Summary of knowledge and thinking about asthma and diving since 1993*: Discussion paper for the Thoracic Society of Australia and New Zealand, November 2004

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Summary of knowledge and thinking about asthma and diving since 1993*: Discussion paper for the Thoracic Society of Australia and New Zealand, November 2004

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Title: Summary of knowledge and thinking about asthma and diving since 1993*: Discussion paper for the Thoracic Society of Australia and New Zealand, November 2004
Author: Anderson, SD; Wong, R; Bennett, M; Beckert, L
Abstract: Reprinted with the kind permission of the authors and The Thoracic Society of Australia and New Zealand. This discussion paper was originally published in the Thoracic Society News, 2004; 14 (4): 61-8. Introduction: The 1993 TSANZ discussion paper appears to have been one of the first to be published by a Thoracic Society.1 This probably reflects the high prevalence of asthma in the Australian and New Zealand population and the high morbidity and mortality associated with the disease at that time. Since 1993 there has been a nationwide effort to improve education of doctors and patients about asthma and its treatment through advertising campaigns. Inhaled corticosteroids are more available and more widely used than they were 10 years ago. Lung function tests are more commonly requested and the testing apparatus used in laboratories is more sophisticated, permitting measurements of flow at low lung volumes. Self-monitoring of symptoms is more common and many asthmatics own peak flow meters. The finding of bronchial hyperresponsiveness (BHR) or bronchial hyperreactivity in a significant proportion of healthy young adults, with a past history of asthma, seeking employment in occupations excluding active asthma, or seeking permission to use drugs before sporting events, supports the need for objective testing before clearance to dive. It is now clear that BHR to hyperpnoea of dry air, an absolute contraindication for scuba diving, can be associated with normal values for resting spirometry.2 It is also clear that responses to pharmacological challenges cannot be used to exclude BHR to dry air or to hyperosmolar aerosols.3 In 2004 most public hospital laboratories and many private laboratories provide a choice of bronchial provocation tests. These tests are now well standardised relative to 1993.4-8 The bronchial provocation tests recommended are those that involve the stimulus to which the intending diving is exposed, either exercise or eucapnic hyperpnoea of dry air and non-isotonic aerosols.8
Description: The Journal of the South Pacific Underwater Medicine Society (Incorporated in Victoria) A0020660B and the European Underwater and Baromedical Society
URI: http://archive.rubicon-foundation.org/10167
Date: 2006

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