Longitudinal change in professional divers' lung function: literature review

Abstract

BACKGROUND: The aim of this study was to assess changes in lung function of professional divers. MATERIALS AND METHODS: This is a review of the literature. Only studies about professional divers were included. All published studies between 01.01.1984 and 07.01.2014 were systematically searched. The search was performed in Medline and Embase databases and in the "Medicina Maritima" journal. The results of pulmonary function tests were extracted from each study. RESULTS: Fifteen articles were found. Four studies showed a significant decrease in forced vital capacity (FVC). Five studies demonstrated a significant decrease in forced expiratory flows (FEF) at 75% and 50% of FVC expired (FEF75% and FEF50%) after 3 years of diving. Seven studies demonstrated a significant decrease in forced expiratory volume in 1 second (FEV1) after 3 years of diving. But only 2 studies did an age-standardisation so that only 1 study demonstrated a significant decrease in FEV1 after age-standardisation. Three articles showed a decrease in transfer factor for carbon monoxide (TLCO) after 5 years. Dives parameters (like depth, number by year) were not always related to variations on the different lung variables. CONCLUSIONS: This literature review showed a decrease in TLCO, FEF75% and FEF25-75%. One wonders whether these variations are due to the age or to diving. The results of such a long-term study would be interesting and might help to guide fundamental research.