m (12500ft) without using versions of decompression tables or dive computers that are modified for high-altitude.[38] [42]

Individual

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The following individual factors have been identified as possibly contributing to increased risk of DCS: a person's age there are some reports indicating a higher risk of altitude DCS with increasing age.[20] [36] previous injury there is some indication that recent joint or limb injuries may predispose individuals to developing decompression-related bubbles.[20] [43] ambient temperature there is some evidence suggesting that individual exposure to very cold ambient temperatures may increase the risk of altitude DCS.[20] [36] Decompression sickness risk can be reduced by increased ambient temperature during decompression following dives in cold water.[44]

Atrial septal defect (PFO) showing left-to-right shunt. A right-to-left shunt may allow bubbles to pass into the arterial circulation.

body type typically, a person who has a high body fat content is at greater risk of DCS.[20] [36] This is due to nitrogen's five times greater solubility in fat than in water, leading to greater amounts of total body dissolved nitrogen during time at pressure. Fat represents about 1525 percent of a healthy adult's body, but stores about half of the total amount of nitrogen (about 1 litre) at normal pressures.[45] alcohol consumption and dehydration although alcohol consumption increases dehydration and therefore may increase susceptibility to DCS,[36] a 2005 study concluded that alcohol consumption did not increase the risk of DCS.[46] Studies by Walder concluded that decompression sickness could be reduced in aviators when the serum surface tension was raised by drinking isotonic saline,[47] and the high surface tension of water is generally regarded as helpful in controlling bubble size.[36] Maintaining proper hydration is recommended.[48] patent foramen ovale a hole between the atrial chambers of the heart in the fetus is normally closed by a flap with the first breaths at birth. In about 20% of adults the flap does not completely seal, however, allowing blood through the hole when coughing or during activities that raise chest pressure. In diving, this can allow venous blood with microbubbles of inert gas to bypass the lungs, where the bubbles would otherwise be filtered out by the lung capillary system, and return directly to the arterial system (including arteries to the brain, spinal cord and heart).[49] In the arterial system, bubbles (arterial gas embolism) are far more dangerous because they block circulation and cause infarction (tissue death, due to local loss of blood flow). In the brain, infarction results in stroke, and in the spinal cord it may result in paralysis.[50]

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Mechanism
Depressurisation causes inert gases, which were dissolved under higher pressure, to come out of physical solution and form gas bubbles within the body. These bubbles produce the symptoms of decompression sickness.[20] [51] Bubbles may form whenever the body experiences a reduction in pressure, but not all bubbles result in DCS.[52] The amount of gas dissolved in a liquid is described by Henry's Law, which indicates that, when the pressure of a gas in contact with a liquid is decreased, the amount of that gas dissolved in the liquid will also decrease proportionately. On ascent from a dive, inert gas comes out of solution in a process called "outgassing" or "offgassing". Under normal conditions, most offgassing occurs by gas exchange in the lungs.[53] [54] If inert gas comes out of solution too quickly to allow outgassing in the lungs then bubbles may form in the blood or within the solid tissues of the body. The formation of bubbles in the skin or joints results in milder symptoms, while large numbers of bubbles in the venous blood can cause lung damage. The most severe types of DCS interrupt and This surfacing diver must enter a decompression ultimately damage spinal cord function, leading to paralysis, chamber to avoid decompression sickness. sensory dysfunction, or death. In the presence of a right-to-left shunt of the heart, such as a patent foramen ovale, venous bubbles may enter the arterial system, resulting in an arterial gas embolism.[10] [55] A similar effect, known as ebullism, may occur during explosive decompression, when water vapour forms bubbles in body fluids due to a dramatic reduction in environmental pressure.[56]

Inert gases
The main inert gas in air is nitrogen, but nitrogen is not the only gas that can cause DCS. Breathing gas mixtures such as trimix and heliox include helium, which can also cause decompression sickness. Helium both enters and leaves the body faster than nitrogen, so different decompression schedules are required, but, since helium does not cause narcosis, it is preferred over nitrogen in gas mixtures for deep diving.[57] There is some debate as to the decompression requirements for helium during short-duration dives. Most divers do longer decompressions, however some groups like the WKPP have been pioneering the use of shorter decompression times by including deep stops.[58] Any inert gas that is breathed under pressure can form bubbles when the ambient pressure decreases. Very deep dives have been made using hydrogen-oxygen mixtures (hydrox),[59] but controlled decompression is still required to avoid DCS.[60]

Isobaric counterdiffusion
Further information: Isobaric counterdiffusion DCS can also be caused at a constant ambient pressure when switching between gas mixtures containing different proportions of inert gas. This is known as isobaric counterdiffusion, and presents a problem for very deep dives.[61] For example, after using a very helium-rich trimix at the deepest part of the dive, a diver will switch to mixtures containing progressively less helium and more oxygen and nitrogen during the ascent. Nitrogen diffuses into tissues 2.65 times slower than helium, but is about 4.5 times more soluble. Switching between gas mixtures that have very different fractions of nitrogen and helium can result in "fast" tissues (those tissues that have a good blood supply) actually increasing their total inert gas loading. This is often found to provoke inner ear decompression sickness, as

Decompression sickness the ear seems particularly sensitive to this effect.[62]

45

Diagnosis
Decompression sickness should be suspected if any of the symptoms associated with the condition occurs following a drop in pressure, in particular, within 24 hours of diving.[63] In 1995, 95% of all cases reported to Divers Alert Network had shown symptoms within 24 hours.[64] An alternative diagnosis should be suspected if severe symptoms begin more than six hours following decompression without an altitude exposure or if any symptom occurs more than 24 hours after surfacing.[65] The diagnosis is confirmed if the symptoms are relieved by recompression.[65] [66] Although MRI or CT can frequently identify bubbles in DCS, they are not as good at determining the diagnosis as a proper history of the event and description of the symptoms.[8]

Prevention
Underwater diving
To prevent the excess formation of bubbles that can lead to decompression sickness, divers limit their ascent rate to about 10 metres (33ft) per minute, and carry out a decompression schedule as necessary.[67] This schedule requires the diver to ascend to a particular depth, and remain at that depth until sufficient gas has been eliminated from the body to allow further ascent.[68] Each of these is termed a "decompression stop", and a schedule for a given bottom time and depth may contain one or more stops, or none at all. Dives that contain no decompression stops are called "no-stop dives", but divers usually schedule a short "safety stop" at 3 metres (10ft), 4.6 metres (15ft), or 6 metres (20ft), depending on the training agency.[67] [69] The decompression schedule may be derived from decompression tables, decompression software, or from dive computers, and these are The display of a basic personal dive computer commonly based upon a mathematical model of the body's uptake and shows depth, dive time, and decompression information. release of inert gas as pressure changes. These models, such as the Bhlmann decompression algorithm, are designed to fit empirical data and provide a decompression schedule for a given depth and dive duration.[70] Since divers on the surface after a dive still have excess inert gas in their bodies, any subsequent dive before this excess is fully eliminated needs to modify the schedule to take account of the residual gas load from the previous dive. This will result in a shorter available time under water or an increased decompression time during the subsequent dive. The total elimination of excess gas may take many hours, and tables will indicate the time at normal pressures that is required, which may be up to 18 hours.[71] Decompression time can be significantly shortened by breathing mixtures containing much less inert gas during the decompression phase of the dive (or pure oxygen at stops in 6 metres (20ft) of water or less). The reason is that the inert gas outgases at a rate proportional to the difference between the partial pressure of inert gas in the diver's body and its partial pressure in the breathing gas; whereas the likelihood of bubble formation depends on the difference between the inert gas partial pressure in the diver's body and the ambient pressure. Reduction in decompression requirements can also be gained by breathing a nitrox mix during the dive, since less nitrogen will be taken into the body than during the same dive done on air.[72] Following a decompression schedule does not completely protect against DCS. The algorithms used are designed to reduce the probability of DCS to a very low level, but do not reduce it to zero.[73]

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Exposure to altitude
One of the most significant breakthroughs in the prevention of altitude DCS is oxygen pre-breathing. Breathing pure oxygen significantly reduces the nitrogen loads in body tissues and, if continued without interruption, provides effective protection upon exposure to low-barometric pressure environments.[26] [27] However, breathing pure oxygen during flight alone (ascent, en route, descent) does not decrease the risk of altitude DCS.[26] [27] Although pure oxygen pre-breathing is an effective method to protect against altitude DCS, it is logistically complicated and expensive for the protection of civil aviation flyers, either commercial or private. Therefore, it is currently used only by military flight crews and astronauts for protection during high-altitude and space operations. It is also used by flight test crews involved with certifying aircraft. Astronauts aboard the International Space Station preparing for extra-vehicular activity (EVA) "camp out" at low atmospheric pressure, 10.2psi (0.70bar), spending eight sleeping hours in the Quest airlock chamber before their spacewalk. During the EVA they breathe 100% oxygen in their spacesuits, which operate at 4.3psi (0.30bar),[74] although research has examined the possibility of using 100% O2 at 9.5psi (0.66bar) in the suits to lessen the pressure reduction, and hence the risk of DCS.[75]

Treatment
Further information: Hyperbaric medicine All cases of decompression sickness should be treated initially with 100% oxygen until hyperbaric oxygen therapy (100% oxygen delivered in a high-pressure chamber) can be provided.[76] Mild cases of the "bends" and some skin symptoms may disappear during descent from high altitude; however, it is recommended that these cases still be evaluated. Neurological symptoms, pulmonary symptoms, and mottled or marbled skin lesions should be treated with hyperbaric oxygen therapy if seen within 10 to 14 days of development.[77]

The recompression chamber at the Neutral Buoyancy Lab.

Recompression on room air was shown to be an effective treatment for minor DCS symptoms by Keays in 1909.[78] Evidence of the effectiveness of recompression therapy utilizing oxygen was first shown by Yarbrough and Behnke,[79] and has since become the standard of care for treatment of DCS.[80] Recompression is normally carried out in a recompression chamber. At a dive site, a riskier alternative is in-water recompression.[81] [82] [83] Oxygen first aid has been used as an emergency treatment for diving injuries for years.[84] If given within the first four hours of surfacing, it increases the success of recompression therapy as well as a decrease the number of recompression treatments required.[85] Most fully closed-circuit rebreathers can deliver sustained high concentrations of oxygen-rich breathing gas and could be used as a means of supplying oxygen if dedicated equipment is not available.[86] It is beneficial to give fluids, as this helps reduce dehydration. It is no longer recommended to administer aspirin, unless advised to do so by medical personnel, as analgesics may mask symptoms. People should be made comfortable and placed in the supine position (horizontal), or the recovery position if vomiting occurs.[63] In the past, both the Trendelenburg position and the left lateral decubitus position (Durant's maneuver) have been suggested as beneficial where air emboli are suspected,[87] but are no longer recommended for extended periods, owing to concerns regarding cerebral edema.[84] [88]

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Prognosis
Immediate treatment with 100% oxygen, followed by recompression in a hyperbaric chamber, will in most cases result in no long term effects. However, permanent long-term injury from DCS is possible. Three-month follow-ups on diving accidents reported to DAN in 1987 showed 14.3% of the 268 divers surveyed "still had residual signs and symptoms from Type II DCS and 7% from Type I DCS".[89] [90] Long-term follow-ups showed similar results, with 16% having permanent neurological sequelae.[91]

Epidemiology
The incidence of decompression sickness is rare, estimated at 2.8 cases per 10,000 dives, with the risk 2.6 times greater for males than females.[8] DCS affects approximately 1,000 U.S. scuba divers per year.[63] In 1999, the Divers Alert Network (DAN) created "Project Dive Exploration" to collect data on dive profiles and incidents. From 1998 to 2002, they recorded 50,150 dives, from which 28 recompressions were required although these will almost certainly contain incidents of arterial gas embolism (AGE) a rate of about 0.05%.[7] [92]

History
1670: Robert Boyle demonstrated that a reduction in ambient pressure could lead to bubble formation in living tissue. This description of a viper in a vacuum was the first recorded description of decompression sickness.[93] 1769: Giovanni Morgagni described the post mortem findings of air in cerebral circulation and surmised that this was the cause of death.[94] 1840: Colonel William Pasley, who was involved in the recovery of the sunken warship HMS Royal George, commented that, of those having made frequent dives, "not a man escaped the repeated attacks of rheumatism and cold".[95] 1841: First documented case of decompression sickness, reported by a mining engineer who observed pain and muscle cramps among coal miners working in mine shafts air-pressurized to keep water out. 1870: Bauer published outcomes of 25 paralyzed caisson workers. From 1870 to 1910, all prominent features were established. Explanations at the time included: cold or exhaustion causing reflex spinal cord damage; electricity cause by friction on compression; or organ congestion; and vascular stasis caused by decompression.[94] 1871: The Eads Bridge in St Louis employed 352 compressed air workers including Dr. Alphonse Jaminet as the physician in charge. There were 30 seriously injured and 12 fatalities. Dr. Jaminet developed decompression sickness and his personal description was the first such recorded.[29]

The Eads Bridge where 42 workers were injured by caisson disease

1872: The similarity between decompression sickness and iatrogenic air embolism as well as the relationship between inadequate decompression and decompression sickness was noted by Friedburg. He suggested that intravascular gas was released by rapid decompression and recommended: slow compression and decompression; four-hour working shifts; limit to maximum depth 44.1 psig (4 ATA); using only healthy workers; and recompression treatment for severe cases. 1873: Dr. Andrew Smith first utilized the term "caisson disease" describing 110 cases of decompression sickness as the physician in charge during construction of the Brooklyn Bridge.[29] [96] The project employed 600 compressed air workers. Recompression treatment was not used. The project chief engineer Washington Roebling suffered from caisson disease.[29] (He took charge after his father John Augustus Roebling died of tetanus.) Washington's wife, Emily, helped manage the construction of the bridge after his sickness confined him to his home in Brooklyn. He battled the after-effects of the disease for the rest of his life. During this project, decompression sickness became known as "The [Grecian] Bends" because afflicted individuals characteristically

Decompression sickness arched their backs: this is possibly reminiscent of a then fashionable women's dance maneuver known as the Grecian Bend, or as historian David McCullough asserts in The Great Bridge it was a crude reference to "Greek" or anal sex.[97] 1900: Leonard Hill used a frog model to prove that decompression causes bubbles and that recompression resolves them.[94] [98] Hill advocated linear or uniform decompression profiles.[94] [98] This type of decompression is used today by saturation divers. His work was financed by Augustus Siebe and the Siebe Gorman Company.[94] 1908: "The Prevention of Compressed Air Illness" was published by JS Haldane, Boycott and Damant recommending staged decompression.[99] These tables were accepted for use by the Royal Navy.[94] 1924: The US Navy published the first standardized recompression procedure.[100] 1930s: Albert R Behnke separated the symptoms of Arterial Gas Embolism (AGE) from those of DCS.[94] 1935: Behnke et al. experimented with oxygen for recompression therapy.[94] [100] [101]

48

An early recompression chamber

1937: Behnke introduced the no-stop decompression tables.[94] 1941: Altitude DCS is treated with hyperbaric oxygen for the first time.[102] 1957: Robert Workman established a new method for calculation of decompression requirements (M-values).[103] 1959: The "SOS Decompression Meter", a submersible mechanical device that simulated nitrogen uptake and release, was introduced.[104] 1960: FC Golding et al. split the classification of DCS into Type 1 and 2.[105] 1982: Paul K Weathersby, Louis D Homer and Edward T Flynn introduce survival analysis into the study of decompression sickness.[106] 1983: Orca produced the "EDGE", a personal dive computer, using a microprocessor to calculate nitrogen absorption for twelve tissue compartments.[104] 1984: Albert A Bhlmann released his book "Decompression-Decompression Sickness," which detailed his deterministic model for calculation of decompression schedules.[107]

Society and culture

Economics
In the United States, it is common for medical insurance not to cover treatment for the bends that is the result of recreational diving. This is because scuba diving is considered an elective and "high-risk" activity and treatment for decompression sickness is expensive. A typical stay in a recompression chamber will easily cost several thousand dollars, even before emergency transportation is included. As a result, groups such as Divers Alert Network (DAN) offer medical insurance policies that specifically cover all aspects of treatment for decompression sickness at rates of less than $100 per year.[108] In the United Kingdom, treatment of DCS is provided by the National Health Service, either at a specialised facility or at a Hyperbaric Centre based within a general hospital.[109]

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Footnotes
[1] [2] [3] [4] [5] [6] [7] http:/ / apps. who. int/ classifications/ apps/ icd/ icd10online/ ?gt66. htm+ t703 http:/ / www. icd9data. com/ getICD9Code. ashx?icd9=993. 3 http:/ / www. diseasesdatabase. com/ ddb3491. htm http:/ / www. emedicine. com/ emerg/ topic121. htm http:/ / www. nlm. nih. gov/ cgi/ mesh/ 2011/ MB_cgi?mode=& term=Decompression+ Sickness& field=entry#TreeC21. 866. 120. 248 Francis & Mitchell p.578 Pulley, Stephen A (27 November 2007). "Decompression Sickness" (http:/ / emedicine. medscape. com/ article/ 769717-overview). Medscape. . Retrieved 15 May 2010. [8] Marx p.1908 [9] Francis & Mitchell p.579 [10] Francis, T James R; Smith, DJ (1991). "Describing Decompression Illness" (http:/ / archive. rubicon-foundation. org/ 4499). 42nd Undersea and Hyperbaric Medical Society Workshop 79(DECO)5-15-91. . Retrieved 23 May 2010. [11] Francis & Mitchell p.580 [12] U.S. Navy Supervisor of Diving (2008). "Chapter20: Diagnosis and Treatment of Decompression Sickness and Arterial Gas Embolism" (http:/ / supsalv. org/ pdf/ DiveMan_rev6. pdf) (PDF). U.S. Navy Diving Manual. SS521-AG-PRO-010, revision 6. volume5. U.S. Naval Sea Systems Command. p.37. . Retrieved 15 May 2010. [13] Powell p.71 [14] Francis & Mitchell pp.578584 [15] Doolette, David J; Mitchell, Simon J (2003). "Biophysical basis for inner ear decompression sickness" (http:/ / jap. physiology. org/ cgi/ content/ full/ 94/ 6/ 2145). Journal of Applied Physiology 94 (6): 214550. doi:10.1152/japplphysiol.01090.2002 (inactive 7 January 2010). PMID12562679. . Retrieved 15 May 2010. [16] Inner ear counter diffusion is a rare form of DCS sometimes experienced by divers engaged in extreme deep diving, caused by helium being released from the tissues but blocked by heavier nitrogen molecules. Two of the best-recorded instances of it both occurred at Boesmansgat, South Africa once to Nuno Gomes in an early world record attempt, and later to Don Shirley when he tried to rescue David Shaw on his fateful dive trying to recover the body of Deon Dreyer, who had been one of Gomes's support divers. [17] Powell p.70 [18] U.S. Navy Supervisor of Diving (2008) (PDF). U.S. Navy Diving Manual (http:/ / supsalv. org/ pdf/ DiveMan_rev6. pdf). SS521-AG-PRO-010, revision 6. vol.5. U.S. Naval Sea Systems Command. pp.2025. . Retrieved 18 May 2010. [19] TDI Decompression Procedures Manual (Rev 1c), page 38 [20] Vann, Richard D, ed (1989). "The Physiological Basis of Decompression" (http:/ / archive. rubicon-foundation. org/ 6853). 38th Undersea and Hyperbaric Medical Society Workshop. 75(Phys)6-1-89: 437. . Retrieved 15 May 2010. [21] Benton, BJ (2001). "Acute Decompression Illness (DCI): the Significance of Provocative Dive Profiles" (http:/ / archive. rubicon-foundation. org/ 1002). Undersea and Hyperbaric Medicine Abstract 28 (Supplement). ISSN1066-2936. OCLC26915585. . Retrieved 18 May 2010. [22] Wong, RM (1999). "Taravana revisited: Decompression illness after breath-hold diving" (http:/ / archive. rubicon-foundation. org/ 6010). South Pacific Underwater Medicine Society Journal 29 (3). ISSN0813-1988. OCLC16986801. . Retrieved 18 May 2010. [23] Lippmann & Mitchell pp.6566 [24] Ohta, Yoshimi; Matsunaga, Hitoshi (February 1974). "Bone lesions in divers" (http:/ / www. jbjs. org. uk/ cgi/ content/ abstract/ 56-B/ 1/ 3). Journal of Bone and Joint Surgery (British Editorial Society of Bone and Joint Surgery) 56B (1): 315. . Retrieved 18 May 2010. [25] Elliott, David H (1999). "Early Decompression experience: Compressed air work" (http:/ / archive. rubicon-foundation. org/ 5988). South Pacific Underwater Medicine Society Journal 29 (1). ISSN0813-1988. OCLC16986801. . Retrieved 18 May 2010. [26] Dehart, RL; Davis, JR (2002). Fundamentals Of Aerospace Medicine: Translating Research Into Clinical Applications (3rd Rev ed.). United States: Lippincott Williams And Wilkins. p.720. ISBN978-0-7817-2898-0. [27] Pilmanis, Andrew A (1990). "The Proceedings of the Hypobaric Decompression Sickness Workshop" (http:/ / archive. rubicon-foundation. org/ 5892). US Air Force Technical Report AL-SR-1992-0005. . Retrieved 18 May 2010. [28] Vann, Richard D; Torre-Bueno, JR (1984). "A theoretical method for selecting space craft and space suit atmospheres". Aviation, Space, and Environmental Medicine 55 (12): 10971102. ISSN0095-6562. PMID6151391. [29] Butler, WP (2004). "Caisson disease during the construction of the Eads and Brooklyn Bridges: A review" (http:/ / archive. rubicon-foundation. org/ 4028). Undersea and Hyperbaric Medicine 31 (4): 44559. PMID15686275. . Retrieved 30 May 2010. [30] Gerth, Wayne A; Vann, Richard D (1995). "Statistical Bubble Dynamics Algorithms for Assessment of Altitude Decompression Sickness Incidence" (http:/ / archive. rubicon-foundation. org/ 4102). US Air Force Technical Report TR-1995-0037. . Retrieved 18 May 2010. [31] Vann, Richard D; Gerth, Wayne A; DeNoble, Petar J; Pieper, Carl F; Thalmann, Edward D (2004). "Experimental trials to assess the risks of decompression sickness in flying after diving" (http:/ / archive. rubicon-foundation. org/ 4027). Undersea and Hyperbaric Medicine 31 (4): 43144. ISSN1066-2936. OCLC26915585. PMID15686274. . Retrieved 18 May 2010. [32] Robinson, RR; Dervay, JP; Conkin, Johnny. "An Evidenced-Based Approach for Estimating Decompression Sickness Risk in Aircraft Operations" (http:/ / ston. jsc. nasa. gov/ collections/ TRS/ _techrep/ TM-1999-209374. pdf) (PDF). NASA STI Report Series NASA/TM1999209374. . Retrieved 18 May 2010.

Decompression sickness
[33] Powell, Michael R (2002). "Decompression limits in commercial aircraft cabins with forced descent" (http:/ / archive. rubicon-foundation. org/ 1181). Undersea and Hyperbaric Medicine Supplement (abstract). . Retrieved 18 May 2010. [34] Brown, JR; Antuano, Melchor J (14 July 2005). "Altitude-Induced Decompression Sickness" (http:/ / www. faa. gov/ pilots/ safety/ pilotsafetybrochures/ media/ dcs. pdf). AM-400-95/2. Federal Aviation Administration. . Retrieved 27 June 2010. [35] Pollock, Neal W; Natoli, Michael J; Gerth, Wayne A; Thalmann, Edward D; Vann, Richard D (November 2003). "Risk of decompression sickness during exposure to high cabin altitude after diving" (http:/ / www. ingentaconnect. com/ content/ asma/ asem/ 2003/ 00000074/ 00000011/ art00006). Aviation, Space, and Environmental Medicine 74 (11): 116368. PMID14620473. . Retrieved 18 May 2010. [36] Fryer, DI (1969). Subatmospheric decompression sickness in man. England: Technivision Services. p.343. ISBN978-0-85102-023-5. [37] Lippmann & Mitchell p.232 [38] Bassett, Bruce E (1982). "Decompression Procedures for Flying After Diving, and Diving at Altitudes above Sea Level" (http:/ / archive. rubicon-foundation. org/ 4531). US Air Force School of Aerospace Medicine Technical Report SAM-TR-82-47. . Retrieved 18 May 2010. [39] Sheffield, Paul J; Vann, Richard D (2002). Flying After Diving Workshop. Proceedings of the DAN 2002 Workshop (http:/ / archive. rubicon-foundation. org/ 5611). United States: Divers Alert Network. p.127. ISBN0-9673066-4-7. . Retrieved 18 May 2010. [40] Vann, Richard D; Pollock, Neal W; Freiberger, John J; Natoli, Michael J; Denoble, Petar J; Pieper, Carl F (2007). "Influence of bottom time on preflight surface intervals before flying after diving" (http:/ / archive. rubicon-foundation. org/ 7343). Undersea and Hyperbaric Medicine 34 (3): 21120. PMID17672177. . Retrieved 18 May 2010. [41] Lippmann & Mitchell p.79 [42] Egi, SM; Brubakk, Alf O (1995). "Diving at altitude: a review of decompression strategies" (http:/ / archive. rubicon-foundation. org/ 2194). Undersea and Hyperbaric Medicine 22 (3): 281300. ISSN1066-2936. OCLC26915585. PMID7580768. . Retrieved 18 May 2010. [43] Karlsson, L; Linnarson, D; Gennser, M; Blogg, SL; Lindholm, Peter (2007). "A case of high doppler scores during altitude decompression in a subject with a fractured arm" (http:/ / archive. rubicon-foundation. org/ 5136). Undersea Hyperbaric Medicine 34 (Supplement). ISSN1066-2936. OCLC26915585. . Retrieved 18 May 2010. [44] Gerth, Wayne A; Ruterbusch, VL; Long, Edward T (2007). "The Influence of Thermal Exposure on Diver Susceptibility to Decompression Sickness" (http:/ / archive. rubicon-foundation. org/ 5063). United States Navy Experimental Diving Unit Technical Report NEDU-TR-06-07. . Retrieved 18 May 2010. [45] Boycott, AE; Damant, JCC (1908). "Experiments on the influence of fatness on susceptibility to caisson disease". Journal of Hygiene (Cambridge University Press) 8 (4): 44556. doi:10.1017/S0022172400015862. PMC2167151. PMID20474366. [46] Leigh, BC; Dunford, Richard G (2005). "Alcohol use in scuba divers treated for diving injuries: A comparison of decompression sickness and arterial gas embolism" (http:/ / depts. washington. edu/ adai/ pubs/ pres/ LeighRSAPoster. pdf). Alcoholism: Clinical and Experimental Research (29 (Suppl.), 157A). . Presented at the Annual Meeting of the Research Society on Alcoholism, Santa Barbara, California, June 2005. [47] Walder, Dennis N (1945). "The Surface Tension of the Blood Serum in 'Bends'". Royal Air Force Technical Report. [48] Lippmann & Mitchell p.71 [49] Moon, Richard E; Kisslo, Joseph (1998). "PFO and decompression illness: An update" (http:/ / archive. rubicon-foundation. org/ 5949). South Pacific Underwater Medicine Society Journal 28 (3). ISSN0813-1988. OCLC16986801. . Retrieved 18 May 2010. [50] Lippmann & Mitchell p.70 [51] Ackles, KN (1973). "Blood-Bubble Interaction in Decompression Sickness" (http:/ / archive. rubicon-foundation. org/ 3867). Defence R&D Canada (DRDC) Technical Report DCIEM-73-CP-960. . Retrieved 23 May 2010. [52] Nishi, Ron Y; Brubakk, Alf O; Eftedal, Olav S (2003). "10.3: Bubble Detection". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving, 5th Revised edition. United States: Saunders Ltd. p.501. ISBN0-7020-2571-2. OCLC51607923. [53] Kindwall, Eric P; Baz, A; Lightfoot, EN; Lanphier, Edward H; Seireg, A (1975). "Nitrogen elimination in man during decompression" (http:/ / archive. rubicon-foundation. org/ 2741). Undersea Biomedical Research 2 (4): 285297. ISSN0093-5387. OCLC2068005. PMID1226586. . Retrieved 23 May 2010. [54] Kindwall, Eric P (1975). "Measurement of helium elimination from man during decompression breathing air or oxygen" (http:/ / archive. rubicon-foundation. org/ 2742). Undersea Biomedical Research 2 (4): 277284. ISSN0093-5387. OCLC2068005. PMID1226585. . Retrieved 23 May 2010. [55] Francis & Mitchell pp.58041 [56] Landis, Geoffrey A (19 March 2009). "Explosive Decompression and Vacuum Exposure" (http:/ / www. geoffreylandis. com/ vacuum. html). . Retrieved 30 July 2010. [57] Hamilton & Thalmann p.475 [58] Wienke, Bruce R; O'Leary, Timothy R (10 October 2002). "Deep stops and deep helium" (http:/ / www. tek-dive. com/ portal/ upload/ deep. pdf). RGBM Technical Series 9. Tampa, Florida: NAUI Technical Diving Operations. . Retrieved 27 June 2010. [59] Fife, William P (1979). "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". Texas A&M University Sea Grant TAMU-SG-79-201. [60] Brauer, RW, ed (1985). "Hydrogen as a Diving Gas" (http:/ / archive. rubicon-foundation. org/ 4862). 33rd Undersea and Hyperbaric Medical Society Workshop (Undersea and Hyperbaric Medical Society) (UHMS Publication Number 69(WSHYD)3187). . Retrieved 23 May 2010. [61] Hamilton & Thalmann p.477

50

Decompression sickness
[62] Burton, Steve (December 2004). "Isobaric Counter Diffusion" (http:/ / www. scubaengineer. com/ isobaric_counter_diffusion. htm). ScubaEngineer. . Retrieved 10 January 2010. [63] Thalmann, Edward D (March/April 2004). "Decompression Illness: What Is It and What Is The Treatment?" (http:/ / www. diversalertnetwork. org/ medical/ articles/ article. asp?articleid=65). Divers Alert Network. . Retrieved 3 August 2010. [64] Divers Alert Network (1997). Report on Diving Accidents and Fatalities in 1995 (http:/ / archive. rubicon-foundation. org/ 4269). Divers Alert Network. . Retrieved 23 May 2010. [65] Moon, Richard E (1998). "Assessment of patients with decompression illness" (http:/ / archive. rubicon-foundation. org/ 5919). South Pacific Underwater Medicine Society Journal 28 (1). . Retrieved 23 May 2010. [66] Moon, Richard E; Sheffield, Paul J, eds (1996). "Treatment of Decompression Illness. 45th Undersea and Hyperbaric Medical Society Workshop" (http:/ / archive. rubicon-foundation. org/ 7999). UHMS Publication Number WD712 (Undersea and Hyperbaric Medical Society): 426. . Retrieved 25 May 2010. [67] Hamilton & Thalmann p.471 [68] Hamilton & Thalmann p.455 [69] Tables based on US Navy tables have a safety stop at 15 feet (4.6m); BSAC tables have a safety stop at 6 metres (20ft); Bhlmann tables have a safety stop at 3 metres (9.8ft) [70] Hamilton & Thalmann pp.45657 [71] Hamilton & Thalmann pp.47173 [72] Hamilton & Thalmann pp.47475 [73] Hamilton & Thalmann p.456 [74] Nevills, Amiko (2006). "Preflight Interview: Joe Tanner" (http:/ / www. nasa. gov/ mission_pages/ shuttle/ shuttlemissions/ sts115/ interview_tanner. html). NASA. . Retrieved 26 June 2010. [75] Webb, James T; Olson, RM; Krutz, RW; Dixon, G; Barnicott, PT (1989). "Human tolerance to 100% oxygen at 9.5 psia during five daily simulated 8-hour EVA exposures". Aviation Space and Environmental Medicine 60 (5): 41521. PMID2730484. [76] Marx p.1912 [77] Marx p.1813 [78] Keays, FJ (1909). "Compressed air illness, with a report of 3,692 cases". Department of Medicine Publications of Cornell University Medical College 2: 155. [79] Yarbrough, OD; Behnke, Albert R (1939). "The treatment of compressed air illness using oxygen". Journal of industrial hygiene and toxicology 21: 21318. ISSN0095-9030. [80] Berghage, Thomas E; Vorosmarti Jr, James; Barnard, EEP (1978). "Recompression treatment tables used throughout the world by government and industry" (http:/ / archive. rubicon-foundation. org/ 3414). US Naval Medical Research Center Technical Report NMRI-78-16. . Retrieved 25 May 2010. [81] Edmonds, Carl (1998). "Underwater oxygen for treatment of decompression sickness: A review" (http:/ / archive. rubicon-foundation. org/ 6428). South Pacific Underwater Medicine Society Journal 25 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-04-05. [82] Pyle, Richard L; Youngblood, David A (1995). "In-water Recompression as an emergency field treatment of decompression illness" (http:/ / archive. rubicon-foundation. org/ 6083). AquaCorp 11. . Retrieved 25 May 2010. [83] Kay, Edmond; Spencer, Merrill P (1999). In water recompression. 48th Undersea and Hyperbaric Medical Society Workshop (http:/ / archive. rubicon-foundation. org/ 5629). United States: Undersea and Hyperbaric Medical Society. p.108. . Retrieved 25 May 2010. [84] Moon & Gorman p.616 [85] Longphre, John M; DeNoble, Petar J; Moon, Richard E; Vann, Richard D; Freiberger, John J (2007). "First aid normobaric oxygen for the treatment of recreational diving injuries" (http:/ / archive. rubicon-foundation. org/ 5514). Undersea and Hyperbaric Medicine 34 (1): 4349. ISSN1066-2936. OCLC26915585. PMID17393938. . Retrieved 25 May 2010. [86] Goble, Steve (2003). "Rebreathers" (http:/ / archive. rubicon-foundation. org/ 7782). Journal of the South Pacific Underwater Medicine Society 33 (2): 98102. . Retrieved 25 July 2010. [87] O'Dowd, Liza C; Kelley, Mark A (October 2000). "Air embolism" (http:/ / cmbi. bjmu. edu. cn/ uptodate/ critical care/ embolic disease/ air embolism. htm). Chinese Medical Biotechnology Information Network. Peking University. . Retrieved 8 August 2010. [88] Bove, Alfred A (April 2009). "Arterial Gas Embolism: Injury During Diving or Work in Compressed Air" (http:/ / www. merck. com/ mmpe/ sec21/ ch323/ ch323c. html). Merck Manual Professional. Merk Sharp and Dohme. . Retrieved 8 August 2010. [89] Bennett, Peter B; Dovenbarger, Joel A; Corson, Karen (1991). Epidemiology of Bends (http:/ / archive. rubicon-foundation. org/ 7997). In Nashimoto, I; Lanphier, EH. "What is Bends?". 43rd Undersea and Hyperbaric Medical Society Workshop (Undersea and Hyperbaric Medical Society) 80(BENDS)6-1-91: 1320. . Retrieved 30 May 2010. [90] Dovenbarger, Joel A (1988). Report on Decompression Illness and Diving Fatalities (1988) (http:/ / archive. rubicon-foundation. org/ 4261). Divers Alert Network. . Retrieved 30 May 2010. [91] Desola, J (1989). "Epidemiological review of 276 dysbaric diving accidents". Proceedings XV Meeting European Undersea Biomedical Society: 209. [92] "Project Dive Exploration: Project Overview" (http:/ / www. diversalertnetwork. org/ research/ projects/ pde/ overview. asp). Divers Alert Network. 2010. . Retrieved 30 May 2010. [93] Acott, Chris (1999). "The diving "Law-ers": A brief resume of their lives" (http:/ / archive. rubicon-foundation. org/ 5990). South Pacific Underwater Medicine Society Journal (South Pacific Underwater Medicine Society) 29 (1). ISSN0813-1988. OCLC16986801. . Retrieved

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Decompression sickness
30 May 2010. [94] Acott, Chris (1999). "A brief history of diving and decompression illness" (http:/ / archive. rubicon-foundation. org/ 6004). South Pacific Underwater Medicine Society Journal (South Pacific Underwater Medicine Society) 29 (2). ISSN0813-1988. OCLC16986801. . Retrieved 30 May 2010. [95] Marx p.1903 [96] Smith, Andrew Heermance (1886). The Physiological, Pathological and Therapeutical Effects of Compressed Air (http:/ / books. google. com/ ?id=hLq981_A5bMC& printsec=frontcover& dq=Diving). George S. Davis. . Retrieved 30 May 2010. [97] McCullough, David (June 2001). The Great Bridge: The Epic Story of the Building of the Brooklyn Bridge (http:/ / www. simonsays. com/ content/ book. cfm?tab=1& pid=414117& er=9780743217378). Simon & Schuster. ISBN0-7432-1737-3. . Retrieved 30 May 2010. [98] Hill, Leonard Erskine (1912). Caisson sickness, and the physiology of work in compressed air (http:/ / books. google. com/ ?id=FTC0AAAAIAAJ& dq=Leonard+ Erskine+ Hill& printsec=frontcover). London: Arnold. ISBN1-113-96529-0. . Retrieved 30 May 2010. [99] Boycott, AE; Damant, GCC; Haldane, John Scott (1908). "Prevention of compressed air illness" (http:/ / archive. rubicon-foundation. org/ 7489). Journal of Hygiene 8 (3): 342443. doi:10.1017/S0022172400003399. PMC2167126. PMID20474365. . Retrieved 30 May 2010. [100] Thalmann, Edward D (1990). Principles of U.S Navy recompression treatments for decompression sickness (http:/ / archive. rubicon-foundation. org/ 7996). In Bennett, Peter B; Moon, Richard E. "Diving Accident Management". 41st Undersea and Hyperbaric Medical Society Workshop (Undersea and Hyperbaric Medical Society) 78(DIVACC)12-1-90. . Retrieved 30 May 2010. [101] Behnke, Albert R; Shaw, Louis A; Messer, Anne C; Thomson, Robert M; Motley, E Preble (January 31, 1936). "The circulatory and respiratory disturbances of acute compressed-air illness and the administration of oxygen as a therapeutic measure" (http:/ / ajplegacy. physiology. org/ cgi/ content/ citation/ 114/ 3/ 526). Americal Journal of Physiology 114 (3): 526533. . Retrieved 30 May 2010. [102] Davis Jefferson C, Sheffield Paul J, Schuknecht L, Heimbach RD, Dunn JM, Douglas G, Anderson GK (August 1977). "Altitude decompression sickness: hyperbaric therapy results in 145 cases". Aviation, Space, and Environmental Medicine 48 (8): 72230. PMID889546. [103] Workman, Robert D (1957). "Calculation of air saturation decompression tables" (http:/ / archive. rubicon-foundation. org/ 3458). Navy Experimental Diving Unit Technical Report NEDU-RR-11-57. . Retrieved 30 May 2010. [104] Carson, Daryl. "Dive Computer Evolution" (http:/ / www. skin-diver. com/ departments/ gearingup/ accessories/ may00_computer. asp?theid=1212). Skin-Diver.com. . Retrieved 30 May 2010. [105] Golding, F Campbell; Griffiths, P; Hempleman, HV; Paton, WDM; Walder, DN (July 1960). "Decompression sickness during construction of the Dartford Tunnel". British Journal of Industrial Medicine 17 (3): 16780. PMC1038052. PMID13850667. [106] Weathersby, Paul K; Homer, Louis D; Flynn, Edward T (September 1984). "On the likelihood of decompression sickness" (http:/ / jap. physiology. org/ cgi/ pmidlookup?view=long& pmid=6490468). Journal of Applied Physiology 57 (3): 81525. PMID6490468. . Retrieved 2009-04-27. [107] Bhlmann, Albert A (1984). Decompression-Decompression Sickness. Berlin New York: Springer-Verlag. ISBN0-387-13308-9. [108] "DAN Insurance" (http:/ / www. diversalertnetwork. org/ insurance/ index. asp). Divers Alert Network. 2003. . Retrieved 25 July 2010. [109] "NHS Funded Treatment" (http:/ / www. londonhyperbaric. com/ decompression-illness/ nhs-funded-treatment). London Hyperbaric Ltd. . Retrieved 22 August 2011.

52

References Bibliography
Hamilton, Robert W; Thalmann, Edward D (2003). "10.2: Decompression Practice". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th Revised ed.). United States: Saunders Ltd. pp.455500. ISBN0-7020-2571-2. OCLC51607923. Francis, T James R; Mitchell, Simon J (2003). "10.4: Pathophysiology of Decompression Sickness". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th Revised ed.). United States: Saunders Ltd. pp.53056. ISBN0-7020-2571-2. OCLC51607923. Francis, T James R; Mitchell, Simon J (2003). "10.6: Manifestations of Decompression Disorders". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th Revised ed.). United States: Saunders Ltd. pp.57899. ISBN0-7020-2571-2. OCLC51607923. Moon, Richard E; Gorman, Des F (2003). "10.7: Treatment of the Decompression Disorders". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th Revised ed.). United States: Saunders Ltd. pp.600650. ISBN0-7020-2571-2. OCLC51607923. Lippmann, John; Mitchell, Simon (2005). Deeper into Diving (2nd ed.). Melbourne, Australia: J L Publications. ISBN0-9752290-1-X.

Decompression sickness Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice (7th ed.). Philadelphia, PA: Mosby/Elsevier. ISBN978-0-323-05472-0. Powell, Mark (2008). Deco for Divers. Southend-on-Sea: Aquapress. ISBN1-905492-07-3.

53

External links
Environmental Physiology Medical Literature (http://archive.rubicon-foundation.org) Divers Alert Network: diving medicine articles (http://www.diversalertnetwork.org/medical/articles/index. asp) Dive Tables from the NOAA (http://www.ndc.noaa.gov/dp_forms.html)

Decompression stop
A decompression stop is a period of time a diver must spend at a constant depth in shallow water at the end of a dive to safely eliminate absorbed inert gases from the diver's body to avoid decompression sickness.[1] The practice of making decompression stops is called staged decompression,[2] [3] as opposed to continuous decompression.[4] [5]

Free floating decompression stop.

Doing a stop
The diver uses decompression tables[6] or dive computers to find, for his planned dive profile and breathing gas, if decompression stops are needed, and if so, the depths and durations of the stops. A "no stop" dive is a dive that needs no decompression stops during the ascent.[1] Shorter and shallower decompression dives may only need one single short shallow decompression stop, for example 5minutes at 3 metres (10ft). Longer and deeper dives often need a series of decompression stops, each stop being longer but shallower than the previous stop.

Decompression stop

54

Safety stop
As a precaution against any unnoticed dive computer malfunction, diver error or physiological predisposition to decompression sickness, many divers do an extra "safety stop"[7] in addition to those ordered by their dive computer or tables. A safety stop is typically 1 to 5minutes at 3 to 6 metres (10 to 20 ft). They are even done during no-stop dives.

Ascent rate
In addition to stops, the diver must not exceed a safe ascent rate during the whole of the ascent from depth. Normally the time to ascend from the shallowest stop to the surface will take at least 1minute. Typically with tables, the maximum ascent rate is 10 metres (33ft) per minute when deeper than 6 metres (20ft). Some dive computers have variable maximum ascent rates, depending on depth.

Mechanism
During the stop, the "microbubbles" present after every dive leave the diver's body safely through the lungs. If they are not given enough time to leave safely or more bubbles are created than can be eliminated naturally, the bubbles grow in size and number causing the symptoms and injuries of decompression sickness.[8] When diving with nitrogen-based breathing gases, decompression stops are typically carried out in the 3 to 20 metres (10 to 70 ft) depth range. With helium-based breathing gases, the stop depths may be between 20 and 40 metres (70 and 130 ft). The length of "surface interval" between dives is also very important for decompression. It typically takes from 16 to 24hours for the body to return to its normal atmospheric levels of inert gas saturation after a dive. The surface interval can be thought of as the last decompression stop of a dive.[9]

Breathing gas type

Only divers breathing gas at high pressure, such as when using scuba, may need to do decompression stops. A diver who breathes gas at atmospheric pressure, such as in free-diving, snorkeling, or when using an atmospheric diving suit, does not need to do decompression stops. However, it is possible to get taravana from repetitive deep free-diving with short surface intervals.[10]

Deep stops
A "Pyle stop" is an additional brief deep-water stop, which is increasingly used in deep diving (named after Richard Pyle, an early advocate of deep stops).[11] Typically, a Pyle stop is 2minutes long and at the depth where the pressure change halves on an ascent between the bottom and the first conventional decompression stop. For example, a diver ascents from a maximum depth of 60 metres (200ft), where the ambient pressure is 7 bars (100psi), to a decompression stop at 20 metres (66ft), where the pressure is 3 bars (40psi). The Pyle stop would take place at the halfway pressure, which is 5 bars (70psi) corresponding to a depth of 40 metres (130ft).[12]

Missed stops
A diver missing a decompression stop risks developing decompression sickness. The longer the stops missed, the greater the risk. The usual causes for missing stops are: not having enough breathing gas to complete the stops, or accidentally losing control of buoyancy. An aim of most basic diver training is to prevent these two faults. There are less predictable causes of missing decompression stops. Diving suit failure in cold water forces the diver to choose between hypothermia and decompression sickness. Diver injury or marine animal attack may also limit the duration of stops the diver is willing to carry out.

Decompression stop Technical diving education organizations define special procedures to be done if decompression stops are missed. These procedures may need repeating one or several stops.

55

Equipment
There are several pieces of safety equipment used to help divers carry out decompression stops. A diving shot, a surface marker buoy or a decompression buoy can be used to mark the underwater position of the diver and act as a buoyancy control aid in low visibility or currents. A decompression trapeze is useful for comfortably carrying out long stops. A Jonline may be used to fasten a diver to an anchor line or rope during a decompression stop. Decompression may be shortened (or accelerated) by breathing an oxygen-rich "deco gas" such as a nitrox with 50% or more oxygen. The high partial pressure of oxygen in such decompression mixes create the effect of the oxygen window. This decompression gas is often carried in side-slung cylinders. Divers take great care to avoid breathing oxygen enriched "deco gas" at great depths because of the high risk of oxygen toxicity. To prevent this happening, cylinders containing oxygen-rich gases must always be marked with their maximum operating depth as clearly as possible.[13] Other safety precautions may include using different coloured regulator housing, flavoured mouthpieces, or simply placing a rubber band vertically across the mouthpiece as an alert.[14]

References
[1] Brubakk, A. O.; T. S. Neuman (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed.. United States: Saunders Ltd.. pp.800. ISBN0702025712. [2] Boycott, A. E.; G. C. C. Damant, J. S. Haldane. (1908). "Prevention of compressed air illness" (http:/ / archive. rubicon-foundation. org/ 7489). J. Hygiene 8: 342443. doi:10.1017/S0022172400003399. PMC2167126. PMID20474365. . Retrieved 2008-08-06. [3] Bhlmann Albert A. (1984). Decompression-Decompression Sickness. Berlin New York: Springer-Verlag. ISBN0387133089. [4] Bert, P. (originally published 1878). "Barometric Pressure: researches in experimental physiology". Translated by: Hitchcock MA and Hitchcock FA. College Book Company; 1943. [5] Sport Diving, British Sub Aqua Club, ISBN 0091638313, page 110 [6] US Navy Diving Manual, 6th revision (http:/ / www. supsalv. org/ 00c3_publications. asp?destPage=00c3& pageID=3. 9). United States: US Naval Sea Systems Command. 2006. . Retrieved 2008-04-24. [7] Uguccioni, DM (1984). Doppler Detection of Silent Venous Gas Emboli in Non-Decompression Diving Involving Safety Stops (http:/ / archive. rubicon-foundation. org/ 3430). Wilmington, NC: University of North Carolina at Wilmington. . Retrieved 2008-04-25. [8] Sport Diving, British Sub Aqua Club, ISBN 0091638313, page 104 [9] BSAC '88 Decompression Tables Levels 1 to 4 [10] Wong, R. M. (1999). "Taravana revisited: Decompression illness after breath-hold diving" (http:/ / archive. rubicon-foundation. org/ 6010). South Pacific Underwater Medicine Society Journal 29 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-04-08. [11] "Decoweenie" (http:/ / www. decoweenie. com/ DecoWeenie Manual 39. pdf) (PDF). . Retrieved 2008-09-26. [12] Pyle, Richard L (2007-09-27). "Deep Decompression Stops" (http:/ / www. bishopmuseum. org/ research/ treks/ palautz97/ deepstops. html). Bishop Museum. . Retrieved 2009-09-09. [13] Jablonski, Jarrod (2006). "Details of DIR Equipment Configuration". Doing it Right: The Fundamentals of Better Diving. High Springs, Florida: Global Underwater Explorers. p.113. ISBN0-9713267-0-3. [14] Gary Gentile, The Technical Diving Handbook

Deep diving

56

Deep diving
The meaning of the term deep diving is a form of technical diving.[1] It is defined by the level of the diver's diver training, diving equipment, breathing gas, and surface support: in recreational diving, PADI define anything from 18 metres / 60 feet - 30 metres / 100 feet as a "deep dive" (other diving organisations vary) in technical diving, 60 metres / 200 feet may be a "deep dive" in surface supplied diving, 100 metres / 330 feet may be a "deep dive" This definition essentially relates to recreational diving. Deep diving may have quite a different meaning in the commercial diving field. For instance the early experiments carried out by Comex S.A. (Compagnie maritime d'expertises) using hydrox and also nitrogen trimix attained far greater depths than any recreational technical diving. One example being the Comex Janus IV open-sea dive to 500 metres, in 1977.[2] The open-sea diving depth record was achieved in 1988 by a team of Comex divers who performed pipe line connection exercises at a depth of 534 metres in the Mediterranean Sea as part of the Hydra 8 programme.[3] These divers needed to breathe special gas mixtures because they were exposed to very high ambient pressure (more than 50 times atmospheric pressure). An atmospheric diving suit allows very deep dives of up to 700 metres. These suits are capable of withstanding the pressure at great depth permitting the diver to remain at normal atmospheric pressure. This eliminates the problems associated with breathing high pressure gases.

