Further Comments on Dive Fatalities: A Matter of Perspective?

Why the Fatalities – Training?
Or just plain Attitude? Or a bit of both?

By Keith Cardwell, PhD.

Diving is an adventure.
Adventure often brings risks.
And risks often have dire consequences.

But most of the time for the majority of us, it brings just sheer pleasure and one that I experience frequently when I dive the Great Barrier Reef. Every day there I see folk having a go at what we do – doing one of those adventures they probably have on their ‘bucket list’. I know full well that there will be more than 300 ‘adventurers’ leaving from the same harbour I do, every day.

Some of these adventurers can’t even swim. Some return from their first dive experience (adventure) thankful that they survived and can now tick an item on that list. Some even return from the dive wanting to pursue it as a career. There are so many folk wanting to try diving.

My first realisation of how many this might be was in the late ’70s when I first started inviting folk for free ‘try dives’ at Sportways Aqua-Lung Centre in Auckland. The early results indicated an enormous demand that we appeared unable to meet with the resources we had.

With this burgeoning training demand, we realised we had to improve the system so that we could offer realistic and necessary skill learning – starting even at a very basic level.

However, when change was made to the way training was conducted, criticism was rampant. The criticism then, as I read it now, nearly always included the arguments that courses were shorter (hence less thorough); didn’t contain ‘important’ skills like perhaps ditch and recovery (for good equipment familiarisation and stress testing); and, of course, the snide “put another dollar in” (because on a dive course now you don’t get taught everything that you should be taught, but you can be sold another course to catch up) … and so on.

However, the truth behind any issue should be gained from real experts, not well-wishers who give the appearance of being knowledgeable.

One expert group, the Police Dive Squad, has recently published in this magazine its “Top 10 Recommendations [to avoid diving incidents] based on Fatalities 2006–2016” (‘Police National Dive Squad Present Their Findings’, August/September, issue 155). This has been put out there for divers to review and improve on their present diving conduct.

But on review of these recommendations, it begs the question as to whether they shed light on problems with present-day diver training courses?

Do these courses, for instance, suggest that perhaps a diver:

  • Dives alone?
  • Dives even if they have a cold or when not feeling the best?
  • Puts on more than enough weight so they can get down quickly?
  • Doesn’t have to bother with pre-dive checks of either buddy or gear?

No, of course not. Emphasis is constantly placed on following basic rules as much as insisting on mastery of basic skills.

And as Richard Taylor stated in the last issue: “To have people say that today’s training standards are to blame [for recent dive fatalities] is like saying that people have more car accidents because we let them drive sooner and with less time under supervision. People crash cars because they drive too fast, ignore safety rules, drive without WOFs or even without licences and use a myriad of alcohol and drugs.”

I would also add perhaps, driving with an unknown medical condition due to lack of recent check-ups!

Diving is an adventure and nearly all adventures have an element of risk. It should be no surprise that some folk push things just a little too far.

It should be patently clear: it is not diver training that is the prime culprit for unnecessary diving deaths; it is far too often the overzealous adventurer breaking the very rules they have been taught to follow.

A Weighty Issue: Rethinking Training

Dear Dave,
I recently came across the June/July 2016 issue, in which there is further discussion by Bruce Adams of the Police Diving Squad and a correspondent on recent scuba diving deaths in NZ. You kindly forwarded Bruce’s earlier articles in the magazine when I contacted you and I must agree with everything that he wrote. However, I would like to point out a major omission from these contributions – that of divers not releasing their weight belt in an emergency.

If one looks at the published data, the majority of recovered dead divers are still wearing their weight belt. Establishing positive buoyancy is the one action that more than any other can save a diver’s life, if only divers (or their buddies, if they have one) who get into trouble would do this. In a recent report on Danish scuba diving fatalities, Vinkel et al comment that: “Of the 25 divers who were known to use weights, only two ditched their weights during the course of the diving incident. Through careful review of these cases, it is thought that in 21 cases the odds of survival would have been enhanced if the diver had dropped their weights, improving the probability of reaching the surface alive” and further, “establishing positive buoyancy by the release of weight underwater is a mandatory element in dive training because it can be a critical response to threatening circumstances”. (1)

In reviewing the Danish deaths, the Australian fatalities papers from 2006 to 2010 and my own report on New Zealand deaths between 1980 and 2000, of 67 divers in whom the individual reports document whether or not the weight belt was dropped by the diver, 51 (76%) were still wearing it when their bodies were recovered. (1, 2, 3)  Further, in Andy McClelland’s paper on 40 New Zealand fatalities from 2000 to 2006, he says “there was no definite history of weight-belt release by any diver, although one scuba diver had possibly dropped his weight belt.”(4)

This is a feature of every published series of scuba diving fatalities that I have read (there are plenty more in the literature) and has been remarked on by many investigators. This is the message that I wish to emphasise – divers do NOT ditch their weight belt in an emergency.

This reflects a failure of current teaching methods by the dive training agencies and it is time that they reconsidered how this aspect of emergency training is taught and emphasised during their courses. I believe that it could/should be a component repeated in every single skills course and at every level subsequent to basic Open Water, including Instructor courses. It needs to be repeated time and time again if such a potentially life-saving action is to become a properly learned response to a major incident underwater or on the surface. The data have been there for all to see for many years. How the agencies resolve this problem needs their close attention. I challenge them that it is time to rethink this component of diver training.

I also list below an earlier report of New Zealand diving fatalities by Peter Lewis that readers may be interested to chase up. (5)

Assoc. Professor (ret’d) Mike Davis, MD, FANZCA, Cert DHM (ANZCA)
Formerly Medical Director, the Hyperbaric Medicine Unit, Christchurch Hospital.

References
1. Lippmann J, Lawrence CL, Wodak T, Fock A, Jamieson S, Walker D, Harris R. Provisional report on diving-related fatalities in Australian waters 2010. Diving and Hyperbaric Medicine. 2015; 45(3): 154–175. (Available on application to editorialassist@dhmjournal.com)
2. Davis M, Warner M, Ward B. Snorkelling and scuba diving deaths in New Zealand, 1980–2000. SPUMS Journal. 2002; 32(2): 70–80. Available at: http://archive.rubicon-foundation.org/xmlui/bitstream/handle/123456789/7670/SPUMS_V32N2_3.pdf?sequence=1
3. Vinkel J, Bak P, Hyldegaard O. Danish diving-related fatalities 1999–2012. Diving and Hyperbaric Medicine. 2016; 46(3): 142–149.
4. McClelland A. Diving-related deaths in New Zealand 2000–2006. Diving and Hyperbaric Medicine. 2007; 37(4): 174–178. Available at: http://archive.rubicon-foundation.org/xmlui/bitstream/handle/123456789/9713/DHM_N37V4_2.pdf?sequence=1
5. Lewis PRF. Skin diving fatalities in New Zealand. New Zealand Medical Journal. 1979; 89: 472–475.