Importance of Diving Medicals

General requirements

The medical, mental and physical fitness of professional divers is important for safety at work for the diver and the other members of the diving team.

As a general principle, fitness to dive is dependent on the absence of conditions which would constitute an unacceptable risk for the diver, and for professional divers, to any member of the diving team. General physical fitness requirements are also often specified by a certifying agency, and are usually related to ability to swim and perform the activities that are associated with the relevant type of diving.

The general hazards of diving are much the same for recreational divers and professional divers, but the risks vary with the diving procedures used. These risks are reduced by appropriate skills and equipment.

Medical fitness to dive generally implies that the diver has no known medical conditions that limit the ability to do the job, jeopardise the safety of the diver or the team, that might get worse as an effect of diving, or predispose the diver to diving or occupational illness.

There are 3 types of diver medical assessment: Initial assessments, routine re-assessments and special re-assessments after injury or decompression illness.

Fitness of recreational divers
Standards for fitness to dive are specified by the diver certification agency which will issue certification to the diver after training. Some agencies consider assessment of fitness to dive as largely the responsibility of the individual diver, others require a registered medical practitioner to make an examination based on specified criteria. These criteria are generally common to certification agencies, and are based on the criteria for professional divers, though the standards may be relaxed.

The purpose of establishing fitness to dive is to reduce risk of a range of diving related medical conditions associated with known or suspected pre-existing conditions, and is not generally an indication of the person’s psychological suitability for diving and has no reference to their diving skills.

A certification of fitness to dive is generally for a specified period, (usually a year or less), and may specify limitations or restrictions.

In most cases, a statement or certificate of fitness to dive for recreational divers is only required during training courses. Ordinary recreational diving is at the diver’s own risk.

In rare cases, state or national legislation may require recreational divers to be examined by registered medical examiners of divers. In France, Norway, Portugal and Israel. recreational divers are required by regulation to be examined for medical fitness to dive.

Standard forms for recreational diving
Recreational diver certification agencies may provide a standard document which the diver is required to complete, specifying whether any of a range of conditions apply to the diver. If no disqualifying conditions are admitted, the diver is considered to be fit to dive. Occasionally divers have provided deliberately falsified medical forms, stating that they do not have conditions which would disqualify them from diving, sometimes with fatal consequences.

The RSTC medical statement is used by all RSTC member affiliates of the RSTC Canada, RSTC, RSTC-Europe and IAC (former Barakuda), FIAS, ANIS, SSI Europe, PADI Norway, PADI Sweden, PADI Asia Pacific, PADI Japan, PADI Canada, PADI Americas, PADI Worldwide, IDD Europe, YMCA, IDEA, PDIC, SSI International, BSAC Japan and NASDS Japan.

Other certification agencies may rely on the competence of a general practitioner to assess fitness to dive, either with or without an agency specified checklist.

In some cases the certification agency may require a medical examination by a registered medical examiner of divers.

Fitness of professional divers
The requirements for medical examination and certification of fitness of professional divers is typically regulated by national or state legislation for occupational health and safety