Diver returning from a 600ft/180 metres dive

Deep Diving
Depth [4] Comments Recreational diving limit for divers aged under 12 years old and beginner divers. Recreational diving limit for divers with Open Water certification but without greater training and experience. Recommended recreational diving limit for divers. adults. [1] Average depth at which nitrogen narcosis symptoms begin to appear in

40 feet/12 meters 60 feet/18 meters 100 feet/30 meters

130 feet/40 meters 180 feet/55 meters 218 feet/65 meters

Absolute recreational diving limit for divers specified by Recreational Scuba Training Council (RSTC). Technical diving limit for "extended range" dives breathing air to a maximum ppO2 of 1.4 ATA. Depth at which compressed air results in an unacceptable risk of oxygen toxicity. [5]

[1]

330 feet/100 meters Technical diving training limit for divers breathing trimix. Recommended technical diving limit. 509 feet/155 meters Record depth for scuba dive on compressed air.[6] 660 feet/200 meters Absolute limit for surface light penetration sufficient for plant growth, though minimal visibility possible farther down.[7]

Deep diving
[8]

57

1,083 feet/330 meters 2,000 feet/610 meters

World record for deepest dive on SCUBA.

Navy diver in Atmospheric Diving System (ADS) suit .

[9]

Particular problems associated with deep dives

Deep diving has more consequences and dangers than basic open water diving.[10] Nitrogen narcosis, the narks or rapture of the deep, starts with feelings of euphoria and over-confidence but then leads to numbness and memory impairment similar to alcohol intoxication. Decompression sickness, or the bends, can happen if a diver ascends too fast, when excess inert gas leaves solution in the blood and tissues and forms bubbles. These bubbles produce mechanical and biochemical effects that lead to the condition. The effects tend to be delayed until reaching the surface. Bone degeneration (dysbaric osteonecrosis) is caused by the bubbles forming inside the bones; most commonly the upper arm and the thighs. Air embolism causes loss of consciousness and speech and visual problems. This tends to be life threatening, and requires a recompression chamber for treatment. Deep diving involves a much greater danger of all of these, and presents the additional risk of oxygen toxicity, which may lead to a convulsion underwater. Very deep diving using a heliumoxygen mixture (heliox) carries a risk of high pressure nervous syndrome. Coping with the physical and physiological stresses of deep diving requires good physical conditioning.[11] Using normal scuba equipment, breathing gas consumption is proportional to ambient pressure - so at 50 metres (160ft), where the pressure is 6 bar, a diver breathes 6 times as much as on the surface (1 bar). Heavy physical exertion causes even more gas to be breathed, and gas becomes denser requiring increased effort to breathe with depth, leading to increasing risk of hypercapnia, an excess of carbon dioxide in the blood. The need to do decompression stops increases with depth. A diver at 6 metres (20ft) may be able to dive for many hours without needing to do decompression stops. At depths greater than 40 metres (130ft), a diver may have only a few minutes at the deepest part of the dive before decompression stops are needed. In the event of an emergency the diver cannot make an immediate ascent to the surface without risking decompression sickness. All of these considerations result in the amount of breathing gas required for deep diving being much greater than for shallow open water diving. The diver needs a disciplined approach to planning and conducting dives to minimise these additional risks.

Dealing with depth

Divers carry larger volumes of breathing gas to compensate for the increased gas consumption and decompression stops. Rebreathers manage gas much more efficiently than open circuit scuba, but are inherently more complex than open circuit scuba. Use of helium-based breathing gases such as trimix reduces nitrogen narcosis and stays below the limits of oxygen toxicity. A diving shot, a decompression trapeze or a decompression buoy can help divers return to their surface safety cover at the end of a dive.

Technical divers preparing for a mixed-gas decompression dive in Bohol, Philippines. Note the backplate and wing setup with sidemounted stage tanks containing EAN50 (left side) and pure oxygen (right side).

Deep diving

58

Ultra-deep diving
Verified SCUBA dives below 800 feet
Name Nuno Gomes Location Red Sea Red Sea South Africa South Africa Depth 1044 feet (318m) 890 feet (270m) 927 feet (283m) 826 feet (252m) Year 2005 2004 1996 1994

Pascal Bernab

Mediterranean Mediterranean

1083 feet 2005 (330m) 2005 873 feet (266m) 888 feet (271m) 2004 898 feet (274m) 2002 1010 feet 2001 (310m) 2001 833 feet (254m) 925 feet (282m) 825 feet (251m) 1994 1993

David Shaw

[12]

South Africa

Gilberto M de Oliveira Brazil John Bennett [12] Philippines Philippines

Jim Bowden

Mexico Mexico South Africa Mexico South Africa Andaman Sea Thailand

Sheck Exley Don Shirley

[12]

863 feet (263m) 1993 867 feet (264m) 1989 820 feet (250m) 2005 1026 feet 2003 (313m) 2003 850 feet (260m)

Mark Ellyatt

Amongst technical divers, there are certain elite divers who participate in ultra-deep diving on SCUBA (using closed circuit rebreathers and heliox) below 660 feet (200m). Ultra-deep diving requires extraordinarily high levels of training, experience, fitness and surface support. Only eight (or possibly nine) persons are known to have ever dived below a depth of 800 feet (240m) on self contained breathing apparatus recreationally.[13] [14] [15] [16] That is fewer than the number of people who have walked on the surface of the moon. The Holy Grail of deep SCUBA diving was the 1000ft (300m) mark, first achieved by John Bennett in 2001, and has only been achieved five times since. Dives of this nature have been impossible to verify - proof being as tangible as faith more often than not. Since the recent introduction of depth gauges capable of reading to 330m it is unlikely that such records will be attempted in the future. In 2003 Mark Ellyatt claimed dives to depths of 260m and 313m. Besides scuba, there is a small group of divers who have reached depths below 200 meters on closed-circuit rebreathers. Some examples are David Shaw, Don Shirley, Alessandro Scuotto, Marco Reis, Mario Marconi, Paul Raymeakers and Pim van der Horst.

Ultra deep air

While extreme deep diving on air is extremely dangerous, before the popularity of Trimix attempts were made to set world record depths using conventional air. This created an extreme risk of both narcosis and oxygen toxicity in the divers and, perhaps unsurprisingly, contributed to an astonishingly high fatality rate amongst those attempting records. In his book, Deep Diving, Bret Gilliam chronicles the various fatal attempts to set records as well as the smaller number of successes.[17] From the comparatively few who survived extremely deep air dives:

Deep diving 1947 Frdric Dumas, a colleague of Jacques Cousteau, dived to 307 feet (94m) on air 1959 Ennie Falco reported having reached a depth of 435 feet (133m) on air, but had no means to record it 1965 Tom Mount and Frank Martz dive to a depth of 360 feet (110m) on air 1967 Hal Watts and AJ Muns dive to a depth of 390 feet (120m) on air 1968 Neil Watson and John Gruener dived to 437 feet (133m) on air in the Bahamas. Watson reported that he had no recollection at all of what transpired at the bottom of the descent due to narcosis. 1990 Bret Gilliam dived to a depth of 452 feet (138m) on air. Unusually, Gilliam remained largely functional at depth and was able to complete basic maths problems and answer simple questions written on a slate by his crew beforehand. 1993 Bret Gilliam extended his own world record to 475 feet (145m), again reporting no ill effects from narcosis or oxygen toxicity. 1994 Dan Manion set the current record for a deep dive on air at 509 feet (155m). Manion reported he was almost completely incapacitated by narcosis and has no recollection of time at depth. In deference to the high death rate, the Guinness World Records ceased to publish records on deep air dives.

59

References
[1] Brylske, A. (2006). Encyclopedia of Recreational Diving, 3rd edition. United States: PADI. ISBN1878663011. [2] Hydra 8: Pre-commercial Hydrogen Diving Project (http:/ / www. onepetro. org/ mslib/ servlet/ onepetropreview?id=SUT-AUTOE-v14-107& soc=SUT& speAppNameCookie=ONEPETRO) [3] Comex S.A. HYDRA 8 and HYDRA 10 test projects (http:/ / www. comex. fr/ suite/ ceh/ histo/ histo anglais. html) [4] All depths specified for sea water. Fractionally deeper depths may apply in relation to freshwater due to its lower density [5] Oxygen toxicity depends upon a combination of partial pressure and time of exposure, individual physiology, and other factors not fully understood. NOAA recommends that divers do not expose themselves to breathing oxygen at greater than 1.6 bar ppO2, which occurs at 218 feet breathing air. [6] Set by Dr Dan Marion on March 18, 1994. The record is not officially recognised anywhere, and it should be noted that Dr Marion's second dive computer only registered a depth of 490 feet. See generally Deep Diving by Bret Gilliam, ISBN 0-922769-31-1, at pages 35 and following. (http:/ / books. google. vg/ books?id=HVbjgdorRXAC& lpg=PA35& ots=TjUeuuvLmB& dq="bret gilliam" record air& pg=PA35#v=onepage& q="bret gilliam" record air& f=false) [7] Assuming crystal clear water; surface light may disappear completely at much shallower depths in murky conditions. Minimal visibility is still possible far deeper. Deep sea explorer William Beebe reported seeing blueness, not blackness, at 1400 feet (424 meters). "I peered down and again I felt the old longing to go farther, although it looked like the black pit-mouth of hell itself---yet still showed blue." (William Beebe, "A Round Trip to Davey Jones's Locker," The National Geographic Magazine, June 1931, p. 660.) [8] 1,083 feet was the depth reportedly achieved by Pascal Bernab in 2005. However, the Guinness World Records still recognises the 1,044 feet dive by Nuno Gomes earlier in the same year as the current official world record. [9] Navy diver sets world record (http:/ / www. military. com/ features/ 0,15240,108883,00. html) [10] Egstrom GH (2006). "Historic Perspective: Scientific Deep Diving and the Management of the Risk" (http:/ / archive. rubicon-foundation. org/ 4653). In: Lang, MA and Smith, NE (eds). Proceedings of Advanced Scientific Diving Workshop (Washington, DC). . Retrieved 2008-07-05. [11] Southerland, DG (2006). "Medical Fitness at 300 FSW" (http:/ / archive. rubicon-foundation. org/ 4659). In: Lang, MA and Smith, NE (eds). Proceedings of Advanced Scientific Diving Workshop (Washington, DC). . Retrieved 2008-07-05. [12] Subsequently died during diving accidents. [13] Gomes, N. "Verified dives below 200 metres" (http:/ / www. nunogomes. co. za/ rec. htm). . Retrieved 2008-06-14. [14] Scubarecords.com. "Recorded Deep Dives Below 200m" (http:/ / www. scubarecords. com/ DeepRecords. htm). . Retrieved 2008-06-14. [15] Statistics exclude military divers (classified), and commercial divers (although commercial diving to that depth is unknown on SCUBA). In 1989 the US Navy experimental diving unit published a paper entitled EX19 [a type of experimental rebreather] Performance Testing at 850 and 450 FSW which included a section on results from tests on the use of rebreathers at 850 feet. --Knafelc, ME (1989). "EX 19 Performance Testing at 850 and 450 FSW (Feet of Seawater)" (http:/ / archive. rubicon-foundation. org/ 7423). US Naval Experimental Diving Unit Technical Report NEDU-8-89. . Retrieved 2008-07-24. [16] In 2007 Erdogan Bayburt, a former Turkish Navy diver, dived to a depth of 998 feet (304m) off the coast of Cyprus, but that dive has not been independently verified. He used a closed-circuit rebreather. His dive was aborted due to equipment failure. It was a Turkish Navy experimental dive. [17] Deep Diving, an advanced guide to physiology, procedures and systems (http:/ / books. google. com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=Bret+ Gilliam+ deep+ diving#v=onepage& q=& f=false). Bret Gilliam. 1995-01-25. ISBN9780922769315. . Retrieved 2009-11-19.

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Footnotes Further reading

Dent, W (2006). "AAUS Deep Diving Standards" (http://archive.rubicon-foundation.org/4669). In: Lang, MA and Smith, NE (eds). Proceedings of Advanced Scientific Diving Workshop (Washington, DC). Retrieved 2008-07-05.

External links
Recreational Deep Diving (http://www.divinglore.com/RecreationalDeepDiving.htm)

Equivalent air depth

The equivalent air depth (EAD) is a way of approximating the decompression requirements of breathing gas mixtures that contain nitrogen and oxygen in different proportions to those in air, known as nitrox.[1] [2] [3] The equivalent air depth, for a given nitrox mix and depth, is the depth of a dive when breathing air that would have the same partial pressure of nitrogen. So, for example, a gas mix containing 36% oxygen (EAN36) being used at 27 metres (89ft) has an EAD of 20 metres (66ft).

Calculations in metres
The equivalent air depth can be calculated for depths in metres as follows: EAD = (Depth + 10) Fraction of N2 / 0.79 10 Working the earlier example, for a nitrox mix containing 64% nitrogen (EAN36) being used at 27 metres, the EAD is: EAD = (27 + 10) 0.64 / 0.79 10 EAD = 37 0.81 10 EAD = 30 10 EAD = 20 metres So at 27 metres on this mix, the diver would calculate their decompression requirements as if on air at 20 metres.

Calculations in feet
The equivalent air depth can be calculated for depths in feet as follows: EAD = (Depth + 33) Fraction of N2 / 0.79 33 Working the earlier example, for a nitrox mix containing 64% nitrogen (EAN36) being used at 90 feet, the EAD is: EAD = (90 + 33) 0.64 / 0.79 33 EAD = 123 0.81 33 EAD = 100 33 EAD = 67 feet So at 90 feet on this mix, the diver would calculate their decompression requirements as if on air at 67 feet.

Equivalent air depth

61

Dive tables
Although not all dive tables are recommended for use in this way, the Bhlmann tables are suitable for use with these kind of calculations. At 27 metres the Bhlmann 1986 table (0700 m) allows 20 minutes bottom time without requiring a decompression stop. While at 20 metres the no-stop time is 35 minutes. This shows that using EAN36 for a 27 metre dive can give a 75% increase in bottom time over using air.

References
[1] Logan, JA (1961). "An evaluation of the equivalent air depth theory" (http:/ / archive. rubicon-foundation. org/ 3835). United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. . Retrieved 2008-05-01. [2] Berghage Thomas E, McCraken TM (December 1979). "Equivalent air depth: fact or fiction" (http:/ / archive. rubicon-foundation. org/ 2835). Undersea Biomedical Research 6 (4): 37984. PMID538866. . Retrieved 2008-05-01. [3] Lang, Michael A. (2001). DAN Nitrox Workshop Proceedings (http:/ / archive. rubicon-foundation. org/ 4855). Durham, NC: Divers Alert Network. p.197. . Retrieved 2008-05-02.

Equivalent narcotic depth

Equivalent narcotic depth (END) is used in technical diving as a way of estimating the narcotic effect of a breathing gas mixture, such as heliox and trimix. The method is, for a given mix and depth, to calculate the depth which would produce the same narcotic effect when breathing air. The equivalent narcotic depth of a breathing gas mix at a particular depth is calculated by finding the depth of a dive when breathing air that would have the same total partial pressure of nitrogen and oxygen as the breathing gas in question. For example, a trimix containing 20% oxygen, 40% helium, 40% nitrogen (trimix 20/40) being used at 60 metres (200ft) has an END of 32 metres (105ft).

Calculations
Metres
The equivalent narcotic depth can be calculated for depths in metres as follows: END = (Depth + 10) (1 Fraction of helium) 10 Working the earlier example, for a gas mix containing 40% helium being used at 60 metres, the END is: END = (60 + 10) (1 0.4) 10 END = 70 0.6 10 END = 42 10 END = 32 metres So at 60 metres on this mix, the diver would feel the same narcotic effect as a dive on air to 32 metres.

Equivalent narcotic depth

62

Feet
The equivalent narcotic depth can be calculated for depths in feet as follows: END = (Depth + 33) (1 Fraction of helium) 33 Working the earlier example, for a gas mix containing 40% helium being used at 200 feet, the END is: END = (200 + 33) (1 0.4) 33 END = 233 0.6 33 END = 140 33 END = 107 feet So at 200 feet on this mix, the diver would feel the same narcotic effect as a dive on air to 107 feet.

Oxygen Narcosis
Since there is evidence that oxygen plays a part in the narcotic effects of a gas mixture,[1] the NOAA diving manual recommends treating oxygen and nitrogen as equally narcotic.[2] This is now preferred to the previous method of considering only nitrogen as narcotic, since it is more conservative. In this analysis, it is assumed that the narcotic potentials of nitrogen and oxygen are similar. Although oxygen has greater lipid solubility than nitrogen and therefore should be more narcotic (Meyer-Overton correlation), it is likely that some of the oxygen is metabolised, thus reducing its effect to a level similar to that of nitrogen.

References
[1] Hesser CM, Fagraeus L, Adolfson J (December 1978). "Roles of nitrogen, oxygen, and carbon dioxide in compressed-air narcosis" (http:/ / archive. rubicon-foundation. org/ 2810). Undersea Biomed Res 5 (4): 391400. PMID734806. . Retrieved 2008-05-01. [2] "Mixed-Gas & Oxygen". NOAA Diving Manual, Diving for Science and Technology. 4th. National Oceanic and Atmospheric Administration. 2002. "[16.3.1.2.4] ... since oxygen has some narcotic properties, it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. 1977,1978). The non-helium portion (i.e., the sum of the oxygen and the nitrogen) is to be regarded as having the same narcotic potency as an equivalent partial pressure of nitrogen in air, regardless of the proportions of oxygen and nitrogen."

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High-pressure nervous syndrome

High-pressure nervous syndrome (HPNS also known as high-pressure neurological syndrome) is a neurological and physiological diving disorder that results when a commercial diver or scuba diver descends below about 500 feet (150m) while breathing a heliumoxygen mixture. The effects depend on the rate of descent and the depth.[1] HPNS is a limiting factor in future deep diving. "Helium tremors" were first widely described in 1965 by Royal Navy physiologist Peter B. Bennett, who also founded the Divers Alert Network.[1] [2] Russian scientist G. L. Zal'tsman also reported on helium tremors in his experiments from 1961. Unfortunately these reports were not available in the West until 1967.[3] The term high pressure nervous syndrome was first used by Brauer to describe the combined symptoms of tremor, electroencephalography (EEG) changes, and somnolence that appeared during a 1189-foot (362m) chamber dive in Marseilles.[4]

Symptoms
Symptoms of HPNS include tremors, myoclonic jerking, somnolence, EEG changes,[5] visual disturbance, nausea, dizziness, and decreased mental performance.[1] [2]

Causes
HPNS has two components, one resulting from the speed of compression and the other from the absolute pressure. The compression effects may occur when descending below 500 feet (150m) at rates greater than a few metres per minute, but reduce within a few hours once the pressure has stabilised. The effects from depth become significant at depths exceeding 1000 feet (300m) and remain regardless of the time spent at that depth.[1] The susceptibility of divers and animals to HPNS varies over a wide range depending on the individual, but has little variation between different dives by the same diver.[1]

Prevention
It is likely that HPNS can not be entirely prevented but there are effective methods to delay or change the development of the symptoms.[1] [6]

Rate of Compression
Utilizing slow rates of compression or adding stops to the compression have been found to prevent large initial decrements in performance.[1] [7]

Breathing Mixture
Including other gases in the mix, such as nitrogen (creating trimix) or hydrogen (hydreliox) suppresses the neurological effects.[8] [9] [10]

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64

Drugs
Alcohol, anesthetics and anticonvulsant drugs have had varying results in suppressing HPNS with animals.[1] None are currently in use for humans.

References
[1] Bennett, Peter B; Rostain, Jean Claude (2003). "The High Pressure Nervous Syndrome". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders. pp.32357. ISBN0702025712. [2] Bennett, P. B. (1965). "Psychometric impairment in men breathing oxygen-helium at increased pressures". Royal Navy Personnel Research Committee, Underwater Physiology Subcommittee Report No. 251 (London). [3] Zal'tsman, G. L. (1967). "Psychological principles of a sojourn of a human in conditions of raised pressure of the gaseous medium (in Russian, 1961)". English translation, Foreign Technology Division. AD655 360 (Wright Patterson Air Force Base, Ohio). [4] Brauer, R. W. (1968). "Seeking man's depth level". Ocean Industry (London) 3: 2833. [5] Brauer, R. W.; S. Dimov; X. Fructus; P. Fructus; A. Gosset; R. Naquet. (1968). "Syndrome neurologique et electrographique des hautes pressions". Rev Neurol (Paris) 121 (3): 2645. PMID5378824. [6] Hunger Jr, W. L.; P. B. Bennett. (1974). "The causes, mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. rubicon-foundation. org/ 2661). Undersea Biomed. Res. 1 (1): 128. ISSN0093-5387. OCLC2068005. PMID4619860. . Retrieved 2008-04-07. [7] Bennett, P. B.; R. Coggin; M. McLeod. (1982). "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. rubicon-foundation. org/ 2920). Undersea Biomed. Res. 9 (4): 33551. ISSN0093-5387. OCLC2068005. PMID7168098. . Retrieved 2008-04-07. [8] Vigreux, J. (1970). "Contribution to the study of the neurological and mental reactions of the organism of the higher mammal to gaseous mixtures under pressure". MD Thesis (Toulouse University). [9] Fife, W. P. (1979). "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". Texas A&M University Sea Grant TAMU-SG-79-201. [10] Rostain, J. C.; Gardette-Chauffour, M. C.; Lemaire, C.; Naquet, R. (1988). "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw" (http:/ / archive. rubicon-foundation. org/ 2487). Undersea Biomedical Research 15 (4): 25770. ISSN0093-5387. OCLC2068005. PMID3212843. . Retrieved 2008-04-07.

External links
Select publications about HPNS (http://archive.rubicon-foundation.org/dspace/simple-search?query=high+ pressure+nervous+syndrome) hosted by the Rubicon Foundation

List of diving hazards and precautions

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List of diving hazards and precautions

Divers face specific physical and health risks when they go underwater (e.g. with scuba or other diving equipment) or use high pressure breathing gases. Some of these conditions also affect people who work in raised pressure environments out of water, e.g. in caissons. According to a North American 1970 study, diving was (on a man-hours based criteria) 96 times more dangerous than driving an automobile.[1] According to a 2000 Japanese study, every hour of recreational diving is 36 to 62 times riskier than automobile driving.[2]

Effects of relying on breathing equipment while underwater

Being unable to breathe fresh air naturally whilst submerged and relying on limited breathing gas supplies and fallible breathing equipment can have these effects. Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type Drowning Secondary drowning Cause Being unable to inhale anything but water Can occur hours after a near drowning How to avoid it See under "anoxia" hereinunder Prompt medical treatment after near drowning Proper training before using a rebreather or oxygen enriched gases such as nitrox.

Oxygen toxicity

Breathing gas at too high a partial pressure of oxygen; partial pressure depends upon proportion of oxygen and depth

Hypoxia or anoxia occurs while having gas to breathe, but where the oxygen partial pressure is too low to sustain normal activity or consciousness.

A faulty or misused rebreather can provide the diver with Keep rebreathers properly maintained. hypoxic gas Proper training before using a rebreather. Some deep diving breathing gases such as trimix and heliox can be hypoxic at shallow depths Don't breathe hypoxic gas in shallow water. Proper training before using mixed gases. Corerect identification of cylinder gases and safe procedures for gas changes. Keep cylinders routinely checked and tested. If a cylinder has stood full for months, empty it and refill it. Keep equipment routinely checked and in good condition Better training of divers. More disciplined attitude when underwater. Better awareness underwater. Carry a diver's net cutter, or dive tool/knife. Specific training and leadership for such types of diving. See cave diving and wreck diving. Better training and leadership, including in using a compass underwater Keep equipment routinely checked and in good condition

A full cylinder standing for a long time while the inside of the cylinder rusts, using up oxygen in the contained air, before the diver uses the cylinder Anoxia due to having no air or gas to breathe Equipment failure - particularly in rebreathers that monitor and maintain oxygen content Running out of air due to a number of factors, including poor dive discipline Running out of air due to getting trapped by nets

Running out of air due to getting trapped or lost in enclosed spaces underwater (e.g. caves and shipwrecks)

Running out of air due to getting lost in open water

Salt water aspiration syndrome

Inhaling a mist of sea water from a faulty demand valve causing a reaction in the lungs

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Air cylinder filled by a compressor which sucked in products of combustion, often its own engine's exhaust gas Oil getting into the air feed and firing in the air compression cylinder, like in a diesel engine Proper precautions when filling cylinders

Carbon monoxide poisoning

Proper servicing of the compressor

Emphysema caused by inhaling oil mist

This happens gradually over a long time. This is a particular risk with a pumped surface air feed. Re-inhaling carbon dioxide-laden exhaled gas

Use proper filters in the air pump or air compressor. Minimise the volume of any enclosed spaces which the diver breathes through. For example, this hazard can happen with diving with a large "bubblehead" helmet. British naval divers called it shallow water blackout. Keep rebreathers properly maintained. Proper training before using a rebreather. Check conditions where you have your cylinders refilled. Put the proper gas identification markings on cylinders.

Carbon dioxide poisoning: hypercapnia

With a rebreather, the diver re-inhales carbon dioxide because the soda lime scrubber cannot absorb the exhaled carbon dioxide as fast as the diver produces it. See Rebreather#Carbon dioxide scrubber. Various effects of breathing a wrong gas A wrong gas was put in a cylinder

Effects of barotrauma or pressure damage

See barotrauma and pressure for more information.

On descent
Air spaces within the body provide no support against greater outside pressure. This can happen from losing control of buoyancy causing excessive vertical speed during descent. Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type Eardrum damage. Cold water in the middle ear chills the inner ear, causing dizziness and disorientation etc. Cause Failing to equalize the pressure in the middle ear with surrounding pressure. How to avoid it Do not dive if the eustachian tube is congested, e.g. with the common cold. Proper diver training in clearing the ears. Make sure that your hood does not make an airtight seal over the outside ear hole; never wear earplugs. Do not dive with conditions such as the common cold Let air into the mask through the nose. Do not dive with eyes-only goggles.

The pressure in the outer ear not equalizing with surrounding pressure

Damage to other body air spaces, such as the paranasal sinuses. Squeeze damage to blood vessels around the eyes

Obstruction to the sinus ducts

Caused by suction from the air space inside a mask ("mask squeeze") which is not a fullface mask

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Modern drysuits have a tube connection to inflate the drysuit from the cylinder Use an underwater breathing set Keep equipment in good order and inspected. Proper training in its use.

Squeeze damage to skin under Suction into the space inside the fold folds in a drysuit

Lung squeeze: blood in lungs

Extreme depth when snorkelling

Helmet squeeze, with the old standard diving dress. This does not happen with scuba where there is no solid pressure-tight helmet

A non-return valve in the helmet failing, accompanied by a failure of the air compressor (on the surface) to pump enough air into the suit for the gas pressure inside the suit remaining equal to the outside pressure of the water. In severe cases much of the diver's body could be mangled and compacted inside the helmet, however, this requires substantial pressure difference caused by aforementioned failures in the air supply and the non-return valve (which was absent from the earliest models of this type of diving suit).

On ascent
Air spaces within the body expand when the outside pressure decreases. This can happen from holding the breath on ascent, or from losing control of buoyancy causing excessive vertical speed during ascent. Click on the boldface links to find symptoms and more information for each topic.

Types of this sort of diving disorder, and how to avoid them

Type Cause How to avoid it Never hold your breath while diving with breathing apparatus

Pulmonary barotrauma: "burst lung" Holding the breath while ascending This can cause: Pneumothorax Interstitial emphysema Subcutaneous emphysema Gas embolism Collapsed lung, air loose in the pleural cavity Gas trapped in the chest after burst lung Gas loose under the skin. Air or other gas in the blood stream. Its effects can be very similar to decompression sickness. Blockage of the sinus's duct Blocked Eustachian tube

Pain in a sinus Eardrum bursting outwards

Do not dive with nasal congestion, e.g. the common cold.

Effects of breathing gas at high pressure

Click on the boldface links to find symptoms and more information for each topic.

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Types of this sort of diving disorder, and how to avoid them

Type Decompression sickness ("the bends") Cause Gas dissolves in tissues under pressure according to Henry's Law over time. After dive, ascending too quickly will cause gas to supersaturate and form bubbles in tissues depending on time and depth of the dive. Many deep dives in succession. See taravana. How to avoid it Plan your dive. Know how long you can stay at the planned depth and still make a normal ascent. If stops are necessary, do not miss or cut short decompression stops. Training in using diving tables and a dive computer. See decompression sickness for a detailed list of the symptoms. Use breathing gas mixtures with reduced inert gas fraction, eg Nitrox. Provide something for the diver to hold onto while ascending and decompressing to maintain accurate depth during stops and correct ascent rate. Avoid dehydration and hypothermia. Maintain cardiovascular fitness. Reduce the number of deep dives, increase surface interval or reduce dive depth. Use an underwater breathing apparatus and ascend at a rate determined by decompression tables or computer. Dont dive deep on air. Limit the depth of the dive to limit the partial pressures of gases with narcotic effects to a level that you can safely manage. With mixed gas diving, use the correct breathing gas mixture to limit the equivalent narcotic depth to an acceptable level for the planned depth. This hazard is well known with closed circuit rebreathers when the control of the mixture fails. This can also happen when diving with open-circuit scuba and semi-closed circuit rebreathers if the maximum operating depth for the breathing gas is exceeded. Use another diving technique, such as an ROV; or add a little nitrogen as described at HPNS.

Bends in snorkellers. Uncommon but known. Nitrogen narcosis

Breathing a high partial pressure of nitrogen (or other gas, to varying degrees)

Oxygen toxicity

Breathing a high partial pressure of oxygen

HPNS: High Pressure Nervous Syndrome or Helium Tremors

Breathing a high partial pressure of helium

The term dysbarism describes Decompression sickness, arterial gas embolism, and barotrauma. Divers face specific physical and health risks when they go underwater (e.g. with scuba) or use high pressure breathing gases. Some of these conditions also affect people who work in raised pressure environments out of water, e.g. in caissons.

Other risks encountered by people in water

Types of this class of diving disorder, and how to avoid them. Click on the boldface links to find symptoms and more information for each topic. Where it says "Avoid diving with bare skin", a boilersuit could be worn in very warm water.
Type Hypothermia Cause Losing body heat to the water. Water carries heat away far better than air. How to avoid it In cool or cold water, wear an adequately warm diving suit for the conditions. Also, much heat can be lost from a head without a hood. Do not get too close to coral. Avoid diving with bare skin.

Cuts, sometimes with Coral coral tissue left in them Cuts Rock, metal, etc.

Avoid diving in bare skin, particularly in caves or shipwrecks. It is yellow. Learn to identify it. Learn about the dangerous species. Avoid diving with bare skin.

Stings Stings, some dangerous

Fire coral Some jellyfish

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Do not poke about in sand where they live. Care when wading.

A deep cut which leaves poison in the wound Reef rash

sting ray (its self-defence reaction)

A generic catch-all term that refers to the various cuts, scrapes, bruises and skin conditions that result from diving in tropical waters. This includes sunburn, jellyfish stings, sea lice bites, fire coral inflammation and other skin injuries that a diver may gain from using a shorty wetsuit or no diving suit. lionfish, stonefish, crown of thorns starfish, some sea urchins in warm seas Blue ringed octopus, in parts of the Pacific Ocean Sharks, likelihood of risk is location dependent

Wear a full-body exposure suit to prevent direct skin to environment contact.

Poison-injecting spines Poison injection Shark bites

Learn to identify them. Keep away from them. Care when wading.

Consult location-specific information to determine risk; never molest even seemingly-tame sharks underwater. Get proper information on them. Avoid waters known to be inhabited by crocodiles. Keep a lookout for the fish and move away if they act aggressively

Crocodile attack

Crocodiles, in some tropical waters

Attack by Titan Triggerfish Attack by an unusually large grouper.

This tropical Indo-Pacific fish is very territorial during breeding season and will attack and bite divers

Epinephelus lanceolatus can grow very big in tropical waters, Get proper information on them. where protected from attack by sharks. There have been cases [3] [4] [5] of very large groupers trying to swallow humans. [6] [7] Electric eel, in some South American fresh water Electric ray, in some warm seas It is said that some naval anti-frogman defences use electric shock Keep out of armed forces areas Get proper information on them

Electrocution

Powerful ultrasound

It is said that some naval anti-frogman defences use powerful ultrasound. Also used for long-range communication with submarines Weil's disease (in rat's urine) Bilharzia (in some warm fresh water) Various bacteria found in sewage May be found in water polluted by industrial waste outfalls or by natural sources. For example hydrogen sulfide in some lakes and caves can be absorbed through the skin. Colliding with a boat or its propeller. Wave action on the shore.

Keep out of armed forces areas. Avoid large ships' ordinary sonar. See Underwater Port Security System. In affected water, dive in watertight drysuit and full face diving mask

Exposure to disease carried by in-water organisms Exposure to harmful chemicals in the water Broken bones, bleeding wounds and other trauma

Use Surface detection aids or a diving shot to mark surfacing position and aid searchers. Plan a safe exit point and check weather and tidal conditions. Ensure that boat uses a positive check system to identify each diver is on board after a dive. Carry a yellow flag or surface marker buoy to attract attention. Carry a personal submersible EPIRB or submersible vhf radio. Carry a signalling mirror and/or sound signalling device. Local knowledge, good weather forecasts, plan alternative exits

Diver lost at sea after Separated from boat cover due to poor visibility at surface or a boat dive strong underwater currents. Left behind due to inaccurate check by boat crew

Diver lost at sea after Big waves made it unsafe to leave the water; currents moved a shore dive the diver away from a safe exit; surface weather on the shore make the sea too rough to safely exit. Sudden loss of underwater visibility Silt out: stirring up silt or other light loose material

Training in diving in zero visibility. Learn the frog kick.

List of diving hazards and precautions

70
Carry at least one line cutting implement. Dive with a buddy who is capable of helping to free you and will stay close enough to notice, Train in wreck diving and cave diving techniques, Use low snag equipment configurations (avoid dangling gear and snap hooks that can snag on lines)

Entrapment

Snagging on lines, nets, wrecks, debris or caves

Getting lost under an overhead

Losing your way in wrecks and caves where there is no direct Proper training and dive planning, Correct use of reels and route to the surface lines, directional markers. Backup lights.

References
[1] Lansche, James M (1972). "Deaths During Skin and Scuba Diving in California in 1970". California Medicine 116 (6): 1822. PMC1518314. PMID5031739. [2] Ikeda, T; Ashida, H (2000). "Is recreational diving safe?" (http:/ / archive. rubicon-foundation. org/ 6770). Undersea and Hyperbaric Medical Society. . Retrieved 2009-08-08. [3] Alevizon, Bill (July 2000). "A Case for Regulation of the Feeding of Fishes and Other Marine Wildlife by Divers and Snorkelers" (http:/ / www. reefrelief. org/ science_body4. shtml). Reef Relief. . Retrieved 2009-08-08. [4] Allard, Evan T (2002-01-04). "Did fish feeding cause recent shark, grouper attacks?" (http:/ / www. cdnn. info/ eco/ e020104/ e020104. html). Cyber Diver News Network. . Retrieved 2009-08-08. [5] "Goliath grouper attacks" (http:/ / www. jacksonville. com/ tu-online/ stories/ 061905/ spo_19030958. shtml). Jacksonville.com (Florida Times-Union). 2005-06-19. . Retrieved 2009-08-08. [6] Sargent, Bill (2005-06-26). "Big Grouper Grabs Diver On Keys Reef" (http:/ / www. flmnh. ufl. edu/ fish/ InNews/ grouperattack2005. html). FloridaToday.com. Florida Museum of Natural History. . Retrieved 2009-08-08. [7] Arthur C. Clarke, Reefs of Taprobane, ISBN 0-7434-4502-3, page 138: 15 feet long, 4 feet side side to side. in the sunken Admiralty floating dock in Trincomalee, Sri Lanka

External links
Diving Diseases Research Centre (http://www.DDRC.org)

Maximum operating depth

71

Maximum operating depth

In technical diving and nitrox diving, the maximum operating depth (MOD) of a breathing gas is the depth at which the partial pressure of oxygen (ppO2) of the gas mix exceeds a safe limit. This safe limit varies depending on the diver training agency, the level of underwater exertion planned and the planned duration of the dive, but is normally in the range of 1.2 to 1.6 bar.[1] The MOD is significant when planning dives using gases such as nitrox and trimix because the proportion of oxygen in the mix determines the maximum safe depth for breathing that gas. There is a risk of oxygen toxicity if the MOD is exceeded.[1] The tables below show MODs for a selection of oxygen mixes. Note that 21% is the concentration of oxygen in normal air.

Safe limit of partial pressure of oxygen

The maximum single exposure limits recommended in the NOAA Diving Manual are 45 minutes at 1.6 bar, 120 minutes at 1.5 bar, 150 minutes at 1.4 bar, 180 minutes at 1.3 bar and 210 minutes at 1.2 bar.[1]

Formulas
To calculate the MOD for a specific ppO2 and percentage of oxygen, the following formulas are used:

In feet

In which ppO2 is the desired partial pressure in oxygen and the FO2 is the decimal value of the fraction of oxygen in the mixture. For example, if a gas contains 36% oxygen and the maximum ppO2 is 1.4 bar, the MOD (fsw) is 33 feet (10m) x [(1.4 / 0.36) - 1] = 95.3 feet (29.0m). Note that the formula simply divides the total partial pressure of PURE oxygen which can be tolerated (expressed in bar or atmospheres) by the fraction of oxygen in the nitrox, to calculate to total atmospheres pressure this mix can be breathed at (obviously 50% nitrox can be breathed at twice the pressure of 100% oxygen, so divide by 0.5, etc.). Of this total pressure which can be tolerated by the diver, 1 atmosphere is due to the Earth's air, and the rest is due to depth in water. So the 1 atm for the air is subtracted out, to give the rest of the pressure added by water (in atmospheres). The remaining part in each formula merely converts pressure in atm produced by depth in water, to the depth. It does this by multiplying by the appropriate amount of depth to produce an atmosphere of pressure: 33 feet (10m) of salt water (fsw) or 10 meters of salt water.

In metres

In which ppO2 is the desired partial pressure in oxygen and the FO2 is the decimal value of the fraction of oxygen in the mixture. For example, if a gas contains 36% oxygen and the maximum ppO2 is 1.4 bar, the MOD (m) is 10 metres x [(1.4 / 0.36) - 1] = 28.9 metres.

Maximum operating depth

72

MOD table in feet

Maximum Operating Depth (MOD) in feet of sea water for ppO2 1.2 to 1.6
MOD (fsw) 3 6 9 12 15 18 21 24 27 30 % oxygen 33 36 39 42 45 50 55 60 65 70 75 80 85 90 100

Maximum ppO2 (bar) 1.6 1727 847 553 407 319 260 218 187 162 143 127 113 102 92 84 72 63 54 48 42 37 33 29 25 93 1.5 1617 792 517 379 297 242 202 173 150 132 117 104 95 1.4 1507 737 480 352 275 223 187 159 138 121 107 97 1.3 1397 682 443 324 253 205 171 145 125 110 99 1.2 1287 627 407 297 231 187 155 132 113 87 77 68 61 55 46 39 33 27 23 19 16 13 11 86 77 69 62 52 45 38 33 28 24 20 17 14 85 77 69 59 51 44 38 33 28 24 21 18 84 77 66 57 49 43 37 33 28 25 22

19

16

13

These depths are rounded down to the nearest foot.

MOD table in metres

Maximum Operating Depth (MOD) in metres of sea water for ppO2 1.2 to 1.6
MOD (msw) 3 6 9 12 15 18 21 24 27 30 33 % oxygen 36 39 42 45 50 55 60 65 70 75 80 85 90 100

Maximum ppO2 1.6 523.3 256.7 167.8 123.3 96.7 78.9 66.2 56.7 49.3 43.3 38.5 34.4 31.0 28.1 25.6 22.0 19.1 16.7 14.6 12.9 11.3 10.0 8.8 7.8 6.0 (bar) 8.8 1.5 490.0 240.0 156.7 115.0 90.0 73.3 61.4 52.5 45.6 40.0 35.5 31.7 28.5 25.7 23.3 20.0 17.3 15.0 13.1 11.4 10.0 7.6 6.7 5.0

8.7 1.4 456.7 223.3 145.6 106.7 83.3 67.8 56.7 48.3 41.9 36.7 32.4 28.9 25.9 23.3 21.1 18.0 15.5 13.3 11.5 10.0

7.5 6.5 5.6 4.0

98.3 1.3 423.3 206.7 134.4 76.7 62.2 51.9 44.2 38.1 33.3 29.4 26.1 23.3 21.0 18.9 16.0 13.6 11.7 10.0

8.6

7.3

6.3 5.3 4.4 3.0

90.0 1.2 390.0 190.0 123.3 70.0 56.7 47.1 40.0 34.4 30.0 26.4 23.3 20.8 18.6 16.7 14.0 11.8 10.0

8.5

7.1

6.0

5.0 4.1 3.3 2.0

Maximum operating depth

73

References
[1] Lang, M.A. (2001). DAN Nitrox Workshop Proceedings (http:/ / archive. rubicon-foundation. org/ 4855). Durham, NC: Divers Alert Network. p.197. . Retrieved 2008-06-24.

Nitrogen narcosis
Inert gas narcosis [Nitrogen narcosis]
Classification and external resources

Divers breathe a mixture of oxygen, helium and nitrogen for deep dives to avoid the effects of narcosis. A cylinder label shows the maximum operating depth and mixture (oxygen/helium). DiseasesDB MeSH 30088 [1] [2]

C21.613.455.571

Some components of breathing gases, and their relative narcotic potentcies

[3]

Gas Ne H2 N2 O2 Ar Kr CO2 Xe

Relative narcotic potency 0.3 0.6 1.0 1.7 2.3 7.1 20.0 25.6

Narcosis while diving (also known as nitrogen narcosis, inert gas narcosis, raptures of the deep, Martini effect), is a reversible alteration in consciousness that occurs while scuba diving at depth. The Greek word (narcosis) is derived from narke, "temporary decline or loss of senses and movement, numbness", a term used by Homer and Hippocrates.[4] Narcosis produces a state similar to alcohol intoxication or nitrous oxide inhalation, and can occur during shallow dives, but usually does not become noticeable until greater depths, beyond 30 meters (100ft). Apart from helium, and probably neon, all gases that can be breathed have a narcotic effect, which is greater as the lipid solubility of the gas increases.[5] As depth increases, the effects may become hazardous as the diver is increasingly impaired. Although divers can learn to cope with the effects, it is not possible to develop a tolerance. While narcosis affects all divers, predicting the depth at which narcosis will affect a diver is difficult, as susceptibility varies widely from dive to dive and amongst individuals.

Nitrogen narcosis The condition is completely reversed by ascending to a shallower depth with no long-term effects. For this reason, narcosis while diving in open water rarely develops into a serious problem as long as the divers are aware of its symptoms and ascend to manage it. Diving beyond 40m (130ft) is considered outside the scope of recreational diving: as narcosis and oxygen toxicity become critical factors, specialist training is required in the use of various gas mixtures such as trimix or heliox.

74

Classification
Narcosis results from breathing gases under elevated pressure and may be classified by the principal gas involved. The noble gases, except helium and probably neon,[5] as well as nitrogen, oxygen and hydrogen cause a decrement in mental function, but their effect on psychomotor function (processes affecting the coordination of sensory or cognitive processes and motor activity) varies widely. The effects of carbon dioxide consistently result in a decrease of both mental and psychomotor function.[6] The noble gases argon, krypton, and xenon are more narcotic than nitrogen at a given pressure, and xenon has so much anesthetic activity that it is actually a usable anesthetic at 80% concentration and normal atmospheric pressure. Xenon has historically been too expensive to be used very much in practice, but it has been successfully used for surgical operations, and xenon anesthesia systems are still being proposed and designed.[7]

Signs and symptoms

Due to its perception-altering effects, the onset of narcosis may be hard to recognize.[8] [9] At its most benign, narcosis results in relief of anxiety - a feeling of tranquility and mastery of the environment. These effects are essentially identical to various concentrations of nitrous oxide. They also resemble (though not as closely) the effects of alcohol and the familiar benzodiazepine drugs such as diazepam and alprazolam.[10] Such effects are not harmful unless they cause some immediate danger not to be recognized and addressed. Once stabilized, the effects generally remain the same at a given depth, only worsening if the diver ventures deeper.[11]

Narcosis can produce tunnel vision, making it difficult to read multiple gauges

The most dangerous aspects of narcosis are the loss of decision-making ability and focus, and impaired judgement, multi-tasking and coordination. Other effects include vertigo, and visual or auditory disturbances. The syndrome may cause exhilaration, giddiness, extreme anxiety, depression, or paranoia, depending on the individual diver and the diver's medical or personal history. When more serious, the diver may feel overconfident, disregarding normal safe diving practices.[12] The relation of depth to narcosis is sometimes informally known as "Martini's law". This is the idea that narcosis results in the feeling of one martini for every 10m (33ft) below 20m (66ft) depth. This is a very rough guide, and not a substitute for an individual diver's known susceptibility, or for standard diving safety guides. Professional divers use such a calculation only as a rough guide to give new divers a metaphor, comparing a situation they may be more familiar with.[13] Reported signs and symptoms are summarized against typical depths in meters and feet of sea water in the following table:[12]

Nitrogen narcosis

75

Signs and symptoms of narcosis (breathing air)

Pressure (bar) 12 24 Depth (m) 010 1030 Depth (ft) 0-33 33100 Comments

Unnoticeable small symptoms, or no symptoms at all. Mild impairment of performance of unpracticed tasks. Mildly impaired reasoning. Mild euphoria possible. Delayed response to visual and auditory stimuli. Reasoning and immediate memory affected more than motor coordination. Calculation errors and wrong choices. Idea fixation. Over-confidence and sense of well-being. Laughter and loquacity (in chambers) which may be overcome by self control. Anxiety (common in cold murky water). Sleepiness, impaired judgment, confusion. Hallucinations. Severe delay in response to signals, instructions and other stimuli. Occasional dizziness. Uncontrolled laughter, hysteria (in chamber). Terror in some. Poor concentration and mental confusion. Stupefaction with some decrease in dexterity and judgment. Loss of memory, increased excitability. Hallucinations. Increased intensity of vision and hearing. Sense of impending blackout, euphoria, dizziness, manic or depressive states, a sense of levitation, disorganization of the sense of time, changes in facial appearance. Unconsciousness. Death.

46

3050

100165

68

5070

165230

810

7090

230300

10+

90+

300+

Causes
The cause of narcosis is related to the increased solubility of gases in body tissues, as a result of the elevated pressures at depth (Henry's law).[14] Modern theories have suggested that inert gases dissolving in the lipid bilayer of cell membranes cause narcosis.[15] More recently, researchers have been looking at neurotransmitter receptor protein mechanisms as a possible cause of the narcosis.[16] The breathing gas mix entering the diver's lungs will have the same pressure as the surrounding water, known as the ambient pressure. For any given depth, the pressure of gases in the blood passing through the brain catches up with ambient pressure within a minute or two and this produces a delay in narcotic effect after coming to a new depth.[14] [17] Rapid compression potentiates narcosis, owing to carbon dioxide retention.[18] [19] A divers' cognition may be affected on dives as shallow as 10m (33ft), but the changes are not usually noticeable.[20] However there is no reliable method to predict the depth at which narcosis becomes noticeable, or the severity of the effect on an individual diver, as the effect may vary from dive to dive (even on the same day).[14] [19] Significant impairment due to narcosis is an increasing risk below depths of about 30m (100ft), corresponding to an ambient pressure of about 4bar (400kPa).[14] Most sport scuba training organizations recommend depths of no more than 40m (130ft) because of risk of narcosis.[13] When breathing air at depths of 90m (300ft)an ambient pressure of about 10bar (1000kPa)narcosis in most divers leads to hallucinations, loss of memory, and unconsciousness.[14] [21] A number of divers have died in attempts to set air depth records below 120m (400ft). Because of these incidents, the Guinness Book of World Records no longer reports on this figure.[22]

Nitrogen narcosis Narcosis has been compared with altitude sickness insofar as its variability (though not its symptoms); its effects depend on many factors, with variations between individuals. Thermal cold, stress, heavy work, fatigue, and carbon dioxide retention all increase the risk and severity of narcosis.[6] [14] Carbon dioxide has a high narcotic potential and also causes increased blood flood to the brain, increasing the effects of other gases.[23] Increased risk of narcosis results from increasing the amount of carbon dioxide retained through heavy exercise, shallow or skip breathing, or because of poor gas exchange in the lungs.[24] Narcosis is known to be additive to even minimal alcohol intoxication,[25] [26] and also to the effects of other drugs such as marijuana (which is more likely than alcohol to have effects which last into a day of abstinence from use).[27] Other sedative and analgesic drugs, such as opiate narcotics and benzodiazepines, add to narcosis.[25]

76

Mechanism
The precise mechanism is not well understood, but it appears to be the direct effect of gas dissolving into nerve membranes and causing temporary disruption in nerve transmissions. While the effect was first observed with air, other gases including argon, krypton and hydrogen cause very similar effects at higher than atmospheric pressure.[28] Some of these effects may be due to antagonism at NMDA receptors and potentiation of GABAA receptors,[29] similar to the mechanism of nonpolar anesthetics such diethyl ether or ethylene.[30] However, their Illustration of a lipid bilayer, typical of a cell reproduction by the very chemically inactive gas argon makes them membrane, showing the hydrophilic heads on the unlikely to be a strictly chemical bonding to receptors in the usual outside and hydrophobic tails inside sense of a chemical bond. An indirect physical effectsuch as a change in membrane volumewould therefore be needed to affect the ligand-gated ion channels of nerve cells.[31] Trudell et al. have suggested non-chemical binding due to the attractive van der Waals force between proteins and inert gases.[32] Similar to the mechanism of ethanol's effect, the increase of gas dissolved in nerve cell membranes may cause altered ion permeability properties of the neural cells' lipid bilayers. The partial pressure of a gas required to cause a measured degree of impairment correlates well with the lipid solubility of the gas: the greater the solubility, the less partial pressure is needed.[31] An early theory, the Meyer-Overton hypothesis suggested that narcosis happens when the gas penetrates the lipids of the brain's nerve cells, causing direct mechanical interference with the transmission of signals from one nerve cell to another.[14] [15] [19] More recently, specific types of chemically-gated receptors in nerve cells have been identified as being involved with anesthesia and narcosis. However, the basic and most general underlying idea, that nerve transmission is altered in many diffuse areas of the brain as a result of gas molecules dissolved in the nerve cells' fatty membranes, remains largely unchallenged.[16] [33]

Diagnosis and management

The symptoms described may be caused by other factors during a dive: ear problems causing disorientation or nausea;[34] early signs of oxygen toxicity causing visual disturbances;[35] or hypothermia causing rapid breathing and shivering.[36] Nevertheless the presence of any of these symptoms should imply narcosis. Alleviation of the effects upon ascending to a shallower depth will confirm the diagnosis. Given the setting, other likely conditions do not produce reversible effects. In the rare event of misdiagnosis when another condition is causing the symptoms, the initial managementascending closer to the surfaceis still essential.[9] The management of narcosis is simply to ascend to shallower depths; the effects then disappear within minutes.[37] In the event of complications or other conditions being present, ascending is always the correct initial response.

