Risk factors of decompression sickness in scuba diving

Oliwia Pińkowska, Zuzanna Podstawka, Aleksandra Byś, Piotr Gawda

DOI: http://dx.doi.org/10.12775/JEHS.2020.10.09.069



Recreational diving with aqualung can be called an extreme sport because the divers are exposed to physical and psychological risks. A serious danger in diving is the very exposure to a change in pressure underwater, which every diver must deal with. That kind of danger may cause many problems related to any pressure exposure and unfortunately, diving-related illnesses have shown the increasing tendency. Recreational divers are the most numerous group among the people who suffer from decompression sickness (DCS) and alas, similar condition can be expected in future years. Aim of this literature review was to determine the risk factors of decompression sickness after scuba diving.

Materials and methods

Material for this literature review was found by two independent authors searching PubMed, Cochrane library and ScienceDirect databases by using a combination of keywords: „scuba diving”, „risk factors”, „decompression sickness”, „DCS”. Finally, 4 publications qualified for a review of literature.


Many authors presented factors such as patent foramen ovale, BMI and fat mass, age, diving exposure, heavy exercise, sex, strong current, workload during diving, circulatory right-to-left shunt and the lack of changes in the diving style to have an impact on developing DCS. In the opposite, one study stated that overweight and gender had minor contribution to DSC.


Risk factors of decompression sickness  in scuba diving could be: high-grade PFO, age, diving exposure, strong current, heavy exercise, workload during diving, dehydration, repetitive diving, violation of dive profiles, experience in diving, presence of circulatory right-to-left shunt and the lack of changes in the diving style after previous DCS episode. Further research is needed to verify the role of gender and fat mass in developing symptoms of decompression sickness.


decompression sickness; scuba diving; risk factors; DCS; extreme sports

Full Text:



Murray DM. Living on the edge: Sensation seeking and extreme sports participation. 2003.

Newton HB. Neurologic complications of scuba diving. Am Fam Physician.2001;63(11):2211–8.

Levett DZH, Millar IL. Bubble trouble: a review of diving physiology and disease. Postgrad Med J. 2008;84(997):571–8.

Coetzee N. Personality profiles of recreational scuba divers. Afr J Phys Health Educ Recreat Dance 2013;16(4).

Gorman DF. Decompression Sickness and Arterial Gas Embolism in Sports Scuba Divers: Sports Med. 1989;8(1):32–42.

Denoble PJ, Ranapurwala SI, Vaithiyanathan P, Clarke RE, Vann RD. Per-capita claims rates for decompression sickness among insured Divers Alert Network members. Undersea Hyperb Med J Undersea Hyperb Med Soc Inc. 2012;39(3):709–15.

Honěk J, Šrámek M, Šefc L, Januška J, Fiedler J, Horváth M, i in. High-grade patent foramen ovale is a risk factor of unprovoked decompression sickness in recreational divers. J Cardiol. 2019;74(6):519–23.

Cialoni D, Pieri M, Balestra C, Marroni A. Dive Risk Factors, Gas Bubble Formation, and Decompression Illness in Recreational SCUBA Diving: Analysis of DAN Europe DSL Data Base. Front Psychol. 2017;8:1587.

Smerz RW. The relationship of decongestant use and risk of decompression sickness; a case-control study of Hawaiian scuba divers. Hawaii J Med Public Health J Asia Pac Med Public Health. 2014;73(2):61–5.

Gempp E, Louge P, Blatteau JE, Hugon M. Risks factors for recurrent neurological decompression sickness in recreational divers: a case-control study. J Sports Med Phys Fitness. 2012;52(5):530–6.

Davis D, Tisdell C. Economic Management of Recreational Scuba Diving and the Environment. J Environ Manage. 1996;48(3):229–48.

Cater C. The life aquatic: scuba diving and the experiential imperative. 2008;

Straughan ER. Touched by water: The body in scuba diving. Emot Space Soc.2012;5(1):19–26.

