FLYING AFTER DIVING GUIDELINES:

Ascent to altitude after diving as !eco"e a co""on #ractice$ Altoug te incidence is lo%&
deco"#ression sic'ness (D)S* so"eti"es occurs during or after ascent$ During te dive& a ig
nitrogen #artial #ressure (#N+* in te lungs drives N+ into tissue$ ,n ascent& tissue #N+ re"ains ig as
te a"!ient #ressure dro#s$ -en tissue #N+ e.ceeds a"!ient #ressure& su#ersaturation occurs$ So"e
degree of su#ersaturation can !e tolerated& !ut asa critical level is reaced& gas !u!!les for" in !lood
and tissue$ )ontinued ascent causes !u!!le gro%t to te #oint %ere te diver "a/ !eco"e
s/"#to"atic of D)S$ In so"e cases& divers !eco"e s/"#to"atic at te surface& and in oter cases&
te/ !eco"e s/"#to"atic in fligt or i""ediatel/ follo%ing fligt$ Te diver can reduce te ris' of
D)S !/ e.tending te surface interval or !/ !reating o./gen during te surface interval(0& +*$
Since te 0123s& "an/ guidelines ave !een #ro#osed for fl/ing after diving$ Earl/ "ilitar/
guidelines set surface intervals of 4ero to +5 ours (678*$ Guidelines for co""ercial divers %ere
esta!lised in 019+ !/ te United :ingdo" Diving ;edicine$ Advisor/ )o""ittee& %ic
reco""ended surface intervals of t%o to 59 ours !efore e.#osures to +&333 feet (203 "* and 9&333
feet (+&569 "* altitude& de#ending on te t/#e of diving (9*$ </ 0191 te literature contained over 63
reco""endations for recreational divers& %it surface intervals ranging fro" 3 to 59 ours& !ut fe% ad
!een validated in u"an trials (1*$ Differences in diving tecni=ues and lac' of readil/ availa!le
/#er!aric treat"ent "a'e guidelines for "ilitar/ and co""ercial divers ina##ro#riate for recreational
divers$$In 0191& te Undersea and >/#er!aric ;edical Societ/ (U>;S* eld a %or'so# %it te
o!?ective of esta!lising te !est guidelines for recreational divers tat data and e.#ert o#inion could
su##ort$ Te %or'so# revie%ed te li"ited fl/ing after diving researc tat %as te !asis of "an/ of
te reco""endations of te da/$ Duffner and :iessling re#orted a D)S incidence of @@A %en
su!?ects %ere ta'en to 09&333 feet (@&@33 "* altitude after 13 feet (+8 "* dive e.#osures (03*$ Furr/&
Reeves and <ec'"an (0128* suggested tat a 0+7our surface interval %as needed to #rotect dogs fro"
D)S after sallo%& long dives (00*$ Edel et al (0121* su!?ected e.#erienced divers to 9&333 feet (+&533
"* altitude follo%ing dives to te no7deco"#ression li"its of te U$S$ Nav/ Air Diving Ta!les and
saturation e.#osures of 63766 fs% (1703 "s%*$ Edel et al reco""ended a surface interval of t%o ours
follo%ing no7deco"#ression dives and +5 ours follo%ing dives tat re=uire deco"#ression sto#s (0+*$
<alldin (0181* detected !u!!les in 23A of su!?ects e.#osed to 6&333 " (03&333 feet* after 61 "s% (0+1
fs%* dives and concluded tat divers sould %ait longer tan tree ours !efore "a'ing a co""ercial
fligt (06*$ <assett (019+* Do##ler7"onitored "ilitar/ divers during 0+3 "anned validation tests of
various de#ts of te U$S$ Nav/ Air Diving Ta!le follo%ed !/ i""ediate ascent to 03&333 feet (6&333
"*$ >e reco""ended a 0+7our surface interval !efore fl/ing after dives %it "ore conservative no7
deco"#ression li"its& i$e$& reducing te USN Bno7deco"#ression li"itsC !/ five to 03 "inutes (05&
0@*$ Te 0191 Undersea and >/#er!aric ;edical Societ/ (U>;S* -or'so# on Fl/ing After Diving
for"ali4ed guidelines for recreational divers !ased on e.#ert consensus concerning te li"ited
scientific evidence at te ti"e$ Te consensus %as antici#ated to !e conservative and te surface
intervals safe for te vast "a?orit/ of divers$
Reco""endations included:
(a* a 0+7our %ait after u# to t%o ours of no7sto# diving %itin te #revious 59 oursD
(!* a +57our %ait after "ultida/& unli"ited no7sto# divingD
(c* a +57 to 597our %ait after dives tat re=uired deco"#ression sto#sD and
(d* no fl/ing for divers %it D)S s/"#to"s unless it is re=uired to o!tain /#er!aric treat"ent
(1*$
To simplify these guidelines and make them safer for recreational divers, DAN proposed a
wait of 24 hours before flying after either single or repetitive no-stop dives Te DAN guideline
%as revised in 0110 in res#onse to an a##eal fro" te recreational diving co""unit/ %o argued tat
te lo% D)S incidence did not ?ustif/ a +57our #refligt surface interval for all t/#es of diving$ At te
ti"e& DAN data contained 60 cases a"ong an esti"ated + "illion divers %o fle% during te #eriod
0198713& for an overall incidence of 07+ cases #er 033&333 divers$
!eferences
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+723$
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0121D 53(03*:003@703$
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