Nitrogen narcosis Should problems remain, then it is necessary to abort the dive. The decompression schedule can still be followed unless other conditions require emergency assistance.[38]

77

Prevention
The most straightforward way to avoid nitrogen narcosis is for a diver to limit the depth of dives. If narcosis does occur, the effects disappear almost immediately upon ascending to a shallower depth. Since narcosis becomes more severe as depth increases, a diver keeping to shallower depths can avoid serious narcosis. Most recreational dive schools will only certify basic divers to depths of 18m (60ft), and at these depths narcosis does not present a large risk. Further training is normally required for certification up to 30m (100ft) on air, and this training should include a discussion of narcosis, its effects, and cure. Some diver training agencies offer specialty training to prepare recreational divers to go to depths of 40m (130ft), often consisting of further theory and some practice in deep dives with close supervision.[39] [40] Scuba organizations which train for diving beyond Narcosis while deep diving is prevented by filling recreational depths,[41] may forbid diving with gases that cause too dive cylinders with a gas mixture containing much narcosis at depth in the average diver, and strongly encourage helium. Helium is stored in brown cylinders. the use of other breathing gas mixes containing helium in place of some or all of the nitrogen in airsuch as trimix and helioxbecause helium has no narcotic potential.[5] [42] The use of these gases forms part of technical diving and requires further training and certification.[13] While the individual diver cannot predict exactly at what depth the onset of narcosis will occur on a given day, the first symptoms of narcosis for any given diver are often more predictable and personal. For example, one diver may have trouble with eye focus (close accommodation for middle-aged divers), another may experience feelings of euphoria, and another feelings of claustrophobia. Some divers report that they have hearing changes, and that the sound which their exhaled bubbles make becomes different. Specialist training may help divers in identifying these personal onset signs, and these may then be used as a signal to ascend to shallower depths. Although severe narcosis may interfere with the judgment necessary to take preventive action, a diver who remains calm and is alert to the danger will be capable of resolving these problems at an earlier stage.[37] Deep dives should be made only after a gradual training to gradually test the individual diver's sensitivity to increasing depths, with careful supervision and logging of reactions. Diving organizations such as Global Underwater Explorers (GUE) emphasize that such sessions are for the purpose of gaining experience in recognizing the onset symptoms of narcosis for an individual, which are somewhat more repeatable than for the average group of divers. Scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth or become tolerant of it.[43] Equivalent narcotic depth (END) is a commonly used way of expressing the narcotic effect of different breathing gases.[44] The National Oceanic and Atmospheric Administration (NOAA) Diving Manual now states that both oxygen and nitrogen should be considered equally narcotic.[45] Standard tables, based on relative lipid solubilities, list conversion factors for narcotic effect of other gases.[46] For example, neon at a given pressure has a narcotic effect equivalent to nitrogen at 0.28 times that pressure, so in principle it should be usable at nearly four times the depth. Argon, however, has 2.33 times the narcotic effect of nitrogen, and is not suitable as a breathing gas for diving (it is used as a drysuit inflation gas, owing to its low thermal conductivity). Some gases have other dangerous effects when breathed at pressure; for example, high-pressure oxygen can lead to oxygen toxicity. Although helium is the

Nitrogen narcosis least intoxicating of the breathing gases, at greater depths it can cause high pressure nervous syndrome, a still-mysterious but apparently unrelated phenomenon.[47] Inert gas narcosis is only one factor which influences the choice of gas mixture; the risks of decompression sickness and oxygen toxicity, cost, and other factors are also important.[48] Because of similar and additive effects, divers should avoid sedating medications and drugs, such as marijuana and alcohol before any dive. A hangover, combined with the reduced physical capacity that goes with it, makes nitrogen narcosis more likely.[25] Experts recommend total abstinence from alcohol at least 12hours before diving, and longer for other drugs.[49] Abstinence time needed for marijuana is unknown, but due to the much longer half-life of the active agent of this drug in the body, it is likely to be longer than for alcohol.[27]

78

Prognosis and epidemiology

Narcosis is potentially one of the most dangerous conditions to affect the scuba diver below about 30m (100ft). Except for occasional amnesia of events at depth, the effects of narcosis are entirely reversible by ascending and therefore pose no problem in themselves, even for repeated, chronic or acute exposure.[14] [19] Nevertheless, the severity of narcosis is unpredictable and it can be fatal while diving, as the result of illogical behavior in a dangerous environment.[19] Tests have shown that all divers are affected by nitrogen narcosis, though some are less affected than others. Even though it is possible that some divers can manage better than others because of learning to cope with the subjective impairment, the underlying behavioral effects remain.[30] [50] [51] These effects are particularly dangerous because a diver may feel they are not experiencing narcosis, yet still be affected by it.[14]

History
French researcher Victor T. Junod was the first to describe symptoms of narcosis in 1834, noting "the functions of the brain are activated, imagination is lively, thoughts have a peculiar charm and, in some persons, symptoms of intoxication are present."[52] [53] Junod suggested that narcosis resulted from pressure causing increased blood flow and hence stimulating nerve centers.[54] Walter Moxon (18361886), a prominent Victorian physician, hypothesized in 1881 that pressure forced blood to inaccessible parts of the body and the stagnant blood then resulted in emotional changes.[55] The first report of anesthetic potency being related to Both Meyer and Overton discovered that the narcotic potency of an anesthetic can lipid solubility was published by Hans generally be predicted from its solubility in oil H. Meyer in 1899, entitled Zur Theorie der Alkoholnarkose. Two years later a similar theory was published independently by Charles Ernest Overton.[56] What became known as the Meyer-Overton Hypothesis is illustrated in the diagram to the right.

Nitrogen narcosis In 1939, Albert R. Behnke and O. D. Yarborough demonstrated that gases other than nitrogen also could cause narcosis.[57] For an inert gas the narcotic potency was found to be proportional to its lipid solubility. As hydrogen has only 0.55 the solubility of nitrogen, deep diving experiments using hydrox were conducted by Arne Zetterstrm between 1943 and 1945.[58] Jacques-Yves Cousteau in 1953 famously described it as "livresse des grandes profondeurs" or the "rapture of the deep".[59] Further research into the possible mechanisms of narcosis by anesthetic action led to the "minimum alveolar concentration" concept in 1965. This measures the relative concentration of different gases required to prevent motor response in 50% of subjects in response to stimulus, and shows similar results for anesthetic potency as the measurements of lipid solubility.[60] The (NOAA) Diving Manual was revised to recommend treating oxygen as if it were as narcotic as nitrogen, following research by Christian J. Lambertsen et al. in 1977 and 1978.[61]

79

Footnotes
[1] http:/ / www. diseasesdatabase. com/ ddb30088. htm [2] http:/ / www. nlm. nih. gov/ cgi/ mesh/ 2011/ MB_cgi?mode=& term=Nitrogen+ Narcosis& field=entry#TreeC21. 613. 455. 571 [3] Bennett, Peter; Rostain, Jean Claude (2003). "Inert Gas Narcosis". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders Ltd. p.304. ISBN0702025712. OCLC51607923. (Value for Krypton from 4th Edition, p.176). [4] Askitopoulou, Helen; Ramoutsaki, Ioanna A; Konsolaki, Eleni (April 12, 2000). "Etymology and Literary History of Related Greek Words" (http:/ / www. anesthesiaanalgesia. org/ content/ 91/ 2/ 486. full). Analgesia and Anesthesia. International Anesthesia Research Society. . Retrieved June 9, 2010. [5] Brubakk & Neuman 2003, p.305 [6] Hesser, CM; Fagraeus, L; Adolfson, J (1978). "Roles of nitrogen, oxygen, and carbon dioxide in compressed-air narcosis" (http:/ / archive. rubicon-foundation. org/ 2810). Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society, Inc) 5 (4): 391400. ISSN0093-5387. OCLC2068005. PMID734806. . Retrieved 2009-07-29. [7] Burov, NE; Kornienko, Liu; Makeev, GN; Potapov, VN (NovemberDecember 1999). "Clinical and experimental study of xenon anesthesia" (http:/ / www. general-anaesthesia. com/ xenon-anaesthesia. html). Anesteziol Reanimatol (6): 5660. . Retrieved 2008-11-03. [8] Brubakk & Neuman 2003, p.301 [9] U.S. Navy Supervisor of Diving (2008) (PDF). U.S. Navy Diving Manual (http:/ / supsalv. org/ pdf/ DiveMan_rev6. pdf). SS521-AG-PRO-010, revision 6. U.S. Naval Sea Systems Command. . Retrieved 2009-06-29. [10] Hobbs M (2008). "Subjective and behavioural responses to nitrogen narcosis and alcohol" (http:/ / archive. rubicon-foundation. org/ 8101). Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc 35 (3): 17584. PMID18619113. . Retrieved 2009-08-07. [11] Lippmann, John; Mitchell, Simon J (2005). "Nitrogen narcosis". Deeper into Diving (2nd ed.). Victoria, Australia: J.L. Publications. p.103. ISBN097522901X. OCLC66524750. [12] Lippmann & Mitchell 2005, p.105 [13] Brylske, A (2006). Encyclopedia of Recreational Diving (3rd ed.). United States: Professional Association of Diving Instructors. ISBN1878663011. [14] Brubakk & Neuman 2003, p.308 [15] Paton, William (1975). "Diver narcosis, from man to cell membrane" (http:/ / archive. rubicon-foundation. org/ 5897). Journal of the South Pacific Underwater Medicine Society (first published at Oceans 2000 Conference) 5 (2). . Retrieved 2008-12-23. [16] Rostain, Jean C; Balon N (2006). "Recent neurochemical basis of inert gas narcosis and pressure effects" (http:/ / archive. rubicon-foundation. org/ 5060). Undersea and Hyperbaric Medicine 33 (3): 197204. PMID16869533. . Retrieved 2008-12-23. [17] Case, EM; Haldane, John Burdon Sanderson (1941). "Human physiology under high pressure". Journal of Hygiene 41 (3): 22549. doi:10.1017/S0022172400012432. PMC2199778. PMID20475589. [18] Brubakk & Neuman 2003, p.303 [19] Hamilton, RW; Kizer, KW (eds) (1985). "Nitrogen Narcosis" (http:/ / archive. rubicon-foundation. org/ 4496). 29th Undersea and Hyperbaric Medical Society Workshop (Bethesda, MD: Undersea and Hyperbaric Medical Society) (UHMS Publication Number 64WS(NN)4-26-85). . Retrieved 2008-12-23. [20] Petri, NM (2003). "Change in strategy of solving psychological tests: evidence of nitrogen narcosis in shallow air-diving" (http:/ / archive. rubicon-foundation. org/ 3976). Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society, Inc) 30 (4): 293303. PMID14756232. . Retrieved 2008-12-23. [21] Hill, Leonard; David, RH; Selby, RP; et al. (1933). "Deep diving and ordinary diving". Report of a Committee Appointed by the British Admiralty. [22] PSAI Philippines. "Professional Scuba Association International History" (http:/ / www. psai-philippines. com/ history. html). Professional Scuba Association International - Philippines. . Retrieved 2008-10-31.

Nitrogen narcosis
[23] Kety, Seymour S; Schmidt, Carl F (1948). "The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow ans cerebral oxygen consumption of normal young men". Journal of Clinical Investigation 27 (4): 484492. doi:10.1172/JCI101995. ISSN0021-9738. PMC439519. PMID16695569. [24] Lippmann & Mitchell 2005, pp.1103 [25] Fowler, B; Hamilton, K; Porlier, G (1986). "Effects of ethanol and amphetamine on inert gas narcosis in humans" (http:/ / archive. rubicon-foundation. org/ 3050). Undersea Biomedical Research 13 (3): 34554. PMID3775969. . Retrieved 2008-12-23. [26] Michalodimitrakis, E; Patsalis, A (1987). "Nitrogen narcosis and alcohol consumption--a scuba diving fatality". Journal of Forensic Sciences 32 (4): 10957. PMID3612064. [27] Pope, Harrison G; Gruber, Amanda J; Hudson, James I; Huestis, Marilyn A; Yurgelun-Todd, Deborah (2001). "Neuropsychological performance in long-term cannabis users" (http:/ / archpsyc. ama-assn. org/ cgi/ content/ full/ 58/ 10/ 909). Archives of General Psychiatry (American Medical Association) 58 (10): 90915. doi:10.1001/archpsyc.58.10.909. PMID11576028. . Retrieved 2008-10-31. [28] Brubakk & Neuman 2003, p.304 [29] Hapfelmeier, Gerhard; Zieglgnsberger, Walter; Haseneder, Rainer; Schneck, Hajo; Kochs, Eberhard (December 2000). "Nitrous oxide and xenon increase the efficacy of GABA at recombinant mammalian GABA(A) receptors" (http:/ / www. anesthesia-analgesia. org/ cgi/ content/ full/ 91/ 6/ 1542). Anesthesia and Analgesia 91 (6): 15429. doi:10.1097/00000539-200012000-00045. PMID11094015. . Retrieved 2009-07-29. [30] Hamilton, K; Lalibert, MF; Fowler, B (1995). "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. rubicon-foundation. org/ 2199). Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 22 (1): 419. ISSN1066-2936. OCLC26915585. PMID7742709. . Retrieved 2009-07-29. [31] Franks, NP; Lieb, WR (1994). "Molecular and cellular mechanisms of general anaesthesia". Nature 367 (6464): 60714. doi:10.1038/367607a0. PMID7509043. [32] Trudell, JR; Koblin, DD; Eger, EI (1998). "A molecular description of how noble gases and nitrogen bind to a model site of anesthetic action" (http:/ / www. anesthesia-analgesia. org/ cgi/ content/ abstract/ 87/ 2/ 411). Anesthesia and Analgesia 87 (2): 4118. doi:10.1097/00000539-199808000-00034. PMID9706942. . Retrieved 2008-12-01. [33] Smith, EB (July 1987). "Priestley lecture 1986. On the science of deep-sea diving--observations on the respiration of different kinds of air" (http:/ / archive. rubicon-foundation. org/ 2720). Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 14 (4): 34769. PMID3307084. . Retrieved 2009-07-29. [34] Molvaer, Otto I (2003). "Otorhinolaryngological aspects of diving". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders Ltd. p.234. ISBN0702025712. OCLC51607923. [35] Clark, James M; Thom, Stephen R (2003). "Oxygen under pressure". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders Ltd. p.374. ISBN0702025712. OCLC51607923. [36] Mekjavic, Igor B; Tipton, Michael J; Eiken, Ola (2003). "Thermal considerations in diving". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders Ltd. p.129. ISBN0702025712. OCLC51607923. [37] Lippmann & Mitchell 2005, p.106 [38] U.S. Navy Diving Manual 2008, vol.2, ch.9, p.3546 [39] "Extended Range Diver" (http:/ / www. tdisdi. com/ index. php?did=80& site=2). International Training. 2009. . Retrieved 2009-07-02. [40] A number of technical diving agencies, such as TDI and IANTD teach "extended range" or "deep air" courses which teach diving to depths of up to 55m (180ft) without helium. [41] BSAC, SAA and other European training agencies teach recreational diving to a depth limit of 50m (160ft). [42] Hamilton Jr, RW; Schreiner, HR (eds) (1975). "Development of Decompression Procedures for Depths in Excess of 400feet" (http:/ / archive. rubicon-foundation. org/ 4498). 9th Undersea and Hyperbaric Medical Society Workshop (Bethesda, MD: Undersea and Hyperbaric Medical Society) (UHMS Publication Number WS2-28-76): 272. . Retrieved 2008-12-23. [43] Hamilton, K; Lalibert, MF; Heslegrave, R (1992). "Subjective and behavioral effects associated with repeated exposure to narcosis". Aviation, space, and environmental medicine 63 (10): 8659. PMID1417647. [44] IANTD (1 January 2009). "IANTD Scuba & CCR, PSCR & SCR Rebreather Diver Programs (Recreational Trimix Diver)" (http:/ / www. iantd. com/ iantd3. html). IANTD/IAND, Inc. . Retrieved 2009-03-22. [45] "Mixed-Gas & Oxygen". NOAA Diving Manual, Diving for Science and Technology. 4th. National Oceanic and Atmospheric Administration. 2002. "[16.3.1.2.4] ... since oxygen has some narcotic properties, it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. 1977,1978). The non-helium portion (i.e., the sum of the oxygen and the nitrogen) is to be regarded as having the same narcotic potency as an equivalent partial pressure of nitrogen in air, regardless of the proportions of oxygen and nitrogen." [46] Anttila, Matti. "Narcotic factors of gases" (http:/ / www. techdiver. ws/ exotic_gases. shtml#6). . Retrieved 2008-06-10. [47] Bennett, Peter; Rostain, Jean Claude (2003). "The High Pressure Nervous Syndrome". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders Ltd.. pp.32357. ISBN0702025712. OCLC51607923. [48] Lippmann & Mitchell 2005, pp.4301 [49] St Leger Dowse, Marguerite (2008). "Diving Officer's Conference presentations" (http:/ / www. bsac. com/ page. asp?section=2595& sectionTitle=DOC+ presentation+ summaries& preview=1). British Sub-Aqua Club. . Retrieved 2009-08-16. [50] Fowler, B; Ackles, KN; Porlier, G (1985). "Effects of inert gas narcosis on behavior--a critical review." (http:/ / archive. rubicon-foundation. org/ 3019). Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 12 (4): 369402.

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Nitrogen narcosis
ISSN0093-5387. OCLC2068005. PMID4082343. . Retrieved 2009-07-29. [51] Rogers, WH; Moeller, G (1989). "Effect of brief, repeated hyperbaric exposures on susceptibility to nitrogen narcosis" (http:/ / archive. rubicon-foundation. org/ 2522). Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 16 (3): 22732. ISSN0093-5387. OCLC2068005. PMID2741255. . Retrieved 2009-07-29. [52] Brubakk & Neuman 2003, p.300 [53] Junod, Victor T (1834). "Recherches physiologiques et thrapeutiques sur les effets de la compression et de la rarfaction de l'air" (http:/ / books. google. com/ ?id=K5XREXyDSQoC). Revue mdicale franaise et trangre: journal des progrs de la mdecine hippocratique (Chez Gabon et compagnie): 350368. . Retrieved 2009-06-04. [54] Brubakk & Neuman 2003, p.306 [55] Moxon, Walter (1881). "Croonian lectures on the influence of the circulation on the nervous system" (http:/ / www. informaworld. com/ smpp/ content~content=a789031692~db=all). British Medical Journal 1: 4917, 5835. doi:10.1136/bmj.1.1057.491. PMID20749857. . Retrieved 2009-03-22. [56] Overton, Charles Ernest (1901). "Studien ber Die Narkose" (in German). Allgemeiner Pharmakologie (Institut fr Pharmakologie). [57] Behnke, AR; Yarborough, OD (1939). "Respiratory resistance, oil-water solubility and mental effects of argon compared with helium and nitrogen". American Journal of Physiology (126): 40915. [58] Ornhagen, H (1984). "Hydrogen-Oxygen (Hydrox) breathing at 1.3 MPa". FOA Rapport C58015-H1 (Stockholm: National Defence Research Institute). ISSN0347-7665. [59] Cousteau, Jacques-Yves; Dumas, Frdric (1953). The Silent World: A Story of Undersea Discovery and Adventure. Harper & Brothers Publishers. pp.266. ISBN0792267966. [60] Eger, EI; Saidman, LJ; Brandstater, B (1965). "Minimum alveolar anesthetic concentration: a standard of anesthetic potency". Anesthesiology 26 (6): 75663. doi:10.1097/00000542-196511000-00010. PMID5844267. [61] Lambertsen, Christian J; Gelfand, R; Clark, JM (1978). "University of Pennsylvania Institute for Environmental Medicine report, 1978" (http:/ / archives. mc. duke. edu/ uhmsupiemr. html). University of Pennsylvania. Institute for Environmental Medicine. . Retrieved 2009-03-22.

81

References External links

Undersea and Hyperbaric Medical Society (http://www.uhms.org) Scientific body, publications about nitrogen narcosis. Rubicon Research Repository (http://archive.rubicon-foundation.org/) Searchable repository of Diving and Environmental Physiology Research. Diving Diseases Research Centre (DDRC) (http://www.ddrc.org/) UK charity dedicated to treatment of diving diseases. Campbell, Ernest S. (2009-06-25). "Diving While Using Marijuana" (http://scuba-doc.com/marij.html). Retrieved 2009-08-25. ScubaDoc's overview of marijuana and diving. Campbell, Ernest S. (2009-05-03). "Alcohol and Diving" (http://scuba-doc.com/alch.htm). Retrieved 2009-08-25. ScubaDoc's overview of alcohol and diving. Campbell, George D. (2009-02-01). "Nitrogen Narcosis" (http://www.deep-six.com/page74.htm). Diving with Deep-Six. Retrieved 2009-08-25.

Nitrox

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Nitrox
Nitrox refers to any gas mixture composed (excluding trace gases) of nitrogen and oxygen; this includes normal air which is approximately 78% nitrogen, 21% oxygen, and 1% other gases, primarily argon.[1] [2] [3] However, in scuba diving, nitrox is normally Typical Nitrox cylinder marking differentiated and handled differently from air.[3] The most common use of nitrox mixtures containing higher than normal levels of oxygen is in scuba, where the reduced percentage of nitrogen is advantageous in reducing nitrogen uptake in the body's tissues and so extending the possible dive time, and/or reducing the risk of decompression sickness (also known as the bends).

Purpose
Enriched Air Nitrox, nitrox with an oxygen content above 21%, is mainly used in scuba diving to reduce the proportion of nitrogen in the breathing gas mixture. Reducing the proportion of nitrogen by increasing the proportion of oxygen reduces the risk of decompression sickness for the same dive profile, or allows extended dive times without increasing the need for decompression stops for the same risk. Nitrox is not a safer gas than compressed air in all respects; although its use can reduce the risk of decompression sickness, it increases the risk of oxygen toxicity and fire, which are further discussed below.

Enriched Air Nitrox diving tables, showing adjusted no-decompression times.

Breathing nitrox is not thought to reduce the effects of narcosis, as oxygen seems to have equally narcotic properties under pressure as nitrogen; thus one should not expect a reduction in narcotic effects due only to the use of nitrox.[4] [5] [6] Nonetheless, there are people in the diving community who insist that they feel reduced narcotic effects at depths breathing nitrox.[7] This may be due to a dissociation of the subjective and behavioural effects of narcosis.[8] However, it should be noted that because of risks associated with oxygen toxicity, divers tend not to utilize nitrox at greater depths where more pronounced narcosis symptoms are more likely to occur. For a reduction in narcotic effects trimix or heliox, gases which also contain helium, are generally used by divers. There is anecdotal evidence that the use of nitrox reduces post-dive fatigue,[9] particularly in older and or obese divers; however a double-blind study to test this found no statistically significant reduction in reported fatigue.[1] [10] There was, however, some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i.e. micro bubbles in the blood insufficient to cause symptoms of DCS); the fact that the study mentioned was conducted in a dry chamber with an ideal decompression profile may have been sufficient to reduce sub-clinical DCS and prevent fatigue in both nitrox and air divers. In 2008, a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen.[11] Further studies with a number of different dive profiles, and also different levels of exertion, would be necessary to fully investigate this issue. For example, there is much better scientific evidence that breathing high-oxygen gases

Nitrox increase exercise tolerance, during aerobic exertion.[12] Though even moderate exertion while breathing from the regulator is a relatively uncommon occurrence in scuba, as divers usually try to minimize it in order to conserve gas, episodes of exertion while regulator-breathing do occasionally occur in sport diving. Examples are surface-swimming a distance to a boat or beach after surfacing, where residual "safety" cylinder gas is often used freely, since the remainder will be wasted anyway when the dive is completed. It is possible that these so-far un-studied situations have contributed to some of the positive reputation of nitrox.

83

Naming
Nitrox is known by many names: EnhancedAirNitrox, OxygenEnrichedAir, Nitrox, EANx or SafeAir.[3] [13] The name "nitrox" may be capitalized when referring to specific mixtures such as Nitrox32, which contains 68% nitrogen and 32% oxygen. When one figure is stated, it refers to the oxygen percentage, not the nitrogen percentage. The original convention, Nitrox68/32 became shortened as the first figure is redundant. Although "nitrox" usually refers to a mixture of nitrogen and oxygen with more than 21% oxygen, it can refer to mixtures that are leaner in oxygen than air.[3] "Enriched Air Nitrox", "Enriched Air" or "EAN" are used to emphasise richer than air mixtures.[3] In "EANx", the "x" indicates the percentage of oxygen in the mix and is replaced by a number when the percentage is known; for example a 40% oxygen mix is called EAN40. The two most popular blends are EAN32 and EAN36 (also named Nitrox I and Nitrox II, respectively, or Nitrox68/32 and Nitrox64/36).[2]
[3]

In its early days of introduction to non-technical divers, nitrox has occasionally also been known by detractors by less complimentary terms, such as "devil gas" or "voodoo gas" (a term now sometimes used with pride). These percentages are what the gas blender aims for in partial-pressure blending, but the final actual mix in such cases will be unique, and so a small flow of gas from the cylinder must be measured with a handheld oxygen analyzer, before the diver breathes from the cylinder underwater.[14]

Richness of mix
The two most common recreational diving nitrox mixes contain 32% and 36% oxygen, which have maximum operating depths (MODs) of 34 metres (112ft) and 29 metres (95ft) respectively when limited to a maximum partial pressure of oxygen of 1.4bar (140kPa). Divers may calculate an equivalent air depth to determine their decompression requirements or may use nitrox tables or a nitrox-capable dive computer.[2] [3] [15] [16] Nitrox with more than 40% oxygen is uncommon within recreational diving. There are two main reasons for this: the first is that Technical divers preparing for a mixed-gas decompression dive in Bohol, Philippines. Note the backplate and wing setup with sidemounted stage tanks all pieces of diving equipment that come containing EAN50 (left side) and pure oxygen (right side). into contact with mixes containing higher proportions of oxygen, particularly at high pressure, need special cleaning and servicing to reduce the risk of fire.[2] [3] The second reason is that richer mixes extend the time the diver can stay underwater without needing decompression stops far further than the duration of typical diving cylinders. For example, based on the PADI nitrox recommendations, the maximum operating depth

Nitrox for EAN45 would be 21 metres (69ft) and the maximum dive time available at this depth even with EAN36 is nearly 1 hour 15 minutes: a diver with a breathing rate of 20 litres per minute using twin 10 litre, 230 bar (about double 85 cu. ft.) cylinders would have completely emptied the cylinders after 1 hour 14 minutes at this depth. Usage of nitrox mixtures containing 50% to 80% oxygen is common in technical diving as a decompression gas, which by virtue of its lower partial pressure of inert gases such as nitrogen and helium, allows for more efficient (faster) elimination of these gases from the tissues than leaner oxygen mixtures. In deep open circuit technical diving, where hypoxic gases are breathed during the bottom portion of the dive, a Nitrox mix with 50% or less oxygen called a "travel mix" is sometimes breathed during the beginning of the descent in order to avoid hypoxia. Normally, however, the most oxygen-lean of the diver's decompression gases would be used for this purpose, since descent time spent reaching a depth where bottom mix is no longer hypoxic is normally small, and the distance between this depth and the MOD of any nitrox decompression gas is likely to be very short, if it occurs at all.

84

Cylinder markings
Any cylinder containing any blend of gas other than the standard air content is required by most diving training organizations to be clearly marked. Some organizations, e.g. GUE, argue that it does not make sense to have a permanent marking on a gas tank that can be filled with any gas. The standard nitrox cylinder is yellow in color and marked with a green band around the shoulder of the tank, with Nitrox or "Enriched air" marked in white or yellow letters inside. Tanks of any other color are generally marked with six inch band around the shoulder, with a one inch yellow band on the top and bottom, with four inches of green in the middle. This green band will also have the designation of "NITROX" or something similar inside, in yellow or white letters. Every nitrox cylinder should also have a sticker stating whether or not the cylinder is oxygen clean and suitable for partial pressure blending. Any oxygen clean cylinder may have any mix up to 100% oxygen inside. If by some accident an oxygen clean cylinder is filled at a station which does not supply gas to oxygen-clean standards it is then considered contaminated and must be re-cleaned before a gas containing more than 40% oxygen may again be added.[17] Cylinders marked as not-oxygen clean may only be filled with enriched oxygen mixtures from membrane or stick blending systems where the gas is mixed before being added to the cylinder. Finally, all nitrox cylinders should have a tag that, at minimum, states the oxygen content of the cylinder, the date it was blended, the gas blender's name, and the maximum operating depth along with the partial pressure this depth was calculated with. Other requirements Cylinder showing Nitrox band and sticker marked with MOD and O2% may be made as to what is marked on the cylinder, but these markings are considered standard and safe by the diving community, and any cylinders lacking these markings should be considered possibly unsafe. Training for nitrox certification suggests this tag be verified by the diver himself by using an oxygen analyzer.

Nitrox

85

Dangers
Oxygen toxicity
Diving and handling nitrox raises a number of potentially fatal dangers due to the high partial pressure of oxygen (ppO2).[2] [3] Nitrox is not a deep-diving gas mixture owing to the increased proportion of oxygen, which becomes toxic when breathed at high pressure. For example, the maximum operating depth of nitrox with 36% oxygen, a popular recreational diving mix, is 29 metres (95ft) to ensure a maximum ppO2 of no more than 1.4bar (140kPa). The exact value of the maximum allowed ppO2 and maximum operating depth varies depending on factors such as the training agency, the type of dive, the breathing equipment and the level of surface support, with professional divers sometimes being allowed to breath higher ppO2 than those recommended to recreational divers. To dive safely with nitrox, the diver must learn good buoyancy control, a vital part of scuba diving in its own right, and a disciplined approach to preparing, planning and executing a dive to ensure that the ppO2 is known, and the maximum operating depth is not exceeded. Most dive shops, dive operators, and gas blenders require the diver to have a nitrox certification card before selling nitrox to divers. Some training agencies, such as Technical Diving International, teach the use of two depth limits to protect against oxygen toxicity. The shallower depth is called the "maximum operating depth" and is reached when the partial pressure of oxygen in the breathing gas reaches 1.4bar (140kPa). The deeper depth, called the "contingency depth", is reached when the partial pressure reaches 1.6bar (160kPa). Diving at or beyond this level exposes the diver to the risk of central nervous system (CNS) oxygen toxicity. This can be extremely dangerous since its onset is often without warning and can lead to drowning, as the regulator may be spat out during convulsions, which occur in conjunction with sudden unconsciousness (general seizure induced by oxygen toxicity). Divers trained to use nitrox memorise the acronym VENTID-C (which stands for Vision (blurriness), Ears (ringing sound), Nausea, Twitching, Irritability, Dizziness, and Convulsions). However, evidence from non-fatal oxygen convulsions indicates that most convulsions are not preceded by any warning symptoms at all.[18] Further, many of the suggested warning signs are also symptoms of nitrogen narcosis, and so may lead to misdiagnosis by a diver. A solution to either is to ascend to a shallower depth.

Precautionary procedures at the fill station

Many training agencies such as PADI,[19] CMAS, SSI and NAUI train their divers to personally check the oxygen percentage content of each nitrox cylinder before every dive. If the oxygen percentage deviates by more than 1% from the value written on the cylinder by the gas blender, the scuba diver must either recalculate his or her bottom times with the new mix, or else abort the dive to remain safe and avoid oxygen toxicity or decompression sickness. Under IANTD and ANDI rules for use of nitrox,[20] which are followed by most dive resorts around the world, filled nitrox cylinders are signed out personally in a gas blender log book, which contains, for each cylinder and fill, the cylinder number, the measured oxygen percent composition, the signature of the receiving diver (who should have personally measured the oxygen percent with an instrument at the fill-shop), and finally a calculation of the maximum operating depth for that fill/cylinder. All of these steps minimize danger but increase complexity of operations (for example, personalized cylinders for each diver must generally be kept track of on dive boats with nitrox, which is not the case with generic compressed air cylinders).

Nitrox

86

Fire and toxic cylinder contamination from oxygen reactions

Diving cylinders are usually filled with nitrox by a gas blending technique such as partial pressure blending or premix decanting (in which a nitrox mix is supplied to the filler in pressurized larger cylinders). A few facilities have begun to fill cylinders with air which has been enriched with oxygen by a pre-mixing process, so that it is pressurized as nitrox for the first time in the diving cylinder. The pre-mixing is accomplished either by a membrane system which removes nitrogen from the air during compression or by a 'stick' blending technique where pure oxygen is mixed with air in a baffled chamber attached to the compressor intake. With the use of pure oxygen during "partial pressure blending" (where pure oxygen is added from a large oxygen cylinder to the nearly empty dive cylinder until it reaches 300500 psi (2030 bar) before air is added by compressor) there is an especially increased risk of fire. Partial blending using pure oxygen is often used to provide nitrox for multiple dives on live-aboard dive boats, but it is also used in some smaller diver shops. However, any gas which contains a significantly larger percentage of oxygen than air is a fire hazard. Furthermore, such gases can also react with hydrocarbons or incorrect lubricants inside a dive cylinder to produce carbon monoxide, even if a recognized fire does not happen. At present, there is some discussion over whether or not mixtures of gas which contain less than 40% oxygen may sometimes be exempt from oxygen clean standards.[21] Some of the controversy comes from a single U.S. regulation intended for commercial divers (not recreational divers) years ago.[3] However, the U.S. Compressed Gas Association (CGA) and two international nitrox teaching agencies (IANTD and ANDI) now support the standard that any gas containing more than 23.5% oxygen should be treated as nitrox (which is to say, no differently from pure oxygen) for purposes of oxygen cleanliness and oxygen compatibility (i.e., oxygen "servicability"). However, the largest training agency - PADI - is still teaching that pre-mixed nitrox (i.e. nitrox which is mixed before being put into the cylinder) below 40% oxygen does not require a specially cleaned cylinder or other equipment.[2] [3] [19] Most nitrox fill stations which supply pre-mixed nitrox will fill non-oxygen clean cylinders with mixtures below 40%. For a history of this controversy[3] see Luxfer cylinders [22] .

History
In the 1920s or 1930s Draeger of Germany made a nitrox backpack independent air supply for a standard diving suit. In World War II or soon after, British commando frogmen and work divers started sometimes diving with oxygen rebreathers adapted for semi-closed-circuit nitrox (which they called "mixture") diving by fitting larger cylinders and carefully setting the gas flow rate using a flow meter. These developments were kept secret until independently duplicated by civilians in the 1960s. In the 1950s the United States Navy (USN) documented enriched oxygen gas procedures for military use of what we today call nitrox, in the USN Diving Manual.[23] In 1970, Dr. Morgan Wells, who was the first director of the National Oceanographic and Atmospheric Administration (NOAA) Diving Center, began instituting diving procedures for oxygen-enriched air. He also developed a process for mixing oxygen and air which he called a continuous blending system. For many years Dr. Wells' invention was the only practical alternative to partial pressure blending. In 1979 NOAA published Wells' procedures for the scientific use of nitrox in the NOAA Diving Manual.[2] [3] In 1985 Dick Rutkowski, a former NOAA diving safety officer, formed IAND (International Association of Nitrox Divers) and began teaching nitrox use for recreational diving. This was considered dangerous by some, and met with heavy skepticism by the diving community. In 1991, in a watershed moment, the annual DEMA show (held in Houston, Texas that year) banned nitrox training providers from the show. This created a backlash, and when DEMA relented, a number of organisations took the opportunity to present nitrox workshops outside the show. In 1992 BSAC banned its members from using nitrox.

Nitrox In 1992 the name was changed to the International Association of Nitrox and Technical Divers (IANTD), the T being added when the European Association of Technical Divers (EATD) merged with IAND. In the early 1990s, the agencies teaching nitrox were not the main scuba agencies. New organizations, including Ed Betts' American Nitrox Divers International (ANDI) - which invented the term "Safe Air" for marketing purposes - and Bret Gilliam's Technical Diving International (TDI) gave scientific credence to nitrox. Meanwhile, diving stores were finding a purely economic reason to offer nitrox: not only was an entire new course and certification needed to use it, but instead of cheap or free tank fills with compressed air, dive shops found they could charge premium amounts of money for custom-gas blending of nitrox to their ordinary moderately experienced divers. With the new dive computers which could be programmed to allow for the longer bottom-times and shorter residual nitrogen times which nitrox gave, the incentive for the sport diver to use the gas increased. An intersection of economics and scientific validity had occurred. In 1993 Skin Diver magazine, the leading recreational diving publication at the time, published a three part series arguing that nitrox was unsafe for sport divers.[24] Against this trend, in 1992 NAUI became the first existing major sport diver training agency to sanction nitrox. In 1993 Dive Rite manufactured the first nitrox compatible dive computer, called the Bridge.[25] In 1996, the Professional Association of Diving Instructors (PADI) announced full educational support for nitrox.[19] While other main line scuba organizations had announced their support of nitrox earlier,[26] it was PADI's endorsement that put nitrox over the top as a standard sport diving "option."[27]

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Nitrox in nature
Sometimes in the geologic past the Earth's atmosphere contained much more than 20% oxygen: e.g. up to 35% in the Upper Carboniferous. This let animals absorb oxygen more easily and influenced evolution.[28] [29]

References
[1] Brubakk, A. O.; T. S. Neuman (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed.. United States: Saunders Ltd.. pp.800. ISBN0702025712. [2] Joiner, J. T. (2001). NOAA Diving Manual: Diving for Science and Technology, Fourth Edition. United States: Best Publishing. pp.660. ISBN0941332705. [3] Lang, M.A. (2001). DAN Nitrox Workshop Proceedings (http:/ / archive. rubicon-foundation. org/ 4855). Durham, NC: Divers Alert Network. pp.197. . Retrieved 2008-05-02. [4] Hesser, CM; Fagraeus, L; Adolfson, J (1978). "Roles of nitrogen, oxygen, and carbon dioxide in compressed-air narcosis." (http:/ / archive. rubicon-foundation. org/ 2810). Undersea Biomedical Research (Bethesda, Md: Undersea and Hyperbaric Medical Society) 5 (4): 391400. ISSN0093-5387. OCLC2068005. PMID734806. . Retrieved 2008-04-08. [5] Brubakk, Alf O; Neuman, Tom S (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders Ltd. p.304. ISBN0702025712. [6] Oxygen has the potential to be 1.7 times more narcotic than nitrogen - see relevant narcotic potency of gases [7] Although oxygen appears chemically more narcotic at the surface, relative narcotic effects at depth have never been studied in detail. It is clear that different gases result in different narcotic effects at depth. Helium is considered to have very little narcotic effect, but results in HPNS when breathed at high pressures, which does not happen with gases with have greater narcotic qualities. [8] Hamilton K, Lalibert MF, Fowler B (March 1995). "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. rubicon-foundation. org/ 2199). Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 22 (1): 419. PMID7742709. . Retrieved 2009-01-27. [9] "How does nitrox make you feel?" (http:/ / www. scubaboard. com/ forums/ basic-scuba-discussions/ poll-1630-a. html). ScubaBoard. 2007. . Retrieved 2009-05-21. [10] Harris RJ, Doolette DJ, Wilkinson DC, Williams DJ (2003). "Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox" (http:/ / archive. rubicon-foundation. org/ 3975). Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 30 (4): 28591. PMID14756231. . Retrieved 2008-05-02. [11] Chapman SD, Plato PA. Measurement of Fatigue following 18 msw Open Water Dives Breathing Air or EAN36.. In: Brueggeman P, Pollock NW, eds. Diving for Science 2008. Proceedings of the American Academy of Underwater Sciences 27th Symposium.. http:/ / archive. rubicon-foundation. org/ 8005. Retrieved 2009-05-21. [12] Ergogenic Aids (http:/ / www. pponline. co. uk/ encyc/ 1008. htm)

Nitrox
[13] Elliott, D (1996). "Nitrox" (http:/ / archive. rubicon-foundation. org/ 6309). South Pacific Underwater Medicine Society Journal 26 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-05-02. [14] Lippmann, John; Mitchell, Simon J (October 2005). "28". Deeper into Diving (2 ed.). Victoria, Australia: J.L. Publications. pp.4034. ISBN097522901X. OCLC66524750. [15] Logan, JA (1961). "An evaluation of the equivalent air depth theory" (http:/ / archive. rubicon-foundation. org/ 3835). United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. . Retrieved 2008-05-01. [16] Berghage Thomas E, McCraken TM (December 1979). "Equivalent air depth: fact or fiction" (http:/ / archive. rubicon-foundation. org/ 2835). Undersea Biomedical Research 6 (4): 37984. PMID538866. . Retrieved 2008-05-01. [17] Butler, Glen L; Mastro, Steven J; Hulbert, Alan W; Hamilton Jr, Robert W. (1992). "Oxygen safety in the production of enriched air nitrox breathing mixtures." (http:/ / archive. rubicon-foundation. org/ 9033). In: Cahoon, LB. (ed.) Proceedings of the American Academy of Underwater Sciences Twelfth Annual Scientific Diving Symposium "Diving for Science 1992". Held September 24-27, 1992 at the University of North Carolina at Wilmington, Wilmington, NC. (American Academy of Underwater Sciences). . Retrieved 2011-01-11. [18] Clark, James M; Thom, Stephen R (2003). "Oxygen under pressure". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders. p.375. ISBN0702025712. OCLC51607923. [19] Richardson, D and Shreeves, K (1996). "The PADI Enriched Air Diver course and DSAT oxygen exposure limits." (http:/ / archive. rubicon-foundation. org/ 6310). South Pacific Underwater Medicine Society Journal 26 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-05-02. [20] http:/ / www. andihq. com/ pages/ mainpage. html [21] Rosales KR, Shoffstall MS, Stoltzfus JM (2007). "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems." (http:/ / archive. rubicon-foundation. org/ 4861). NASA Johnson Space Center Technical Report NASA/TM-2007-213740. . Retrieved 2008-06-05. [22] http:/ / www. luxfercylinders. com/ support/ faq/ aluminumoxygen. shtml [23] US Navy Diving Manual, 6th revision (http:/ / www. supsalv. org/ 00c3_publications. asp?destPage=00c3& pageID=3. 9). United States: US Naval Sea Systems Command. 2006. . Retrieved 2008-04-24. [24] A position which it would formally maintain until in 1995 magazine editor Bill Gleason was reported to say that nitrox was "all right". Skin Diver would later go into bankruptcy. [25] TDI, Nitrox Gas Blending Manual, at pages 9-11 [26] Allen, C (1996). "BSAC gives the OK to nitrox." (http:/ / archive. rubicon-foundation. org/ 6275). Diver 1995; 40(5) May: 35-36. reprinted in South Pacific Underwater Medicine Society Journal 26 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-05-02. [27] http:/ / www. americandivecenter. com/ nitrox/ preview_p03. htm [28] R.A.BERNER AND D.E.CANFIELD (1989. A NEW MODEL FOR ATMOSPHERIC OXYGEN OVER PHANEROZOIC TIME. AMERICAN JOURNAL OF SCIENCE 289, pp.333-361. [29] ATMOSPHERIC OXYGEN, GIANT PALEOZOIC INSECTS AND THE EVOLUTION OF AERIAL LOCOMOTOR PERFORMANCE. ROBERT DUDLEY* Department of Zoology, University of Texas, Austin, TX 78712, USA and Smithsonian Tropical Research Institute, PO Box 2072, Balboa, Republic of Panama Accepted 28 October 1997; published on WWW 24 March 1998.

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Footnotes External links

Nitrox - frequently asked questions (http://www.gasdiving.co.uk/pages/misc/Nitrox.htm) Useful Luxfer FAQ on the CGA and "40% rule" controversy (http://www.luxfercylinders.com/support/faq/ aluminumoxygen.shtml) Online Nitrox calculator for EAD, MOD and PPO2; warns if a critical limit is reached (http://www.dive-hive. com/nitrox_calc.php?lang=en) Diving Nitrox (http://dive-center.org/diving-nitrox.html)

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Oxygen toxicity
Oxygen toxicity
Classification and external resources

In 194243 the UK Government carried out extensive testing for oxygen toxicity in divers. The chamber is pressurised with air to 3.7bar. The [1] subject in the centre is breathing 100% oxygen from a mask. ICD-10 ICD-9 MeSH T59.8 987.8 [2] [3] [4]

D018496

Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen (O2) at elevated partial pressures. It is also known as oxygen toxicity syndrome, oxygen intoxication, and oxygen poisoning. Historically, the central nervous system condition was called the Paul Bert effect, and the pulmonary condition the Lorrain Smith effect, after the researchers who pioneered its discovery and description in the late 19th century. Severe cases can result in cell damage and death, with effects most often seen in the central nervous system, lungs and eyes. Oxygen toxicity is a concern for scuba divers, those on high concentrations of supplemental oxygen (particularly premature babies), and those undergoing hyperbaric oxygen therapy. The result of breathing elevated concentrations of oxygen is hyperoxia, an excess of oxygen in body tissues. The body is affected in different ways depending on the type of exposure. Central nervous system toxicity is caused by short exposure to high concentrations of oxygen at greater than atmospheric pressure. Pulmonary and ocular toxicity result from longer exposure to elevated oxygen levels at normal pressure. Symptoms may include disorientation, breathing problems, and vision changes such as myopia. Prolonged or very high oxygen concentrations can cause oxidative damage to cell membranes, the collapse of the alveoli in the lungs, retinal detachment, and seizures. Oxygen toxicity is managed by reducing the exposure to elevated oxygen levels. Studies show that, in the long term, a robust recovery from most types of oxygen toxicity is possible. Protocols for avoidance of hyperoxia exist in fields where oxygen is breathed at higher-than-normal partial pressures, including underwater diving using compressed breathing gases, hyperbaric medicine, neonatal care and human spaceflight. These protocols have resulted in the increasing rarity of seizures due to oxygen toxicity, with pulmonary and ocular damage being mainly confined to the problems of managing premature infants. In recent years, oxygen has become available for recreational use in oxygen bars. The US Food and Drug Administration has warned those suffering from problems such as heart or lung disease not to use oxygen bars. Scuba divers use breathing gases containing up to 100% oxygen, and should have specific training in using such gases.