Weber CD, Horst K, Nguyen AR, Lefering R, Pape H-C, Hildebrand F, i in. Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis. Arch Orthop Trauma Surg. 2018;138(7):963–70.

Petri NM, Andri D. Differential Diagnostic Problems of Decompression Sickness—Examples from Specialist Physicians’ Practices in Diving Medicine. Arch Med Res. 2003;34(1):26–30.

Brymer E, Schweitzer R. Extreme sports are good for your health: a phenomenological understanding of fear and anxiety in extreme sport. J Health Psychol. 2013;18(4):477–87.

Breivik G. Trends in adventure sports in a post-modern society. Sport Soc. 2010;13(2):260–73.

Laver L, Pengas IP, Mei-Dan O. Injuries in extreme sports. J Orthop Surg. 2017;12.

Colodro Plaza J, Garcés de los Fayos Ruiz EJ, López García JJ, Colodro Conde L. Prediction of human adaptation and performance in underwater environments. Psicothema. 2014;26(3):336–42.

Naval Sea Systems Command, U.S. Department of the Navy. U.S. Navy Diving Manual. 2010.

Busuttil A, Obafunwa JO. A review of the forensic investigation of scuba diving deaths. Sci Justice. 1995;35(2):87–95.

Obafunwa JO, Busuttil A, Purdue B. Deaths of amateur scuba divers. Med Sci Law. 1994;34(2):123–9.

Møllerløkken A. The future of diving research in Norway. Diving Hyperb Med. 2018;48(2):72.

Caine DJ. The Epidemiology of Injury in Adventure and Extreme Sports. W: Heggie TW, Caine DJ. Medicine and Sport Science. Basel: S. KARGER AG; 2012. s. 1–16.

Bahr R, Engebretsen L. Sports injury prevention. Chichester; Hoboken, NJ: Wiley-Blackwell; 2009.

Trevett A, Peck D, Forbes R. The psychological impact of accidents on recreational divers: A prospective study. J Psychosom Res. 2010;68(3):263–8.

Shuer ML, Dietrich MS. Psychological effects of chronic injury in elite athletes. West J Med. 1997;166(2):104–9.

Smith AM. Psychological impact of injuries in athletes. Sports Med Auckl NZ. 1996;22(6):391–405.

Carlsson K, Lidholm SO, Maehly AC. Scuba diving accidents in Sweden 1960 – 1976. Forensic Sci. 1978;11(2):93–108.

Feletti F, Mucci V, Aliverti A. Chest Ultrasonography in Modern Day Extreme Settings: From Military Setting and Natural Disasters to Space Flights and Extreme Sports. Can Respir J. ;2018.

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014


POL-index 2011 - 2014


BASE 2011 - 2014




Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska, EuroPub database, NLM Catalog Result - NCBI, BASE, Russian Sciences Index, Arianta.



US NLM = 101679844

101679844 - NLM Catalog Result - NCBI


Find a library that holds this journal: http://worldcat.org/issn/23918306


PBN Poland






Redaction, Publisher and Editorial Office

Publisher and Editorial Office
Department of Physical Culture,
Faculty of Earth Sciences and Spatial Management,
Nicolaus Copernicus University in Toruń, Poland
Address: Str. Lwowska 1, 87-100 Toruń, Poland

  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at https://dbh.nsd.uib.no/publiseringskanaler/erihplus/periodical/info?id=485984

Indexed in Index Copernicus Journals Master List.


ICV 2019 = 100.00 ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

RG Journal Impact: 0.18 *

*This value is calculated using ResearchGate data and is based on average citation counts from work published in this journal. The data used in the calculation may not be exhaustive.

RG Journal impact history

2020Available summer 2021
2018 / 20190.18

RG Journal impact over time

RG Journal impact

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (https://pbn.nauka.gov.pl/journals/36616)

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ) http://elibrary.ru/contents.asp?titleid=37467

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski


Partnerzy platformy czasopism