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Classification

The effects of oxygen toxicity may be classified by the organs affected, producing three principal forms:[5] [6] [7] Central nervous system, characterised by convulsions followed by unconsciousness, occurring under hyperbaric conditions; Pulmonary (lungs), characterised by difficulty in breathing and pain within the chest, occurring when breathing elevated pressures of oxygen for extended periods; Ocular (retinopathic conditions), characterised by alterations to the eyes, occurring when breathing elevated pressures of oxygen for extended periods. Central nervous system oxygen toxicity can cause seizures, brief periods of rigidity followed by convulsions and unconsciousness, and is of concern to divers who encounter greater than atmospheric pressures. Pulmonary oxygen toxicity results in damage to the lungs, causing pain and difficulty in breathing. Oxidative damage to the eye may lead to myopia or partial detachment of the retina. Pulmonary and ocular damage are most likely to occur when supplemental oxygen is administered as part of a treatment, particularly to newborn infants, but are also a concern during hyperbaric oxygen therapy. Oxidative damage may occur in any cell in the body but the effects on the three most susceptible organs will be the primary concern. It may also be implicated in red blood cell destruction (hemolysis),[8] [9] damage to liver (hepatic),[10] heart (myocardial),[11] endocrine glands (adrenal, gonads, and thyroid),[12] [13] [14] or kidneys (renal),[15] and general damage to cells.[5] [16] In unusual circumstances, effects on other tissues may be observed: it is suspected that during spaceflight, high oxygen concentrations may contribute to bone damage.[17] Hyperoxia can also indirectly cause carbon dioxide narcosis in patients with lung ailments such as chronic obstructive pulmonary disease or with central respiratory depression.[17] Oxygen toxicity is not associated with hyperventilation, because breathing air at atmospheric pressure always has a partial pressure of oxygen (ppO2) of 0.21bar (21kPa) and the lower limit for toxicity is more than 0.3bar (30kPa).[18]

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Signs and symptoms

Oxygen Poisoning at 90ft (27m) in the Dry in 36 Subjects in Order of Performance K W Donald[1]
Exposure (mins.) 96 6069 5055 3135 2130 1620 1115 610 Num. of Subjects 1 3 4 4 6 8 4 6 Symptoms Prolonged dazzle; severe spasmodic vomiting Severe lip-twitching; Euphoria; Nausea and vertigo; arm twitch Severe lip-twitching; Dazzle; Blubbering of lips; fell asleep; Dazed Nausea, vertigo, lip-twitching; Convulsed Convulsed; Drowsiness; Severe lip-twitching; epigastric aura; twitch L arm; amnesia Convulsed; Vertigo and severe lip twitching; epigastric aura; spasmodic respiration; Inspiratory predominance; lip-twitching and syncope; Nausea and confusion Dazed and lip-twitching; paraesthesiae; vertigo; "Diaphragmatic spasm"; Severe nausea

Central nervous system

Central nervous system oxygen toxicity manifests as symptoms such as visual changes (especially tunnel vision), ringing in the ears (tinnitus), nausea, twitching (especially of the face), irritability (personality changes, anxiety, confusion, etc.), and dizziness. This may be followed by a tonicclonic seizure consisting of two phases: intense muscle contraction occurs for several seconds (tonic); followed by rapid spasms of alternate muscle relaxation and contraction producing convulsive jerking (clonic). The seizure ends with a period of unconsciousness (the postictal state).[19] [20] The onset of seizure depends upon the partial pressure of oxygen (ppO2) in the breathing gas and exposure duration. However, exposure time before onset is unpredictable, as tests have shown a wide variation, both amongst individuals, and in the same individual from day to day.[19] [21] [22] In addition, many external factors, such as underwater immersion, exposure to cold, and exercise will decrease the time to onset of central nervous system symptoms.[1] Decrease of tolerance is closely linked to retention of carbon dioxide.[23] [24] [25] Other factors, such as darkness and caffeine, increase tolerance in test animals, but these effects have not been proven in humans.[26] [27]

Pulmonary
Pulmonary toxicity symptoms result from an inflammation that starts in the airways leading to the lungs and then spreads into the lungs (tracheobronchial tree). The symptoms appear in the upper chest region (substernal and carinal regions).[28] [29] [30] This begins as a mild tickle on inhalation and progresses to frequent coughing.[28] If breathing elevated partial pressures of oxygen is not discontinued, patients experience a mild burning on inhalation along with uncontrollable coughing and occasional shortness of breath (dyspnea).[28] Physical findings related to pulmonary toxicity have included bubbling sounds heard through a stethoscope (bubbling rales), fever, and increased blood flow to the lining of the nose (hyperemia of the nasal mucosa).[30] The radiological finding from the lungs shows inflammation and swelling (pulmonary edema).[28] [29] Pulmonary function measurements are reduced, as noted by a reduction in the amount of air that the lungs can hold (vital capacity) and changes in expiratory function and lung elasticity.[30] [31] Tests in animals have indicated a variation in tolerance similar to that found in central nervous system toxicity, as well as significant variations between species. When the exposure to oxygen above 0.5bar (50kPa) is intermittent, it permits the lungs to recover and delays the onset of toxicity.[32]

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Ocular
In premature babies, signs of damage to the eye (retinopathy of prematurity, or ROP) are observed via an ophthalmoscope as a demarcation between the vascularized and non-vascularised regions of an infant's retina. The degree of this demarcation is used to designate four stages: (I) the demarcation is a line; (II) the demarcation becomes a ridge; (III) growth of new blood vessels occurs around the ridge; (IV) the retina begins to detach from the inner wall of the eye (choroid).[33]

Causes
Oxygen toxicity is caused by exposure to oxygen at partial pressures greater than those to which the body is normally exposed. This occurs in three principal settings: underwater diving, hyperbaric oxygen therapy and the provision of supplemental oxygen, particularly to premature infants. In each case, the risk factors are markedly different.

Central nervous system toxicity

Exposures, from minutes to a few hours, to partial pressures of oxygen above 1.6 bars (160kPa)about eight times the atmospheric concentrationare usually associated with central nervous system oxygen toxicity and are most likely to occur among patients undergoing hyperbaric oxygen therapy and divers. Since atmospheric pressure is about 1 bar (100kPa), central nervous system toxicity can only occur under hyperbaric conditions, where ambient pressure is above normal.[34] [35] Divers breathing air at depths greater than 60m (200ft) face an increasing risk of an oxygen toxicity "hit" (seizure). Divers breathing a gas mixture enriched with oxygen, such as nitrox, can similarly suffer a seizure at shallower depths, should they descend below the maximum depth allowed for the mixture.[36]

Pulmonary toxicity
The lungs, as well as the remainder of the respiratory tract, are exposed to the highest concentration of oxygen in the human body and are therefore the first organs to show toxicity. Pulmonary toxicity occurs with exposure to concentrations of oxygen greater than 0.5bar (50kPa), corresponding to an oxygen fraction of 50% at normal atmospheric pressure. Signs of pulmonary toxicity begins with evidence of tracheobronchitis, or inflammation of the upper airways, after an asymptomatic period between 4 and 22 hours at greater than 95% oxygen,[37] with some studies suggesting symptoms usually begin after approximately 14 hours at this level of oxygen.[38] At partial pressures of oxygen of 2 to 3 bar (200 to 300 kPa)100% oxygen at 2 to 3 times atmospheric pressurethese symptoms may begin as early as 3 hours after exposure to oxygen.[37] Experiments on rats show pulmonary manifestations of oxygen toxicity are not the same for normobaric conditions as they are for hyperbaric conditions.[39] Evidence of decline in lung function as measured by pulmonary function testing can occur as quickly as 24 hours of continuous exposure to 100% oxygen,[38] with evidence of diffuse alveolar damage and the onset of acute respiratory distress syndrome usually occurring after 48 hours on 100% oxygen.[37] Breathing 100% oxygen also eventually leads to collapse of the alveoli (atelectasis), whileat the same partial pressure of oxygenthe presence of significant partial pressures of inert gases, typically nitrogen, will prevent this effect.[40] Preterm newborns are known to be at higher risk for bronchopulmonary dysplasia with extended exposure to high concentrations of oxygen.[41] Other groups at higher risk for oxygen toxicity are patients on mechanical ventilation with exposure to levels of oxygen greater than 50%, and patients exposed to chemicals that increase risk for oxygen toxicity such the chemotherapeutic agent bleomycin.[38] Therefore, current guidelines for patients on mechanical ventilation in intensive care suggests keeping oxygen concentration less than 60%.[37] Likewise, divers who undergo treatment of decompression sickness are at increased risk of oxygen toxicity as treatment entails exposure to long periods of oxygen breathing under hyperbaric conditions, in addition to any oxygen exposure during the dive.[34]

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Ocular toxicity
Prolonged exposure to high inspired fractions of oxygen causes damage to the retina.[42] [43] [44] Damage to the developing eye of infants exposed to high oxygen fraction at normal pressure has a different mechanism and effect from the eye damage experienced by adult divers under hyperbaric conditions.[45] [46] Hyperoxia may be a contributing factor for the disorder called retrolental fibroplasia or retinopathy of prematurity (ROP) in infants.[45] [47] In preterm infants, the retina is often not fully vascularised. Retinopathy of prematurity occurs when the development of the retinal vasculature is arrested and then proceeds abnormally. Associated with the growth of these new vessels is fibrous tissue (scar tissue) that may contract to cause retinal detachment. Supplemental oxygen exposure, while a risk factor, is not the main risk factor for development of this disease. Restricting supplemental oxygen use does not necessarily reduce the rate of retinopathy of prematurity, and may raise the risk of hypoxia-related systemic complications.[45] Hyperoxic myopia has occurred in closed circuit oxygen rebreather divers with prolonged exposures.[46] [48] [49] It also occurs frequently in those undergoing repeated hyperbaric oxygen therapy.[43] [50] This is due to an increase in the refractive power of the lens, since axial length and keratometry readings do not reveal a corneal or length basis for a myopic shift.[50] [51] It is usually reversible with time.[43] [50]

Mechanism
The biochemical basis for the toxicity of oxygen is the partial reduction of oxygen by one or two electrons to form reactive oxygen species,[52] which are natural by-products of the normal metabolism of oxygen and have important roles in cell signalling.[53] One species produced by the body, the superoxide anion (O2),[54] is possibly involved in iron acquisition.[55] Higher than normal concentrations of oxygen lead to increased levels of reactive oxygen species.[56] Oxygen is necessary for cell metabolism, and the blood supplies it to all parts of the body. When oxygen is breathed at high partial pressures, a hyperoxic condition will rapidly spread, The lipid peroxidation mechanism shows a single radical initiating a chain reaction with the most vascularised tissues being which converts unsaturated lipids to lipid peroxides, most vulnerable. During times of environmental stress, levels of reactive oxygen species can increase dramatically, which can damage cell structures and produce oxidative stress.[22] [57] While all the reaction mechanisms of these species within the body are not yet fully understood,[58] one of the most reactive products of oxidative stress is the hydroxyl radical (OH), which can initiate a damaging chain reaction of lipid peroxidation in the unsaturated lipids within cell membranes.[59] High concentrations of oxygen also increase the formation of other free radicals, such as nitric oxide, peroxynitrite, and trioxidane, which harm DNA and other biomolecules.[22] [60] Although the body has many antioxidant systems such as glutathione that guard against oxidative stress, these systems are eventually overwhelmed at very high concentrations of free oxygen, and the rate of cell damage exceeds the capacity of the systems that prevent or repair it.[61] [62] [63] Cell damage and cell death then result.[64]

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Diagnosis
Diagnosis of central nervous system oxygen toxicity in divers prior to seizure is difficult as the symptoms of visual disturbance, ear problems, dizziness, confusion and nausea can be due to many factors common to the underwater environment such as narcosis, congestion and coldness. However, these symptoms may be helpful in diagnosing the first stages of oxygen toxicity in patients undergoing hyperbaric oxygen therapy. In either case, unless there is a prior history of epilepsy or tests indicate hypoglycemia, a seizure occurring in the setting of breathing oxygen at partial pressures greater than 1.4bar (140kPa) suggests a diagnosis of oxygen toxicity.[65] Diagnosis of bronchopulmonary dysplasia in new-born infants with breathing difficulties is difficult in the first few weeks. However, if the infant's breathing does not improve during this time, blood tests and x-rays may be used to confirm bronchopulmonary dysplasia. In addition, an echocardiogram can help to eliminate other possible causes such as congenital heart defects or pulmonary arterial hypertension.[66] The diagnosis of retinopathy of prematurity in infants is typically suggested by the clinical setting. Prematurity, low birth weight and a history of oxygen exposure are the principal indicators, while no hereditary factors have been shown to yield a pattern.[67]

Prevention
The prevention of oxygen toxicity depends entirely on the setting. Both underwater and in space, proper precautions can eliminate the most pernicious effects. Premature infants commonly require supplemental oxygen to treat complications of preterm birth. In this case prevention of bronchopulmonary dysplasia and retinopathy of prematurity must be carried out without compromising a supply of oxygen adequate to preserve the infant's life.

Underwater
A seizure caused by oxygen toxicity to the central nervous system is a deadly but avoidable event while diving.[36] The diver may experience no warning symptoms.[20] The effects are sudden convulsions and unconsciousness, during which victims can lose their regulator and The label on the diving cylinder shows that it drown.[68] One of the advantages of a full-face diving mask is contains oxygen-rich gas (36%) and is boldly prevention of regulator loss in the event of a seizure. As there is an marked with a maximum operating depth of increased risk of central nervous system oxygen toxicity on deep dives, 28metres. long dives and dives where oxygen-rich breathing gases are used, divers are taught to calculate a maximum operating depth for oxygen-rich breathing gases, and cylinders containing such mixtures must be clearly marked with that depth.[25] [69] In some diver training courses for these types of diving, divers are taught to plan and monitor what is called the oxygen clock of their dives.[69] This is a notional alarm clock, which ticks more quickly at increased ppO2 and is set to activate at the maximum single exposure limit recommended in the National Oceanic and Atmospheric Administration Diving Manual.[25] [69] For the following partial pressures of oxygen the limit is: 45minutes at 1.6bar (160kPa), 120minutes at 1.5bar (150kPa), 150minutes at 1.4bar (140kPa), 180minutes at 1.3bar (130kPa) and 210minutes at 1.2bar (120kPa), but is impossible to predict with any reliability whether or when toxicity symptoms will occur.[70] [71] Many Nitrox-capable dive computers calculate an oxygen loading and can track it across multiple dives. The aim is to avoid activating the alarm by reducing the ppO2 of the breathing gas or the length of time breathing gas of higher ppO2. As the ppO2 depends on the fraction of oxygen in the breathing gas and the depth of the dive, the diver obtains more time on the oxygen clock by diving at a shallower depth, by

Oxygen toxicity breathing a less oxygen-rich gas, or by shortening the duration of exposure to oxygen-rich gases.[72] [73] Diving below 60m (200ft) on air would expose a diver to increasing danger of oxygen toxicity as the partial pressure of oxygen exceeds 1.4bar (140kPa), so a gas mixture must be used which contains less than 21% oxygen (a hypoxic mixture). Increasing the proportion of nitrogen is not viable, since it would produce a strongly narcotic mixture. However, helium is not narcotic, and a usable mixture may be blended either by completely replacing nitrogen with helium (the resulting mix is called heliox), or by replacing part of the nitrogen with helium, producing a trimix.[74] Pulmonary oxygen toxicity is an entirely avoidable event while diving. The limited duration and naturally intermittent nature of most diving makes this a relatively rare (and even then, reversible) complication for divers.[18] Guidelines have been established that allow divers to calculate when they are at risk of pulmonary toxicity.[75] [76]
[77]

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Hyperbaric setting
The presence of a fever or a history of seizure is a relative contraindication to hyperbaric oxygen treatment.[78] The schedules used for treatment of decompression illness allow for periods of breathing air rather than 100% oxygen (oxygen breaks) to reduce the chance of seizure or lung damage. The U.S. Navy uses treatment tables based on periods alternating between 100% oxygen and air. For example, U.S.N. table 6 requires 75minutes (three periods of 20minutes oxygen/5minutes air) at an ambient pressure of 2.8 standard atmospheres (280kPa), equivalent to a depth of 18 metres (60ft). This is followed by a slow reduction in pressure to 1.9atm (190kPa) over 30minutes on oxygen. The patient then remains at that pressure for a further 150minutes, consisting of two periods of 15minutes air/60minutes oxygen, before the pressure is reduced to atmospheric over 30minutes on oxygen.[79] Vitamin E and selenium were proposed and later rejected as a potential method of protection against pulmonary oxygen toxicity.[80] [81] [82] There is however some experimental evidence in rats that vitamin E and selenium aid in preventing in vivo lipid peroxidation and free radical damage, and therefore prevent retinal changes following repetitive hyperbaric oxygen exposures.[83]

Normobaric setting
Bronchopulmonary dysplasia is reversible in the early stages by use of break periods on lower pressures of oxygen, but it may eventually result in irreversible lung injury if allowed to progress to severe damage. One or two days of exposure without oxygen breaks are needed to cause such damage.[17] Retinopathy of prematurity is largely preventable by screening. Current guidelines require that all babies of less than 32weeks gestational age or having a birth weight less than 1.5kg (3.3lb) should be screened for retinopathy of prematurity at least every two weeks.[84] The National Cooperative Study in 1954 showed a causal link between supplemental oxygen and retinopathy of prematurity, but subsequent curtailment of supplemental oxygen caused an increase in infant mortality. To balance the risks of hypoxia and retinopathy of prematurity, modern protocols now require monitoring of blood oxygen levels in premature infants receiving oxygen.[85]

Hypobaric setting
In low-pressure environments oxygen toxicity may be avoided since the toxicity is caused by high partial pressure of oxygen, not merely by high oxygen fraction. This is illustrated by modern pure oxygen use in spacesuits, which must operate at low pressure (also historically, very high percentage oxygen and lower than normal atmospheric pressure was used in early spacecraft, for example, the Gemini and Apollo spacecraft).[86] In such applications as extra-vehicular activity, high-fraction oxygen is non-toxic, even at breathing mixture fractions approaching 100%, because the oxygen partial pressure is not allowed to chronically exceed 0.3bar (4.4psi).[86]

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Management
During hyperbaric oxygen therapy, the patient will usually breathe 100% oxygen from a mask, while inside a hyperbaric chamber pressurised with air to about 2.8bar (280kPa). Seizures during the therapy are managed by removing the mask from the patient, thereby dropping the partial pressure of oxygen inspired below 0.6bar (60kPa).[20] A seizure underwater requires that the diver is brought to the surface as soon as practicable. Although for many years the recommendation has been not to raise the diver during the seizure itself, owing to the danger of arterial gas embolism,[87] there is no evidence of expiratory obstruction during seizure and benefit may be gained by raising the diver during the seizure's clonic phase.[88] Rescuers need to ensure that their own safety is not compromised during the convulsive phase. They then ensure that the victim's air supply is established and maintained, and carry out a controlled buoyant lift. Lifting an unconscious body is taught by most diver training agencies. Upon reaching the surface, emergency services are always contacted as there is a possibility of further complications requiring medical attention.[89] The U.S. Navy has procedures for completing the decompression stops where a recompression chamber is not immediately available.[90]

The retina (red) is detached at the top of the eye.

The silicone band (scleral buckle, blue) is placed The occurrence of symptoms of bronchopulmonary dysplasia or acute around the eye. This brings the wall of the eye respiratory distress syndrome is treated by lowering the fraction of into contact with the detached retina, allowing the oxygen administered, along with a reduction in the periods of exposure retina to re-attach. and an increase in the break periods where normal air is supplied. Where supplemental oxygen is required for treatment of another disease (particularly in infants), a ventilator may be needed to ensure that the lung tissue remains inflated. Reductions in pressure and exposure will be made progressively and medications such as bronchodilators and pulmonary surfactants may be used.[91]

Retinopathy of prematurity may regress spontaneously, but should the disease progress beyond a threshold (defined as five contiguous or eight cumulative hours of stage 3 retinopathy of prematurity), both cryosurgery and laser surgery have been shown to reduce the risk of blindness as an outcome. Where the disease has progressed further, techniques such as scleral buckling and vitrectomy surgery may assist in re-attaching the retina.[92]

Prognosis
Although the convulsions caused by central nervous system oxygen toxicity may lead to incidental injury to the victim, it remained uncertain for many years whether damage to the nervous system following the seizure could occur and several studies searched for evidence of such damage. An overview of these studies by Bitterman in 2004 concluded that following removal of breathing gas containing high fractions of oxygen, no long-term neurological damage from the seizure remains.[22] [93] The majority of infants who have survived following an incidence of bronchopulmonary dysplasia will eventually recover near-normal lung function, since lungs continue to grow during the first 57 years and the damage caused by bronchopulmonary dysplasia is to some extent reversible (even in adults). However, they are likely be more susceptible to respiratory infections for the rest of their lives and the severity of later infections is often greater than that in their peers.[94] [95]

Oxygen toxicity Retinopathy of prematurity (ROP) in infants frequently regresses without intervention and eyesight may be normal in later years. Where the disease has progressed to the stages requiring surgery, the outcomes are generally good for the treatment of stage 3 ROP, but are much worse for the later stages. Although surgery is usually successful in restoring the anatomy of the eye, damage to the nervous system by the progression of the disease leads to comparatively poorer results in restoring vision. The presence of other complicating diseases also reduces the likelihood of a favourable outcome.[96]

97

Epidemiology
The incidence of central nervous system toxicity among divers has decreased since the Second World War, as protocols have developed to limit exposure and partial pressure of oxygen inspired. In 1947, Donald recommended limiting the depth allowed for breathing pure oxygen to 7.6m (25ft), or a ppO2 of 1.8bar (180kPa).[98] This limit has been reduced, until today a limit of 1.4bar (140kPa) during a recreational dive and 1.6bar (160kPa) during shallow decompression stops is accepted. Oxygen toxicity has now become a rare occurrence other than when caused by equipment malfunction and Retinopathy of prematurity (ROP) is more common in middle income countries where neonatal intensive care services are increasing; but greater awareness of the problem, human error. Historically, the U.S. [97] leading to preventive measures, has not yet occurred. Navy has refined its Navy Diving Manual Tables to reduce oxygen toxicity incidents. Between 1995 and 1999, reports showed 405 surface-supported dives using the heliumoxygen tables; of these, oxygen toxicity symptoms were observed on 6 dives (1.5%). As a result, the U.S. Navy in 2000 modified the schedules and conducted field tests of 150 dives, none of which produced symptoms of oxygen toxicity. Revised tables were published in 2001.[99] The variability in tolerance and other variable factors such as workload have resulted in the U.S. Navy abandoning screening for oxygen tolerance. Of the 6,250 oxygen-tolerance tests performed between 1976 and 1997, only 6 episodes of oxygen toxicity were observed (0.1%).[100] [101] Central nervous system oxygen toxicity among patients undergoing hyperbaric oxygen therapy is rare, and is influenced by a number of a factors: individual sensitivity and treatment protocol; and probably therapy indication and equipment used. A study by Welslau in 1996 reported 16 incidents out of a population of 107,264 patients (0.015%), while Hampson and Atik in 2003 found a rate of 0.03%.[102] [103] Yildiz, Ay and Qyrdedi, in a summary of 36,500 patient treatments between 1996 and 2003, reported only 3 oxygen toxicity incidents, giving a rate of 0.008%.[102] A later review of over 80,000 patient treatments revealed an even lower rate: 0.0024%. The reduction in incidence may be partly due to use of a mask (rather than a hood) to deliver oxygen.[104] Bronchopulmonary dysplasia is among the most common complications of prematurely born infants and its incidence has grown as the survival of extremely premature infants has increased. Nevertheless, the severity has decreased as better management of supplemental oxygen has resulted in the disease now being related mainly to

Oxygen toxicity factors other than hyperoxia.[41] In 1997 a summary of studies of neonatal intensive care units in industrialised countries showed that up to 60% of low birth weight babies developed retinopathy of prematurity, which rose to 72% in extremely low birth weight babies, defined as less than 1kg (2.2lb) at birth. However, severe outcomes are much less frequent: for very low birth weight babiesthose less than 1.5kg (3.3lb) at birththe incidence of blindness was found to be no more than 8%.[97]

98

History
Central nervous system toxicity was first described by Paul Bert in 1878.[105] [106] He showed that oxygen was toxic to insects, arachnids, myriapods, molluscs, earthworms, fungi, germinating seeds, birds, and other animals. Central nervous system toxicity may be referred to as the "Paul Bert effect".[17] Pulmonary oxygen toxicity was first described by J. Lorrain Smith in 1899 when he noted central nervous system toxicity and discovered in experiments in mice and birds that 0.43bar (43kPa) had no effect but 0.75bar (75kPa) of oxygen was a pulmonary irritant.[32] Pulmonary toxicity may be referred to as the "Lorrain Smith effect".[17] The first recorded human exposure was undertaken in 1910 by Bornstein when two men breathed oxygen at 2.8bar (280kPa) for 30minutes while he went on to 48minutes with no symptoms. In 1912, Bornstein developed cramps in his hands and legs while breathing oxygen at Paul Bert, a French physiologist, first described oxygen toxicity in 1878. 2.8bar (280kPa) for 51minutes.[6] Smith then went on to show that intermittent exposure to a breathing gas with less oxygen permitted the lungs to recover and delayed the onset of pulmonary toxicity.[32] Albert R. Behnke et al. in 1935 were the first to observe visual field contraction (tunnel vision) on dives between 1.0bar (100kPa) and 4.1bar (410kPa).[107] [108] During World War II, Donald and Yarbrough et al. performed over 2,000 experiments on oxygen toxicity to support the initial use of closed circuit oxygen rebreathers.[42] [109] Naval divers in the early years of oxygen rebreather diving developed a mythology about a monster called "Oxygen Pete", who lurked in the bottom of the Admiralty Experimental Diving Unit "wet pot" (a water-filled hyperbaric chamber) to catch unwary divers. They called having an oxygen toxicity attack "getting a Pete".[110] [111] In the decade following World War II, Lambertsen et al. made further discoveries on the effects of breathing oxygen under pressure as well as methods of prevention.[112] [113] Their work on intermittent exposures for extension of oxygen tolerance and on a model for prediction of pulmonary oxygen toxicity based on pulmonary function are key documents in the development of standard operating procedures when breathing elevated pressures of oxygen.[18] Lambertsen's work showing the effect of carbon dioxide in decreasing time to onset of central nervous system symptoms has influenced work from current exposure guidelines to future breathing apparatus design.[24] [25] [114] Retinopathy of prematurity was not observed prior to World War II, but with the availability of supplemental oxygen in the decade following, it rapidly became one of the principal causes of infant blindness in developed countries. By 1960 the use of oxygen had become identified as a risk factor and its administration restricted. The resulting fall in retinopathy of prematurity was accompanied by a rise in infant mortality and hypoxia-related complications. Since then, more sophisticated monitoring and diagnosis have established protocols for oxygen use which aim to balance between hypoxic conditions and problems of retinopathy of prematurity.[97] Bronchopulmonary dysplasia was first described by Northway in 1967, who outlined the conditions that would lead to the diagnosis.[115] This was later expanded by Bancalari and in 1988 by Shennan, who suggested the need for supplemental oxygen at 36weeks could predict long-term outcomes.[116] Nevertheless, Palta et al. in 1998 concluded that radiographic evidence was the most accurate predictor of long-term effects.[117]

Oxygen toxicity Bitterman et al. in 1986 and 1995 showed that darkness and caffeine would delay the onset of changes to brain electrical activity in rats.[26] [27] In the years since, research on central nervous system toxicity has centred on methods of prevention and safe extension of tolerance.[118] Sensitivity to central nervous system oxygen toxicity has been shown to be affected by factors such as circadian rhythm, drugs, age, and gender.[119] [120] [121] [122] In 1988, Hamilton et al. wrote procedures for the National Oceanic and Atmospheric Administration to establish oxygen exposure limits for habitat operations.[75] [76] [77] Even today, models for the prediction of pulmonary oxygen toxicity do not explain all the results of exposure to high partial pressures of oxygen.[123]

99

Society and culture

Recreational scuba divers commonly breathe nitrox containing up to 40% oxygen, while technical divers use pure oxygen or nitrox containing up to 80% oxygen. Divers who breathe oxygen fractions greater than in air (21%) need to be trained in the dangers of oxygen toxicity and how to prevent them.[69] In order to buy nitrox, a diver has to show evidence of such qualification.[124] Since the late 1990s the recreational use of oxygen has been promoted by oxygen bars, where customers breathe oxygen through a nasal cannula. Claims have been made that this reduces stress, increases energy, and lessens the effects of hangovers and headaches, despite the lack of any scientific evidence to support them.[125] There are also devices on sale that offer "oxygen massage" and "oxygen detoxification" with claims of removing body toxins and reducing body fat.[126] The American Lung Association has stated "there is no evidence that oxygen at the low flow levels used in bars can be dangerous to a normal person's health", but the U.S. Center for Drug Evaluation and Research cautions that people with heart or lung disease need their supplementary oxygen carefully regulated and should not use oxygen bars.[125] Victorian society had a fascination for the rapidly expanding field of science. In "Dr. Ox's Experiment", a short story written by Jules Verne in 1872, the eponymous doctor uses electrolysis of water to separate oxygen and hydrogen. He then pumps the pure oxygen throughout the town of Quiquendone, causing the normally tranquil inhabitants and their animals to become aggressive and plants to grow rapidly. An explosion of the hydrogen and oxygen in Dr Ox's factory brings his experiment to an end. Verne summarised his story by explaining that the effects of oxygen described in the tale were his own invention.[127] There is also a brief episode of oxygen intoxication in his "From the Earth to the Moon".[128]

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"Tolerating oxygen exposure" (http:/ / archive. rubicon-foundation. org/ 6038). South Pacific Underwater Medicine Society Journal 27 (1). ISSN0813-1988. OCLC16986801. . Retrieved 2008-04-29. [78] Latham, Emi (2008-11-07). "Hyperbaric Oxygen Therapy: Contraindications" (http:/ / emedicine. medscape. com/ article/ 1464149-overview). Medscape. . Retrieved 2008-09-25. [79] U.S. Navy Diving Manual 2008, vol.5, ch.20, p.41 [80] Schatte, C.L. (1977). "Dietary selenium and vitamin E as a possible prophylactic to pulmonary oxygen poisoning". Proceedings of the Sixth International Congress on Hyperbaric Medicine, University of Aberdeen, Aberdeen, Scotland (Aberdeen: Aberdeen University Press): 8491. ISBN0-08-024918-3. OCLC16428246. [81] Boadi, W.Y.; Thaire, L.; Kerem, D.; Yannai, S. (1991). "Effects of dietary supplementation with vitamin E, riboflavin and selenium on central nervous system oxygen toxicity". Pharmacology & Toxicology 68 (2): 7782. doi:10.1111/j.1600-0773.1991.tb02039.x. PMID1852722. [82] Piantadosi, Claude A. (2006). In: The Mysterious Malady: Toward an understanding of decompression injuries (http:/ / www. gue. com/ ?q=en/ node/ 193). [DVD]. Global Underwater Explorers. . Retrieved 2008-09-19. [83] Stone, W.L.; Henderson, R.A.; Howard, G.H.; Hollis, A.L.; Payne, P.H.; Scott, R.L. (1989). "The role of antioxidant nutrients in preventing hyperbaric oxygen damage to the retina". Free Radical Biology & Medicine 6 (5): 50512. doi:10.1016/0891-5849(89)90043-9. PMID2744583. [84] "UK Retinopathy of Prematurity Guideline" (http:/ / www. rcophth. ac. uk/ docs/ publications/ ROP_Guideline_-_Masterv11-ARF-2. pdf) (PDF). Royal College of Paediatrics and Child Health, Royal College of Ophthalmologists & British Association of Perinatal Medicine. 2007. p. i. . Retrieved 2009-04-02. [85] Silverman, William (1980). Retrolental Fibroplasia: A Modern Parable (http:/ / www. neonatology. org/ classics/ parable/ ). Grune & Stratton, Inc. pp.39, 41, 143. ISBN0-8089-1264-X. . [86] Webb, James T.; Olson, R.M.; Krutz, R.W.; Dixon, G.; Barnicott, P.T. (1989). "Human tolerance to 100% oxygen at 9.5 psia during five daily simulated 8-hour EVA exposures". Aviation Space and Environmental Medicine 60 (5): 41521. PMID2730484. [87] U.S. Navy Diving Manual 2008, vol.1, ch.3, p.45 [88] Mitchell, Simon J (2008-01-20). "Standardizing CCR rescue skills" (http:/ / www. rebreatherworld. com/ rebreather-accidents-incidents/ 16705-standardizing-ccr-rescue-skills-3. html#post163661). RebreatherWorld. . Retrieved 2009-05-26. This forum post's author chairs the diving committee of the Underwater and Hyperbaric Medical Society. [89] Thalmann, Edward D (2003-12-02). "OXTOX: If You Dive Nitrox You Should Know About OXTOX" (http:/ / www. diversalertnetwork. org/ medical/ articles/ article. asp?articleid=35). Divers Alert Network. . Retrieved 2008-10-20. - Section "What do you do if oxygen toxicity or a convulsion happens?" [90] U.S. Navy Diving Manual 2008, vol.2, ch.9, pp.3739 [91] "NIH MedlinePlus: Bronchopulmonary dysplasia" (http:/ / www. nlm. nih. gov/ medlineplus/ ency/ article/ 001088. htm). U.S. National Library of Medicine. . Retrieved 2008-10-02. [92] Regillo, Brown & Flynn 1998, p.184 [93] Lambertsen, Christian J. (1965). "Effects of oxygen at high partial pressure". In: Fenn, W.O.; Rahn, H. (eds.) Handbook of Physiology: Respiration (American Physiological Society) Sec3 Vol2: 102746. [94] "National Institutes of Health: What is bronchopulmonary dysplasia?" (http:/ / www. nhlbi. nih. gov/ health/ dci/ Diseases/ Bpd/ Bpd_WhatIs. html). U.S. Department of Health & Human Services. . Retrieved 2008-10-02. [95] Spear, Michael L. - reviewer, (June 2008). "Bronchopulmonary dysplasia (BPD)" (http:/ / kidshealth. org/ parent/ medical/ lungs/ bpd. html). Nemours Foundation. . Retrieved 2008-10-03. [96] Regillo, Brown & Flynn 1998, p.190 [97] Gilbert, Clare (1997). "Retinopathy of prematurity: epidemiology" (http:/ / www. cehjournal. org/ 0953-6833/ 10/ jceh_10_22_022. html). Journal of Community Eye Health (London: International Centre for Eye Health) 10 (22): 224. . [98] Donald 1947b [99] Gerth, Wayne A. (2006). "Decompression sickness and oxygen toxicity in U.S. Navy surface-supplied He-O2 diving" (http:/ / archive. rubicon-foundation. org/ 4654). Proceedings of Advanced Scientific Diving Workshop (Smithsonian Institution). ISBN20060725. . Retrieved 2008-10-02. [100] Walters, K.C.; Gould, M.T.; Bachrach, E.A.; Butler, Frank K. (2000). "Screening for oxygen sensitivity in U.S. Navy combat swimmers" (http:/ / archive. rubicon-foundation. org/ 2358). Undersea and Hyperbaric Medicine 27 (1): 216. PMID10813436. . Retrieved 2008-10-02. [101] Butler, Frank K.; Knafelc, M.E. (1986). "Screening for oxygen intolerance in U.S. Navy divers" (http:/ / archive. rubicon-foundation. org/ 3046). Undersea Biomedical Research 13 (1): 918. PMID3705251. . Retrieved 2008-10-02.

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[102] Yildiz, S.; Ay, H.; Qyrdedi, T. (2004). "Central nervous system oxygen toxicity during routine hyperbaric oxygen therapy" (http:/ / archive. rubicon-foundation. org/ 4007). Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society, Inc) 31 (2): 18990. PMID15485078. . Retrieved 2008-10-03. [103] Hampson Neal, Atik D. (2003). "Central nervous system oxygen toxicity during routine hyperbaric oxygen therapy" (http:/ / archive. rubicon-foundation. org/ 3967). Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society, Inc) 30 (2): 14753. PMID12964858. . Retrieved 2008-10-20. [104] Yildiz, S.; Aktas S, Cimsit M, Ay H, Torol E (2004). "Seizure incidence in 80,000 patient treatments with hyperbaric oxygen" (http:/ / www. ingentaconnect. com/ content/ asma/ asem/ 2004/ 00000075/ 00000011/ art00011). Aviation, Space and Environmental Medicine 75 (11): 9924. PMID15559001. . Retrieved 2009-07-01. [105] Bert, Paul (1943) [First published in French in 1878]. Barometric pressure: Researches in Experimental Physiology. Columbus, OH: College Book Company. Translated by: Hitchcock, Mary Alice; Hitchcock, Fred A. [106] British Sub-aqua Club (1985). Sport diving : the British Sub-Aqua Club diving manual. London: Stanley Paul. p.110. ISBN0-09-163831-3. OCLC12807848. [107] Behnke, Alfred R.; Johnson, F.S.; Poppen, J.R.; Motley, E.P. (1935). "The effect of oxygen on man at pressures from 1 to 4atmospheres". American Journal of Physiology 110: 56572. Note: 1atmosphere (atm) is 1.013bars. [108] Behnke, Alfred R.; Forbes, H.S.; Motley, E.P. (1935). "Circulatory and visual effects of oxygen at 3atmospheres pressure". American Journal of Physiology 114: 436442. Note: 1atmosphere (atm) is 1.013bars. [109] Donald 1992 [110] Taylor, Larry "Harris" (1993). "Oxygen Enriched Air: A New Breathing Mix?" (http:/ / www. mindspring. com/ ~divegeek/ eanx. htm). IANTD Journal. . Retrieved 2008-05-29. [111] Davis, Robert H. (1955). Deep Diving and Submarine Operations (6th ed.). Tolworth, Surbiton, Surrey: Siebe Gorman & Company Ltd. p.291. [112] Lambertsen, Christian J.; Clark, John M.; Gelfand, R. (2000). "The Oxygen research program, University of Pennsylvania: Physiologic interactions of oxygen and carbon dioxide effects and relations to hyperoxic toxicity, therapy, and decompression. Summation: 1940 to 1999". EBSDC-IFEM Report No. 3-1-2000 (Philadelphia, PA: Environmental Biomedical Stress Data Center, Institute for Environmental Medicine, University of Pennsylvania Medical Center). [113] Vann, Richard D. (2004). "Lambertsen and O2: Beginnings of operational physiology" (http:/ / archive. rubicon-foundation. org/ 3987). Undersea and Hyperbaric Medicine 31 (1): 2131. PMID15233157. . Retrieved 2008-04-29. [114] Lang 2001, pp.816 [115] Northway, W.H.; Rosan, R.C.; Porter, D.Y. (1967). "Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia". New England Journal of Medicine 276 (7): 35768. doi:10.1056/NEJM196702162760701. PMID5334613. [116] Shennan, A.T.; Dunn, M.S.; Ohlsson, A.; Lennox, K.; Hoskins, E.M. (1988). "Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period". Pediatrics 82 (4): 52732. PMID3174313. [117] Palta, M.; Sadek, M.; Barnet, J.H.; et al. (1998). "Evaluation of criteria for chronic lung disease in surviving very low birth weight infants. Newborn Lung Project". Journal of Pediatrics 132 (1): 5763. doi:10.1016/S0022-3476(98)70485-8. PMID9470001. [118] Natoli, M.J.; Vann, Richard D. (1996). "Factors Affecting CNS Oxygen Toxicity in Humans" (http:/ / archive. rubicon-foundation. org/ 21). Report to the U.S. Office of Naval Research (Durham, NC: Duke University). . Retrieved 2008-04-29. [119] Hof, D.G.; Dexter, J.D.; Mengel, C.E. (1971). "Effect of circadian rhythm on CNS oxygen toxicity". Aerospace Medicine 42 (12): 12936. PMID5130131. [120] Torley, L.W.; Weiss, H.S. (1975). "Effects of age and magnesium ions on oxygen toxicity in the neonate chicken" (http:/ / archive. rubicon-foundation. org/ 2432). Undersea Biomedical Research 2 (3): 2237. PMID15622741. . Retrieved 2008-09-20. [121] Troy, S.S.; Ford, D.H. (1972). "Hormonal protection of rats breathing oxygen at high pressure". Acta Neurologica Scandinavica 48 (2): 23142. doi:10.1111/j.1600-0404.1972.tb07544.x. PMID5061633. [122] Hart, George B.; Strauss, Michael B. (2007). "Gender differences in human skeletal muscle and subcutaneous tissue gases under ambient and hyperbaric oxygen conditions" (http:/ / archive. rubicon-foundation. org/ 7346). Undersea and Hyperbaric Medicine 34 (3): 14761. PMID17672171. . Retrieved 2008-09-20. [123] Shykoff, Barbara E. (2007). "Performance of various models in predicting vital capacity changes caused by breathing high oxygen partial pressures" (http:/ / archive. rubicon-foundation. org/ 6867). NEDU-TR-07-13 (Panama City, FL: U.S. Naval Experimental Diving Unit Technical Report). . Retrieved 2008-06-06. [124] British Sub-Aqua Club (2006). "The Ocean Diver Nitrox Workshop" (http:/ / www. bsac. org/ uploads/ moved/ documents/ Resources/ Nitrox/ OD_Nitrox_Workshop_Student_Workbook_V00bh. pdf) (PDF). British Sub-Aqua Club. p. 6. . Retrieved 2010-09-15. [125] Bren, Linda (NovemberDecember 2002). "Oxygen Bars: Is a Breath of Fresh Air Worth It?" (http:/ / www. mamashealth. com/ doc/ oxygen. asp). FDA Consumer magazine. . Retrieved 2009-06-26. [126] O2Planet (2006). "O2 Planet - Exercise and Fitness Equipment" (http:/ / www. o2planet. com/ HTML/ fitness. html). O2Planet LLC. . Retrieved 2008-10-21. [127] Verne, Jules (2004) [1872]. A Fantasy of Dr Ox (http:/ / search. barnesandnoble. com/ A-Fantasy-of-Dr-Ox/ Jules-Verne/ e/ 9781843910671/ ?itm=1). Hesperus Press. ISBN978-1-84391-067-1. . Retrieved 2009-05-08. Translated from French. [128] Verne, Jules (1877) [1870]. "VIII [At seventy-eight thousand one hundred and fourteen leagues]" (http:/ / www. gutenberg. org/ etext/ 12901). Autour de la Lune [Round the Moon]. London: Ward Lock. ISBN2253005878. . Retrieved 2009-09-02. Translated from French.

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104

Sources
Clark, James M.; Thom, Stephen R. (2003). "Oxygen under pressure". In Brubakk, Alf O.; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders Ltd. pp.358418. ISBN0-7020-2571-2. OCLC51607923. Clark, John M.; Lambertsen, Christian J. (1970). "Pulmonary oxygen tolerance in man and derivation of pulmonary oxygen tolerance curves" (http://archive.rubicon-foundation.org/3863). IFEM Report No. 1-70 (Philadelphia, PA: Environmental Biomedical Stress Data Center, Institute for Environmental Medicine, University of Pennsylvania Medical Center). Retrieved 2008-04-29. Donald, Kenneth W. (1947). "Oxygen poisoning in manpart I". British Medical Journal 1 (4506): 66772. doi:10.1136/bmj.1.4506.667. PMC2053251. PMID20248086. Donald, Kenneth W. (1947). "Oxygen poisoning in manpart II". British Medical Journal 1 (4507): 7127. doi:10.1136/bmj.1.4507.712. PMC2053400. PMID20248096. Revised version of Donald's articles also available as: Donald, Kenneth W. (1992). Oxygen and the diver. UK: Harley Swan, 237 pages. ISBN1-85421-176-5. OCLC26894235. Lang, Michael A. (ed.) (2001). DAN nitrox workshop proceedings (http://archive.rubicon-foundation.org/ 4855). Durham, NC: Divers Alert Network, 197 pages. Retrieved 2008-09-20. Regillo, Carl D.; Brown, Gary C.; Flynn, Harry W. (1998). Vitreoretinal Disease: The Essentials. New York: Thieme, 693 pages. ISBN0-86577-761-6. OCLC39170393. U.S. Navy Supervisor of Diving (2008) (PDF). U.S. Navy Diving Manual (http://supsalv.org/pdf/ DiveMan_rev6.pdf). SS521-AG-PRO-010, revision 6. U.S. Naval Sea Systems Command. Retrieved 2009-06-29.

Further reading
Lamb, John S. (1999). The Practice of Oxygen Measurement for Divers. Flagstaff: Best Publishing, 120 pages. ISBN0-941332-68-3. OCLC44018369. Lippmann, John; Bugg, Stan (1993). The Diving Emergency Handbook. Teddington, UK: Underwater World Publications. ISBN0-946020-18-3. OCLC52056845. Lippmann, John; Mitchell, Simon (2005). "Oxygen". Deeper into Diving (2nd ed.). Victoria, Australia: J.L. Publications. pp.1214. ISBN0-9752290-1-X. OCLC66524750.

External links
General The following external site is a compendium of resources: Rubicon Research Repository (http://archive.rubicon-foundation.org/dspace/simple-search?query=oxygen+ toxicity&submit=Go). Online collection of the oxygen toxicity research Specialised The following external sites contain resources specific to particular topics: 2008 Divers Alert Network Technical Diving Conference (http://www.diversalertnetwork.org/FastAccess/ 2008TechnicalDiving.aspx). Video of "Oxygen Toxicity" lecture by Dr. Richard Vann (free download, mp4, 86MB). Physiology at MCG 4/4ch7/s4ch7_7 (http://www.lib.mcg.edu/edu/eshuphysio/program/section4/4ch7/ s4ch7_7.htm). Wide and detailed discussion of the effects of breathing oxygen on the respiratory system.

Oxygen toxicity Rajiah, Prabhakar (2009-03-11). "Bronchopulmonary Dysplasia" (http://emedicine.medscape.com/article/ 406564-overview). eMedicine. Retrieved 2009-06-29. Concise clinical overview with extensive references.

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Partial pressure
In a mixture of ideal gases, each gas has a partial pressure which is the pressure which the gas would have if it alone occupied the volume.[1] The total pressure of a gas mixture is the sum of the partial pressures of each individual gas in the mixture. In chemistry, the partial pressure of a gas in a mixture of gases is defined as above. The partial pressure of a gas dissolved in a liquid is the partial pressure of that gas which would be generated in a gas phase in equilibrium with the liquid at the same temperature. The partial pressure of a gas is a measure of thermodynamic activity of the gas's molecules. Gases will always flow from a region of higher partial pressure to one of lower pressure; the larger this difference, the faster the flow. Gases dissolve, diffuse, and react according to their partial pressures, and not according to their concentrations in gas mixtures or liquids. This general property of gasses is also true of chemical reactions of gasses in biology. For example, the necessary amount of oxygen for human respiration, and the amount that is toxic, is set by the partial pressure of oxygen alone. This is true across a very wide range of different concentrations of oxygen present in various inhaled breathing gases, or dissolved in blood.

Dalton's law of partial pressures

The partial pressure of an ideal gas in a mixture is equal to the pressure it would exert if it occupied the same volume alone at the same temperature. This is because ideal gas molecules are so far apart that they don't interfere with each other at all. Actual real-world gases come very close to this ideal. A consequence of this is that the total pressure of a mixture of ideal gases is equal to the sum of the partial pressures of the individual gases in the mixture as stated by Dalton's law.[2] For example, given an ideal gas mixture of nitrogen (N2), hydrogen (H2) and ammonia (NH3):

where: = total pressure of the gas mixture = partial pressure of nitrogen (N2) = partial pressure of hydrogen (H2) = partial pressure of ammonia (NH3)

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Ideal gas mixtures

Ideally the ratio of partial pressures is the same as the ratio of molecules. That is, the mole fraction of an individual gas component in an ideal gas mixture can be expressed in terms of the component's partial pressure or the moles of the component:

and the partial pressure of an individual gas component in an ideal gas can be obtained using this expression:

where: = mole fraction of any individual gas component in a gas mixture = partial pressure of any individual gas component in a gas mixture = moles of any individual gas component in a gas mixture = total moles of the gas mixture = total pressure of the gas mixture

The mole fraction of a gas component in a gas mixture is equal to the volumetric fraction of that component in a gas mixture.[3]

Partial volume (Amagat's law of additive volume)

The partial volume of a particular gas is the volume which the gas would have if it alone occupied the volume, with unchanged pressure and temperature, and is useful in gas mixtures, e.g. air, to focus on one particular gas component, e.g. oxygen. It can be approximated both from partial pressure and molar fraction: [4]

Vx is the partial volume of any individual gas component (X) Vtot is the total volume in gas mixture Px is the partial pressure of gas X Ptot is the total pressure in gas mixture nx is the amount of substance of a gas (X) ntot is the total amount of substance in gas mixture

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Vapor pressure
Vapor pressure is the pressure of a vapor in equilibrium with its non-vapor phases (i.e., liquid or solid). Most often the term is used to describe a liquid's tendency to evaporate. It is a measure of the tendency of molecules and atoms to escape from a liquid or a solid. A liquid's atmospheric pressure boiling point corresponds to the temperature at which its vapor pressure is equal to the surrounding atmospheric pressure and it is often called the normal boiling point. The higher the vapor pressure of a liquid at a given temperature, the lower the normal boiling point of the liquid. The vapor pressure chart to the right has graphs of the vapor pressures versus temperatures for a variety of liquids.[5] As can be seen in the chart, the liquids with the highest vapor pressures have the lowest normal boiling points. For example, at any given temperature, propane has the highest vapor pressure of any of the liquids in the chart. It also has the lowest normal boiling point (-43.7 C), which is where the vapor pressure curve of propane (the purple line) intersects the horizontal pressure line of one atmosphere (atm) of absolute vapor pressure.

A typical vapor pressure chart for various liquids

Equilibrium constants of reactions involving gas mixtures

It is possible to work out the equilibrium constant for a chemical reaction involving a mixture of gases given the partial pressure of each gas and the overall reaction formula. For a reversible reaction involving gas reactants and gas products, such as:

the equilibrium constant of the reaction would be:

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where: = the equilibrium constant of the reaction = coefficient of reactant = coefficient of reactant = coefficient of product = coefficient of product = the partial pressure of = the partial pressure of = the partial pressure of = the partial pressure of raised to the power of raised to the power of raised to the power of raised to the power of

For reversible reactions, changes in the total pressure, temperature or reactant concentrations will shift the equilibrium so as to favor either the right or left side of the reaction in accordance with Le Chatelier's Principle. However, the reaction kinetics may either oppose or enhance the equilibrium shift. In some cases, the reaction kinetics may be the over-riding factor to consider.

Henry's Law and the solubility of gases

Gases will dissolve in liquids to an extent that is determined by the equilibrium between the undissolved gas and the gas that has dissolved in the liquid (called the solvent).[6] The equilibrium constant for that equilibrium is: (1)
where: = the equilibrium constant for the solvation process = partial pressure of gas = the concentration of gas in equilibrium with a solution containing some of the gas in the liquid solution

The form of the equilibrium constant shows that the concentration of a solute gas in a solution is directly proportional to the partial pressure of that gas above the solution. This statement is known as Henry's Law and the equilibrium constant is quite often referred to as the Henry's Law constant.[6] [7] [8] Henry's Law is sometimes written as:[9] (2) where above, is also referred to as the Henry's Law constant.[9] As can be seen by comparing equations (1) and (2) is the reciprocal of . Since both may be referred to as the Henry's Law constant, readers of the technical

literature must be quite careful to note which version of the Henry's Law equation is being used. Henry's Law is an approximation that only applies for dilute, ideal solutions and for solutions where the liquid solvent does not react chemically with the gas being dissolved.

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Partial pressure in diving breathing gases

In recreational diving and professional diving the richness of individual component gases of breathing gases is expressed by partial pressure. Using diving terms, partial pressure is calculated as: partial pressure = total absolute pressure x volume fraction of gas component For the component gas "i": ppi = P x Fi For example, at 50 metres (165 feet), the total absolute pressure is 6 bar (600 kPa) (i.e., 1 bar of atmospheric pressure + 5 bar of water pressure) and the partial pressures of the main components of air, oxygen 21% by volume and nitrogen 79% by volume are: ppN2 = 6 bar x 0.79 = 4.7 bar absolute ppO2 = 6 bar x 0.21 = 1.3 bar absolute
where: ppi P Fi ppN2 ppO2 = partial pressure of gas component i = = total pressure = in the terms used in this article

in the terms used in this article , in the terms used in this article

= volume fraction of gas component i = mole fraction, = partial pressure of nitrogen = = partial pressure of oxygen =

in the terms used in this article in the terms used in this article

The minimum safe lower limit for the partial pressures of oxygen in a gas mixture is 0.16 bar (16 kPa) absolute. Hypoxia and sudden unconsciousness becomes a problem with an oxygen partial pressure of less than 0.16 bar absolute. Oxygen toxicity, involving convulsions, becomes a problem when oxygen partial pressure is too high. The NOAA Diving Manual recommends a maximum single exposure of 45 minutes at 1.6 bar absolute, of 120 minutes at 1.5 bar absolute, of 150 minutes at 1.4 bar absolute, of 180 minutes at 1.3 bar absolute and of 210 minutes at 1.2 bar absolute. Oxygen toxicity becomes a risk when these oxygen partial pressures and exposures are exceeded. The partial pressure of oxygen determines the maximum operating depth of a gas mixture. Nitrogen narcosis is a problem when breathing gases at high pressure. Typically, the maximum total partial pressure of narcotic gases used when planning for technical diving is 4.5bar absolute, based on an equivalent narcotic depth of 35 metres (115ft).

References
[1] [2] [3] [4] [5] [6] [7] [8] [9] Charles Henrickson (2005). Chemistry. Cliffs Notes. ISBN0-764-57419-1. Dalton's Law of Partial Pressures (http:/ / dbhs. wvusd. k12. ca. us/ webdocs/ GasLaw/ Gas-Dalton. html) Pittsburgh University chemical engineering class notes (http:/ / granular. che. pitt. edu/ ~mccarthy/ che0035/ MB/ single/ ideal. html) Page 200 in: Medical biophysics. Flemming Cornelius. 6th Edition, 2008. Perry, R.H. and Green, D.W. (Editors) (1997). Perry's Chemical Engineers' Handbook (7th ed.). McGraw-Hill. ISBN0-07-049841-5. Intute University Introductory Chemistry (http:/ / www. intute. ac. uk/ sciences/ reference/ plambeck/ chem2/ p01182. htm) University of Delaware physical chemistry lecture (http:/ / www. udel. edu/ pchem/ C443/ Lectures/ Lecture33. pdf) Rice University chemistry class notes (http:/ / www. owlnet. rice. edu/ ~chem312/ Class Summaries/ Class12. html) University of Arizona chemistry class notes (http:/ / www. chem. arizona. edu/ ~salzmanr/ 103a004/ nts004/ l41/ l41. html)

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Rebreather
A rebreather is a type of breathing set that provides a breathing gas containing oxygen and recycled exhaled gas. This recycling reduces the volume of breathing gas used, making a rebreather lighter and more compact than an open-circuit breathing set for the same duration in environments where humans cannot safely breathe from the atmosphere. In the armed forces it is sometimes called "CCUBA" (Closed Circuit Underwater Breathing Apparatus). Rebreather technology is used in many environments: Underwater where it is sometimes known as CCR = "closed circuit rebreather", "closed circuit scuba", "semi closed scuba", SCR = "semi closed rebreather", or CCUBA = "closed circuit underwater breathing apparatus", as opposed to Aqua-Lung-type equipment, which is known as "open circuit scuba".[1] Mine rescue and in industry where poisonous gases may be present or oxygen may be absent. Crewed spacecraft and space suits outer space is, for all intents and purposes, a vacuum where there is no oxygen to support life. Hospital anaesthesia breathing systems to supply controlled proportions of gases to patients without letting anaesthetic gas get into the atmosphere that the staff breathe.
A fully closed circuit electronic rebreather (Ambient Pressure Diving Inspiration)

Submarines and hyperbaric oxygen therapy chambers where the gas in the habitat must remain safe. Here the rebreather is big and is connected to the air in the habitat. Himalayan mountaineering. Both chemical and compressed oxygen has been used in experimental closed-circuit oxygen systemsthe first on Mt. Everest in 1938. A high rate of system failures due to extreme cold has not been solved.[2]

Theory
As a person breathes, the body consumes oxygen and makes carbon dioxide. At shallow depths, a person with an open-circuit breathing set typically only uses about a quarter of the oxygen in the air that is breathed in (4%5% of the inspired volume). The remaining oxygen is exhaled along with nitrogen and carbon dioxide. As the diver goes deeper, roughly the same quantity of oxygen is used, which represents an increasingly smaller fraction of the compressed air breathed in. Because exhaled air can contain as much as 79% nitrogen (which is not utilized in the body) and 16% (or more) unused oxygen, every exhaled breath from an open-circuit scuba set represents at least 95% wasted, potentially useful gas volume, which has to be replaced from the air supply. The rebreather recirculates the exhaled gas for re-use and does not discharge it to the atmosphere or water.[1] [3] It absorbs the carbon dioxide, which otherwise would accumulate and cause carbon dioxide poisoning. It removes the carbon dioxide by a process called scrubbing.[1] The rebreather adds oxygen, to replace the oxygen that was consumed.[1] Thus, the gas in the rebreather's circuit remains breathable and supports life and the diver needs only a fraction of the gas that would be required for an open-circuit system.

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History of rebreathers
Around 1620 in England, Cornelius Drebbel made an early oar-powered submarine. Records show that, to re-oxygenate the air inside it, he likely generated oxygen by heating saltpetre (potassium nitrate) in a metal pan to make it emit oxygen. That would turn the saltpetre into potassium oxide or hydroxide, which would tend to absorb carbon dioxide from the air around. That may explain how Drebbel's men were not affected by carbon dioxide build-up as much as would be expected. If so, he accidentally made a crude rebreather more than two centuries before Saint Simon Sicard's patent.[4] The oldest known rebreather used an oxygen reservoir and relates to the 1849 patent from the Frenchman Pierre Aimable De Saint Simon Sicard.[5] In 1853 Professor T. Schwann designed a rebreather in Belgium; he exhibited it in Paris in 1878.[6] In 1878 Henry Fleuss invented a rebreather using stored oxygen and absorption of carbon dioxide by an absorbent (here rope yarn soaked in caustic potash solution), to rescue mineworkers who were trapped by water.[7] [8] The Davis Escape Set was the first rebreather which was practical for use and produced in quantity. It was designed about 1900 in Britain for escape from Royal Navy frogman in 1945 sunken submarines. Various industrial oxygen rebreathers (e.g. the Siebe Gorman Salvus and the Siebe Gorman Proto, both invented in the early 1900s) were descended from it; this link shows a Draeger rebreather used for mines rescue in 1907.

[9]

In 1903 to 1907 Professor Georges Jaubert, invented Oxylithe, which is a form of sodium peroxide (Na2O2) or sodium dioxide (NaO2). As it absorbs carbon dioxide it emits oxygen. In 1909 Captain S.S. Hall, R.N., and Dr. O. Rees, R.N., developed a submarine escape apparatus using Oxylithe; the Royal Navy accepted it. It was used for shallow water diving but never in a submarine escape;[8] it was used in the first filming (1907) of Twenty Thousand Leagues Under the Sea. The first recorded mass production of rebreathers started in 1912 with the Drger rebreathers, invented some years sooner by an engineer of the Drger company, Hermann Stelzner.[10] The Drger rebreathers, especially the DM40 model series, were those used by the German helmet divers during World War II. Another systematic use of rebreathers for diving was by Italian sport spearfishers in the 1930s. This practice came to the attention of the Italian Navy, which developed its frogman unit Decima Flottiglia MAS, which was used effectively in World War II.[8] In World War II captured Italian frogmen's rebreathers influenced design of British frogmen's rebreathers.[8] Many British frogmen's breathing sets' oxygen cylinders were German pilot's oxygen cylinders recovered from shot-down German Luftwaffe planes. Those first breathing sets may have been modified Davis Submarine Escape Sets; their fullface masks were the type intended for the Siebe Gorman Salvus. But in later operations different designs were used, leading to a fullface mask with one big face window, at first oval like in this image, and later rectangular (mostly flat, but the ends curved back to allow more vision sideways). Early British frogman's rebreathers had rectangular breathing bags on the chest like Italian frogman's rebreathers; later British frogman's rebreathers had a square recess in the top so they could extend further up onto his shoulders; in front they had a rubber collar that was clamped around the absorbent canister, as in the illustration below.[8] Some British armed forces divers used bulky thick diving suits called Sladen suits; one version of it had a flip-up single window for both eyes to let the user get binoculars to his eyes when on the surface.

Rebreather In the early 1940s US Navy rebreathers were developed by Dr. Christian J. Lambertsen for underwater warfare and is considered by the US Navy as "the father of the Frogmen".[11] [12] Lambertsen held the first closed-circuit oxygen rebreather course in the United States for the Office of Strategic Services maritime unit at the Naval Academy on 17 May 1943.[12] [13]

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Advantages of rebreather diving

Efficiency advantages
The main advantage of the rebreather over other breathing equipment is the rebreather's economical use of gas. With open circuit scuba, the entire breath is expelled into the surrounding water when the diver exhales. A breath inhaled from an open circuit scuba system whose cylinders are filled with ordinary air is about 21%[14] oxygen. When that breath is exhaled back into the surrounding environment, it has an oxygen level in the range of 15 to 16% when the diver is at atmospheric pressure.[14] This leaves the available oxygen utilization at about 25%; the remaining 75% is lost. As the remaining 79% of the breathing gas (mostly nitrogen) is inert, the diver on open-circuit scuba only uses about 5% of his cylinders' contents. At depth, the advantage of a rebreather is even more marked. Since the generation of CO2 is directly related to the body's consumption of O2 (about ~99.5% of O2 is converted to CO2 on exhalation), the amount of O2 consumption doesn't change, therefore CO2 generation doesn't change. This means that at depth, the diver is not using any more of the O2 gas supply than when shallower. This is a marked difference from open circuit where the amount of gas used is directly proportional to the depth.

Feasibility advantages
Long or deep dives using open circuit equipment may not be feasible as there are limits to the number and weight of diving cylinders the diver can carry. The economy of gas consumption is also useful when the gas mix being breathed contains expensive gases, such as helium. In normal use, only oxygen is consumed: small volumes of expensive inert gases are reused during (only) one dive, due to venting of the gas on ascent. For example, a closed circuit rebreather diver effectively doesn't use any of their diluent gas once they've reached the bottom phase of the dive; they could turn off their diluent. On ascent, no diluent is added, however most of that in circuit is lost. A very small amount of trimix would then last for many dives. It is not uncommon for a 3litre (19cubicfoot) diluent cylinder to last for eight 40m (130ft) dives.

Other advantages
Except on ascent, closed circuit rebreathers produce no bubbles and make no bubble noise and much less gas hissing, unlike open-circuit scuba;[14] this can conceal military divers and allow divers engaged in marine biology and underwater photography to avoid alarming marine animals and thereby get closer to them.[15] This lack of exhale also allows shipwreck divers to enter enclosed areas on sunken ships and avoid slowly filling them with air, which then supports the growth of rust. The fully closed circuit rebreather is able to minimise the proportion of inert gases in the breathing mix, and therefore minimise the decompression requirements of the diver, by maintaining a specific and relatively high oxygen partial pressure (ppO2) at all depths. The breathing gas in a rebreather is warmer and more moist than the dry and cold gas from open circuit equipment making it more comfortable to breathe on long dives and causing less dehydration in the diver. Most modern rebreathers have a system of very sensitive oxygen sensors, which allow the diver to adjust the partial pressure of oxygen. This can offer a dramatic advantage at the end of deeper dives, where a diver can raise the partial pressure of oxygen somewhat at shallower depth, in order to shorten decompression times. Care must be taken that the ppO2 is not set to a level where it can become toxic though. Research has shown that a ppO2 of 1.6 bar is toxic

Rebreather with extended exposure[16] One major difference between rebreather diving and open-circuit scuba diving is in keeping neutral buoyancy. When an open-circuit scuba diver inhales, a quantity of highly compressed gas from his cylinder is reduced in pressure by a regulator, and enters the lungs at a much higher volume than it occupied in the cylinder. This means that the diver has a tendency to rise slightly with each inhalation, and lower slightly with each exhalation. This does not happen to a rebreather diver, because the diver is circulating a roughly constant volume of gas between his lungs and the breathing bag.

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Main rebreather design variants

Oxygen rebreather
This is the oldest type of rebreather and was commonly used by navies from the early twentieth century. Oxygen rebreathers can be remarkably simple designs, and their invention predates that of open-circuit scuba. The only gas that it supplies is oxygen.[17] As pure oxygen is toxic when inhaled at pressure, oxygen rebreathers are currently limited to a depth of 6 meters (20ft); some say 9 meters (30ft). In the past they have been used deeper (up to 20 meters) but such dives were more risky than what is now considered acceptable. Oxygen rebreathers are also sometimes used when decompressing from a deep open-circuit dive, as breathing pure oxygen makes the nitrogen diffuse out of the blood more rapidly.

Simplified diagram of the loop in an oxygen rebreather

The diving pioneer Hans Hass used Drger oxygen rebreathers in the early 1940s. In some rebreathers, e.g. the Siebe Gorman Salvus, the oxygen cylinder has two first stages in parallel. One is constant flow; the other is a plain on-off valve called a bypass; both feed into the same exit pipe which feeds the breathing bag.[7] In the Salvus there is no second stage and the gas is turned on and off at the cylinder. Some simple oxygen rebreathers had no constant-flow valve, but only the bypass, and the diver had to operate the valve at intervals to refill the breathing bag as he used the oxygen. Oxygen rebreathers are no longer commonly used in diving because of the depth limit imposed by oxygen toxicity. However, they are still the most commonly used for industrial applications on the surface, (SCBA) such as in mines, due to their simplicity and compact size.

Semi-closed circuit rebreather

Military and recreational divers use these because they provide better underwater duration than open circuit, have a deeper maximum operating depth than oxygen rebreathers and are fairly simple and cheap. Semi-closed circuit equipment generally supplies one breathing gas such as air or nitrox or trimix. The gas is injected into the loop at a constant rate to replenish oxygen consumed from the loop by the diver. Excess gas must be constantly vented from the loop in small volumes to make space for fresh, oxygen-rich gas. As the oxygen in the vented gas cannot be separated from the inert gas, semi-closed circuit is wasteful of oxygen.[18] The diver must fill the cylinders with gas mix that has a maximum operating depth that is safe for the depth of the dive being planned.

Simplified diagram of the loop in a semi-closed circuit rebreather

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As the amount of oxygen required by the diver increases with work rate, the gas injection rate must be carefully chosen and controlled to prevent unconsciousness in the diver due to hypoxia.[19] A higher gas injection rate reduces the likelihood of hypoxia but consumes more gas and wastes more oxygen.

Non-simplified diagram of the loop in a semi-closed circuit rebreather

Fully closed circuit rebreather

Military, photographic, and recreational divers use these because they allow long dives and produce no bubbles.[20] Closed circuit rebreathers generally supply two breathing gases to the loop: one is pure oxygen and the other is a diluent or diluting gas such as air or trimix. The major task of the fully closed circuit rebreather is to control the oxygen concentration, known as the oxygen partial pressure, in the loop and to warn the diver if it is becoming dangerously low or high. The concentration of oxygen in the loop depends on two factors: depth and the proportion of oxygen in the mix. Too low a concentration of oxygen results in hypoxia leading to sudden unconsciousness and ultimately death. Too high a concentration of oxygen results in hyperoxia, leading to oxygen toxicity, a condition causing convulsions which can make the diver lose the mouthpiece when they occur underwater, and can lead to drowning. In fully automatic closed-circuit systems, a mechanism injects oxygen into the loop when it detects that the partial pressure of oxygen in the loop has fallen below the required level. Often this mechanism is electrical and relies on oxygen sensitive electro-galvanic fuel cells called ppO2 meters to measure the concentration of oxygen in the loop. The diver may be able to manually control the mixture by adding diluent gas or oxygen. Adding diluent can prevent the loop's gas mixture becoming too oxygen rich. Manually adding oxygen is risky as additional small volumes of oxygen in the loop can easily raise the partial pressure of oxygen to dangerous levels.

Simplified diagram of the loop in a fully closed circuit rebreather

Non-simplified diagram of the loop in a fully closed circuit rebreather

Rebreathers using an absorbent that releases oxygen

There have been a few rebreather designs (e.g. the Oxylite) which had an absorbent canister filled with potassium superoxide, which gives off oxygen as it absorbs carbon dioxide: 4KO2 + 2CO2 = 2K2CO3 + 3O2; it had a very small oxygen cylinder to fill the loop at the start of the dive.[21] This system is dangerous because of the explosively hot reaction that happens if water gets on the potassium superoxide. The Russian IDA71 military and naval rebreather was designed to be run in this mode or as an ordinary rebreather. Tests on the IDA71 at the United States Navy Experimental Diving Unit in Panama City, Florida showed that the IDA71 could give significantly longer dive time with superoxide in one of the canisters than without.[21]

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Rebreathers which store liquid oxygen

If used underwater, the liquid-oxygen tank must be well insulated against heat coming in from the water. As a result, industrial sets of this type may not be suitable for diving, and diving sets of this type may not be suitable for use out of water. The set's liquid oxygen tank must be filled immediately before use. They include these types: Aerophor. Aerorlox [22] Cryogenic rebreather: see below. Cryogenic rebreather A cryogenic rebreather has a tank of liquid oxygen and no absorbent canister. The carbon dioxide is frozen out in a "snow box" by the cold produced as the liquid oxygen expands to gas as the oxygen is used and is replaced from the oxygen tank.
Aerorlox rebreather in a coal mining museum A cryogenic rebreather called the S-1000 was built around or soon after 1960 by Sub-Marine Systems Corporation. It had a duration of 6 hours and a maximum dive depth of 200 meters of salt water. Its ppO2 could be set to anything from 0.2 bar to 2 bar without electronics, by controlling the temperature of the liquid oxygen, thus controlling the equilibrium pressure of oxygen gas above the liquid. The diluent could be either liquid nitrogen or helium depending on the depth of the dive. The set could freeze out 230grams of carbon dioxide per hour from the loop, corresponding to an oxygen consumption of 2 liters per minute. If oxygen was consumed faster (high workload), a regular scrubber was needed.[23]

Cryogenic rebreathers were widely used in Soviet oceanography in the period 1980 to 1990.[24] [25]

Other designs
In the Siebe Gorman Proto the absorbent was in a flexible-walled compartment in the bottom of the breathing bag and not in a canister. This link [26] describes an experimental drysuit (with built-in hood and fullface mask) and rebreather combination where the drysuit acts as the breathing bag, like in an old Draeger standard diving suit variant which had a rebreather pack attached. Some British naval rebreathers (e.g. the Siebe Gorman CDBA) had a backpack weight pouch instead of the diver having a separate weight belt.

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Parts of a rebreather
The loop
Although there are several design variations of diving rebreather, all types have a gas-tight loop that the diver inhales from and exhales into. The loop consists of components sealed together. The diver breathes through a mouthpiece or a fullface mask (or with industrial breathing sets, sometimes a mouth-and-nose mask). This is connected to one or more tubes bringing inhaled gas and exhaled gas between the diver and a counterlung or breathing bag. This holds gas when it is not in the diver's lungs. The loop also includes a scrubber containing carbon dioxide absorbent to remove from the loop the carbon dioxide exhaled by the diver. Attached to the loop there will be at least one valve allowing injection of gases, such as oxygen and perhaps a diluting gas, from a gas source into the loop. There may be valves allowing venting of gas from the loop. Most modern rebreathers have a twin hose mouthpiece or breathing mask where the direction of flow of gas through the loop is controlled by one-way valves. Some have a single pendulum hose, where the inhaled and exhaled gas passes through the same tube in opposite directions. The mouthpiece often has a valve letting the diver take the mouthpiece from the mouth while underwater or floating on the surface without water getting into the loop. Many rebreathers have "water traps" in the counterlungs, to stop large volumes of water from entering the loop if the diver removes the mouthpiece underwater without closing the valve, or if the diver's lips get slack letting water leak in. Regardless of whether the rebreather in question has the facility to trap any ingress of water, any training on a rebreather will feature procedures for removing any excess water.

A simple naval-type diving oxygen rebreather with the parts labelled

Gas sources

A rebreather must have a source of oxygen to replenish that consumed by the diver. Nearly always, this oxygen is stored in a gas cylinder. Depending on the rebreather design variant, the oxygen source will either be pure or a breathing gas mixture.

Back of a closed circuit rebreather, with the casing opened

Pure oxygen is not considered to be safe for recreational diving deeper than 6 meters, so recreational rebreathers and many professional diving rebreathers also have a cylinder of diluent gas. This diluent cylinder may be filled with compressed air or another diving gas mix such as nitrox or trimix. The diluent reduces the percentage of oxygen breathed and increases the maximum operating depth of the rebreather. It is important that the diluent is not an oxygen-free gas, such as pure nitrogen or helium, and is breathable; it may be used in an emergency either to flush the loop with breathable gas or as a bailout.

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Carbon dioxide scrubber

The exhaled gases are directed through the chemical scrubber, a canister full of some suitable carbon dioxide absorbent such as a form of soda lime, which removes the carbon dioxide from the gas mixture and leaves the oxygen and other gases available for re-breathing.[14] Some absorbent chemical designed for diving applications are Sofnolime, Dragersorb, or Sodasorb. Some systems use a prepackaged Reactive Plastic Curtain (RPC)[27] based cartridge: Reactive Plastic Curtain (RPC) was first used between Micropore Inc. and the US Navy to describe Micropore's absorbent curtains for emergency submarine use, and then more recently RPC has been used on the web to describe their Reactive Plastic Cartridges ExtendAir [28]. The carbon dioxide passing through the scrubber absorbent is removed when it reacts with the absorbent in the canister; this chemical reaction is exothermic. This reaction occurs along a "front" which is a cross section of the canister, of the unreacted soda lime that is exposed to carbon dioxide-laden gas. This front moves through the scrubber canister, from the gas input end to the gas output end, as the reaction consumes the active ingredients. However, this front would be a wide zone, because the carbon dioxide in the gas going through the canister needs time to reach the surface of a grain of absorbent, and then time to penetrate to the middle of each grain of absorbent as the outside of the grain becomes exhausted. In larger environments, such as recompression chambers, a fan is used to pass gas through the canister. Scrubber failure The term "break through" means the failure of the "scrubber" to continue removing carbon dioxide from the exhaled gas mix. There are several ways that the scrubber may fail or become less efficient: Complete consumption of the active ingredient ("break through"). The scrubber canister has been incorrectly packed or configured. This allows the exhaled gas to bypass the absorbent. In a rebreather, the soda lime must be packed tightly so that all exhaled gas comes into close contact with the granules of soda lime and the loop is designed to avoid any spaces or gaps between the soda lime and the loop walls that would let gas avoid contact with the absorbent. If any of the seals, such as o rings, or spacers that prevent bypassing of the scrubber, are not cleaned or lubricated or fitted properly, the scrubber will be less efficient, or outside water or gas may get in circuit. When the gas mix is under pressure caused by depth, the inside of the canister is more crowded by other gas molecules (oxygen or diluent) and the carbon dioxide molecules are not so free to move around to reach the absorbent. In deep diving with a nitrox or other gas-mixture rebreather, the scrubber needs to be bigger than is needed for a shallow-water or industrial oxygen rebreather, because of this effect. Among British naval rebreather divers, this type of carbon dioxide poisoning was called shallow water blackout. A Caustic Cocktail Soda lime is caustic and can cause burns to the eyes and skin. A "caustic cocktail" is a mixture of water and soda lime that occurs when the "scrubber" floods. It gives rise to a chalky taste, which should prompt the diver to switch to an alternative source of breathing gas and rinse his or her mouth out with water. Many modern diving rebreather absorbents are designed not to produce "cocktail" if they get wet. in below-freezing operation (primarily mountain climbing) the wet scrubber chemicals can freeze when oxygen bottles are changed, thus preventing CO2 from reaching the scrubber material. Failure prevention An indicating dye in the soda lime. It changes the colour of the soda lime after the active ingredient is consumed. For example, a rebreather absorbent called "Protosorb" supplied by Siebe Gorman had a red dye, which was said to go white when the absorbent was exhausted. Color indicating dye was removed from US Navy fleet use in 1996 when it was suspected of releasing chemicals into the circuit.[29] With a transparent canister, this may be able to show the position of the reaction "front". This is useful in dry open environments, but is not useful on diving equipment, where:

Rebreather A transparent canister would likely be brittle and easily cracked by knocks. Opening the canister to look inside would flood it with water or let unbreathable external gas in. The canister is usually out of sight of the user, e.g. inside the breathing bag or inside a backpack box. Temperature monitoring. As the reaction between carbon dioxide and soda lime is exothermic, temperature sensors, most likely digital, along the length of the scrubber can be used to measure the position of the front and therefore the life of the scrubber.[30] [31] Diver training. Divers are trained to monitor and plan the exposure time of the soda lime in the scrubber and replace it within the recommended time limit. At present, there is no effective technology for detecting the end of the life of the scrubber or a dangerous increase in the concentration of carbon dioxide causing carbon dioxide poisoning. The diver must monitor the exposure of the scrubber and replace it when necessary. Carbon dioxide gas sensors exist, the first CO2 detector to be produced for rebreathers in a diving application was patented by Clive Wilcox of Amphilogic. Such systems are not useful as a tool for monitoring scrubber life when underwater as the onset of scrubber "break through" occurs quite rapidly. Such systems should be used as an essential safety device to warn divers to bail off the loop immediately. Effectiveness In rebreather diving, the typical effective duration of the scrubber will be half an hour to several hours of breathing, depending on the granularity and composition of the soda lime, the ambient temperature, the design of the rebreather, and the size of the canister. In some dry open environments, such as a recompression chamber or a hospital, it may be possible to put fresh absorbent in the canister when break through occurs.

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Controlling the mix

A basic need with a rebreather is to keep the partial pressure of oxygen (ppO2) in the mix from getting too low (causing hypoxia) or too high (causing oxygen toxicity). If not enough new oxygen is being added, the proportion of oxygen in the loop may be too low to support life. In humans, the urge to breathe is normally caused by a build-up of carbon dioxide in the blood, rather than lack of oxygen. The resulting serious hypoxia causes sudden blackout with little or no warning. This makes hypoxia a deadly problem for rebreather divers. In many rebreathers the diver can control the gas mix and volume in the loop manually by injecting each of the different available gases to the loop and by venting the loop. The loop often has a pressure relief valve to prevent over-pressure injuries caused by over-pressure of the loop. In some early rebreathers the diver had to manually open and close the valve to the oxygen cylinder to refill the counter-lung each time. In others the oxygen flow is kept constant by a pressure-reducing flow valve like the valves on blowtorch cylinders; the set also has a manual on/off valve called a bypass. In some modern rebreathers, the pressure in the breathing bag controls the oxygen flow like the demand valve in open-circuit scuba; for example, trying to breathe in from an empty bag makes the cylinder release more gas. Most modern closed-circuit rebreathers have electro-galvanic fuel cell sensors and onboard electronics, which monitor the ppO2, injecting more oxygen if necessary or issuing an audible warning to the diver if the ppO2 reaches dangerously high or low levels.
Narked at 90 Ltd Deep Pursuit Advanced electronic rebreather controller.

Counterlung

Rebreather The counterlung is a flexible part of the loop, which is designed to change in size by the same volume as the diver's lungs when breathing. Its purpose is to let the loop expand to hold the gas exhaled by the diver and to contract when the diver inhales letting the total volume of gas in the lungs and the loop remain constant throughout the diver's breathing cycle. Underwater, the position of the breathing bag, on the chest, over the shoulders, or on the back, has an effect on the ease of breathing. This is due to the pressure difference between the counterlung and the diver's lung caused by the vertical distance between the two. It is easier to inhale from a front mounted counterlung and exhale to a back mounted counterlung for diver swimming facedown and horizontally. The design of the rebreathers' counterlungs can also affect the swimming diver's streamlining due to location of the counterlungs themselves. Some are designed as over-the-shoulder lungs (e.g. Innerspace Systems Megalodon), while others incorporate the counter lungs into a solid case (e.g. The KISS Classic). For use out of water, this does not matter so much: for example, in an industrial version of the Siebe Gorman Salvus the breathing bag hangs down by the left hip. A rebreather whose counterlung is rubber and not in an enclosed casing, should be sheltered from sunlight when not in use, to prevent the rubber from perishing due to UV light.

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Bailout
While the diver is underwater, the rebreather may fail and be unable to provide a safe breathing mix for the duration of the ascent back to the surface. In this case the diver needs an alternative breathing source: the bailout. Although some rebreather diversreferred to as "alpinists"do not carry bailouts, bailout strategy becomes a crucial part of dive planning, particularly for long dives and deeper dives in technical diving. Often the planned dive is limited by the capacity of the bailout and not the capacity of the rebreather.
Rebreather diver with bailout and decompression cylinders

Several types of bailout are possible: An open-circuit demand valve connected to the rebreather's diluent cylinder. While this option has the advantages of being permanently mounted on the rebreather and not heavy, the quantity of gas held by the rebreather is small so the protection offered is low. An open-circuit demand valve connected to the rebreather's oxygen cylinder. This is similar to the open circuit diluent bailout except it can only safely be used in depths of 6 metres (20ft) or less because of the risk of oxygen toxicity.[32] An independent open-circuit system. The extra cylinders are heavy and cumbersome but larger cylinders let the diver carry more gas providing protection for the ascent from deeper and long dives. The breathing gas mix must be carefully chosen to be safe at all depths of the ascent. An independent closed-circuit system.

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Casing
Many rebreathers have their main parts in a hard backpack casing. This casing needs venting to let surrounding water or air in and out to allow for volume changes as the breathing bag inflates and deflates. In a diving rebreather this needs fairly large holes, including a hole at the bottom to drain the water out when the diver comes out of water. The SEFA, which is used for mine rescue, to keep grit and stones out of its working, is completely sealed, except for a large vent panel covered with metal mesh, and holes for the oxygen cylinder's on/off valve and the cylinder pressure gauge. Underwater the casing also serves for streamlining, e.g. in the IDA71 and Cis-Lunar.

Diffuser
Some military rebreathers have a diffuser over the blowoff valve, which helps to conceal the diver's presence by masking the release of bubbles.[33]

Disadvantages of rebreather diving

Risks
The percentage of deaths that involve the use of a rebreather among United States and Canadian residents increased from approximately 1 to 5% of the total diving fatalities collected by the Divers Alert Network from 1998 through 2004.[34] Investigations into rebreather deaths focus on three main areas: medical, equipment, and procedural.[34] In mountaineering, closed-circuit rebreathers are ideal to treat various altitude related illnesses as the user is brought back to sea level in terms of oxygen pp. The danger is that a sick climber using a rebreather might become unconscious. Because an absolute atmospheric seal is required for rebreathers to work correctly, such a seal could conceivably cause an unconscious user to suffocate when the oxygen ran out or the scrubber became exhausted. (Because there has been very little use of mountaineering rebreathers, this danger is still only theoretical.)

Closed circuit disorders

In addition to the other diving disorders suffered by divers, rebreather divers are also more susceptible to the following disorders (all of which are directly connected with the effectiveness of actual rebreather designs and construction, not with the theory of rebreathing): Sudden blackout due to hypoxia caused by too low a partial pressure of oxygen in the loop. A particular problem when using a closed circuit rebreather is the drop in ambient pressure caused by the ascent phase of the dive, which reduces the partial pressure of oxygen to hypoxic levels leading to what is sometimes called deep water blackout. Seizures due to oxygen toxicity caused by too high a partial pressure of oxygen in the loop. This can be caused by the rise in ambient pressure caused by the descent phase of the dive, which raises the partial pressure of oxygen to hyperoxic levels. In fully closed circuit equipment, aging oxygen sensors may become "current limited" and fail to measure high partial pressures of oxygen resulting in dangerously high oxygen levels. Disorientation, panic, headache, and hyperventilation due to excess of carbon dioxide caused by incorrect configuration, failure or inefficiency of the scrubber. The scrubber must be configured so that no exhaled gas can bypass it; it must be packed and sealed correctly. Another problem is the diver producing carbon dioxide faster than the absorbent can handle; for example, during hard work or fast swimming. The solution to this is to slow down and let the absorbent catch up. The scrubber efficiency may be reduced at depth where the increased concentration of other gas molecules, due to pressure, stops all the carbon dioxide molecules reaching the active ingredient of the scrubber. The rebreather diver must keep breathing in and out all the time, to keep the exhaled gas flowing over the carbon dioxide absorbent, so the absorbent can work all the time. Divers need to lose any air conservation habits that may have been developed while diving with open-circuit scuba. In closed circuit rebreathers, this also has the

Rebreather advantage of mixing the gases preventing oxygen-rich and oxygen-lean spaces developing within the loop, which may give inaccurate readings to the oxygen control system. "Caustic cocktail" in the loop if water comes into contact with the soda lime used in the carbon dioxide scrubber. The diver is normally alerted to this by a chalky taste in the mouth. A safe response is to bail out to "open circuit" and rinse the mouth out. Restoring the oxygen content of the loop Many diver training organizations teach the "diluent flush" technique as a safe way to restore the mix in the loop to a level of oxygen that is neither too high nor too low. It only works when partial pressure of oxygen in the diluent alone would not cause hypoxia or hyperoxia, such as when using a normoxic diluent and observing the diluent's maximum operating depth. The technique involves simultaneously venting the loop and injecting diluent. This flushes out the old mix and replaces it with a known proportion of oxygen

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Compared with open circuit

When compared with Aqua-Lungs, rebreathers have some disadvantages including expense, complexity of operation and maintenance, and fewer failsafes. A malfunctioning rebreather can supply a gas mixture which contains too little oxygen to sustain life, or it may allow carbon dioxide to build up to dangerous levels. Typically rebreathers try to solve these problems by monitoring the system with electronics, sensors and alarm systems. These are expensive and susceptible to failure, improper configuration and misuse. The bailout requirement of rebreather diving can sometimes also require a rebreather diver to carry almost as much bulk of cylinders as an open-circuit diver so the diver can complete the necessary decompression stops if the rebreather fails completely.[35] Some rebreather divers prefer not to carry enough bailout for a safe ascent breathing open circuit, but instead rely on the rebreather, believing that an irrecoverable rebreather failure is very unlikely. This practice is known as alpinism or alpinist diving and is generally maligned due to the perceived extremely high risk of death if the rebreather fails.[36]

Sport diving rebreather technology innovations

Over the past ten or fifteen years rebreather technology has advanced considerably, often driven by the growing market in recreational diving equipment. Innovations include: The electronic, fully closed circuit rebreather itself use of electronics and electro-galvanic fuel cells to monitor oxygen concentration within the loop and maintain a certain partial pressure of oxygen Automatic diluent valves these inject diluent gas into the loop when the loop pressure falls below the limit at which the diver can comfortably breathe. Dive/surface valves or bailout valves a device in the mouthpiece on the loop which connects to a bailout demand valve and can be switched to provide gas from either the loop or the demand valve without the diver taking the mouthpiece from his or her mouth. An important safety device when carbon dioxide poisoning occurs.[37] Integrated decompression computers these allow divers to take advantage of the content and generate a schedule of decompression stops. Carbon dioxide scrubber life monitoring systems temperature sensors monitor the progress of the reaction of the soda lime and provide an indication of when the scrubber will be exhausted.[38] Carbon dioxide monitoring systems Gas sensing cell and interpretive electronics which detect the presence of carbon dioxide in the unique environment of a rebreather loop. The first ever system that was proved to function correctly was patented by Clive Wilcox of Amphilogic.

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References
[1] Richardson, Drew; Menduno, Michael; Shreeves, Karl (eds). (1996). "Proceedings of Rebreather Forum 2.0." (http:/ / archive. rubicon-foundation. org/ 7555). Diving Science and Technology Workshop.: 286. . Retrieved 2008-08-20. [2] Holzel, Tom (2006). "Closed circuit oxygen system, high altitude oxygen" (http:/ / www. velocitypress. com/ closedcircuit. shtml). Velocity Press. . Retrieved 19 September 2010. [3] Goble, Steve (2003). "Rebreathers" (http:/ / archive. rubicon-foundation. org/ 7782). Journal of the South Pacific Underwater Medicine Society 33 (2): 98102. . Retrieved 2008-10-24. [4] "Cornelius Drebbel: inventor of the submarine" (http:/ / www. dutchsubmarines. com/ specials/ special_drebbel. htm). Dutch Submarines. . Retrieved 2008-02-23. [5] Saint Simon Sicard's invention as mentioned by the Muse du Scaphandre website (a diving museum in Espalion, south of France) (http:/ / www. espalion-12. com/ scaphandre/ autonomie/ autonomes_sans_detendeur. htm) [6] Bech, Janwillem. "Theodor Schwann" (http:/ / www. therebreathersite. nl/ Zuurstofrebreathers/ German/ theodore_schwann. htm). . Retrieved 2008-02-23. [7] Davis, RH (1955). Deep Diving and Submarine Operations (6th ed.). Tolworth, Surbiton, Surrey: Siebe Gorman & Company Ltd. p.693. [8] Quick, D. (1970). "A History Of Closed Circuit Oxygen Underwater Breathing Apparatus" (http:/ / archive. rubicon-foundation. org/ 4960). Royal Australian Navy, School of Underwater Medicine. RANSUM-1-70. . Retrieved 2008-04-25. [9] http:/ / www. therebreathersite. nl/ Zuurstofrebreathers/ German/ photos_draeger_1907_rescue_apparatus. htm [10] Drgerwerk page in Divingheritage.com, a specialised website. (http:/ / www. divingheritage. com/ drager. htm) [11] Vann RD (2004). "Lambertsen and O2: beginnings of operational physiology" (http:/ / archive. rubicon-foundation. org/ 3987). Undersea Hyperb Med 31 (1): 2131. PMID15233157. . Retrieved 2008-04-25. [12] Butler FK (2004). "Closed-circuit oxygen diving in the U.S. Navy" (http:/ / archive. rubicon-foundation. org/ 3986). Undersea Hyperb Med 31 (1): 320. PMID15233156. . Retrieved 2008-04-25. [13] Hawkins T (1st Quarter 2000). "OSS Maritime". The Blast 32 (1). [14] Reynolds, Glen Harlan (December 2006). "Seeking New Depths". Popular Mechanics 183 (12): 58. ISSN 0032-4558. [15] Lobel, Phillip S (2005). "Scuba Bubble Noise and Fish Behavior: A Rationale for Silent Diving Technology." (http:/ / archive. rubicon-foundation. org/ 9011). In: Godfrey, JM; Shumway, SE. Diving For Science 2005. Proceedings of the American Academy of Underwater Sciences Symposium on March 10-12, 2005 at the University of Connecticut at Avery Point, Groton, Connecticut. (American Academy of Underwater Sciences). . Retrieved 2011-01-09. [16] Manning AM. Oxygen therapy and toxicity. Vet Clin North Am Small Anim Pract 2002;32:1005-1020, v. [17] Older, P. (1969). "Theoretical Considerations in the Design of Closed Circuit Oxygen Rebreathing Equipment" (http:/ / archive. rubicon-foundation. org/ 4958). Royal Australian Navy, School of Underwater Medicine. RANSUM-4-69. . Retrieved 2008-06-14. [18] http:/ / www. bishopmuseum. org/ research/ treks/ palautz97/ rb. html [19] Elliott, D. (1997). "Some limitations of simi-closed rebreathers" (http:/ / archive. rubicon-foundation. org/ 6039). South Pacific Underwater Medicine Society Journal 27 (1). ISSN0813-1988. OCLC16986801. . Retrieved 2008-06-14. [20] Shreeves, K and Richardson, D (2006). "Mixed-Gas Closed-Circuit Rebreathers: An Overview of Use in Sport Diving and Application to Deep Scientific Diving" (http:/ / archive. rubicon-foundation. org/ 4667). In: Lang, MA and Smith, NE (eds.). Proceedings of Advanced Scientific Diving Workshop Smithsonian Institution, Washington, DC. ISBN20060725. . Retrieved 2008-06-14. [21] Kelley, JS; Herron, JM; Dean, WW; Sundstrom, EB (1968). "Mechanical and Operational Tests of a Russian 'Superoxide' Rebreather." (http:/ / archive. rubicon-foundation. org/ 3451). US Navy Experimental Diving Unit Technical Report NEDU-Evaluation-11-68. . Retrieved 2009-01-31. [22] http:/ / www. healeyhero. co. uk/ rescue/ glossary/ aerorlox. htm Fischel H., Closed circuit cryogenic SCUBA, "Equipment for the working diver" 1970 symposium, Washington, DC, USA. Marine Technology Society 1970:229-244. Cushman, L., Cryogenic Rebreather, Skin Diver magazine, June 1969, and reprinted in Aqua Corps magazine, N7, 28, 79. [24] "Popular mechanics (ru), 7(81) June 2009" (http:/ / www. popmech. ru/ article/ 5567-zhidkaya-voda-zhidkiy-vozduh/ ). . Retrieved 2009-07-17. [25] "Sportsmen-podvodnik journal, 1977" (http:/ / www. scubadiving. ru/ biblioteka/ Knigi/ sportsmen_podvodnik_046. pdf). . Retrieved 2008-07-17. [26] http:/ / www. therebreathersite. nl/ 06_Homebuilders/ secret_rebreather. htm [27] Norfleet, W and Horn, W (2003). "Carbon Dioxide Scrubbing Capabilities of Two New Non-Powered Technologies" (http:/ / archive. rubicon-foundation. org/ 4992). US Naval Submarine Medical Research Center Technical Report NSMRL-TR-1228. . Retrieved 2008-06-13. [28] http:/ / www. extendair. com/ productfrm. html [29] Lillo RS, Ruby A, Gummin DD, Porter WR, Caldwell JM (March 1996). "Chemical safety of U.S. Navy Fleet soda lime" (http:/ / archive. rubicon-foundation. org/ 2238). Undersea Hyperb Med 23 (1): 4353. PMID8653065. . Retrieved 2008-06-09. [30] Warkander, DE (2007). "DEVELOPMENT OF A SCRUBBER GAUGE FOR CLOSED-CIRCUIT DIVING. (abstract)" (http:/ / archive. rubicon-foundation. org/ 5110). Undersea Hyperb Med Society Annual Meeting. . Retrieved 2008-06-09. [31] http:/ / www. apdiving. com/ rebreathers/ vision/ scrubbermonitor/

Rebreather
[32] Lang, Michael A. (ed.) (2001). DAN nitrox workshop proceedings (http:/ / archive. rubicon-foundation. org/ 4855). Durham, NC: Divers Alert Network, 197 pages. . Retrieved 2011-07-30. [33] Chapple, JCB; Eaton, David J. "Development of the Canadian Underwater Mine Apparatus and the CUMA Mine Countermeasures dive system." (http:/ / archive. rubicon-foundation. org/ 7981). Defence R&D Canada Technical Report (Defence R&D Canada) (DCIEM 92-06). . Retrieved 2009-03-31. section 1.2.a [34] Vann RD, Pollock NW, and Denoble PJ (2007). "Rebreather Fatality Investigation" (http:/ / archive. rubicon-foundation. org/ 6997). In: NW Pollock and JM Godfrey (Eds.) the Diving for Science2007 (Dauphin Island, Ala.: American Academy of Underwater Sciences) Proceedings of the American Academy of Underwater Sciences (Twenty-sixth annual Scientific Diving Symposium). ISBN0-9800423-1-3. . Retrieved 2008-06-14. [35] Verdier C, Lee DA (2008). Motor skills learning and current bailout procedures in recreational rebreather diving. (http:/ / archive. rubicon-foundation. org/ 7282). Nitrox Rebreather Diving. DIRrebreather publishing. . Retrieved 2009-03-03. [36] Liddiard, John. "Bailout" (http:/ / www. jlunderwater. co. uk/ old_site/ photoix/ bailout/ bailout. htm). jlunderwater.co.uk. . Retrieved 2009-03-03. [37] "OC DSV BOV FFM page" (http:/ / www. therebreathersite. nl/ 01_Informative/ BOV_page/ BOV_page. html). www.therebreathersite.nl. 8 November 2010. . Retrieved 2010-12-29. [38] Warkander Dan E (2007). "Development of a scrubber gauge for closed-circuit diving" (http:/ / archive. rubicon-foundation. org/ 5110). Undersea and Hyperbaric Medicine Abstract 34. . Retrieved 2008-04-25.

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External links
RebreatherPro (http://www.rebreatherpro.com) Free searchable multimedia resource for rebreather divers Image gallery of LAR-6 and LAR-7 and FGT II and LAR V rebreathers, and other combat frogman's kit (http:// www.specwargear.com/dive&swim.html) In-depth explanation on how rebreathers work (http://www.bishopmuseum.org/research/treks/palautz97/rb. html) and many useful references in its "Further Reading" section A history of closed circuit oxygen underwater breathing apparatus (http://archive.rubicon-foundation.org/ 4960), published in 1970, plenty of images, including mountaineering rebreathers, may be slow to download Information on shallow water blackout (http://www.scuba-doc.com/latenthypoxia.html)

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Recreational diving
Recreational diving or sport diving is a type of diving that uses SCUBA equipment for the purpose of leisure and enjoyment. In some diving circles, the term "recreational diving" is used in contradistinction to "technical diving", a more demanding aspect of the sport which requires greater levels of training, experience and equipment.[1] [2]

History
Recreational scuba diving grew out of related activities such as Snorkeling and underwater hunting.[3] For a long time, recreational underwater Divers off Key West, Florida excursions were limited by the amount of breath that could be held. However, the invention of the aqualung in 1943 by Jacques-Yves Cousteau and the wetsuit in 1953 by Georges Beuchat and its development over subsequent years led to a revolution in recreational diving.[3] However, for much of the 1950s and early 1960s, recreational scuba diving was a sport limited to those who were able to afford or make their own kit, and prepared to undergo intensive training to use it. As the sport became more popular, manufacturers became aware of the potential market, and equipment began to appear that was easy to use, affordable and reliable. Continued advances in SCUBA technology, such as buoyancy compensators, modern diving regulators, wet or dry suits, and dive computers, increased the safety, comfort and convenience of the gear encouraging more people to train and use it. Until the early 1950s, navies and other organizations performing professional diving were the only providers of diver training, but only for their own personnel and only using their own types of equipment. The first scuba diving school was created in France to train the owners of the Jacques Yves Cousteau and Emile Gagnan designed double hose scuba. The first school to teach the modern single hose scuba was started in 1953, in Melbourne, Australia, at the Melbourne City Baths. RAN Commander Batterham organized the school to assist the inventor of the single hose regulator, Ted Eldred. However, neither of these schools were international in nature. There were no training courses, in the modern sense, available to civilians who bought the first scuba equipment. Some of the first training started in 1953 Trevor Hampton created the first British diving school, the British Underwater Centre and 1954 when Los Angeles County[4] created an Underwater Instructor Certification Course. Early instruction increased in the form of amateur teaching within a club environment, as exemplified by organizations such as the Scottish Sub-Aqua Club and the British Sub Aqua Club from 1953, Los Angeles County from 1954 and the YMCA from 1959.[5] Professional instruction started in 1959 when the non-profit NAUI was formed,[6] which later effectively was split,[7] to form the for-profit PADI in 1966.[8] NASDS the National Association of Scuba Diving Schools started with their Dive Center based Training programs in 1962 followed by SSI in 1970.[9] PDIC professional diving instructors college was formed in 1965, later changing its name to PDIC professional diving instructors Corporation in 1984,

Recreational diving providing training in a retail environment.[10] Today, PADI alone issues approximately 950,000 diving certifications a year.[11]

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Diving today
Further developments in technology have reduced the cost of training and diving. Scuba-diving has become a popular leisure activity, and many diving locations have some form of dive shop presence that can offer air fills, equipment, and training. In tropical and sub-tropical parts of the world,[12] there is a large market in 'holiday divers'; people who train and dive while on holiday, but rarely dive close to home. Technical diving and use of rebreathers are increasing, particularly in areas of the world where deeper wreck diving is the main underwater attraction. Generally, recreational diving depths are limited to a maximum of between 30 and 40 meters (100 and 130 feet), beyond which a variety of safety issues make it unsafe to dive using recreation diving equipment and practices, and specialized training and equipment for technical diving are needed.

Standard equipment
Diving mask or full face diving mask and snorkel Swimfins or scuba fins Dry suit, wetsuit or regular swimsuit, depending on the water temperature Buoyancy compensator or buoyancy control device (BCD) Diving weighting system or weight belt Diving cylinder or scuba tank Diving regulator Contents gauge or submersible pressure gauge (SPG) Dive computer or depth gauge and timer Surface marker buoy or other surface detection aid

Issues
There are several recreational diving issues that are currently topics of discussion within the diving community. They include:

Training levels
There is a certain amount of disquiet over the level of training and experience necessary to qualify as a diver. Under most entry-level programs (SDI, PADI, BSAC, SSAC, NAUI, SSI, and PDIC) divers can complete a certification with as few as four 'open-water' dives. Such a qualification allows a diver to rent equipment, request air fills, and dive without any higher supervision, provided they do so with a buddy. Critics claim that four dives is too few to prepare new divers for such a level of responsibility, and that either the total should be raised or the certification qualified. Certification agencies normally answer that they advise their students to dive within the envelope of their experience and training, and to seek to extend both through properly supervised (and frequently revenue-producing) programs, but in the 1980s, several of the Agencies with DEMA did collaborate to author ANSI Standard Z86.3 (1989), Minimum Course Content For Safe Scuba Diving which now serves to limit their potential liability from lawsuits on training adequacy issues by defining their training as the definition of Accepted Industry Practices.

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Regular vs. leisure

Some divers see a split beginning to emerge in recreational diving between regular recreational divers, who often dive in their home communities, and leisure divers, characterized as those who dive occasionally, normally when abroad on holiday and in more benign conditions. It is sometimes observed that there is a tension between the two, and that leisure divers are often inexperienced, either under-trained or over-qualified, and sustain only a minimal empathy with the underwater world. The call is usually not that these divers be restrained from diving, but that they be encouraged to dive more regularly in their home communities so as to gain experience and support their local diving scene. However, as recreational diving has a very low accident and death rate, it is a commonly claimed view that current training requirements are adequate.

Specialties
There are many diving activities which need further training than that provided by the initial courses: Altitude diving Cave diving Deep diving Drift diving Free-diving also called skin diving Ice diving Identifying and surveying sea life and freshwater life: see marine biology Maritime archeology or Underwater archeology Night diving Snorkeling Underwater navigation Underwater photography Underwater search and recovery Underwater videography Wreck diving Nitrox diving

Many diver training agencies such as ACUC, BSAC, CMAS, IANTD, NAUI, PADI, PDIC, SDI, SSI and YMCA offer training in these areas, as well as opportunities to move into professional instruction, technical diving, commercial diving and others.

Bodies of water for diving

Most bodies of water can be used as dive sites: Seas and Oceans - these consist of salt water and a huge variety of flora and fauna. Lakes - small lakes are often used for diver training. Large lakes have many features of seas including wrecks and a variety of marine life. Man-made lakes, such as clay pits and gravel pits, often have lower visibility. Some lakes are high in altitude, and they require special considerations for diving. See Altitude diving Caves - these are more adventurous and dangerous than normal diving. See cave diving. Rivers - are often shallow, murky and have strong currents. Quarries - abandoned rock quarries are popular in inland areas for diver training as well as recreational diving. Rock quarries also have reasonable underwater visibility - there is often little mud or sand to create mid-water particles that cause low visibility. As they are not "wild" and usually privately owned, quarries often contain objects intentionally placed for divers to explore, such as sunken boats, automobiles, aircraft, and even structures like grain silos and gravel chutes.

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Dive site features

Many types of underwater feature make an interesting dive site, for example: Wildlife at the site. Popular examples are coral, sponges, fish, sting rays, molluscs, cetaceans, seals, sharks and crustaceans. The Topography of the site. Coral reefs, drop offs (underwater cliffs), rock reefs, gullies and caves can be spectacular. Deep dive sites mean NASA image [13] showing locations of significant coral reefs, which are often sought out by divers for their abundant, diverse life forms. divers must reduce the time they spend because more gas is breathed at depth and decompression sickness risks increase. Shallow regions can be investigated by snorkeling. Historical or cultural items at the site. Ship wrecks and sunken aircraft, apart from their historical value, form artificial habitats for marine fauna making them attractive dive sites. Underwater visibility varies widely. Poor visibility is caused by particles in the water, such as mud, sand and sewage. Dive sites that are close to sources of these particles, such as human settlements and river estuaries, are more prone to poor visibility. Currents can stir up the particles. Diving close to the sediments on the seabed can result in the particles being kicked up by the divers fins. Temperature. Warm water diving is comfortable and convenient. Although cold water is uncomfortable and can cause hypothermia it can be interesting because different species of underwater life thrive in cold conditions. Cold water means divers tend to prefer Dry suits with inner thermal clothing which offer greater thermal protection although require training and experience to use properly. Currents. Tidal currents can transport nutrients to underwater wildlife increasing the variety and density of that life at the site. Currents can also be dangerous to divers as they can result in the diver being swept away from his or her surface support. Tidal currents that meet solid underwater vertical surfaces can cause strong up or down currents that are dangerous because they may cause the diver to lose buoyancy control risking barotrauma.

References
[1] The distinction (if a distinction exists) between "recreational diving" and "technical diving" is a source of some debate within the diving community, but most major diving training agencies recognise a broad distinction (see for example, PADI and DSAT, and SDI and TDI). [2] Gorman DF, Richardson D, Hamilton Jr RW, Elliott D (1996). "SPUMS Policy on technical recreational diving" (http:/ / archive. rubicon-foundation. org/ 6302). South Pacific Underwater Medicine Society Journal 26 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-06-19. [3] Richardson, D (1999). "A brief history of recreational diving in the United States" (http:/ / archive. rubicon-foundation. org/ 6019). South Pacific Underwater Medicine Society Journal 29 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-06-19. [4] Los Angeles County Underwater Instructors Association. "Los Angeles County Underwater Instructors Association Official Homepage" (http:/ / www. lascuba. com/ ). Los Angeles County Underwater Instructors Association. . Retrieved 2008-06-19. [5] YMCA Scuba. "YMCA Scuba Official Homepage" (http:/ / www. ymca. net/ scuba/ ). YMCA Scuba. . Retrieved 2008-06-19. [6] NAUI. "NAUI Official Homepage" (http:/ / www. naui. org/ ). NAUI. . Retrieved 2008-06-19. [7] divinghistory.com. "History of PADI" (http:/ / web. archive. org/ web/ 20010415140300/ http:/ / www. divinghistory. com/ historyofpadi. html). divinghistory.com via Archive.org. Archived from the original (http:/ / www. divinghistory. com/ historyofpadi. html) on 2001-04-15. . Retrieved 2008-06-19. [8] PADI. "PADI Official Homepage" (http:/ / www. padi. com/ ). PADI. . Retrieved 2008-06-19. [9] Scuba Schools International. "Scuba Schools International: 35 Years of Experience" (http:/ / www. divessi. com/ history). Scuba Schools International. . Retrieved 2008-05-08. [10] PDIC. "PDIC Official Homepage" (http:/ / www. pdic-intl. com/ ). PDIC. . Retrieved 2008-06-19. [11] PADI. "PADI certification statistics" (http:/ / www. padi. com/ scuba/ about-padi/ PADI-statistics/ default. aspx#Graph1). PADI. . Retrieved 2009-03-26.. Approximately 550,000 of these PADI certifications are "entry level" certifications and the remainder are advanced

Recreational diving
certifications. [12] Here (http:/ / www. youtube. com/ watch?v=Ip0fBjpN9F4) you can see divers near Sipadan. It was filmed by Christoph Brx [13] http:/ / www. nasa. gov/ vision/ earth/ lookingatearth/ coralreef_image. html

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Footnotes External links

Sport Diver Magazine (http://www.sportdiver.co.uk) - The official magazine of the PADI Diving Society On the Red Sea, as Hotels Go Up, Divers Head Down (http://travel.nytimes.com/2007/04/08/travel/08explo. html) The New York Times (April 8, 2007) BSAC Where to Dive (http://www.bsactravelclub.co.uk/where/index.html) - Dive site atlas from the British Sub Aqua Club Dive Site Directory (http://www.divesitedirectory.com) - Global dive site location atlas created with contributions from the diving community ScubaZine Divers Community (http://www.scubazine.com) - Global GPS based dive site and services location that can be viewed in Google Earth

Scuba diving
Scuba diving ("SCUBA" originally being an acronym for self contained underwater breathing apparatus, now widely [1] considered a word in its own right) is a form of underwater diving in which a diver uses a scuba set to breathe underwater.[2] Unlike early diving, which relied exclusively on air pumped from the surface, scuba divers carry their own source of breathing gas (usually compressed air),[3] allowing them greater freedom than with an air line. Both surface supplied and scuba diving allow divers to stay underwater significantly longer than with breath-holding techniques as used in snorkelling and free-diving. Depending on the purpose of the dive, a diver usually moves underwater by swimfins attached to the feet, but external propulsion can come from an underwater vehicle, or a sled pulled from the surface.

Scuba diver with air tank

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History
The first commercially successful scuba sets were the Aqualung open-circuit units developed by Emile Gagnan and Jacques-Yves Cousteau, in which compressed gas (usually air) is inhaled from a tank and then exhaled into the water adjacent to the tank. However, the scuba regulators of today trace their origins to Australia, where Ted Eldred developed the first mouth piece regulator, known as the Porpoise. This regulator was developed because patents protected the Aqualung's double hose design. It separated the cylinder from the demand valve giving the diver air at the same pressure surrounding his mouth, not surrounding the tank. The open circuit systems were developed after Cousteau had a number of incidents of oxygen toxicity using a rebreather system, in which exhaled air is reprocessed to remove carbon dioxide. Modern versions of rebreather systems (both semi-closed circuit and closed circuit) are still available today, and form the second main type of scuba unit, most commonly used for technical diving, such as deep diving.

Etymology
The term "SCUBA" (an acronym for self-contained underwater breathing apparatus) arose during World War II, and originally referred to United States combat frogmen's oxygen rebreathers, developed by Dr. Christian Lambertsen for underwater warfare.[3] [4] [5]
Original Aqualung scuba set. 1: Air Hose, 2: Mouthpiece, 3: Regulator, 4:Harness, 5: Back plate, 6: Tank

The word "SCUBA" began as an acronym, but it is now usually thought of as a regular word"scuba". It has become acceptable to refer to "scuba equipment" or "scuba apparatus"examples of the linguistic RAS syndrome.

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Types of diving
Scuba diving may be performed for a number of reasons, both personal and professional. Most people begin through recreational diving, which is performed purely for enjoyment and has a number of distinct technical disciplines to increase interest underwater, such as cave diving, wreck diving, ice diving and deep diving. Divers may be employed professionally to perform tasks underwater. Most of these commercial divers are employed to perform tasks related to the running of a business involving deep water, including civil engineering tasks such as in oil exploration, underwater welding or offshore construction. Commercial divers may also be employed to perform tasks specifically related to marine activities, such as naval diving, including the repair and inspection of boats and ships, salvage of wrecks or underwater fishing, like spear fishing. Other specialist areas of diving include military diving, with a long history of military frogmen in various roles. They can perform roles including direct combat, infiltration behind enemy lines, placing mines or using a manned torpedo, bomb disposal or engineering operations. Professional diver performing underwater In civilian operations, many police forces operate police diving teams welding to perform search and recovery or search and rescue operations and to assist with the detection of crime which may involve bodies of water. In some cases diver rescue teams may also be part of a fire department or lifeguard unit. Lastly, there are professional divers involved with the water itself, such as underwater photography or underwater filming divers, who set out to document the underwater world, or scientific diving, including marine biology and underwater archaeology. Reasons for diving may include:
Type of diving Aquarium maintenance in large public aquariums Boat and ship inspection, cleaning and maintenance Cave diving Civil engineering in harbors, water supply, and drainage systems Crude oil industry and other offshore construction and maintenance Demolition and salvage of ship wrecks Diver training for reward Fish farm maintenance Classification Commercial, scientific Commercial, naval Technical, recreational Commercial Commercial Commercial, naval Professional Commercial

Fishing, e.g. for abalones, crabs, lobsters, pearls, scallops, sea crayfish, sponges Commercial Frogman, manned torpedo Harbor clearance and maintenance Media diving: making television programs, etc. Mine clearance and bomb disposal, disposing of unexploded ordnance Pleasure, leisure, sport Policing: diving to investigate or arrest unauthorized divers Military Commercial, military Professional Military, naval Recreational Police diving, military, naval

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Search and recovery diving Search and rescue diving Spear fishing Stealthy infiltration Surveys and mapping Marine biology Underwater archaeology (shipwrecks; harbors, and buildings) Underwater inspections and surveys Underwater photography Underwater tourism Underwater welding Commercial Police, naval Professional (occasionally), recreational Military Scientific Scientific, recreational Scientific, recreational Commercial, military Professional, recreational Recreational Commercial

Breathing underwater
For more information, see Diving regulator. Water normally contains the dissolved oxygen from which fish and other aquatic animals extract all their required oxygen as the water flows past their gills. Humans lack gills and do not otherwise have the capacity to breathe underwater unaided by external devices.[3] Although the feasibility of filling and artificially ventilating the lungs with a dedicated liquid (liquid breathing) has been established for some time,[6] the size and complexity of the equipment allows only for medical applications with current technology.[7] Early diving experimenters quickly discovered it is not enough simply Scuba diver on reef to supply air to breathe comfortably underwater. As one descends, in addition to the normal atmospheric pressure, water exerts increasing pressure on the chest and lungsapproximately 1 bar (14.7 pounds per square inch) for every 33 feet (10 m) of depthso the pressure of the inhaled breath must almost exactly counter the surrounding or ambient pressure to inflate the lungs. It generally becomes difficult to breathe through a tube past three feet under the water.[3] By always providing the breathing gas at ambient pressure, modern demand valve regulators ensure the diver can inhale and exhale naturally and virtually effortlessly, regardless of depth. Because the diver's nose and eyes are covered by a diving mask; the diver cannot breathe in through the nose, except when wearing a full face diving mask. However, inhaling from a regulator's mouthpiece becomes second nature very quickly.

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Open-circuit regulator
The most commonly used scuba set today is the "single-hose" open circuit 2-stage diving regulator, coupled to a single pressurized gas cylinder, with the first stage on the cylinder and the second stage at the mouthpiece.[2] This arrangement differs from Emile Gagnan's and Jacques Cousteau's original 1942 "twin-hose" design, known as the Aqua-lung, in which the cylinder's pressure was reduced to ambient pressure in one or two or three stages which were all on the cylinder. The "single-hose" system has significant advantages over the original system.

Aqualung Legacy regulator

Gekko dive computer with attached pressure gauge and compass

Aqualung 1st stage

In the "single-hose" two-stage design, the first stage regulator reduces the cylinder pressure of about 200 bar (3000 psi) to an intermediate level of about 10 bar (145 psi) The second stage demand valve regulator, connected via a low pressure hose to the first stage, delivers the breathing gas at the correct ambient pressure to the diver's mouth and lungs. The diver's exhaled gases are exhausted directly to the environment as waste. The first stage typically has at least one outlet delivering breathing gas at unreduced tank pressure. This is connected to the diver's pressure gauge or computer, in order to show how much breathing gas remains.

Suunto pressure gauge close up

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Rebreather
Further information: Rebreather Less common are closed (CCR) and semi-closed (SCR) rebreathers,[8] which unlike open-circuit sets that vent off all exhaled gases, reprocess each exhaled breath for re-use by removing the carbon dioxide buildup and replacing the oxygen used by the diver. Rebreathers release few or no gas bubbles into the water, and use much less oxygen per hour because exhaled oxygen is recovered; this has advantages for research, military,[2] photography, and other applications. The first modern rebreather was the MK-19 that was developed at S-Tron by Ralph Osterhout that was the first electronic system. Rebreathers are more complex and more expensive than sport open-circuit scuba, and need special training and maintenance to be safely used due to the larger variety of potential failure modes.[8] In a closed-circuit rebreather the oxygen partial pressure in the rebreather is controlled, so it can be increased to a safe continuous maximum, which reduces the inert gas (nitrogen and/or helium) partial pressure in the breathing loop. Minimising the inert gas loading of the An Inspiration electronic fully closed circuit diver's tissues for a given dive profile reduces the decompression rebreather obligation. This requires continuous monitoring of actual partial pressures with time and for maximum effectiveness requires real-time computer processing by the diver's decompression computer. Decompression can be much reduced compared to fixed ratio gas mixes used in other scuba systems and, as a result, divers can stay down longer. A semi-closed circuit rebreather injects a constant flow of a fixed nitrox mixture in the breathing loop, so the partial pressure of oxygen at any time during the dive depends on the diver's oxygen consumption. Planning decompression requirements requires a more conservative approach for a SCR than for a CCR. Because rebreathers produce very few bubbles, they do not disturb marine life or make a divers presence known at the surface; this is useful for underwater photography, and for covert work.

Gas mixtures
For some diving, gas mixtures other than normal atmospheric air (21% oxygen, 78% nitrogen, 1% trace gases) can be used,[2] [3] so long as the diver is properly trained in their use. The most commonly used mixture is Enriched Air Nitrox, which is air with extra oxygen, often with 32% or 36% oxygen, and thus less nitrogen, reducing the likelihood of decompression sickness. The reduced nitrogen may also allow for no or less decompression stop times and a shorter surface interval between dives. A common misconception is that nitrox can reduce narcosis, but research has shown that oxygen is also narcotic.[9] [10] Several other common gas mixtures are in use, and all need specialized training. The increased oxygen levels in nitrox help fend off decompression sickness; however, below the maximum operating depth of the mixture, the increased partial pressure of oxygen can lead

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134 to oxygen toxicity. To displace nitrogen without the increased oxygen concentration, other diluents can be used, often helium, when the resultant three gas mixture is called trimix, and when the nitrogen is fully substituted by helium, heliox. For technical dives, some of the cylinders may contain different gas mixture for each phase of the dive, typically designated as Travel, Bottom, and Decompression. These different gas mixtures may be used to extend bottom time, reduce inert gas narcotic effects, and reduce decompression times.

Nitrox cylinder marked up for use

Moving and seeing underwater

Refraction and underwater vision
Water has a higher refractive index than air; it's similar to that of the cornea of the eye. Light entering the cornea from water is hardly refracted at all, leaving only the eye's crystalline lens to focus light. This leads to very severe hypermetropia. People with severe myopia, therefore, can see better underwater without a mask than normal-sighted people. Diving masks and diving helmets and fullface masks solve this problem by creating an air space in front of the diver's eyes.[2] The refraction error created by the water is mostly corrected as the light travels from water to air through a flat lens, except that objects appear approximately 34% bigger and 25% closer in salt water than they actually are. Therefore total field-of-view is significantly reduced and eyehand coordination must be adjusted.

A diver wearing an Ocean Reef full face mask

(This affects underwater photography: a camera seeing through a flat window in its casing is affected the same as its user's eye seeing through a flat mask window, and so its user must focus for the apparent distance to target, not for the real distance.) Divers who need corrective lenses to see clearly outside the water would normally need the same prescription while wearing a mask. Generic and custom corrective lenses are available for some two-window masks. Custom lenses can be bonded onto masks that have a single front window. A "double-dome mask" has curved windows in an attempt to cure these faults, but this causes a refraction problem of its own. Commando frogmen concerned about revealing their position when light reflects from the glass surface of their diving masks may instead use special contact lenses to see underwater. As a diver descends, he must periodically exhale through his nose to equalize the internal pressure of the mask with that of the surrounding water. Swimming goggles are not suitable for diving because they only cover the eyes and

Scuba diving thus do not allow for equalization. Failure to equalise the pressure inside the mask may lead to a form of barotrauma known as mask squeeze.[2] [11]

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Light underwater
Water preferentially absorbs red light, and to a lesser extent, yellow and green light, so the color that is least absorbed by water is blue light.[12]

Table of Light Absorption

Color Ultraviolet Violet Blue Green Yellow Orange Red Infra-red Average wavelength 300nm 400nm 475nm 525nm 575nm 600nm 685nm 800nm Approximate depth 25 m 100 m 275 m 110 m 50 m 20 m 5m 3m

Controlling buoyancy underwater

To dive safely, divers must control their rate of descent and ascent in the water.[3] Ignoring other forces such as water currents and swimming, the diver's overall buoyancy determines whether he ascends or descends. Equipment such as diving weighting systems, diving suits (wet, dry or semi-dry suits are used depending on the water temperature) and buoyancy compensators can be used to adjust the overall buoyancy.[2] When divers want to remain at constant depth, they try to achieve neutral buoyancy. This minimizes gas consumption caused by swimming to maintain depth. The downward force on the diver is the weight of the diver and his equipment minus the weight of the same volume of the liquid that he is displacing; if the result is negative, that force is upwards. The buoyancy of any object immersed in water is also affected by the density of the water. The density of fresh water is about 3% less than that of ocean water.[13] Therefore, divers who are neutrally buoyant at one dive destination (e.g. a fresh water lake) will predictably be positively or negatively buoyant at destinations with different water densities (e.g. a tropical coral reef).

Diver under the Salt Pier in Bonaire.

The removal ("ditching" or "shedding") of diver weighting systems can be used to reduce the diver's weight and cause a buoyant ascent in an emergency. Diving suits made of compressible materials, decrease in volume as the diver descends, and expand again as the diver ascends, creating buoyancy changes. Diving in different environments also necessitates adjustments in the amount of weight carried to achieve neutral buoyancy. The diver can inject air into dry suits to counteract the compression effect and squeeze. Buoyancy compensators allow easy and fine adjustments in the diver's overall

Scuba diving volume and therefore buoyancy. For open circuit divers, changes in the diver's lung volume can be used to make fine adjustments of buoyancy.

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Being mobile underwater

The diver needs to be mobile underwater. Streamlining dive gear will reduce drag and improve mobility. Personal mobility is enhanced by swimfins and Diver Propulsion Vehicles. Other equipment to improve mobility includes diving bells and diving shots.

Underwater communication
A diver cannot talk underwater unless he is wearing a full-face mask, but divers can communicate, using hand signals. It is said that if a diver "signals to his buddy regularly during a dive, this will ensure that they remain in close contact and that they can easily notify each other in case problems occur."; a diver should repeat any sign that is not clear to his buddy, and acknowledge every signal that he or she makes with an "OK" signal to show that he understands.[14]
Two divers giving the sign that they are "OK" on a wreck in the Dominican Republic.

Table of Hand Signals

No. Signal Meaning Comment

1.

Hand raised, fingers pointed up, palm to receiver.

STOP

Transmitted in the same way as a traffic police officers STOP

2.

Thumb extended downward from clenched fist. GO DOWN or GOING DOWN Thumb extended upward from clenched fist. GO UP or GOING UP OK! or OK? Divers wearing mittens may not be able to extend 3 remaining fingers distinctly. A diver with only one free arm may make this signal by extending that arm overhead with finger tips touching top of head to make the O shape. Signal is for long-range use. This is the opposite of OK! The signal does not indicate emergency.

3.

4.

Thumb and forefinger making a circle with three remaining fingers extended (if possible). Two arms extended overhead with finger tips touching above head to make a large O shape.

5.

OK! or OK?

6.

Hand flat, fingers together, palm down, thumb sticking out, then hand rocking back and forth on axis of forearm. Hand waving over head (may also thrash hand on water). Fist pounding on chest. Hand slashing or chopping throat. Clenched fist on arm extended in direction of danger.

SOMETHING IS WRONG

7.

DISTRESS

Indicates immediate aid required.

8. 9. 10.

LOW ON AIR OUT OF AIR DANGER

Indicates signaler's air supply is reduced. Indicates that the signaler cannot breathe.

Scuba diving All signals are to be answered by the receivers repeating the signal as sent. When answering signals 7 & 9, the receiver should approach to offer aid to signaler.(Miller 6.11)[15]

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Hazards and dangers

According to a 1970 North American study, diving was (on a man-hours based criteria) 96 times more dangerous than driving an automobile.[16] According to a 2000 Japanese study, every hour of recreational diving is 36 to 62 times riskier than automobile driving.[17] A big difference between the risks of driving and diving is that the diver is less at risk from fellow divers than the driver is from other drivers.

Injuries due to changes in pressure

For a full list, see Diving hazards and precautions. Divers must avoid injuries caused by changes in air pressure. The weight of the water column above the diver causes an increase in pressure in proportion to depth, in the same way that the weight of the column of atmospheric air above the surface causes a pressure of 101.3 kPa (14.7 pounds-force per square inch) at sea level. This variation of pressure with depth will case compressible materials and gas filled spaces to tend to change volume, which can case the surrounding material or tissues to be stressed, with the risk of injury if the stress gets too high. Pressure injuries are called barotrauma[3] and can be quite painful, even potentially fatal - in severe cases causing a ruptured lung, eardrum or damage to the sinuses. To avoid barotrauma, the diver equalizes the pressure in all air spaces with the surrounding water pressure when changing depth. The middle ear and sinus are equalized using one or more of several techniques, which is referred to as clearing the ears. The mask is equalized during descent by periodically exhaling through the nose. During ascent it will automatically equalise by leaking excess air round the edges. If a drysuit is worn, it must be equalized by inflation and deflation, much like a buoyancy compensator. Most dry suits are fitted with an auto-dump valve, which, if set correctly, and kept at the high point of the diver by good trim skills, will automatically release gas as it expands and retain a virtually constant volume during ascent. The buoyancy compensator will not have the automatic dumping characteristic and must be manually vented during ascent to retain correct volume for a controlled ascent rate, During descent both dry suit and buoyancy compensator must be inflated manually. Although there are many dangers involved in scuba diving, divers can decrease the risks through proper procedures and appropriate equpment. The requisite skills are acquired by training and education, and honed by practice. Open-water certification programs highlight diving physiology, safe diving practices, and diving hazards, but do not provide sufficient practice to become truly adept.

Effects of breathing high pressure gas

Decompression sickness The prolonged exposure to breathing gases at high partial pressure will result in increased amounts of non-metabolic gases, usually nitrogen and/or helium, (referred to in this context as inert gases) dissolving in the bloodstream as it passes through the alveolar capillaries, and thence carried to the other tissues of the body, where they will accumulate until saturated. This saturation process has very little immediate effect on the diver. However when the pressure is reduced during ascent, the amount of dissolved inert gas that can be held in stable solution in the tissues is reduced. This effect is described by Henry's Law. As a consequence of the reducing partial pressure of inert gases in the lungs during ascent, the dissolved gas will be diffused back from the bloodstream to the gas in the lungs and exhaled. The reduced gas concentration in the blood has a similar effect when it passes through tissues carrying a higher concentration, and that gas will diffuse back into the bloodsteam, reducing the loading of the tissues.

Scuba diving As long as this process is gradual, all will go well and the diver will reduce the gas loading by diffusion and perfusion until it eventually re-stabilises at the current saturation pressure. The problem arises when the pressure is reduced more quickly than the gas can be removed by this mechanism, and the level of supersaturation rises sufficiently to become unstable. At this point, bubbles may form and grow in the tissues, and may cause damage either by distending the tissue locally, or blocking small blood vessels, shutting off blood supply to the downstream side, and resulting in hypoxia of those tissues. This effect is called decompression sickness[3] or 'the bends', and must be avoided by reducing the pressure on the body slowly while ascending and allowing the inert gases dissolved in the tissues to be eliminated while still in solution. This process is known as "off-gassing", and is done by restricting the ascent (decompression) rate to one where the level of supersaturation is not sufficient for bubbles to form. This is done by controlling the speed of ascent and making periodic stops to allow gases to be eliminated. The procedure of making stops is called staged decompression, and the stops are called decompression stops. Decompression stops that are not computed as strictly necessary are called safety stops, and reduce the risk of bubble formation further. Dive computers or decompression tables are used to determine a relatively safe ascent profile, but are not completely reliable. There remains a statistical possibility of decompression bubbles forming even when the guidance from tables or computer has been followed exactly. Decompression sickness must be treated as soon as practicable. Definitive treatment is usually recompression in a recompression chamber with hyperbaric oxygen treatment. Exact details will depend on severity and type of symptoms, response to treatment, and the dive history of the casualty. Administering enriched-oxygen breathing gas or pure oxygen to a decompression sickness stricken diver on the surface is a good form of first aid for decompression sickness, although death or permanent disability may still occur.[18] Nitrogen narcosis Nitrogen narcosis or inert gas narcosis is a reversible alteration in consciousness producing a state similar to alcohol intoxication in divers who breathe high pressure gas at depth.[3] The mechanism is similar to that of nitrous oxide, or "laughing gas," administered as anesthesia. Being "narced" can impair judgment and make diving very dangerous. Narcosis starts to affect some divers at 66 feet (20 m). At this depth, narcosis manifests itself as a slight giddiness. The effects increase drastically with the increase in depth. Almost all divers are able to notice the effects by 132 feet (40 meters). At these depths divers may feel euphoria, anxiety, loss of coordination and lack of concentration. At extreme depths, hallucinogenic reaction and tunnel vision can occur. Jacques Cousteau famously described it as the "rapture of the deep". Nitrogen narcosis occurs quickly and the symptoms typically disappear during the ascent, so that divers often fail to realize they were ever affected. It affects individual divers at varying depths and conditions, and can even vary from dive to dive under identical conditions. However, diving with trimix or heliox dramatically reduces the effects of inert gas narcosis. Oxygen toxicity Oxygen toxicity occurs when oxygen in the body exceeds a safe "partial pressure" (PPO2).[3] In extreme cases it affects the central nervous system and causes a seizure, which can result in the diver spitting out his regulator and drowning. Oxygen toxicity is preventable provided one never exceeds the established maximum depth of a given breathing gas. For deep divesgenerally past 180 feet (55 m), divers use "hypoxic blends" containing a lower percentage of oxygen than atmospheric air. For more information, see oxygen toxicity.

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Avoiding losing body heat

Water conducts heat from the diver 25 times[19] better than air, which can lead to hypothermia even in mild water temperatures.[3] Symptoms of hypothermia include impaired judgment and dexterity,[20] which can quickly become deadly in an aquatic environment. In all but the warmest waters, divers need the thermal insulation provided by wetsuits or drysuits.[2] In the case of a wetsuit, the suit is designed to minimize heat loss. Wetsuits are usually made of neoprene that has small closed gas cells, generally nitrogen, trapped in it during the manufacturing process. The Dry suit for reducing exposure poor thermal conductivity of this expanded cell neoprene means that wetsuits reduce loss of body heat by conduction to the surrounding water. The neoprene, and to a larger extent the nitrogen gas, in this case acts as an insulator. The effectiveness of the insulation is reduced when the suit is compressed due to depth, as the nitrogen filled bubbles are then smaller and conduct heat better. The second way in which wetsuits reduce heat loss is to trap a thin layer of water between the diver's skin and the insulating suit itself. Body heat then heats the trapped water. Provided the wetsuit is reasonably well-sealed at all openings (neck, wrists, ankles zippers and overlaps with other suit components), this reduces flow of cold water over the surface of the skin, and thereby reduces loss of body heat by convection, which helps keep the diver warm (this is the principle employed in the use of a "Semi-Dry" wetsuit) In the case of a drysuit, it does exactly what the name implies: keeps a diver dry. The suit is waterproof and sealed so that frigid water cannot penetrate the suit. Drysuit undergarments are usually worn under a drysuit to keep a layer of air inside the suit for better thermal insulation. Some divers carry an extra gas bottle dedicated to filling the dry suit. Usually this bottle contains argon gas, because of its better insulation as compared with air.[21] Dry suits should not be inflated with gases containing helium as it is a good thermal conductor. Drysuits fall into two main categories: neoprene and membrane; both systems have their good and bad points but generally their thermal properties can be reduced to: Membrane or Shell drysuits: usually a trilaminate construction; owing to the thinness of the material (around 1mm), these require an undersuit, usually of high insulation value if diving in cooler water. Neoprene drysuits: a similar construction to wetsuits; these are often Spring suit and steamer considerably thicker (78mm) and have sufficient insulation to allow a lighter-weight undersuit (or none at all); however on deeper dives the neoprene can compress to as little as 2mm thus losing a proportion of its insulation. Compressed or crushed neoprene may also be used (where the neoprene is pre-compressed to 23mm) which avoids the variation of insulating properties with depth. These drysuits function more like a membrane suit.

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Avoiding skin cuts and grazes

Diving suits also help prevent the diver's skin being damaged by rough or sharp underwater objects, marine animals, coral, or metal debris commonly found on shipwrecks.

Diving longer and deeper safely

There are a number of techniques to increase the diver's ability to dive deeper and longer: Technical diving diving deeper than 40 metres (130ft), using mixed gases, and/or entering overhead environments (caves or wrecks) Surface supplied diving use of umbilical gas supply and diving helmets.[2] Saturation diving long-term use of underwater habitats under pressure and a gradual release of pressure over several days in a decompression chamber at the end of a dive.[2]

Scuba diver training and certification agencies

Recreational scuba diving does not have a centralized certifying or regulatory agency, and is mostly self regulated. There are, however, several large diving organizations that train and certify divers and dive instructors, and many diving related sales and rental outlets require proof of diver certification from one of these organizations prior to selling or renting certain diving products or services. The largest international certification agencies that are currently recognized by most diving outlets for diver certification include: American Canadian Underwater Certifications (ACUC) [22] (formerly Association of Canadian Underwater Councils) originated in Canada in 1969 and expanded internationally in 1984

Diving lessons in Monterey Bay, California

British Sub Aqua Club (BSAC) based in the United Kingdom, founded in 1953 and is the largest dive club in the world European Committee of Professional Diving Instructors (CEDIP) [23] based in Europe since 1992 (see Cedip on French Wiki pages) Confdration Mondiale des Activits Subaquatiques (CMAS), the World Underwater Federation National Association of Underwater Instructors (NAUI) based in the United States Professional Diving Instructors Corporation (PDIC) based in the United States Professional Association of Diving Instructors (PADI) based in the United States, largest recreational dive training and certification organization in the world Scottish Sub Aqua Club (SSAC or ScotSAC) [24] the National Governing Body for the sport of diving in Scotland. International Training SDI, TDI & ERDi [25] -based in the United States, TDI is the world's largest technical diving agency, SDI is the recreational division focusing on new methods and online courses, and ERDi is the public safety component. Scuba Schools International (SSI) based in the United States with 35 Regional Centers and Area Offices around the globe. YMCA scuba [26] based in the U.S., part of Young Men's Christian Association (YMCA), a Christian related organization (open to all faiths, ages and genders despite the historic name); discontinued after 2008

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Reference list
[1] "Compact Oxford English Dictionary - scuba" (http:/ / www. askoxford. com/ concise_oed/ scuba?view=uk). Oxford University Press. . [2] US Navy Diving Manual, 6th revision (http:/ / www. supsalv. org/ 00c3_publications. asp?destPage=00c3& pageID=3. 9). United States: US Naval Sea Systems Command. 2006. . Retrieved April 24, 2008. [3] Brubakk, Alf O; Neuman, Tom S (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders Ltd. p.800. ISBN0702025712. [4] Vann RD (2004). "Lambertsen and O2: beginnings of operational physiology" (http:/ / archive. rubicon-foundation. org/ 3987). Undersea Hyperb Med 31 (1): 2131. PMID15233157. . Retrieved April 25, 2008. [5] Butler FK (2004). "Closed-circuit oxygen diving in the U.S. Navy" (http:/ / archive. rubicon-foundation. org/ 3986). Undersea Hyperb Med 31 (1): 320. PMID15233156. . Retrieved April 25, 2008. [6] Hirschl, RB; et al (1995). "Liquid ventilatory in adults, children, and full-term neonates". Lancet 346 (8984): 12011202. doi:10.1016/S0140-6736(95)92903-7. PMID7475663. [7] Sekins, KM; et al (1999). "Recent innovation in total liquid ventilation system and component design". Biomedical instrumentation and technology 33 (3): 277284. PMID10360218. [8] Richardson, D; Menduno, M; Shreeves, K. (eds). (1996). "Proceedings of Rebreather Forum 2.0." (http:/ / archive. rubicon-foundation. org/ 7555). Diving Science and Technology Workshop.: 286. . Retrieved August 20, 2008. Scuba diving, grouped

[9] Hesser, CM; Fagraeus, L; Adolfson, J (1978). "Roles of nitrogen, oxygen, and carbon dioxide in compressed-air narcosis." (http:/ / archive. rubicon-foundation. org/ 2810). Undersea Biomed. Res. 5 (4): 391400. ISSN0093-5387. OCLC2068005. PMID734806. . Retrieved April 8, 2008. [10] Brubakk, Alf O; Neuman, Tom S (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders Ltd. p.304. ISBN0702025712. [11] NOAA Diving Manual, 4th Edition, Best Publishing, 2001 [12] Hegde, M (30 September 2009). "The Blue, the Bluer, and the Bluest Ocean" (http:/ / disc. sci. gsfc. nasa. gov/ oceancolor/ additional/ science-focus/ ocean-color/ oceanblue. shtml). NASA Goddard Earth Sciences Data and Information Services. . Retrieved 27 May 2011. [13] Elert, Glenn (2002). "Density of Seawater" (http:/ / hypertextbook. com/ facts/ 2002/ EdwardLaValley. shtml). The Physics Factbook. . Retrieved April 16, 2010. [14] GULLIVER. "Scuba Diving Hand Signals." Scuba Diving. http:/ / www. dailyscubadiving. com, 23 Jan 2010. Web. 1 Dec 2010. http:/ / www. dailyscubadiving. com/ scuba-diving-hand-signals/ [15] Miller, James W. NOAA Diving Manual Diving for Science and Technology. 2nd ed. Washington, D.C.: U.S. Government Printing Office, 1979. 6.11. [16] Deaths During Skin and Scuba Diving in California in 1970 (http:/ / www. pubmedcentral. nih. gov/ pagerender. fcgi?artid=1518314& pageindex=1#page) [17] Is recreational diving safe?, por Ikeda, T y Ashida, H (http:/ / archive. rubicon-foundation. org/ 6770) [18] Longphre, J. M.; P. J. DeNoble; R. E. Moon; R. D. Vann; J. J. Freiberger (2007). "First aid normobaric oxygen for the treatment of recreational diving injuries" (http:/ / archive. rubicon-foundation. org/ 5514). Undersea Hyperb Med. 34 (1): 4349. ISSN1066-2936. OCLC26915585. PMID17393938. . Retrieved May 3, 2008. [19] "Thermal Conductivity" (http:/ / hyperphysics. phy-astr. gsu. edu/ hbase/ tables/ thrcn. html), Georgia State University, accessed February 15, 2008 [20] Weinberg, R. P.; E. D. Thalmann. (1990). "Effects of Hand and Foot Heating on Diver Thermal Balance" (http:/ / archive. rubicon-foundation. org/ 4247). Naval Medical Research Institute Report 90-52. . Retrieved May 3, 2008. [21] Nuckols ML, Giblo J, Wood-Putnam JL. (September 1518, 2008). "Thermal Characteristics of Diving Garments When Using Argon as a Suit Inflation Gas." (http:/ / archive. rubicon-foundation. org/ 7962). Proceedings of the Oceans 08 MTS/IEEE Quebec, Canada Meeting (MTS/IEEE). . Retrieved April 17, 2009. [22] http:/ / www. acuc. org/ [23] http:/ / www. cedip. org/ [24] http:/ / www. scotsac. com/ [25] http:/ / www. tdisdi. com [26] http:/ / www. ymcascuba. org/

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Further reading
Books published by the British Sub-Aqua Club: The Diving Manual, BSAC, ISBN 0-9538919-2-5 Dive Leading, BSAC, ISBN 0-9538919-4-1 The Club 1953-2003, BSAC, ISBN 0-9538919-5-X Free Scuba textbook by George D. Campbell, III called Diving With Deep-Six (http://www.deep-six.com/ page50.htm)

External links
Divers Alert Network (http://www.diversalertnetwork.org/)Diving Emergencies/Hyperbaric Chamber Assistance Scuba diving travel guide from Wikitravel

Scuba set
A scuba set is an independent breathing set that provides a scuba diver with the breathing gas necessary to breathe underwater during scuba diving. It is much used for sport diving and some sorts of work diving. The word SCUBA, acronym for self-contained underwater breathing apparatus, was coined in 1952 by Major Christian Lambertsen who served in the U.S. Army Medical Corps from 1944 to 1946 as a physician.[1] Lambertsen's invention (patented by himself several times from 1940 to 1989) was a rebreather and is not related to the diving regulators and tanks used today.[2] Compressed air-supplied modern regulators, nowadays improperly called SCUBA sets, are a 1943 A scuba diver in usual sport diving gear invention from the Frenchmen mile Gagnan and Jacques-Yves Cousteau, but in the English language Lambertsen's acronym ended by taking the place of the original names of Gagnan's and Cousteau's invention (supposedly to be Aqua-Lung in English, often spelled "aqualung",[3] a name that Cousteau himself coined for commercialization in all English-speaking countries). As with radar, the acronym SCUBA has become so familiar that it is often not capitalized and is treated as an ordinary noun. For example, it has been taken into the Welsh language as sgwba.

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History
What more characterizes a scuba set is its full independence from the surface as a diving device, mainly by transporting breathable air or any other kind of breathing gas. Early attempts to reach this autonomy from the surface were made in the 18th century by the Englishman John Lethbridge, who invented and successfully built his own underwater diving machine in 1715. The first diving dress using a compressed air reservoir was successfully designed and built in 1771 by Sieur (old French for "sir" or "Mister") Frminet, a Frenchman from Paris. After having made some research on surface-supplied diving he conceived an autonomous breathing machine equiped with a reservoir, dragged by and behind the diver,[4] although Frminet later put it on his back.[5] Frminet called his invention machine hydrostatergatique and used it successfully for more than ten years in the harbors of Le Havre and Brest, as states the explaining text of a 1784 painting.[6] [7] The Frenchman Paul Lemaire d'Augerville successfully built and used autonomous diving equipment in 1824.[8] Also did the British William H. James in 1825. James' helmet was a "thin copper or sole of leather" with a plate window and the air was supplied from an iron reservoir.[9]
The Rouquayrol-Denayrouze apparatus was the first regulator to be mass produced (from 1864 to 1965). On this picture the air tank presents its surface-supplied configuration.

A similar system was used in 1831 by the American Charles Condert, who died in 1832 while testing his invention in the East River at only 20 feet deep. The oldest known rebreather relates to the 1849 patent from the Frenchman Pierre Aimable De Saint Simon Sicard.[10] None of those inventions solved the problem of high pressure when compressed air must be supplied to the diver (as modern regulators solve); they were mostly based on a constant-flow supply of the air. After having travelled to England and discovered William James' invention, the French physician Manuel Thodore Guillaumet, from Argentan (Normandy), patented in 1838 the oldest known regulator mecanism. Guillaumet's invention was air-supplied from the surface and from lack of safety never was mass produced. A more successful and safer regulator was mass produced in France from 1864 to 1965 (although production was twice interrupted during that period): invented by Benot Rouquayrol in 1860 for survival in flooded mines it was adapted to diving in 1864 with the help of French Navy officer Auguste Denayrouze. The Rouquayrol-Denayrouze apparatus was independent from the surface for very short duration, and reached worldwide celebrity after having been mentioned by Jules Verne in his adventure book Twenty Thousand Leagues Under the Sea; but Jules Verne wildly exaggerated its dive duration without external air supply. This equipment was the first reliable regulator to be mass produced and was acquired as a standard breathing apparatus by the French Imperial Navy since 1864. Its iron tank suffered from lack of autonomy and French divers tended to prefer their well known diving dress. Rouquayrol-Denayrouze's mecanism was efficient but its autonomy depended too much on the weak high-pressure reservoirs of its time. For a longer and more secure autonomy from the surface technology had to wait until the 20th century had brought stronger and reliable compressed air cylinders. The first diving equipments that combined a high-pressure cylinder and a breathing device (although not a demand regulator as was the Rouquayrol-Denayrouze apparatus) were invented separately by the Japanese Ohgushi in 1918 and the Frenchmen Maurice Fernez and Yves le Prieur in 1926. Both were based on a constant-flow supply of the

Scuba set air. Ohgushi's invention was soon forgotten but the Fernez-Le Prieur apparatus was mass produced during the 1930s and adopted as a standard by the French Navy. It was the autonomus breathing device first used by the first scuba diving clubs in history (Racleurs de fond in California, 1933, founded by Glenn Orr, and Club des sous-l'eau in Paris, 1935, founded by Le Prieur himself).[11] Fernez had prior invented the noseclip, the expiration valve and the diving goggles and Yves le Prieur just joined to those three Fernez elements a hand-controlled regulator and a compressed-air cylinder. Fernez's goggles didn't allow a dive deeper than ten metres ("mask squeeze" phenomenon) so, in 1933, Le Prieur changed all the Fernez equipment (goggles, noseclip and valve) by a full face mask, directly air-supplied from the cylinder (still in constant flow). During the 1930s French pioneers Philippe Tailliez and Jacques-Yves Cousteau used and widely tested the Le Prieur apparatus before mile Gagnan and Cousteau himself had worked together on the invention of the modern regulator in 1943. It was during World War II when regulators' and rebreathers' technologies were improved and fixed in the main lines as they are nowadays known. Among the things that prompted Cousteau to develop efficient air-breathing free-swimming diving gear, were two oxygen toxicity accidents that he had in 1939 with rebreathers, at 15 metres deep, but those accidents happened because he went too deep with pure oxygen.[12] The invention itself of the modern diving regulator was possible after Cousteau met engineer mile Gagnan for the first time. In 1942, in Paris, and following severe fuel restrictions due to the German occupation of France, mile Gagnan, an Air Liquide employee, miniaturized and adapted to gas generators a Rouquayrol-Denayrouze regulator (property of the Bernard Piel company in 1942). Gagnan's boss and owner of the Air Liquide company, Henri Melchior, decided to introduce Gagnan to Jacques-Yves Cousteau, his son-in-law, because he already knew that Cousteau was looking for an efficient and automatic demand regulator. Both men met then in Paris in December 1942 and adapted Gagnan's regulator to a diving cylinder. After fixing some technical problems they patented in 1943 the first modern demand regulator. From 1934 to 1944 the Commeinhes family from Alsace (Ren and his son Georges) invented and successfully tested a 100% demand regulator, but its main inventor, Georges, was killed in 1944 during the liberation of Strasbourg and Cousteau's regulator found no competitors after the war.[13] [14] In July 1943 Georges Commeinhes had reached a depth of 53 metres off Marseille equiped with his GC42 breathing apparatus[15] ("G" for Georges, "C" for Commeinhes and 42 for 1942). Not knowing this, Frdric Dumas (a close friend of Cousteau) reached off Les Goudes, not far from Marseille, a depth of 62 metres in October 1943 with a Cousteau-Gagnan prototype. He felt then what is now called a nitrogen narcosis.[16]

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Technical drawing of a Mistral Cousteau-type regulator (model of 1955) mounted on a diving cylinder. The regulator is formed by the ensemble of the double hose, the mouthpiece and the regulator itself, joint by its sides by the two hoses. The rear of the regulator is connected to the high-pressure valve of the cylinder. 1. Hose 2. Mouthpiece 3. Valve 4. Harness 5. Backplate 6. Tank (also called cylinder)

At the same time rebreathers also took a technological jump. During the 1930s and all through World War II, British, Japaneses, Italians and Germans perfected and extensively

Scuba set used oxygen rebreathers (Germans especially developed the Drger rebreathers as of 1912).[17] In the USA Major Christian J. Lambertsen, who served in the U.S. Army Medical Corps from 1944 to 1946 as a physician, invented in 1939 an underwater free-swimming oxygen rebreather. He first called it breathing apparatus and offered it to the U.S. Navy, which rejected it. He then demonstrated it to the Office of Strategic Services (OSS).[18] OSS then hired Major Lambertsen to lead the program and build-up the dive element of their maritime unit.[18] In 1952 he patented a new modification of his apparatus, this time under the well known name of SCUBA. In spite of having coined the most common English word used for modern diving equipment, Lambertsen did not invent that equipment. Lambertsen designed a series of rebreathers patented on 16 Dec 1940 and 2 May 1944.[19] After World War II, military frogmen of all countries continued to use rebreathers (since they do not make bubbles and thus are not visible from the surface) and Air Liquide started selling commercially the Cousteau-Gagnan regulator as of 1946 under the name of scaphandre Cousteau-Gagnan or CG45 ("C" for Cousteau, "G" for Gagnan and 45 for a new 1945 patent). The same year Air Liquide created a division called La Spirotechnique, fully conceived to develop and sell regulators or other diving equipments. To sell his regulator in English-speaking countries Cousteau coined the Aqua-Lung label, which was first licensed to the U.S. Divers company (the American division of Air Liquide in the USA) and later sold alongside with La Spirotechnique and U.S. Divers to finally constitute the name of the company itself, Aqua-Lung/La Spirotechnique, nowadays sitting in Carros, near Nice.[20] The Cousteau-Gagnan patent was also licensed to Siebe Gorman of England. Siebe Gorman was allowed to sell in Commonwealth countries, but had difficulty in meeting the demand and the U.S. patent prevented others from making the product. Ted Eldred of Melbourne, Australia, met this demand by developing the single hose regulator used today. Ted sold his first Porpoise Model CA single hose scuba in early in 1952. Before 1971 (when the Scubapro company commercialized the first stabiliser jacket) all breathing sets including scuba came with a plain harness of straps with buckles like on a rucksack or spray-tank-pack. The buckles were usually quick-release. Many did not have a backpack plate, but the cylinders were held directly against the diver's back. Sport scuba usually had quick-release fastenings instead of ordinary buckles. The harnesses of many diving rebreathers made by Siebe Gorman included a large back-sheet of strong reinforced rubber. In the beginning scuba divers dived without any buoyancy aid.[21] In emergency they had to jettison their weights. In the 1960s adjustable buoyancy life jackets (ABLJ) for aqualung-type scuba became available; one early make, since 1961, was Fenzy. The ABLJ is used for two purposes: one to adjust the buoyancy of the diver to compensate for loss of buoyancy (chiefly due to compression of neoprene wetsuit) and more importantly as a lifejacket that can be quickly inflated even at depth. It was put on before putting on the cylinder harness. The first were inflated with a small carbon dioxide cylinder, later with a small air cylinder. An extra feed from the first-stage regulator lets the lifejacket be controlled as a buoyancy aid (invention in 1971 of the direct system by Scuba Pro, for what is now called a stabilizer jacket or stab jacket).

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Types
Modern scuba sets are of two types: open-circuit (examples are those invented in 1864 by Rouquayrol and Denayrouze, in 1926 by Yves le Prieur[22] or the Aqua-Lung invented to extend duration with a demand regulator in 1942/43 by Jacques Yves Cousteau and mile Gagnan).[23] Here the diver breathes in from the equipment and all the exhaled gas goes to waste in the surrounding water. This type of equipment is relatively simple, making it cheaper and more reliable. The two-hose design originally used was the one designed by Cousteau and Gagnan. The single-hose design generally used today was invented in Australia by Ted Eldred. In Britain it for a long time was often called an "aqualung". closed-circuit/semi-closed circuit (also referred to as a rebreather). Here the diver breathes in from the set, and breathes back into the set, where the exhaled gas is processed to make it fit to breathe again. These existed before the open-circuit sets and are still used, but less so than open-circuit sets.

Scuba set Both types of scuba provide a means of supplying air or other breathing gas, nearly always from a high pressure diving cylinder, and a harness to strap it to the diver's body. Most open-circuit scuba and some rebreathers have a demand regulator to control the supply of breathing gas. Some "semi-closed" rebreathers only have a constant-flow regulator, or occasionally a set of constant-flow regulators of various outputs. Some divers use the word "scuba" to mean open-circuit sets only.

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Open circuit
The duration of open-circuit dives is shorter than a rebreather dive, in proportion to the weight and bulk of the set. Open-circuit can be less economic than a rebreather when used with expensive gas mixes such as heliox and trimix. Most divers breathe normal air i.e., 21% oxygen and 79% nitrogen. The cylinder is nearly always worn on the back. "Twin sets" with two backpack cylinders were much more common in the 1960s than now; although twin A diving cylinder with its various components cylinders ("doubles") are commonly used by technical divers for increased dive duration and redundancy. At one time a firm called Submarine Products sold a sport air scuba with three backpack cylinders. Cave divers sometimes have cylinders slung at their sides instead, allowing them to swim through narrower spaces. See diving cylinder for more information about the cylinders and how they are arranged. Newspapers and television news often describe open circuit scuba wrongly as "oxygen" equipment, probably by false analogy to airplane pilots' oxygen cylinders. Until Enriched Air Nitrox was widely accepted in the late 1990s, almost all sport scuba used simple compressed air. This allowed the scuba industry in the U.S. to avoid regulation by the U.S. Food and Drug Administration (FDA), which defines non-air gas mixtures intended to prevent or treat diseases as "drugs". Exotic gas mixtures presently used in scuba are intended to prevent decompression illness in diving, but officially, the FDA appears to continue to believe that scuba divers all use compressed air. At higher than normal partial pressures, oxygen becomes toxic, so scuba divers limit their exposure to less than 1.6bar.[24] Open-circuit scuba sets may supply various breathing gases, but rarely pure oxygen, except during decompression stops in technical diving. Some divers use Enriched Air Nitrox, which has a higher percentage of oxygen, usually 32% or 36% (EAN32 and EAN36, respectively). This lets them stay underwater longer, because less nitrogen is absorbed into the body's tissues. The drawback to the higher oxygen content is that the maximum diving depth is decreased in order to avoid oxygen toxicity. The common nitrox blending method by partial pressure requires that the cylinder is in "oxygen service", which is a cylinder that has had any non-oxygen-compatible grease or rubber removed, by cleaning and replacing parts.

Constant flow
Constant flow scuba sets do not have a demand regulator; the breathing gas flows at a constant rate, unless the diver switches it on and off by hand. They run out of air quicker than aqualungs. There were attempts at designing and using these for diving and for industrial use before the Cousteau-type aqualung started to be a common commercialized device (circa 1950). Examples were Charles Condert dress in the USA (as of 1831), "Ohgushi's Peerless Respirator" in Japan (a hand-controlled regulator, as of 1918), and Commandant le Prieur's hand-controlled regulator in France (as of 1926); see Timeline of diving technology.

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With a demand regulator

This type of set consists of one or more diving cylinders containing breathing gas at high pressure, typically 200300 bars (30004000 psi), connected to a diving regulator. The regulator supplies the diver with as much of the gas as needed, at a pressure suitable for breathing at the depth of the diver. Colloquially this type of breathing set is sometimes (depending on the country of the English speaker) often called an aqualung. The word Aqua-Lung, which first appeared in the Cousteau-Gagnan patent, is a trademark, currently owned by Aqua Lung/La Spirotechnique. Twin-hose This is the first type of diving demand valve to come into general use, and the one that can be seen in classic 1960s television scuba adventures, such as Sea Hunt. They often had two cylinders. In this type of set, the two (or occasionally one or three) stages of the regulator are in a large circular valve assembly mounted on top of the cylinder pack. This type has two wide bellows-like breathing tubes like those on many modern rebreathers, one for intake and one for exhalation. The return tube was not for rebreathing, but because the air exhaust needed to be as near as possible to the regulator's second stage diaphragm, to avoid pressure differences, which would cause a free-flow of gas, or extra resistance to breathing, according to the diver's orientation in the water head-up, head-down, level. In Classic twin-hose Cousteau-type aqualung modern single-hose sets this problem is avoided by moving the second-stage regulator to the diver's mouthpiece. The twin-hose sets came with a mouthpiece as standard, but a full-face diving mask was an option. Another optional extra was a mouthpiece that also had a snorkel attached and a valve to switch between aqualung and snorkel. Note the correct layout of this type, in the image to the right. There have been many incorrect depictions in comics of two-cylinder twin-hose aqualungs, showing one wide breathing tube coming directly out of each cylinder top with no regulator: see Diving regulator#Twin-hose without visible regulator valve (fictional).

Scuba set Single-hose Most modern open-circuit scuba sets have a diving regulator consisting of a first-stage pressure-reducing valve fastened over the diving cylinder's output valve. This valve cuts the pressure from the cylinder, which may be up to 300 bars (4400psi), to a constant lower pressure, often about 10bar above the ambient pressure, which is used in the "low pressure" part of the system. A relatively thin low-pressure hose links this with the second-stage regulator, or "demand valve," which is located in the mouthpiece. Exhalation occurs out of a one-way diaphragm in the chamber of the demand valve, directly into the water quite close to the diver's mouth. This configuration type is called "single hose". The first make of this sort of scuba was the Porpoise, which was made in Melbourne, Australia by Ted Eldred. Some early single hose scuba sets used full-face masks instead of a mouthpiece, such as those made by Desco [25] and Scott Aviation [26] (who continue to make breathing units of this configuration for use by firefighters).
A single-hose regulator with 2nd stage, gauges,

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The first Porpoise scuba set design was a rebreather, but when a BC attachment, and dry suit hose. See further detail in photo description. demonstration resulted in a diver passing out, Eldred began to develop the single-hose open-circuit scuba system. Its regulator's first stage and second stage had to be separated to avoid the Cousteau-Gagnan patent, which protected the double-hose scuba. In the process, Eldred also improved performance.

Scuba set The safety second regulator on an octopus, and integrated into the BC Most modern scuba sets have a spare second-stage demand valve on a separate hose, a configuration called an "octopus", because it often has two or more hoses for other purposes coming out of the primary regulator on the cylinder top. This separate second-stage regulator and hose, or "alternate air source", "safe secondary" or "safe-second" for short, is typically yellow in color, signaling that it is an emergency or backup device. It is often worn secured into a clip on the buoyancy compensator (BC) or a special friction plug on a diver's chest, easily available to be grabbed by, or offered to, a second diver short of air. In so doing, this second mouthpiece eliminates the need for two divers who need to share a cylinder to "buddy-breathe," by trading off the same mouthpiece. Diving instructors still continue to teach buddy-breathing as a now obsolete but still useful technique to know; then they show the new method that has superseded it, since availability of two secondary regulators per diver is now assumed in all modern scuba sets. The original octopus idea was conceived by cave-diving pioneer Sheck Exley as a way for single-file-swimming cave divers to share air in a narrow tunnel, but has now become the standard in recreational diving. Modern "octopus" type primary-stage regulators also typically feature high-pressure ports for use by dive-computer pressure sensors, and additional ports for additional low-pressure hoses for inflation of dry suits and BC devices.

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SCUBA backpack with backplate buoyancy compensator 1) DV/Regulator first stage 2) Tank shut-off valve 3) Shoulder straps 4) Buoyancy compensator bladder 5) Buoyancy compensator bladder relief and bottom manual dump valve 6) DV/Regulator second stages (with octopus) 7) Console (pressure gauge, depth gauge & compass) 8) Dry-suit inflator hose 9) Lacasse backplate 10) Buoyancy compensator inflator hose and inflator button 11) Buoyancy compensator mouthpiece and top manual dump valve 12) Under-crotch strap 13) Abdominal straps

Increasingly, in the 21st century, the second "safety" second-stage regulator/mouthpiece has been combined with the inflator and exhaust assembly of the integrated weight BC device. This combination eliminates the need for a separate low pressure hose for the BC (though the low pressure hose for the combined use must be larger than dedicated BC inflation hoses, because demand on it will be higher if it is used for breathing). In this configuration, the safety spare regulator is now integral to the BC, rather than deriving as a separate hose/regulator from the octopus. No matter which configuration of safety secondary regulator is used, many diving schools now suggest that a diver routinely offer another diver in trouble their "primary" mouthpiece, i.e., the one in their mouth, before going to their own safe-secondary regulator. The idea behind this technique is that the primary mouthpiece is certain to be working, and the diver not in trouble has much more time to sort things out with his/her own equipment after temporarily losing ability to breathe (in a great many instances, panicked out-of-air divers have grabbed the primary regulators out of the mouths of other divers, so changing breathing regulators suddenly in an out-of-air emergency becomes necessary for the rescue diver, in any case). With integrated regulator/BC designs, the safe-secondary

Scuba set regulator is at the end of an even shorter hose (the BC mouthpiece/exhaust) than is the case with the traditional octopus safe-secondary, so deliberate use of the primary regulator and hose to help another diver becomes even more natural, and almost necessary, with the BC-integrated-regulator configuration. Cryogenic There have been designs for a cryogenic open-circuit scuba which has liquid-air tanks instead of cylinders. Underwater cinematographer Jordan Klein, Sr. of Florida co-designed such a scuba in 1967, called "Mako", and made at least a prototype. The Russian Kriolang (from Greek cryo- (= "frost" taken to mean "cold") + English "lung") was copied from Jordan Klein's "Mako" cryogenic open-circuit scuba. Janwillem Bech's rebreather site [27] shows pictures of a Kriolang that was made in 1974. Its diving duration is likely several hours. It would have to be filled immediately before use. SCAMP (Supercritical Air Mobility Pack) [28] is an out-of-water liquid-air open-circuit breathing set designed by NASA by adapting space suit technology. Its maker claims that a man wearing it can crawl through a hole 50 centimetres (20in) square.

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Rebreathers
With rebreathers, the gas the diver exhales is stored between breaths in a "counterlung". In some rebreathers, one-way valves direct the gas through a "loop". In other rebreathers, the inhaled and exhaled gas goes back and forth along a single tube: this is called the pendulum system. The oxygen consumed by the diver is replaced, nearly always from a cylinder. The exhaled carbon dioxide generated by the diver is removed by passing the gas through a "scrubber" a canister full of soda lime, making the gas fit to be re-inhaled. This type of scuba equipment is known as closed circuit. Since 80% or more of the oxygen remains in normal exhaled gas, and is thus wasted, rebreathers use gas very economically, making longer dives possible and special mixes cheaper to use at the expense of more complicated technology and more experience and longer training. There are three variants of rebreather oxygen rebreathers, semi-closed circuit rebreathers, and fully closed circuit rebreathers.

An Inspiration rebreather seen from the front

The rebreather's economic use of gas, typically 1.6 litres (0.06cuft) of oxygen per minute, allows dives of much longer duration than is possible with open circuit equipment where gas consumption is typically ten times higher. Oxygen rebreathers have a maximum operating depth of around 6 metres (20ft), but several types of fully closed circuit rebreathers, when using a helium-based diluent, can dive deeper than 100 metres (330ft). The main limiting factors on rebreathers are the duration of the carbon dioxide scrubber, which is generally at least 3 hours, and that the scrubber gets less efficient at depth because the scrubber's inside is more crowded with diluent molecules, hindering the carbon dioxide molecules from reaching the absorbent as quickly.

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Duration of a dive
The duration of an open-circuit dive depends on factors such as the capacity (volume of gas) in the diving cylinder, the depth of the dive and the breathing rate of the diver, which dependent upon activity levels, size, and experience among other factors. New divers frequently consume all the air in a standard "aluminum 80" cylinder in 30 minutes or less on a dive, while experienced divers frequently take 60 to 70 minutes. An open circuit diver whose breathing rate at the surface (atmospheric pressure) is 15 litres per minute will consume 3 x 15 = 45 litres of gas per minute at 20 metres. [(20 m/10 m per bar) + 1 bar atmospheric pressure] 15 L/min = 45 L/min). If an 11 litre cylinder filled to 200 bar is used until there is a reserve of 17% there is (83% 200 11) = 1826 litres. At 45 L/min the dive at depth will be a maximum of 40.5 minutes (1826/45). These depths and times are typical of experienced sport divers leisurely exploring a coral reef using 200 bar aluminum cylinders rented from a commercial sport diving operation in most tropical island or coastal resorts. A semi-closed circuit rebreather dive is about three times the length of the equivalent open circuit dive; gas is recycled but fresh gas must be constantly injected to replace at least the oxygen used, and any excess gas from this must be vented. Although it uses gas more economically, the weight of the rebreathing equipment means the diver carries smaller cylinders. Still, most semi-closed systems allow at least twice the duration of open circuit systems (around 2 hours). An oxygen rebreather diver or a fully closed circuit rebreather diver consumes about 1 litre of oxygen per minute. Except during ascent or descent, the fully closed circuit rebreather that is operating correctly uses no or very little diluent. So, a diver with a 3 litre oxygen cylinder filled to 200 bar who leaves 25% in reserve will be able to do a 450 minute = 7.5 hour dive (3 L 200 bar 0.75 / 1). The life of the soda lime scrubber is likely to be less than this and so will be the limiting factor of the dive. In practice, dive times for rebreathers are more often influenced by other factors, such as water temperature and the need for safe ascent (see decompression sickness). It happens that the amount of gas available in a single scuba compressed air cylinder makes it quite difficult for a diver following normal routine safe assent procedures (including a safety stop at 5 m or 16ft depth), to require any extra decompression time on ascent. A single-cylinder dive usually cannot result in loading of enough nitrogen into a diver's tissues to cause severe decompression sickness, and this is an unintended inherent safety factor for scuba gear of this type. However, this is not true of double-cylinder sets, or a rebreather which doubles or triples the time a diver can spend at common scuba depths. This extra time is almost entirely spent in a region of nitrogen tissue-loading that greatly increases a diver's danger of decompression illness without careful extra decompression stops.

Air cylinders
Air cylinders used for scuba diving come in various sizes and materials and are typically designated by material usually aluminium or steel. In the U.S. the size is designated by how much air they contain when expanded to 1 atmosphere, 80, 100, 120 cubic feet, etc., with the most common being the "Aluminum 80" which will give an average experienced diver from 40 to 60 minutes of dive time under common dive conditions. In Europe the size is given as their internal volume (10 liter, 12 liter, etc.). Air cylinder pressure will vary according to the type of material used, ranging from 200bar (2900psi) up to 300bar (4400psi). Aluminium cylinders are less expensive than steel and have been known to last for 20 years with standard regular maintenance. The drawback is that an aluminium cylinder is thicker and bulkier than a steel cylinder of the same capacity, which means the diver would need to carry more weight. Many steel cylinders also accept higher pressure fills, carrying more air for the same displacement of cylinder. Compressed air diving cylinders are sometimes colloquially called "tanks", although the proper technical term for them is "cylinder".

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Underwater alternatives to scuba

There are alternative methods that a person can use to survive and function while underwater, including: free-diving - swimming underwater on a single breath of air. snorkeling - a form of free-diving where the diver's mouth and nose can remain underwater when breathing, because the diver is able to breathe at the surface through a short tube known as a snorkel. surface-supplied diving - originally used in professional diving for long or deep dives where an umbilical line connects the diver with the surface providing breathing gas, and sometimes warm water to heat the diving suit, and usually nowadays voice communications. Some tourist resorts now offer a surface-supplied diving arrangement, trademarked as Snuba, as an introduction to diving for the inexperienced. Using the same type of equipment as scuba diving, the diver breathes from compressed air cylinders, which float on a free floating raft at the surface, allowing the diver only 2030 feet (69 m) of depth to travel. Atmospheric diving suit - an armored suit which protects the diver from the surrounding water pressure. Liquid breathing - so far, in the real world, liquid breathing for humans is only laboratory experiments, and (one lung at a time) medical treatment. It has possibilities of being used for very deep diving. It is memorably portrayed in the film The Abyss. Artificial gills (human) - these are mostly science fiction. In the real world they have to process a massive amount of water to extract enough oxygen to supply an active diver, and processing this much water takes a great deal of energy (possible for cold-blooded fish, but harder for humans with higher metabolic rates). But see Like-A-Fish for an attempt to develop real artificial gills for divers.

Breathing sets used out of water

Breathing sets operating on the above principles are not only used underwater but in other situations where the atmosphere is dangerous (little oxygen, poisonous etc). Firefighting Other jobs out of water, e.g., welding in a confined space Mining, especially mine rescue Operations in enclosed or poorly ventilated areas, e.g., large fluid or gas containers.

These breathing sets are nowadays called SCBA (Self Contained Breathing Apparatus) (The initials SCBA have had other meanings). The first open-circuit industrial breathing sets were designed by modifying the design of the Cousteau aqualung. Industrial rebreathers have been used since soon after 1900. Rebreather technology is also used in space suits.

Accessories
In modern scuba sets, a buoyancy compensator (BC) or buoyancy control device (BCD), such as a back-mounted wing or stabilizer jacket (also known as a "stab jacket"), is built into the scuba set harness. Although strictly speaking this is not a part of the breathing apparatus, it is usually connected to the diver's air supply, in order to provide easy inflation of the device. This can usually also be done manually via a mouthpiece, in order to save air while on the surface. The bladders inside the BCD inflate with air from the "direct feed" to increase the volume of the SCUBA equipment and cause the diver to float. Another button deflates the BCD and decreases the volume of the equipment and causes the diver to sink. Certain BCD's allow for integrated weight, meaning that the BCD has special pockets for the weights that can be dumped easily in case of an emergency. The aim of using the BCD, whilst underwater, is to keep the diver neutrally buoyant, i.e., neither floating up or sinking. The BCD is used to compensate for the compression of a wet suit, and to compensate for the decrease of the diver's mass as the air from the cylinder is breathed away.

Scuba set Diving weighting systems, ranging from 2 to 15 kilograms, increase density of the scuba diver to compensate for the buoyancy of diving equipment, allowing the diver to fully submerge underwater with ease by obtaining neutral or slightly negative buoyancy. While weighting systems originally consisted of solid lead blocks attached to a belt around the diver's waist, some modern diving weighting systems are now incorporated into the BCD. These systems use small nylon bags of lead shot pellets which are distributed throughout the BCD, allowing a diver to gain a better overall weight distribution leading to a more horizontal position in the water. There are cases of lead weights being threaded on the straps holding the cylinder into the BCD. Many modern rebreathers use advanced electronics to monitor and regulate the composition of the breathing gas. Some scuba sets incorporate attached extra stage cylinders, as bailout in case the main breathing gas supply is used up or malfunctions, or containing another gas mixture. If these extra cylinders are small, they are sometimes called "pony cylinders". They often have their own demand regulators and mouthpieces, and if so, they are technically distinct extra scuba sets. The diver may carry two or more sets of breathing equipment to provide redundant alternative gas systems in the event that the other fails or is exhausted. Modern recreational rigs most often have two regulators connected to a single cylinder, in case the primary regulator fails or another diver runs out of air. Some divers instead connect their backup regulator to a smaller "pony cylinder" for extra safety, and there are also emergency systems which mount a simple regulator directly to the top of a small cylinder. Rebreather divers often carry a side-slung open-circuit "bail out" to be used in the event the rebreather fails. In technical diving, the diver may carry different equipment for different phases of the dive; some breathing gas mixes may only be used at depth, such as trimix and others, such as pure oxygen, which only may be used during decompression stops in shallow water. The heaviest cylinders are generally carried on the back supported from a backplate while others are side slung from strong points on the backplate. When the diver carries many diving cylinders, especially those made of steel, lack of buoyancy becomes a problem. High-capacity BCs are used to allow the diver to control his or her depth. An excess of tubes and connections passing through the water tend to decrease diving performance by causing hydrodynamic drag in swimming. Some diver training organizations and groups of divers teach techniques, such as DIR diving for configuring diving equipment.

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Notable early manufacturers

Normalair is a firm that is now part of the Honeywell Corporation based in Yeovil (UK). They made an early make of single-hose aqualung that had a fullface mask as standard. Normalair provided the Deep-Dive 500 rebreather sets used by fictional secret agent James Bond 007 in the 1981 film For Your Eyes Only. Captain Trevor Hampton in the 1950s or 1960s designed an early single-hose aqualung with a full-face mask with a circular window that was a very big, and thus very sensitive demand regulator diaphragm. However, when he patented it, the Navy requisitioned the patent, and by the time the Navy found no use in the patent and released it, the market had moved on and he got no use from it. The first commercially successful single hose scuba gear was invented by Ted Eldred of Melbourne, Australia, (Porpoise, 1952) although many people were working on the problem at the same time. The second company to make single hose scuba was also in Melbourne. It was made by Jim Ager who owned Air Dive Pty., Ltd. His regulator was the Sea Bee (1955). Jim still makes scuba regulators and is the longest continuous maker of single hose scuba in the world.

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References
[1] From 1939 to 1944 Lambertsen first called breathing apparatus an invention of his own, a rebreather. Later he called it Laru (portmanteau for Lambertsen Amphibious Respiratory Unit) and finally, in 1952, rejected the term Laru to only retain SCUBA (Self Contained Underwater Breathing Aparatus). See Lambertsen's homage by the Passedaway.com website. (http:/ / www. passedaway. com/ in_the_news/ scientist_who_coined_the_word_scuba_passes_away/ 460/ ) [2] Authentic photographed SCUBA sets, images provided by Guardian Spies: The Story of the U.S. Coast Guard and OSS in World War II, a specialized website. Notice that no bubbles are produced upon immersion. (http:/ / www. guardianspies. com/ frogmen) [3] "Aqua-lung" (http:/ / web. mit. edu/ invent/ iow/ cousteau_gagnan. html). Massachusetts Institute of Technology. . [4] Frminet's invention mentioned in the Muse du Scaphandre website (a diving museum in [[Espalion (http:/ / www. espalion-12. com/ scaphandre/ autonomie/ Freminet. htm)], south of France)] [5] Alain Perrier, 250 rponses aux questions du plongeur curieux, ditions du Gerfaut, Paris, 2008, ISBN 978-2-35191-033-7 (p.46, in French) [6] French explorer and inventor Jacques-Yves Cousteau mentions Frminet's invention and shows this 1784 painting in his 1955 documentary Le Monde du silence. [7] In 1784 Frminet sent six copies of a treatise about his machine hydrostatergatique to the chamber of Guienne (nowadays called Guyenne). On April 5, 1784, the archives of the Chamber of Guienne (Chambre de Commerce de Guienne) officially recorded: Au sr Freminet, qui a adress la Chambre six exemplaires d'un prcis sur une machine hydrostatergatique de son invention, destine servir en cas de naufrage ou de voie d'eau dclare. [8] Daniel David, Les pionniers de la plonge - Les prcurseurs de la plonge autonome 1771-1853, 20X27 cm 170 p, first published in 2008 [9] Davis p. 563 [10] James, Augerville, Condert and Saint Simon Sicard as mentioned by the Muse du Scaphandre website (a diving museum in Espalion, south of France) (http:/ / www. espalion-12. com/ scaphandre/ autonomie/ autonomes_sans_detendeur. htm) [11] Histoire de la plonge ("history of diving"), by Mauro Zrcher, 2002 (http:/ / www. mzplongee. ch/ cariboost_files/ 02-histoire_20de_20la_20plong_c3_a9e. pdf) [12] Jacques-Yves Cousteau & Frdric Dumas, Le Monde du silence, ditions de Paris, Paris, 1953, Dpt lgal 1er Trimestre 1954 - dition N 228 - Impression N 741 (pp. 21-22, in French) [13] The Muse du Scaphandre website (a diving museum in Espalion, south of France) mentions the contributions of different inventors: Guillaumet, Rouquayrol and Denayrouze, Le Prieur, Ren and Georges Commheines, Gagnan and Cousteau (in French) (http:/ / www. espalion-12. com/ scaphandre/ autonomie/ scaphandre_autonome. htm) [14] Brief history of diving by the Club aquatique Cellois (in French) (http:/ / cac. plongee. free. fr/ Histoire_plongee. html) [15] See page 52 in Capitaine de frgate PHILIPPE TAILLIEZ, Plonges sans cble, Arthaud, Paris, January 1954, Dpt lgal 1er trimestre 1954 - dition N 605 - Impression N 243 (in French) [16] Jacques-Yves Cousteau & Frdric Dumas, Le Monde du silence, ditions de Paris, Paris, 1953, Dpt lgal 1er Trimestre 1954 - dition N 228 - Impression N 741 (pp. 35-37, in French) [17] Drgerwerk page in Divingheritage.com, a specialised website. (http:/ / www. divingheritage. com/ drager. htm) [18] Shapiro, T. Rees (2011-02-19). "Christian J. Lambertsen, OSS officer who created early scuba device, dies at 93" (http:/ / www. washingtonpost. com/ wp-dyn/ content/ article/ 2011/ 02/ 18/ AR2011021802873. html). The Washington Post. . [19] 1944 Lambertsen's breathing appartus patent in Google Patents (http:/ / www. google. fr/ patents/ about?id=5PRKAAAAEBAJ) [20] Laurent-Xavier Grima, Aqua Lung 1947-2007, soixante ans au service de la plonge sous-marine ! (in French) (http:/ / www. plongeur. com/ magazine/ 2007/ 10/ 24/ spirotechnique-aqualung-60-ans/ ) [21] cf. The Silent World, a film shot in 1955, before the invention of buoyancy control devices: in the film, Cousteau and his divers are permanently using their fins. [22] Yves Paul Gaston Le Prieur, Premier de plonge ('First on Diving'), ditions France Empire, Paris, 1956 [23] J. Y. Cousteau & Frdric Dumas, The Silent World, Hamish Hamilton, London, 1953 [24] Lang, Michael A, ed (2001). DAN nitrox workshop proceedings (http:/ / archive. rubicon-foundation. org/ 4855). Durham, NC: Divers Alert Network. p.195. . Retrieved 2008-09-20. [25] http:/ / www. descocorp. com/ fyi_page. htm [26] http:/ / www. scotthealthsafety. com [27] http:/ / www. therebreathersite. nl/ 03_Historical/ cryo_pjotrr. htm [28] http:/ / www. nasa. gov/ missions/ science/ scamp. html

Scuba set

155

Bibliography
Davis, Robert H (1955). Deep Diving and Submarine Operations (6th ed.). Tolworth, Surbiton, Surrey: Siebe Gorman & Company Ltd.

External images
www.divingmachines.com (http://www.divingmachines.com/vintagescuba.html) Vintage aqualungs including three-cylinder types

Technical diving
Technical diving (sometimes referred to as Tec diving) is a form of scuba diving that exceeds the scope of recreational diving (although the vast majority of technical divers dive for recreation and nothing else). Technical divers require advanced training, extensive experience, specialized equipment and often breathe breathing gases other than air or standard nitrox.[1] The concept and term, technical diving, are both relatively recent Technical diver during a decompression stop. advents,[2] although divers have been engaging in what is now commonly referred to as technical diving for decades. The term technical diving has been credited to Michael Menduno, who was editor of the (now defunct) diving magazine AquaCorps in 1991.[3]

Definition of technical diving

There is some professional disagreement as to what the term should encompass.[4] [5] [6] Until recently, nitrox diving was considered technical, but this is no longer the case. Some say that technical diving is any type of scuba diving that is considered higher risk than conventional recreational diving. However, some advocate that this should include penetration diving (as opposed to open-water diving), whereas others contend that penetrating overhead environments should be regarded as a separate type of diving. Others seek to define technical diving solely by reference to the use of decompression.[7] Certain minority views contend that certain non-specific higher risk factors should cause diving to be classed as technical diving. Even those who agree on the broad definitions of technical diving may disagree on the precise boundaries between technical and recreational diving. PADI, the largest recreational diver training agency in North America, defines technical diving as "diving other than conventional commercial or recreational diving that takes divers beyond recreational diving limits. It is further defined as an activity that includes one or more of the following: diving beyond 40 meters/130 feet, required stage decompression, diving in an overhead environment beyond 130 linear feet from the surface, accelerated stage decompression and/or the use of multiple gas mixtures in a single dive."[8] NOAA defines technical diving in this way: "Technical diving is a term used to describe all diving methods that exceed the limits imposed on depth and/or immersion time for recreational scuba diving. Technical diving often

Technical diving involves the use of special gas mixtures (other than compressed air) for breathing. The type of gas mixture used is determined either by the maximum depth planned for the dive, or by the length of time that the diver intends to spend underwater. While the recommended maximum depth for conventional scuba diving is 130ft, technical divers may work in the range of 170ft to 350ft, sometimes even deeper. Technical diving almost always requires one or more mandatory decompression "stops" upon ascent, during which the diver may change breathing gas mixes at least once."[9] NOAA does not address issues relating to overhead environments in its definition. The following table tries to describe the differences between technical and recreational diving.

156

Technical Diving
Activity Deep diving Decompression [11] diving Mixed gas diving Gas switching Recreational Maximum depth of 40 metres (130ft) No decompression [10] Technical Beyond 40 metres (130ft) Decompression diving

Air and Nitrox Single gas used

Trimix, Heliox, Heliair and Hydrox May switch between gases to accelerate decompression and/or "travel mixes" to permit descent carrying hypoxic gas mixes Deeper penetration

Wreck diving

Penetration limited to "light zone" or 30 metres (100ft) depth/penetration Penetration limited to "light zone" or 30 metres [12] (100ft) depth/penetration Some agencies regard ice diving as recreational diving; PADI [13]

Cave diving

Deeper penetration

Ice diving Rebreathers Solo diving

others as technical diving. NAUI [15]

[14] [14]

Some agencies regard use of semi-closed rebreathers as recreational diving; PADI Recreational diving requires buddy system

others as technical diving. NAUI [16]

Solo diving

Depth
Technical dives may be defined as being dives deeper than about 130 feet (40m) or dives in an overhead environment with no direct access to the surface or natural light.[17] Such environments may include fresh and saltwater caves and the interiors of shipwrecks. In many cases, technical dives also include planned decompression carried out over a number of stages during a controlled ascent to the surface at the end of the dive. The depth-based definition is derived from the fact that breathing regular air while experiencing pressures causes a progressively increasing amount of impairment due to nitrogen narcosis that

Diver returning from a 600ft dive

Technical diving normally becomes serious at depths of 100 feet (30m) or greater. Increasing pressure at depth also increases the risk of oxygen toxicity based on the partial pressure of oxygen in the breathing mixture. For this reason, technical diving often includes the use of breathing mixtures other than air. These factors increase the level of risk and training required for technical diving far beyond that required for recreational diving. This is a fairly conservative definition of technical diving.

157

Inability to ascend directly

Technical dives may alternatively be defined as dives where the diver cannot safely ascend directly to the surface either due to a mandatory decompression stop or a physical ceiling. This form of diving implies a much larger reliance on redundant equipment and training since the diver must stay underwater until it is safe to ascend or the diver has left the overhead environment. Decompression stops A diver at the end of a long or deep dive may need to do decompression stops to avoid decompression sickness, also known as the "bends". Metabolically inert gases in the diver's breathing gas, such as nitrogen and helium, are absorbed into body tissues when inhaled under high pressure during the deep phase of the dive. These dissolved gases must be released slowly from body tissues by pausing or "doing stops" at various depths during the ascent to the surface. In recent years, most technical divers have greatly increased the depth of the first stops to reduce the risk of bubble formation before the more traditional, long, Free floating decompression stop. shallow stops. Most technical divers breathe enriched oxygen breathing gas mixtures such as nitrox during the beginning and ending portion of the dive. To avoid nitrogen narcosis while at maximum depth, it is common to use trimix which adds helium to replace nitrogen in the diver's breathing mixture. Pure oxygen is then used during shallow decompression stops to reduce the time needed by divers to rid themselves of most of the remaining excess inert gas in their body tissues, reducing the risk of "the bends." Surface intervals (time spent on the surface between dives) are usually required to prevent the residual nitrogen from building up to dangerous levels on subsequent dives. Physical ceiling These types of overhead diving can prevent the diver surfacing directly: Cave diving - diving into a cave system. Deep diving - diving into greater depths. Ice diving - diving under ice. Wreck diving - diving inside a shipwreck.

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158

Extremely limited visibility

Technical dives in waters where the diver's vision is severely impeded by low-light conditions, caused by silt or depth, require greater knowledge and skill to operate in such an environment, and because vision is often reduced by water currents. The combination of low visibility and swift current make these technical dives extremely risky to all but the most skilled and well-equipped divers.

Gas mixes
Technical dives may also be characterised by the use of hypoxic breathing gas mixtures other than air, such as trimix, heliox, and heliair. Breathing normal air (with 21 percent oxygen) at depths greater than 180 feet (55m) creates a high risk of oxygen toxicity. The first sign of oxygen toxicity is usually a convulsion without warning which usually results in death, as the breathing regulator falls out and the victim drowns. Sometimes the diver may get warning symptoms prior to the convulsion. These can include visual and auditory hallucinations, nausea, twitching (especially Technical divers preparing for a mixed-gas decompression dive in Bohol, in the face and hands), irritability and mood Philippines. Note the backplate and wing setup with sidemounted stage tanks swings, and dizziness. Increasing pressure containing EAN50 (left side) and pure oxygen (right side). due to depth also causes nitrogen to become narcotic, resulting in a reduced ability to react or think clearly (see nitrogen narcosis). By adding helium to the breathing mix, divers can reduce these effects, as helium does not have the same narcotic properties at depth. These gas mixes can also lower the level of oxygen in the mix to reduce the danger of oxygen toxicity. Once the oxygen is reduced below 18 percent the mix is known as a hypoxic mix as it does not contain enough oxygen to be used safely at the surface. Nitrox is another common gas mix, and while it is not used for deep diving, it decreases the build up of nitrogen within the diver's body by increasing the percentage of oxygen. This reduces the nitrogen percentage, as well as allowing for a greater number of multiple dives compared to standard air. The depth limit of nitrox is governed by the percentage of oxygen used, as there are multiple oxygen percentages available in nitrox. Further training and knowledge is required in order to use safely and understand the effects of these gases on the body during a dive. Deep air/extended range diving One of the more divisive subjects in technical diving concerns using compressed air as a breathing gas on dives below 130 feet (40m).[18] While mainstream training agencies still promote and teach such courses (TDI,[19] IANTD and DSAT/PADI), a minority (NAUI Tec, GUE, UTD) argue that diving deeper on air is unacceptably risky, saying that helium mixes should be used for dives beyond a certain limit (100130 feet (3040 m), depending upon agency). Such courses used to be referred to as "deep air" courses, but are now commonly called "extended range" courses. Deep air proponents base the proper depth limit of air diving upon the risk of oxygen toxicity. Accordingly, they view the limit as being the depth at which partial pressure of oxygen reaches 1.4 ATA, which occurs at about 186 feet (57m). Helitrox/triox proponents argue that the defining risk should be nitrogen narcosis, and suggest that when

Technical diving the partial pressure of nitrogen reaches approximately 4.0 ATA, which occurs at about 130 feet (40m), helium is necessary to offset the effects of the narcosis. Both sides of the community tend to present self-supporting data. Divers trained and experienced in deep air diving report less problems with narcosis than those trained and experienced in mixed gas diving trimix/heliox, although scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth, or become tolerant of it.[20] The Divers Alert Network does not formally reject deep air diving per se, but indicates the additional risks involved.[21]

159

Equipment
Technical divers may use unusual diving equipment. Typically, technical dives last longer than average recreational scuba dives. Because required decompression stops act as an obstacle preventing a diver in difficulty from surfacing immediately, there is a need for redundant equipment. Technical divers usually carry at least two tanks, each with its own regulator. In the event of a failure, the second tank and regulator act as a back-up system. Technical divers therefore increase their supply of available breathing gas by either connecting multiple high capacity diving cylinders and/or by using a rebreather. The technical diver may also carry additional cylinders, known as stage bottles, to ensure adequate breathing gas supply for decompression, with a reserve for bail-out in case of failure of their primary breathing gas. The stage cylinders are normally carried using an adaptation of a sidemount configuration.

Training

Technical diving requires specialised equipment and training. There are many technical training organisations: see the Technical Diving section in the list of diver training organizations. Technical Diving International (TDI), Global Underwater Explorers (GUE), Profesional Scuba Association International(PSAI), International Association of Nitrox and Technical Divers (IANTD) and National Association of Underwater Instructors (NAUI) were popular as of 2009. Recent entries into the market include Unified Team Diving (UTD), and Diving Science and Technology (DSAT), the technical arm of Professional Association of Diving Instructors (PADI). The Scuba Schools International (SSI) Technical Diving Program (TechXR Technical eXtended Range) was launched in 2005.[22] British Sub-Aqua Club (BSAC) training has always had a technical element to its higher qualifications, however, it has recently begun to introduce more technical level Skill Development Courses into all its training schemes by introducing technical awareness into its lowest level qualification of Ocean Diver, for example, and nitrox training will become mandatory. It has also recently introduced trimix qualifications and continues to develop closed circuit training.

Technical diver with decompression gases in side mounted stage cylinders.

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160

References
[1] Richardson, Drew (2003). "Taking 'tec' to 'rec': the future of technical diving" (http:/ / archive. rubicon-foundation. org/ 8125). South Pacific Underwater Medicine Society Journal 33 (4). . Retrieved 2009-08-07. [2] In his 1989 book, Advanced Wreck Diving, author and leading technical diver, Gary Gentile, commented that there was no accepted term for divers who dived beyond agency-specified recreational limits for non-professional purposes. Revised editions use the term technical diving, and Gary Gentile published a further book in 1999 entitled The Technical Diving Handbook. [3] Bret Gilliam (1995-01-25). Deep Diving (http:/ / books. google. com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=bret+ gilliam+ deep+ diving& q=). p.15. ISBN9780922769315. . Retrieved 2009-09-14.. [4] Gorman, Des F (1992). "High-tech diving". South Pacific Underwater Medicine Society Journal 22 (1). [5] Gorman, Des F (1995). "Safe Limits: A International Dive Symposium. Introduction." (http:/ / archive. rubicon-foundation. org/ 6425). South Pacific Underwater Medicine Society Journal 25 (1). . Retrieved 2009-08-07. [6] Hamilton Jr, RW (1996). "What is technical diving? (letter to editor)" (http:/ / archive. rubicon-foundation. org/ 6266). South Pacific Underwater Medicine Society Journal 26 (1). . Retrieved 2009-08-07. [7] As most technical diving training agencies point out, references to "decompression diving" is a misnomer, as all dives involve an element of decompression as the diver off-gases. However, the term decompression diving is often used to describe diving which involves one or more mandatory decompression stops prior to surfacing. [8] PADI, Enriched Air Diving, page 91. ISBN 978-1-878663-31-3 [9] "Technical Diving" (http:/ / oceanexplorer. noaa. gov/ technology/ diving/ technical/ technical. html). NOAA. February 24, 2006. . Retrieved 2008-09-25. [10] Many recreational diving agencies recommend diving no deeper than 30 metres (100ft), and suggest an absolute limit of 40 metres (130ft). (http:/ / www. padi. com/ english/ common/ courses/ rec/ continue/ deepdiver. asp) [11] There is a reasonable body of professional opinion that considers decompression diving to be the sole differentiator for "technical" diving. SSI (http:/ / www. divessi. com/ techxr) [12] Some certification agencies prefer to the term "cavern diving" to cave penetration within recreational diving limits. [13] http:/ / www. padi. com/ padi/ en/ kd/ icedivercourse. aspx [14] http:/ / www. naui. org/ technical_divers. aspx [15] http:/ / www. padi. com/ padi/ en/ kd/ semiclosedrebreather. aspx [16] Some training agencies regard solo diving within the "recreational" sphere. SDI (http:/ / www. tdisdi. com/ index. php?did=60& site=3) [17] Mitchell, SJ (2007). "Technical Diving." (http:/ / archive. rubicon-foundation. org/ 9061). In: Moon RE, Piantadosi CA, Camporesi EM (eds.). Dr. Peter Bennett Symposium Proceedings. Held May 1, 2004. Durham, N.C.: (Divers Alert Network). . Retrieved 2011-01-15. [18] "Deep Air IS Stupdity" (http:/ / www. bluebeyond. com. au/ modx/ bluebeyond-dive-deep-air-is-stupidity. html). . Retrieved 2009-09-03. [19] "TDI - Extended Range Diver" (http:/ / www. tdisdi. com/ index. php?did=80& site=2). . Retrieved 2009-09-03. [20] Hamilton, K; Lalibert, MF; Heslegrave, R (1992). "Subjective and behavioral effects associated with repeated exposure to narcosis". Aviation, space, and environmental medicine 63 (10): 8659. PMID1417647. [21] John Lippmann, DAN. "How deep is too deep?" (http:/ / www. diversalertnetwork. org/ medical/ articles/ article. asp?articleid=29). . Retrieved 2009-09-03. [22] "SSI TechXR - Technical diving program" (http:/ / www. divessi. com/ txr). Scuba Schools International. . Retrieved 2009-06-22.

Footnotes External links

http://www.TechDivingMag.com http://www.TechnicalDiving.com Select publications on technical diving and technical diving history (http://archive.rubicon-foundation.org/ dspace/simple-search?query=technical+diving&submit=Go) - Hosted by the Rubicon Foundation RebreatherPro (http://www.rebreatherpro.com) Jill Heinerth's interactive multimedia technical diving site Transitioning to technical diving (http://www.liquidtravel.org/transitioning-to-technical-diving.html)

Trimix (breathing gas)

161

Trimix (breathing gas)

Trimix is a breathing gas, consisting of oxygen, helium and nitrogen, and is often used in deep commercial diving and during the deep phase of dives carried out using technical diving techniques.[1] [2] With a mixture of three gases it is possible to create mixes suitable for different depths or purposes by adjusting the proportions of each gas. The mixture of helium and oxygen with a 0% nitrogen content is generally known as Heliox. This is frequently used as a breathing gas in deep commercial diving operations, where it is often recycled to save the expensive helium component. Analysis of two-component gases is much simpler than three component gases.

Mixes
Advantages of helium in the mix
The main reason for adding helium to the breathing mix is to reduce the proportions of nitrogen and oxygen below those of air, to allow the gas mix to be breathed safely on deep dives.[1] A lower proportion of nitrogen is required to reduce nitrogen narcosis and other physiological effects of the gas at depth. Helium has very little narcotic effect.[3] A lower proportion of oxygen reduces the risk of oxygen toxicity on deep dives. The lower density of helium reduces breathing resistance at depth.[1] [3] Because of its low molecular weight, helium enters and leaves tissues more rapidly than nitrogen as the pressure is increased or reduced (this is called on-gassing and off-gassing). Because of its lower solubility, helium does not load tissues as heavily as nitrogen, but at the same time the tissues can not support as high an amount of helium when super-saturated. In effect, helium is a faster gas to saturate and desaturate, which is a distinct advantage in saturation diving, but less so in bounce diving, where the increased rate of off-gassing is largely counterbalanced by the equivalently increased rate of on-gassing.

Disadvantages of helium in the mix

Helium conducts heat six times faster than air; often helium breathing divers carry a separate supply of a different gas to inflate drysuits. This is to avoid the risk of hypothermia caused by using helium as inflator gas. Argon, carried in a small, separate tank, connected only to the inflator of the drysuit is preferred to air, since air conducts heat 50% faster than argon.[4] Dry suits (if used together with a buoyancy compensator) still require a minimum of inflation to avoid "squeezing", i.e. damage to skin caused by pressurizing dry suit folds. Some divers suffer from hyperbaric arthralgia during descent.[5] Helium dissolves into tissues more rapidly than nitrogen as the ambient pressure is increased (this is called on-gassing). A consequence of the higher loading in some tissues is that many decompression algorithms require deeper decompression stops than a similar decompression dive using air, and helium is more likely to come out of solution and cause decompression sickness following a fast ascent.

Trimix (breathing gas)

162

Advantages of reducing oxygen in the mix

Lowering the oxygen content increases the maximum operating depth and duration of the dive before which oxygen toxicity becomes a limiting factor. Most trimix divers limit their working oxygen partial pressure [PO2] to 1.4 and may reduce the PO2 further to 1.3 or 1.2 depending on the depth, the duration and the kind of breathing system used [open circuit vs closed circuit rebreather][1] [2] [6] [7]

Advantages of keeping some nitrogen in the mix

Retaining nitrogen in trimix can contribute to the prevention of High Pressure Nervous Syndrome, a problem that can occur when breathing heliox at depths beyond about 130 metres (430ft).[1] [8] [9] [10] Nitrogen is also much less expensive than helium.

Naming
Conventionally, the mix is named by its oxygen percentage, helium percentage and optionally the balance percentage, nitrogen. For example, a mix named "trimix 10/70" or trimix 10/70/20, consisting of 10% oxygen, 70% helium, 20% nitrogen is suitable for a 100-metre (330ft) dive. The ratio of gases in a particular mix is chosen to give a safe maximum operating depth and comfortable equivalent narcotic depth for the planned dive. Safe limits for mix of gases in trimix are generally accepted to be a maximum partial pressure of oxygen (ppO2see Dalton's law) of 1.0 to 1.6 bar and maximum equivalent narcotic depth of 30 to 50 m (100 to 160 ft). At 100m (330ft), "12/52" has a PPO2 of 1.3 bar and an equivalent narcotic depth of 43m (141ft). In open-circuit scuba, two classes of trimix are commonly used: normoxic trimixwith a minimum PO2 at the surface of 0.18 and hypoxic trimixwith a PO2 less than 0.18 at the surface.[11] A normoxic mix such as "19/30" is used in the 30 to 60 m (100 to 200 ft) depth range; a hypoxic mix such as "10/50" is used for deeper diving, as a bottom gas only, and cannot safely be breathed at shallow depths where the ppO2 is less than 0.18 bar. In fully closed circuit rebreathers that use trimix diluents, the mix can be hyperoxic in shallow water because the rebreather automatically adds oxygen to maintain a specific ppO2.[12] Less commonly, hyperoxic trimix is sometimes used on open circuit scuba. Hyperoxic trimix is sometimes referred to as Helitrox or TriOx. See breathing gas for more information on the composition and choice of gas blends.

Blending
Gas blending of trimix involves decanting oxygen and helium into the diving cylinder and then topping up the mix with air from a diving air compressor. To ensure an accurate mix, after each helium and oxygen transfer, the mix is allowed to cool, its pressure is measured and further gas is decanted until the correct pressure is achieved. This process often takes hours and is sometimes spread over days at busy blending stations.[13] A second method called 'continuous blending' is now gaining favor.[13] Oxygen, helium and air are blended on the intake side of a compressor. The oxygen and helium are fed into the air stream using flow meters, so as to achieve the rough mix. The low pressure mixture is analyzed for oxygen content and the oxygen and helium flows adjusted accordingly. On the high pressure side of the compressor a regulator is used to reduce pressure of a sample flow and the trimix is analyzed (preferably for both helium and oxygen) so that the fine adjustment to the intake gas flows can be made. The benefit of such a system is that the helium delivery tank pressure need not be as high as that used in the partial pressure method of blending and residual gas can be 'topped up' to best mix after the dive. This is important mainly because of the high cost of helium.

Trimix (breathing gas) Drawbacks may be that the high heat of compression of helium results in the compressor over-heating (especially in tropical climates) and that the hot trimix entering the analyzer on the high pressure side can affect the reliability of the analysis. DIY versions of the continuous blend units can be made for as little as $200 (excluding analyzers).[13]
[14]

163

"Standard" mixes
Although theoretically trimix can be blended with almost any combination of helium and oxygen, a number of "standard" mixes have evolved (such as 21/35, 18/45 and 15/55). Most of these mixes originated from filling the cylinders with a certain percentage of helium, and then topping the mix with 32% enriched air nitrox. The "standard" mixes evolved because of three coinciding factors - the desire to keep that equivalent narcotic depth (END) of the mix at approximately 34 metres (112ft), the requirement to keep the partial pressure of oxygen at 1.4 ATA or below at the deepest point of the dive, and the fact that many dive shops stored standard 32% enriched air nitrox in banks, which simplified mixing.[15] The use of standard mixes makes it relatively easy to top up diving cylinders after a dive using residual mix - only helium and banked nitrox needs to be used to top up the residual gas from the last fill. The method of mixing a known nitrox mix with helium allows analysis of the fractions of each gas using only an oxygen analyser, since the ratio of the oxygen fraction in the final mix to the oxygen fraction in the initial nitrox gives the fraction of nitrox in the final mix, hence the fractions of the three components are easily calculated. It is demonstrably true that the END of a nitrox-helium mixture at its maximum operating depth (MOD) is equal to the MOD of the nitrox alone.

Hyperoxic trimix
The National Association of Underwater Instructors (NAUI) uses the term "helitrox" for hyperoxic 26/17 Trimix, i.e. 26% oxygen, 17% helium, 57% nitrogen. Helitrox requires decompression stops similar to Nitrox-I (EAN28) and has a maximum operating depth of 44 metres (144ft), where it has an equivalent narcotic depth of 35 metres (115ft). This allows diving throughout the usual recreational range, while decreasing decompression obligation and narcotic effects compared to air.[16] GUE and UTD also promote hyperoxic trimix, but prefer the term "TriOx". Other divers question whether this proliferation of terminology is useful, and feel that the term Trimix is sufficient, modified as appropriate with the terms hypoxic, normoxic and hyperoxic, and the usual forms for indicating constituent gas fraction.

History as a diving gas

1919 Professor Elihu Thompson speculates that helium could be used instead of nitrogen to reduce the breathing resistance at great depth.[17] The effects from narcosis was not proven until the salvage of the USS Squalus in 1939.[17] Heliox was used with air tables resulting in a high incidence of decompression sickness so the use of helium was discontinued.[18] 1925 The US Navy begins examining helium's potential usage and by the mid 1920's lab animals were exposed to experimental chamber dives using heliox. Soon, human subjects breathing heliox 20/80 (20% oxygen, 80% helium) had been successfully decompressed from deep dives. 1937 Several test dives are conducted with helium mixtures, including salvage diver Max "Gene" Nohl's dive to 127 meters.[19] [20]

Trimix (breathing gas) 1939 US Navy used heliox in USS Squalus salvage operation.[17] 1965 First saturation dives using heliox. 1970 Hal Watts performs dual body recovery at Mystery Sink (126 m). Cave divers Sheck Exley and Jochen Hasenmayer use heliox to a depth of 212 meters. 1979 A research team headed by Peter B. Bennett at the Duke University Medical Center Hyperbaric Laboratory began the "Atlantis Dive Series" which proved the mechanisms behind the use of trimix to prevent High Pressure Nervous Syndrome symptoms.[20] 1987 First mass use of trimix and heliox: Wakulla Springs Project. Exley teaches non-commercial divers in relation to trimix usage in cave diving. 1991 Billy Deans commences teaching of trimix diving for recreational diving. Tom Mount develops first trimix training standards (IANTD). Use of trimix spreads rapidly to North East American wreck diving community. 1994 Combined UK/USA team, including leading wreck divers John Chatterton and Gary Gentile, successfully complete a series of wreck dives on the RMS Lusitania expedition to a depth of 100 meters using trimix. 1995 The National Oceanographic and Atmospheric Administration (NOAA) and Key West Divers team up to conduct the first NOAA-sponsored trimix dives on the wreck of USS Monitor off Cape Hatteras, NC. NOAA's mix, initially called "Monitor Mix" became NOAA Trimix I, with decompression tables published in the NOAA Diving Manual. 2001 The Guinness Book of records recognises John Bennett as the first scuba diver to dive to 1000ft, using Trimix. 2005 David Shaw sets depth record for using a trimix rebreather, dying while repeating the dive.[21] [22] Source: "Trimix and heliox diving" [23]. February 14, 2002. Retrieved 2008-10-07.

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References
[1] Brubakk, A. O.; T. S. Neuman (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed.. United States: Saunders Ltd.. pp.800. ISBN0702025712. [2] Gernhardt, ML (2006). "Biomedical and Operational Considerations for Surface-Supplied Mixed-Gas Diving to 300 FSW." (http:/ / archive. rubicon-foundation. org/ 4655). In: Lang, MA and Smith, NE (eds). Proceedings of Advanced Scientific Diving Workshop (Washington, DC). . Retrieved 2008-08-28. [3] "Diving Physics and "Fizzyology"" (http:/ / www. bishopmuseum. org/ research/ treks/ palautz97/ phys. html). Bishop Museum. 1997. . Retrieved 2008-08-28. [4] "Thermal conductivity of some common materials" (http:/ / www. engineeringtoolbox. com/ thermal-conductivity-d_429. html). The Engineering ToolBox. 2005. . Retrieved March 9, 2010. "Argon:0.016; Air:0.024; Helium:0.142 W/mK" [5] Vann RD and Vorosmarti J (2002). "Military Diving Operations and Support" (http:/ / www. bordeninstitute. army. mil/ published_volumes/ harshEnv2/ HE2ch31. pdf). Medical Aspects of Harsh Environments, Volume 2 (Borden Institute): p980. . Retrieved 2008-08-28.

Trimix (breathing gas)

[6] Acott, C. (1999). "Oxygen toxicity: A brief history of oxygen in diving" (http:/ / archive. rubicon-foundation. org/ 6014). South Pacific Underwater Medicine Society Journal 29 (3). ISSN0813-1988. OCLC16986801. . Retrieved 2008-08-28. [7] Gerth, WA (2006). "Decompression Sickness and Oxygen Toxicity in US Navy Surface-Supplied He-O2 Diving." (http:/ / archive. rubicon-foundation. org/ 4654). In: Lang, MA and Smith, NE (eds). Proceedings of Advanced Scientific Diving Workshop (Washington, DC). . Retrieved 2008-08-28. [8] Hunger Jr, W. L.; P. B. Bennett. (1974). "The causes, mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. rubicon-foundation. org/ 2661). Undersea Biomed. Res. 1 (1): 128. ISSN0093-5387. OCLC2068005. PMID4619860. . Retrieved 2008-08-28. [9] Bennett, P. B.; R. Coggin; M. McLeod. (1982). "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. rubicon-foundation. org/ 2920). Undersea Biomed. Res. 9 (4): 33551. ISSN0093-5387. OCLC2068005. PMID7168098. . Retrieved 2008-04-07. [10] Campbell, E. "High Pressure Nervous Syndrome" (http:/ / www. scuba-doc. com/ HPNS. html). Diving Medicine Online. . Retrieved 2008-08-28. [11] Tech Diver. "Exotic Gases" (http:/ / www. techdiver. ws/ exotic_gases. shtml). . Retrieved 2008-08-28. [12] Richardson, D; Menduno, M; Shreeves, K. (eds). (1996). "Proceedings of Rebreather Forum 2.0." (http:/ / archive. rubicon-foundation. org/ 7555). Diving Science and Technology Workshop.: 286. . Retrieved 2008-08-28. [13] Harlow, V (2002). Oxygen Hacker's Companion. Airspeed Press. ISBN0967887321. [14] "Continuous trimix blending with 2 nitrox sticks (English)" (http:/ / shadowdweller. skynetblogs. be/ post/ 3924720/ continuous-trimix-blending-with-2-nitrox-stic). The shadowdweller. 2006. . Retrieved 2008-08-28. [15] TDI Advanced Gas Blender manual [16] "NAUI Technical Courses: Helitrox Diver" (http:/ / www. naui. org/ technical_divers. aspx#070). NAUI Worldwide. . Retrieved 2009-06-11. [17] Acott, Chistopher (1999). "A brief history of diving and decompression illness." (http:/ / archive. rubicon-foundation. org/ 6004). South Pacific Underwater Medicine Society Journal 29 (2). ISSN0813-1988. OCLC16986801. . Retrieved 2009-03-17. [18] Behnke, Albert R. (1969). "Some early studies of decompression.". In: the Physiology and Medicine of Diving and Compressed air work. Bennett PB and Elliott DH. Eds. (Balliere Tindall Cassell): 226251. [19] staff (1937-12-13). "Science: Deepest Dive" (http:/ / www. time. com/ time/ magazine/ article/ 0,9171,758630-1,00. html). Time Magazine. . Retrieved 2011-03-16. [20] Camporesi, Enrico M (2007). "The Atlantis Series and Other Deep Dives." (http:/ / archive. rubicon-foundation. org/ 9057). In: Moon RE, Piantadosi CA, Camporesi EM (eds.). Dr. Peter Bennett Symposium Proceedings. Held May 1, 2004. Durham, N.C.: (Divers Alert Network). . Retrieved 2011-03-16. [21] Mitchell SJ, Cronj FJ, Meintjes WA, Britz HC (February 2007). "Fatal respiratory failure during a "technical" rebreather dive at extreme pressure" (http:/ / www. ingentaconnect. com/ content/ asma/ asem/ 2007/ 00000078/ 00000002/ art00001). Aviat Space Environ Med 78 (2): 816. PMID17310877. . Retrieved 2009-07-29. [22] David Shaw. "The Last Dive of David Shaw" (http:/ / www. youtube. com/ watch?v=mF4iFJ-G74o). . Retrieved 2009-11-29. [23] http:/ / www. techdiver. ws/ trimix_eng. shtml

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Wreck diving

166

Wreck diving
Wreck diving is a type of recreational diving where shipwrecks are explored. Although most wreck dive sites are at shipwrecks, there is an increasing trend to scuttle retired ships to create artificial reef sites. Wreck diving can also pertain to diving to crashed aircraft.[1]

Reasons for diving wrecks

A shipwreck is attractive to divers for several reasons[2] : it is an artificial reef, which creates a habitat for many types of marine life it often is a large structure with many interesting parts and machinery, which is not normally closely observable on working, floating vessels it often has an exciting or tragic history it presents new skill challenges for scuba divers it is part of the underwater cultural heritage and may be an important archaeological resource and aviation archaeology it provides a first-hand insight into context for the loss, such as causal connections, geographical associations, trade patterns and many other areas, providing a microcosm of our maritime heritage and maritime history.

Diver at the wreck of the Hilma Hooker, Netherlands Antilles.

Types of wreck diving

In his seminal work on the subject, The Advanced Wreck Diving Handbook,[3] Gary Gentile sub-divides wreck diving into three categories: Non-penetration diving (i.e. swimming over the wreck) Limited penetration diving, within the "light zone" Full penetration diving, beyond the "light zone" Each succeeding level involves greater risk, and therefore will normally require greater levels of training, experience and equipment. Non-penetration wreck diving is the least hazardous form of wreck diving, although divers still need to be aware of the entanglement risks presented by fishing nets and fishing lines which may be snagged to the wreck (wrecks are often popular fishing sites), and the underlying terrain may present greater risk of sharp edges. Penetration within the light zone presents greater hazards due to overhead and greater proximity of the wreck's structure, but because of the proximity of a visible exit point, and some amount of external light, those hazards are more manageable. However, there is clearly a much greater risk of entanglement and siltout inside of the structure, as well as the requirement to move laterally to a defined exit point before one can surface in the event of an emergency.

Wreck diving Full penetration involves the greatest level of risks, including the risk of getting lost within the structure, the risk of complete darkness in the event of multiple light failures, and the inability to escape unassisted in the event of a disruption to air supply. These categorisations broadly coincides with the traditional division between "recreational" wreck diving (taught as a speciality course by recreational diver training agency which is normally expressed to be limited to the "light zone" and/or 100 cumulative feet of depth plus penetration) and "technical" wreck diving (taught as a stand alone course by technical diver training agencies).

167

Wreck diver training and safety

Wrecks may pose a variety of unique hazards to divers. Wrecks are often snagged by fishing lines or nets and the structure may be fragile and break without notice. Penetration diving, where the diver enters a shipwreck is an advanced skill requiring special training and equipment.[4] Many attractive or well preserved wrecks are in deeper water requiring deep diving precautions. It is essential that at least one cutting device be carried in the event that the diver is entangled with fishing lines or ropes and to have a spare light source in case the primary light fails. If penetrating a wreck, a guideline tied off before entering a wreck and run out inside the wreck is advisable. A guideline helps a wreck diver in finding the way out easier in case of low visibility due to stirred up sediments. For penetration diving, a greater reserve of breathing gas should be allowed for, to ensure there is sufficient to get out of the wreck. Most wreck divers use a minimum of the rule-of-thirds for gas management. This allows for 1/3 of the gas down and into the wreck, 1/3 for exit and ascent and 1/3 reserve. In addition, because of the potential fragility of the wreck, the likelihood of disturbing sediments or disturbing the many marine animals that take advantage of the artificial habitat offered by the wreck, extra care is required when moving and finning. Many divers are taught to use alternative finning methods such as frog kick when inside a wreck. Perfect buoyancy control is a must for diving in the environment of a wreck. Many diver training organizations provide specialist wreck diver training courses, such as SDI, and PADI Wreck Diver, which divers are advised to take before wreck diving. Such courses [4] typically teach skills such as air management and the proper use of guidelines and reels. Most recreational diving organizations teach divers only to penetrate to limit of the "light zone" or a maximum aggregate surface distance (depth + penetration) of 100 feet (whichever is the lesser). Other technical diving organizations, such as IANTD, TDI, and ANDI teach advanced wreck courses, that emphasize a higher level of Diver with porthole recovered from a shipwreck [5] training, experience and equipment and prepare divers for deeper levels in New York's Wreck Alley: Shipwreck Expo of wreck penetration. The Nautical Archaeology Society in the UK, teaches awareness of underwater cultural heritage issues as well as practical diver and archaeological skills. Other organizations, such as the Artificial Reef Society of British Columbia (ARSBC) deliberately create artificial reefs to provide features for divers to explore, as well as substrates for marine life to thrive upon.

Penetration diving
In technical penetration diving, there are broadly two approaches. The conventional approach involves the use of continuous guidelines laid from a wreck reel, tied just outside of the entrance point, just inside the entrance point, and at regular intervals inside (to mitigate the risk of a cut line, or a "line trap"[6] ). In deeper penetrations, two reels are used, so that in the event of a total loss of visibility where the diver loses contact with the primary line or the primary line gets cut, the secondary line can be anchored and then used as a reference point to sweep for the primary line.

Wreck diving An alternative approach, popularised by deep wreck divers in the American Northeast, is referred to as "progressive penetration". Progressive penetration eschews the use of reels, but the diver makes several successive penetrations, each successively deeper than the last, memorising the layout for both the inward and outward journeys. As a diving technique, progressive penetration is not taught by any of the mainstream diver training agencies.[7] Divers engaging in penetration diving are conventionally taught to carry three lights - a primary light and two backup lights - thereby virtually eliminating the risk of completely losing light inside the wreck. Nonetheless, total loss of visibility due to a silt-out remains a risk.

168

Deep diving and wreck diving

Wrecks in shallower waters tend to deteriorate faster than wrecks in deeper water due to higher biological activity. Accordingly, many of the older and larger shipwrecks that tend to offer full penetration dives tend to be deeper dives. This can present additional complications; if a wreck dive is intended to be a decompression dive, then the diver will normally carry decompression gases in sidemount cylinders. However, it is difficult to penetrate many wrecks with sidemount cylinders, requiring divers to either use a different configuration, or leave their decompression gases outside the wreck prior Diver returning from a 600ft wreck dive to penetration. This creates the possibility of a diver being unable to relocate their decompression gases if they exit the wreck at a different point from which they enter it.[8]

Protection of wrecks
In many countries, wrecks are legally protected from unauthorized salvage or desecration. In the United Kingdom, three Acts protect wrecks: Protection of Wrecks Act 1973 : certain designated, charted, historic or dangerous sites may not be dived without a license Protection of Military Remains Act 1986 : all military aircraft and 16 designated ships are considered war graves that can only be dived with a license. Other non-designated ships may be dived providing the divers do not enter, disturb or remove artifacts Merchant Shipping Act 1995 : all wrecks and cargoes are owned: each artifact removed must be reported to the Receiver of Wreck Wrecks that are protected are denoted as such on nautical charts (such as admiralty charts); any diving restrictions should be adhered to. In Greece, during the year 2003 the Greek Government (ministry of culture), issued a Ministerial Order classifying "any wreck of ship or aeroplane, sunk for longer than 50 years from the present" as Cultural Assets / Monuments, setting also a protection zone of 300 meters around them. Terms and conditions for visiting any monument in Greece are set by the Ministry of Culture in Greece.

Wreck diving

169

Wreck diving sites

There are thousands of popular wreck diving sites throughout the world. Some of these are artificial wrecks or sunk deliberately to attract divers (such as the USSSpiegel Grove and the USSOriskany in Florida, the Bianca C in Grenada, and the wrecks of Recife in Pernambuco/Brazil which include artificial and disaster wrecks). Others are wrecks of vessels lost in disasters (such as the RMSRhone in the British Virgin Islands, the Zenobia in Cyprus and the many shipwrecks off the Isles of Scilly in England). In the Marlborough Sounds, New Zealand, the wreck of the MS Mikhail Lermontov is a popular dive site of the 177m cruise liner which was lost in 1986. Lying at 37 meters underwater, this wreck is an excellent base for recreational and technical divers.[9] [10] A number of the most enigmatic wreck diving sites relate to ships lost to wartime hostilities, such as the SSThistlegorm in the Red Sea, the SSPresident Coolidge in Vanuatu and the "ghost fleet" of Truk Lagoon. In the Encyclopedia of Recreational Diving, four "Meccas" of wreck diving are identified: (1) Truk Lagoon in Micronesia, (2) Scapa Flow in Orkney Islands, Scotland, (3) the Outer Banks of North Carolina (known as the "Graveyard of the Atlantic"), and (4) the Great Lakes.[11] For technical divers there are fewer wrecks that have attracted widespread popularity, although for years the SS Andrea Doria was regarded as the "Mount Everest" of wrecks to challenge the diver. However, since the popularisation of using trimix as a breathing gas, technical divers now routinely dive much deeper and more challenging wrecks, and the Andrea Doria is argued by some to now be a good training wreck for trimix divers.[12] Trimix can also be used to visit wrecks in Marlborough Sounds, New Zealand (MS Mikhail Lermontov), as well as in Brazil at Recife,[13] and Fernando de Noronha (Corveta Ipiranga, where technical discovery diving is available).[14]

References
[1] [2] [3] [4] [5] [6] Canadian Harvard Aircraft Association Dive Recovery Team (http:/ / chaa-recovery. ca/ content/ view/ 49/ 50/ ) - Wreck Diving Explained (http:/ / www. scubadivingforlife. com/ wreck-diving-adventure-explained) ISBN 978-1-883056-29-2, at page 75 - PADI Wreck Diver training and qualifications (http:/ / www. oceanconcepts. com/ diver_training/ recreational/ specialties/ wreck_diver) http:/ / www. shipwreckexpo. com/ shipwreckdiving. htm A line trap refers to the situation where a line is laid between two points, but when taut, the line stretches through a narrower opening which the diver cannot swim through. With visibility this is not a problem as the diver can retrace his original route; but with a complete loss of visibility the diver would be unable to follow the line by touch alone back to the exit point. [7] The largest technical diver training organisation, TDI, traditional takes an open-minded and inclusive approach to different techniques. Notwithstanding this general principal, the TDI Advanced Wreck Diving manual describes progressive penetration as a "fairy tale method" (at page 26). [8] In 1992 two divers, Chris and Chrissy Rouse, died of decompression sickness after becoming trapped in the wreck whilst diving German submarine U-869 off the New Jersey coast, and then being unable to relocate their decompression gases after they escaped. The incident became famous after being chronicled in various books, including the New York Times best-selling book, Shadow Divers. [9] http:/ / godive. co. nz/ mikhail_lermontov. html#lermontov [10] http:/ / www. nzmaritime. co. nz/ lermontov. htm [11] In his book, Wreck Diving Adventures, author Gary Gentile says: "I cannot state too often, the Great Lakes have the finest wreck diving the world." [12] An excellent discussion of this is to be found in Kevin McMurray's book, Dark Descent, ISBN 0-7434-0063-1. He discusses how some older divers react poorly to use of the Andrea Doria as a training wreck, perceiving it as diminishing their achievements. [13] www.Aquaticos.com.br (http:/ / www. aquaticos. com. br) [14] www.AtlantisDivers.com.br/transicao.html (http:/ / www. atlantisdivers. com. br/ transicao. html)

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External links
WRECKSITE (http://www.wrecksite.eu) Worldwide free database of + 65.000 wrecks with history, maritime charts and GPS positions (English) (German) (French) (Dutch) Sea Research Society (http://www.shipwrecks.com)

Article Sources and Contributors

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Article Sources and Contributors

Breathing gas Source: http://en.wikipedia.org/w/index.php?oldid=446017928 Contributors: Adrian.benko, Ajchapman, Antarctic-adventurer, Anthony Appleyard, BAICAN XXX, Balthazarduju, Basilicofresco, Benemin, Bogdangiusca, BrendanRyan, Canis Lupus, Captain-n00dle, Casrenooij, CommonsDelinker, Correctaboot, Cybercobra, DaGizza, DabMachine, Dave3141592, Downward machine, Empyema, EncMstr, FJPB, Fibrosis, Foobar, GProcter, Gene Hobbs, Gene Nygaard, Gobonobo, Headbomb, Jaganath, Jaredroberts, Jpxt2000, Jumbo Snails, Jumping cheese, Jwinius, Keenan Pepper, Leptictidium, Leuko, Mark.murphy, Michael Hardy, Mild Bill Hiccup, Mion, NickelShoe, Nickthechemist, Nono64, Phrasecloud, RexxS, Rjwilmsi, SamH, Sbharris, Sceptre, Scubafish, Sir Vicious, Snowolf, Soap, Stewartadcock, TBloemink, TenOfAllTrades, Thumperward, 96 anonymous edits Cave diving Source: http://en.wikipedia.org/w/index.php?oldid=446430837 Contributors: Abyssadventurer, Ainlina, Aldux, Alfie66, Anish531, Anthony Appleyard, Aoi, Archagon, Arjes, BLueFiSH.as, Barkeep, Blankshot218, Bluez57, Cadwaladr, CanisRufus, Cavediver, Cavemex, Cheesy mike, Cherry blossom tree, ChronoSphere, Chroot, Chzz, DSRH, Dave Taylor, Dave3141592, David Newton, DiverDave, DocWatson42, Dracavia, Ehn, EjayHire, Elkman, Evil saltine, Frecklefoot, Gaius Cornelius, Gene Hobbs, Georgekwatson, Ggpab, Hu12, Ida Shaw, Ingolfson, JHunterJ, Jevansen, John Arthur Sheppard, Jumbo Snails, Karstdiver, Ktsparkman, Lightmouse, Macellarius, Madslasher, Maproom, Mark.murphy, Master&Expert, Matt Gies, Mattmexico63, Mergus, Michael Hardy, Michal Nebyla, Mikenorton, MrRadioGuy, Mrh30, Mrslippery, Mtiller, Mttcmbs, Neilc, Owain.davies, Oxbuzos, Pdoege, Plongee souterraine france, Quadell, R'n'B, RJFJR, Radagast83, Ravn, Redseagoby, RexNL, RexxS, Rich Farmbrough, Richard Emerson Bristol, Ricjl, Ridernyc, Rjwilmsi, Rlaird, Rls, Robertg9, Rodw, S0uj1r0, SPART82, Sade, Sam Hocevar, Scuberdiver100, Seba5618, Simon Burchell, Skysmith, Sonicspike, SpaceFlight89, Srrostum, SunCreator, Suwanneeonline, Tango, Tbodders, That Guy, From That Show!, TheRingess, Thumperward, Tim P, Unixxx, Valerius Tygart, Vitor 1234, Vk steve, Vsmith, WTucker, Wilson44691, Wolf530, Wpickel, X96lee15, Yogy, 173 anonymous edits Coral reef Source: http://en.wikipedia.org/w/index.php?oldid=446472641 Contributors: (jarbarf), -Midorihana-, .K, 10987654321, 2D, 2ocean7, 5 albert square, 7, 88dude, 8cee0608, A Softer Answer, A8UDI, ABF, Aaron Brenneman, Aaron23jordan, Abyssadventurer, Ace ETP, Acroterion, Addshore, Againme, Ahoerstemeier, Aitias, Aksi great, Akuku, Alan Liefting, Alansohn, Ale jrb, Aleenf1, AlexanderLee1, AlexiusHoratius, Alfie66, Alfirin, Allstarecho, Alphachimp, Althaea, AmiDaniel, Andre Engels, Andrewjbrooks, Andy M. Wang, Andypandy.UK, Angr, Angrysockhop, Anilocra, Animum, Anlace, Anna Lincoln, Anthony Appleyard, Archelon, Arjuna909, Arpingstone, Asianpig, Assasin Joe, Atjesse, Atomicritual, Autun, Avb, Awesomeperson22, Aymatth2, AzaToth, BarraCuda, Bart133, Barticus88, Baseball Watcher, Bear475, Ben Ben, Benastan, Benhagerty, Benscripps, Benwildeboer, Bevo74, Beyondthislife, BigDunc, Bill37212, Billfincle, Blanchardb, Blood sliver, Blurion, Bob Burkhardt, Bobo192, Boccobrock, Boing! said Zebedee, Bonadea, Bongwarrior, Brian Crawford, Bsadowski1, Bsherr, Bulbear 287, Bunnyhop11, Burkinaboy, Burlywood, Bwbullough, Bwmodular, C&R, CHJL, CSWarren, CWY2190, Caltas, Calvin 1998, Can't sleep, clown will eat me, CapitalR, Capricorn42, Captain panda, CardinalDan, Carpet9, Cavrdg, Cbrown1023, Celarnor, Cena123l, Cfinn06, Chairlunchdinner, CharlotteWebb, Charward, Charybterix, Chasferguson, Ched Davis, Chinchilla78, Cholmes75, Chooserr, Chris G, Chris huh, Chris the speller, Chrislk02, Chroniclev, ChulaOne, Chun-hian, Chuunen Baka, Ckatz, ClaudioFaria, Closedmouth, Cntras, CommonsDelinker, Cool3, Coolfrood, Couloir007, Courcelles, Ctbolt, D. Recorder, DARTH SIDIOUS 2, DJ Clayworth, DSRH, DVD R W, Da monster under your bed, Dan D. Ric, DanMS, Danger, Daniel 1992, Daniel Collins, Daniel5127, DanielCD, Daniil naumoff, Danski14, Dark jedi requiem, Darth Panda, Darth.bob112, Davnor, DeadEyeArrow, Delirium, Deor, DerHexer, Dimionix, Discospinster, Dman98, Dogsgomoo, Dominic iz thebomb, DoubleBlue, Dragons flight, Dreadnaught, Dreadstar, Dysepsion, EJF, ESkog, Edgar181, Edokter, Edward321, Eeekster, El C, Elekhh, Elephantology7, Elfguy, Elipongo, Elizabeth125, Elizawhite78, Elkman, Elnerdo, Elockid, Eloquence, Emre D., Enigmama, Eojsille, Epastore, Epbr123, Epipelagic, Equazcion, Erianna, Erik9, ErrantX, Esm-chix, Esocid, Esoxid, Espresso Addict, Euchiasmus, Eureka84, EurekaLott, Excirial, Extra999, Extransit, FJPB, Farosdaughter, Femto, Fetchcomms, Fieldday-sunday, FinalRapture, Florentino floro, Fraggle81, Francs2000, Franklinacademy, Fratrep, Funandtrvl, Furste, GB fan, Gadget850, Gaia Octavia Agrippa, Gail, Gaius Cornelius, Gekedo, Gene Hobbs, GeneralIroh, Giftlite, Gigemag76, Gilderien, Gilliam, Glagolev, Glenn, Glennmate, Gogo Dodo, Gojerems, GoldHannah, GrahamBould, Greenday6212, GregU, Grenavitar, Griffinofwales, Gripper101, Guettarda, Gurch, Gz33, Halftank, Hamishcaughtaneel, Haplochromis, Harland1, Hdynes, Hendee, Henry W. 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Jones, Rjwilmsi, Rogerd, Ron S, Rosarinagazo, Roseanne74, RupertMillard, Sanguinity, Sbharris, ScottJ, Scubadoc, Seejyb, Sfmammamia, SilentGuy, SiobhanHansa, Sirius683, Snigbrook, SomeStranger, Spellmaster, Stefan, Supaluminal, Swpb, Taoster, Tarquin, Tempodivalse, The Anome, The Thing That Should Not Be, Thiseye, Tide rolls, Tnxman307, Tom Yates, Trevor MacInnis, Trumpet marietta 45750, Trelio, Vargob, Vasi, Voyaging, W guice, Walton One, Wellspring, WesleyDodds, WikiLaurent, WillyJS, Wizardman, Wokwiki424, Woohookitty, X!, Xzqx, Zachlipton, 381 ,55 anonymous edits Decompression stop Source: http://en.wikipedia.org/w/index.php?oldid=446825234 Contributors: Anthony Appleyard, Carl.bunderson, Departurediver, Elkman, Gene Hobbs, Geoventurer, Gr0ff, Graham87, Headbomb, Jan Henry S. Fosse, Jhfrontz, Jumbo Snails, KVDP, Legis, Leuko, Mark.murphy, Michagal, Mingfx, Nishkid64, One Night In Hackney, Owain.davies, Pjf, RexxS, Rjwilmsi, Serguei S. Dukachev, Toutoune25, Wmahan, Yurik, 23 anonymous edits Deep diving Source: http://en.wikipedia.org/w/index.php?oldid=438713788 Contributors: 2, 84user, Alfie66, Animesouth, Anthony Appleyard, Aqualungs, Auraavail, Bryan Derksen, D0762, Davewild, David Newton, Dekisugi, DelanaSmall, Derek.cashman, DiverDave, Docu, Ebayburt, Ellipsis, Gene Hobbs, Hamiltondaniel, Huw Powell, Ianjm, JohnI, Kanazawakid, Legis, Lightmouse, Mark.murphy, Monk3ysonfire, MrWhipple, Nonoisense, OceanVortex, Oleg Eterevsky, Onco p53, Owain.davies, Pjf, Plutonium27, Poppy, ReelExterminator, RexxS, Rholton, RichSed, Selachi, Sirscuba, SpiderJon, Thomei08, Toon05, Vasi, Watch Rider, Wavelength, Xosema, Zaratus, 64 anonymous edits

Article Sources and Contributors

Equivalent air depth Source: http://en.wikipedia.org/w/index.php?oldid=374000974 Contributors: Anthony Appleyard, Chessphoon, Gene Hobbs, GregorB, KRBROWN92, Kaal, Mark.murphy, Michael Hardy, Paul A, RexxS, Steinsky, YK Times, 4 anonymous edits Equivalent narcotic depth Source: http://en.wikipedia.org/w/index.php?oldid=375646843 Contributors: CBM, Paul A, RexxS, 6 anonymous edits High-pressure nervous syndrome Source: http://en.wikipedia.org/w/index.php?oldid=444229703 Contributors: Aarchiba, Angry bee, Anthony Appleyard, Cvf-ps, Dbutler1986, Dhartung, Elendil's Heir, Fang Aili, Feezo, Gene Hobbs, Gene Nygaard, Hamiltondaniel, Mark.murphy, RexxS, Rob.bastholm, Scubasixstring, Strait, Swpb, Tony1, Trovatore, Verne Equinox, Wavelength, Zantolak, 26 anonymous edits List of diving hazards and precautions Source: http://en.wikipedia.org/w/index.php?oldid=446018402 Contributors: Aarchiba, Alai, Andreas Ravn, Anthony Appleyard, BD2412, Beach drifter, Benea, Benjicharlton, Clovis Sangrail, DiverDave, Elkman, ErelOnline, Erich gasboy, Ewlyahoocom, Ex nihil, Fiftytwo thirty, GULLIVER ARM, Gene Hobbs, GoatOverlord, Haruth, Hmoul, JHunterJ, Jaganath, Joyous!, Kbdank71, Kosebamse, Legis, Leuko, Longhair, MacGyverMagic, Mark.murphy, Marshman, Mbell, Mingfx, Mion, Neckro, Nehrams2020, Neutrality, Nono64, Otsykes, Owain.davies, Pazzah, Pbsouthwood, Randroide, RexxS, RoyBoy, SCEhardt, Smile a While, Swpb, Vary, Youremyjuliet, 48 anonymous edits Maximum operating depth Source: http://en.wikipedia.org/w/index.php?oldid=445676160 Contributors: A930913, Anthony Appleyard, Diza, Euchiasmus, Gambitq72, Gene Hobbs, Hibsch, Huw Powell, Lightdarkness, Lumpy Dog, Mark.murphy, Pearle, RexxS, Sbharris, Sn0wflake, Unixsage, WikiWayne, Xanzzibar, 5 anonymous edits Nitrogen narcosis Source: http://en.wikipedia.org/w/index.php?oldid=446002188 Contributors: (, 151.24.146.xxx, 151.24.190.xxx, 62.253.64.xxx, 62.92.51.xxx, 63.61.173.xxx, Aarchiba, Acdx, Adashiel, Alansohn, Amore proprio, Aquaregia27, Arrenlex, Arsenikk, BaileyZRose, Barticus88, Chzz, Cmdrjameson, Colonies Chris, Conversion script, Crum375, DMG413, Darthgriz98, Dave3141592, David Fuchs, Derek.cashman, Dinomite, Dogosaurus, Dougluce, DragonflySixtyseven, Erich gasboy, Eubulides, Extraordinary, Feezo, Finavon, FirstPrinciples, Floaterfluss, Foobar, Franamax, Gaius Cornelius, Garion96, Gene Hobbs, Gogo Dodo, Gr0ff, Graham87, Hqb, Huw Powell, Ixfd64, J.delanoy, Jamesdterry, Jmh649, JonathanDP81, Keenan Pepper, Killiondude, Koavf, Korath, Kosebamse, Kouhoutek, Laban712, Laurascudder, Legis, Mark Zinthefer, Mark.murphy, Mceder, Michael Hardy, MichaelVernonDavis, Milen, Milo99, Moshe Constantine Hassan Al-Silverburg, Muad, Mygerardromance, Nakon, Nono64, Notheruser, Onco p53, Otsykes, Owain.davies, Pakaran, PierreAbbat, Pjf, RexxS, Rhombus, Rich Farmbrough, Rjstott, Rjwilmsi, Roadrunner, Sbharris, Scubadoc, Serpent's Choice, Signalhead, Splamo, Splibubay, Stefan, TachyonJack, Tempshill, Vasiliy Faronov, VernoWhitney, WhatamIdoing, Ynhockey, , 120 anonymous edits Nitrox Source: http://en.wikipedia.org/w/index.php?oldid=441166257 Contributors: 62.92.51.xxx, A More Perfect Onion, Abiermans, Amatulic, Anthony Appleyard, AtonX, Bathat, BenFrantzDale, Biorem, Cades of the Cove, Carey Evans, Clotho, Conversion script, Dave3141592, DiverDave, Elkman, Eternal-sun, Farzanegan, Fuhghettaboutit, Gambitq72, Gene Hobbs, Goldom, Gorm, Headbomb, Hibsch, Hklygre, Hugo-cs, Karn, Killian441, KingTT, Klparrot, Kpjas, Kurykh, Legis, Leuko, Lexicon, Lovibond, Mark.murphy, Mbeatty, Mboverload, MeltBanana, MichaelBillington, MichaelHaeckel, Mion, Mtiller, Nonnormalizable, Nono64, Patrick, PaulHanson, Petterfs, Ploum's, Quadell, RexxS, Rgoodermote, Rich Farmbrough, RichiH, Sbharris, Scubadiver-dad, Spitfire26, Stefan, Stubblyhead, SunDragon34, Swpb, The ClayJar, The Random Editor, Tlunsford, Vk steve, Wperdue, , 76 anonymous edits Oxygen toxicity Source: http://en.wikipedia.org/w/index.php?oldid=442424026 Contributors: A More Perfect Onion, Aaron Kauppi, Ahpook, Amore proprio, Anandology, Angela, Anthony Appleyard, Arcadian, Art LaPella, AtonX, Axl, Basilicofresco, Bigbuck, BitterMan, Bodybagger, Brandingularity, Brianski, Bryan Derksen, BryanG, Campdavid, Canglesea, Casliber, Cdshioshei, ChildofMidnight, Chzz, Circeus, Countincr, Crfoster, DJ Clayworth, Dabomb87, Dancter, Danski14, Dave3141592, Davemarshall04, Delldot, Derek.cashman, Diberri, Dkazdan, DroEsperanto, Drpepper469, Ebr32y8432321121212, Egghead06, Epbr123, Erich gasboy, Eubulides, FKmailliW, FNG0027, Farras Octara, Farzanegan, Finavon, Foobar, Gene Hobbs, H Padleckas, Harland1, Hatcat, Headbomb, Hede2000, Hmoul, Idran, Intermedichbo, Jenda, Jfdwolff, Jmh649, Jordekurt, Jrockley, Julesd, Kaszeta, Keenan Pepper, KnowledgeOfSelf, Kosebamse, Krj373, LWF, LilHelpa, Lotje, Lucius1976, Mark.murphy, Materialscientist, Mmoneypenny, Mnation2, N5iln, Nakon, Nergaal, Nono64, Otsykes, Owain.davies, Pablo X, Piledhigheranddeeper, Prodego, RexxS, Rich Farmbrough, Rifleman 82, Rjwilmsi, S0ckpupet, Sbharris, Scott Roy Atwood, Scubadoc, Sirius683, Sirmylesnagopaleentheda, Snowmanradio, Sunapi386, Swatrecon, TAMilo, Thue, TimVickers, WATransplant, Wavelength, WolfmanSF, Wouterstomp, WriterHound, Xanzzibar, Yamakiri, Yobol, Zigger, 83 ,55 anonymous edits Partial pressure Source: http://en.wikipedia.org/w/index.php?oldid=445830116 Contributors: Alexknight12, Andre Engels, Antandrus, Anthony Appleyard, ArcticWind88, Auntof6, Bdesham, Bensaccount, Bitjungle, Bryan Derksen, Calvin 1998, Cesiumfrog, Christian75, CiaPan, Cristianrodenas, Crowsnest, DabMachine, Dhollm, Dictabeard, Dj Capricorn, Djd sd, Duk, ESkog, El C, Fabiform, Fgb, Fyyer, Gaterion, Gene Nygaard, Gentgeen, Gits (Neo), Grenavitar, Gunnar Larsson, Headbomb, Herbee, Hooperbloob, Itub, Izehar, JabberWok, Joelholdsworth, Johnuniq, Jonathan654321, Kjhskj75, Mark.murphy, Mausy5043, Mbeychok, Mentisock, Michael Hardy, Momet, Mpeisenbr, Nneonneo, Patrick, Peachypoh, Petergans, Peterlin, Pflatau, Physchim62, Postrach, Pt, Quarl, Qxz, RexxS, Sbharris, Shoefly, Sodium, Steamroller Assault, Straker, V8rik, Vsmith, WRK, Webdinger, Zvn, 91 anonymous edits Rebreather Source: http://en.wikipedia.org/w/index.php?oldid=446788456 Contributors: .:Ajvol:., ARHAPSTF, Alan Au, Alansohn, Alex.tan, Alexander UA, Altes2009, AndyCarroll, Animum, Anshuk, Anthony Appleyard, Arawak3, Ashley Pomeroy, Atlant, Attilios, Banaticus, BecauseWhy?, Bgpartri, BillC, Billlion, Bluekieran, Bluez57, Bobblewik, Brainsik, Branciforte3241, Brianski, Carlroller, Ccrvic, Cedricverdier, Chasnor15, Chem-awb, Chrislk02, Cjpuffin, Clayhalliwell, Cloudo, Cremepuff222, Crum375, Cyrius, DabMachine, Dave3141592, Deli nk, Diverite, Dolphin51, Dycedarg, EddEdmondson, Elonka, Elysdir, Emdx, Epbr123, Ex nihil, Famously Sharp, Firien, Frencheigh, Gamkiller, Gene Hobbs, Gobonobo, Gr0ff, GraemeLeggett, Hadal, Headbomb, Heyydude12, Hydraton31, Ian Dunster, Idiosyncrat, Ironholds, Ixfd64, J Swarbrick, JTN, JamesMLane, Jasonvds, Javabrett, Jeus, Jolenine, Jooler, Julesd, KVDP, Karn, Kbdank71, Keller.baum, Kintaro, Knobunc, Koavf, Lmaltier, Lx, MadRat Jack, Maeglin Lmion, Mark.murphy, Marokwitz, Mattmexico63, McHildinger, Moppet65535, Mottmon, Nakon, Naruto Tron, Nasnema, Nedrutland, Nick Number, Nimur, Niteowlneils, No bubbles, Obli, Omegatron, OnePt618, Owain.davies, PBarak, Pankkake, PaulGGraham, Phinneus, Pushnell, Quartertone, RexNL, RexxS, Rich Farmbrough, Rich257, Rmfitzgerald50, Rmhermen, RobertAlanHarris, RobertGougaloff, Rps, SDC, SEWilco, Saimhe, ScubaMagazinedotnet, Sea diver, Seashorewiki, Simon.goodchild, Sirscuba, Sitethief, Skepticus, Spokane wheels, Srice13, Stephen j koch, Steven J. Anderson, Subversive.sound, Superm401, Swerdnaneb, Swpb, Technopat, Th1rt3en, The Man in Question, The Obfuscator, Themfromspace, Tholzel, Thumperward, Todd Vierling, Travelbird, Trovatore, UnbiasedHistory, Vicarious, Viking6, Wabernat, WhiteDragon, Woodshed, Woohookitty, XHT5, Xianggang, Xobnkaj, Ynhockey, ZayZayEM, Zoicon5, Zwiadowca21, , 248 anonymous edits Recreational diving Source: http://en.wikipedia.org/w/index.php?oldid=440537248 Contributors: -hh, AGK, AkioMtFuji, Ali7697, Anthony Appleyard, AtonX, Belindaclarke, Chris j wood, Ckatz, Claymaker88, Cmeilahn, Csrempert, Damiens.rf, Darthgriz98, Dave3141592, Elahk09, Emily Jensen, Espo, Ewlyahoocom, Ex nihil, Finavon, Gadavis2, Gawker, Gene Hobbs, Gogo Dodo, Hadal, Happibunny, HawaiiScubaDivers, Headbomb, Hektor, Hiperformancesports, Hmoul, Hyronimus299, JamesAM, Jghaines, Joelfurr, John Broughton, Jumbo Snails, Jwh, KVDP, Kjaergaard, Lari-fari, Legis, Leuko, Lightmouse, Longhair, Mark.murphy, Maximus Rex, Mbruce81, MickMacNee, Mion, Msh210, N432138, Nikolai, Otsykes, Pinethicket, Pjf, Ranveig, RexxS, Riana, Sadmouse11, SchuminWeb, Scramblin, Scubazine, Signalhead, Simon.goodchild, Superm401, Tabletop, Terry0051, Thinking of England, Thisisjusthowweroll, Truthspeaketh, Yankdownunder, Zolddd, 63 anonymous edits Scuba diving Source: http://en.wikipedia.org/w/index.php?oldid=446507207 Contributors: *drew, -Ozone-, 200footdrop, 2help, 2ocean7, ABF, AbsolutDan, AdamDavid, Akamad, Akrabbim, Alabasterclam, Alansohn, Alexa22, Alexander Phipps, Alvin-cs, Ambrish.shrivastava, Andy Marchbanks, Anthony Appleyard, Ardo191, Art LaPella, Artinge, Aspro, Avjoska, Babcocgf, BaroloLover, Basilicofresco, Bemoeial, Bencherlite, Benweatherhead, Bhadani, Biart studio, Biff-calliafas, Blarrrgy, BlinkingBlimey, Bobbyboybob, Boing! said Zebedee, CStyle, Caese, Cakunk123, Calwolf, CambridgeBayWeather, Canadian-Bacon, Capricorn42, Charlesjsharp, Chris.n, Chunshek, Civertan, Clayoquot, Clueless, Cmeide, Cmichael, Collins18, Commander Shepard, Corti, Crum375, Csrempert, DJ Clayworth, Daddy.twins, Danski14, Darthgriz98, Date delinker, Dave3141592, Dbenbenn, Ddejager, DeathSource, DennyColt, Deputy821, DerHexer, Dfrg.msc, Diliff, Dina, Diver71, Divingdoc36, Donald Albury, DoubleBlue, DougsTech, Doyley, Dr Noonien Soong, Duffman, Dukerobo, E0steven, Echuck215, Edlitz36, Elonka, Emdx, Epastore, Epbr123, Epson291, Ericorbit, Erud, Everyking, Exir Kamalabadi, FF2010, Fagbag456, Finavon, Fitzsflies, Flessas, Fordan, Franamax, Freakofnurture, Fuzzball!, Gadfium, Gareth Griffith-Jones, Gawker, Gene Hobbs, Gene Nygaard, GeorgeLouis, Gettingtoit, Gjs238, Gr0ff, Graham87, GrahamBould, GregorB, GuruSteve, Hadal, Halmstad, Hamiltondaniel, Happibunny, Haukurth, HawaiiScubaDivers, Hbackman, Hektor, Henrikhoffa, Henry Flower, HeroOfTheSovietUnion, HexaChord, HeyStopThat, Hibsch, Hkremer, Hmains, Hmoul, Hotcrocodile, Huw Powell, Hydrargyrum, Imaswfan, Imnotminkus, Intelligentsium, Intothewoods29, J. Finkelstein, J.delanoy, JEJoyce, Jacek Kendysz, Jamal12491, Janemba13, Jarvik, JasonFox, Jawfish, Jax184, Jennavecia, Jhog1978, Jim.belk, Jjharvey8, Joe Bolt, Joeymoe, Jofijk10, Johnbelamaric, Johnlogic, Johnuniq, Jojhutton, Jon Kranhouse, Jon186, Jotimmsy, Jpatokal, Jtowler, Jzouksta, Jna runn, KVDP, Kablammo, Katalaveno, Kbdank71, Kevin Kidd, Khukri, Kimberlygretchen, Kingpin13, Kocio, Kraftlos, Krawi, Kubigula, Kuru, Lari-fari, Leafyplant, LeaveSleaves, Lectonar, Legis, Leonard^Bloom, Leuko, Lightmouse, LilHelpa, Linkspamremover, LonelyBeacon, Longhair, Lotje, Lsi john, Luigi2, Luismiguens, Lukespires, Luna Santin, MIgartua, MZMcBride, Macintosh User, Maldivian, Malicart, Mangostar, Mark.murphy, Markovich292, Matthew Yeager, Maynard Hogg, Mbeatty, Melaen, Mets501, MickMacNee, Mion, Mit027*, Mochila69, Mojodaddy, Momi bear, MrFish, Ms2ger, Mushroom, Nathan Johnson, Nckiller2119, Niele, Nikolai, Noclevername, NoisyMe, Northamerica1000, Nuno Tavares, Nyttend, Obli, Ohnoitsjamie, Ohwell32, OneAhead, Otsykes, Owain.davies, PDH, Pbsouthwood, PeHa, Pennywisdom2099, Peter Horn, Petruchi41, PhilipO, Pmcg47580, Polylerus, PrestonH, Pumpumstealer, Pursey, Quintote, Quuxplusone, RHaworth, Raining girl, Rama, Randroide, RazorICE, Reader contributor, RexNL, RexxS, Riana, Rich Farmbrough, Rincewind32, Risker, Robert P. 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Original uploader was DiverDave at en.wikipedia File:Trimix label.png Source: http://en.wikipedia.org/w/index.php?title=File:Trimix_label.png License: Public Domain Contributors: RexxS Image:Console-narc.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Console-narc.jpg License: Public Domain Contributors: RexxS File:Lipid bilayer section.gif Source: http://en.wikipedia.org/w/index.php?title=File:Lipid_bilayer_section.gif License: Public domain Contributors: Bensaccount File:Gas blending equipment cropped.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Gas_blending_equipment_cropped.jpg License: Public Domain Contributors: User:Mark.murphy File:The Meyer-Overton correlation.png Source: http://en.wikipedia.org/w/index.php?title=File:The_Meyer-Overton_correlation.png License: Public Domain Contributors: Akuznetsova Image:EANxDecal.png Source: http://en.wikipedia.org/w/index.php?title=File:EANxDecal.png License: GNU Free Documentation License Contributors: AtonX, Man vyi, Serguei S. Dukachev, 1 anonymous edits Image:Nitrox tables.JPG Source: http://en.wikipedia.org/w/index.php?title=File:Nitrox_tables.JPG License: Public Domain Contributors: --Legis (talk - contribs). Original uploader was Legis at en.wikipedia Image:Cylinder mod.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Cylinder_mod.jpg License: Public Domain Contributors: RexxS File:File-Oxygen toxicity testing.jpeg Source: http://en.wikipedia.org/w/index.php?title=File:File-Oxygen_toxicity_testing.jpeg License: Public Domain Contributors: UK Admiralty Image:Clark1974.svg Source: http://en.wikipedia.org/w/index.php?title=File:Clark1974.svg License: Public Domain Contributors: Prepared by User:Gene Hobbs from diagram in journal article (see source). Author of article: Clark, John M. 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Contributors: Xobnkaj Image:keywestdiving.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Keywestdiving.jpg License: Public Domain Contributors: Joelfurr Image:Coral reef locations.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Coral_reef_locations.jpg License: Public Domain Contributors: Bryan Derksen, Citron, Grenavitar, Haplochromis, Man vyi, Martin H., Mirgolth, 6 anonymous edits File:Buzo.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Buzo.jpg License: Creative Commons Attribution-ShareAlike 3.0 Unported Contributors: Soljaguar File:Aqualung (PSF).png Source: http://en.wikipedia.org/w/index.php?title=File:Aqualung_(PSF).png License: unknown Contributors: Editor at Large, LA2, 1 anonymous edits File:Working Diver 01.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Working_Diver_01.jpg License: Public Domain Contributors: Mass Communication Specialist Senior Chief Andrew McKaskle File:Scuba diver1.jpg Source: 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