Scuba Diving with Asthma, Is it Possible?

If you’re reading this article, it’s because you’re interested in scuba diving with asthma, or you know someone with this condition who dives. We wrote this article to address your concerns. However, it’s important to note that the authors of the content you’re about to read are not medical professionals but experienced scuba divers. So, note that nothing we say can replace the opinion of a medical specialist in scuba diving and asthma.

So, to reply to the question “Can I scuba dive with asthma?” we should consider the following fact: the topic of asthma and diving has been debated in the recreational diving community for a long time. Due to theoretical concerns about an increased risk inherent to diving, asthmatic divers were approached very cautiously, and scuba diving was not allowed.

However recent studies and experiences have shown that it is possible to scuba dive with asthma. In fact, with proper precautions, people with asthma can enjoy the wonders of the underwater world just like anyone else.

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1. What Is Asthma and How Can It Affect Diving?

Asthma is a condition that causes the narrowing of the airways in response to certain stimuli. Asthma attacks are usually unpredictable and can cause a sudden worsening of lung function known as bronchospasm. Common asthma triggers include allergens like pollen, cold air, atmospheric irritants, a cold, or the flu.

A bronchospasm occurs when the muscles in the airways tighten, causing them to narrow and potentially become obstructed. It has been believed that for asthmatics, breathing compressed air under pressure while diving could be a stressor that triggers bronchospasm due to the increased density, lower relative humidity, and temperature. However, real-world experience has shown that there is not a significant difference in the risk of lung injuries between divers with and without asthma.

Many divers face the challenge of how asthma affects their ability to enjoy diving. There are different types of asthma and depending on your type and prescribed treatment, it may be possible to dive safely.

There are four types of asthma: Intermittent mild asthma, where symptoms occur less than once a week and are usually manageable with short-acting bronchodilators. Mild persistent asthma or moderate persistent asthma, where you may need to take daily medications such as inhaled steroids to control your symptoms. If you have severe persistent asthma, your symptoms will be more severe and you may need to take daily medications, as well as long-acting bronchodilators and oral steroids to control your symptoms.

2. What Are the Risks of Scuba Diving with Asthma?

If you’re an asthmatic scuba diver, it’s important to understand the associated risks and consult with a diving and asthma specialist before making any decisions about diving in the Caribbean or anywhere else. The bronchial narrowing that can occur while diving with asthma has two risks:

1. That it reduces the amount of air that can enter and leave the lungs, which reduces your physical exertion capacity.
2. That the narrowed airways could cause gas to become trapped in the lungs during ascent, meaning that gas would expand faster than it is eliminated, potentially rupturing tissues and causing barotrauma.

However, it’s important to note that most diving accidents are due to behavior and judgment errors rather than structural lung problems. Studies show no significant differences in risks between asthmatic divers and those without this condition. This is because asthmatic divers are typically more knowledgeable about risks and more careful about safety rules.

3. Can I Scuba Dive with Asthma?

So, can I dive with asthma or not? According to recommendations from the UK Sports Diving Medical Committee, if you have well-controlled asthma with a negative exercise test and normal lung function, you can dive.

During the diving season, which we can call “vacation,” you can dive if you only need to monitor your asthma symptoms and perform peak flow measurements a maximum of two times a day.

If you have active asthma symptoms, you should not dive.

The 2003 British Thoracic Society recommends against diving if you have exercise-induced wheezing, cold-induced wheezing, or emotion-induced wheezing.

The Undersea and Hyperbaric Medical Society in the US agrees with the UK doctors and allows those with mild to moderate asthma and normal screening spirometry to dive.

The Thoracic Society of Australia and New Zealand is the most restrictive and advises against diving for anyone who has had the active disease in the past 5 years. For everyone else, it recommends tests that measure bronchial hyperresponsiveness to the same stimuli experienced by the diver.

4. Scuba Diving and Asthma: Tips and Precautions

• First, it’s important to have a diving medical evaluation and undergo a spirometry test to assess the severity of your asthma.
• Maintain good physical fitness because diving requires swimming skills, strength, and cardiovascular conditioning.
• Avoid any known triggers of your asthma symptoms. If you have symptoms requiring rescue medication within 48 hours prior to immersion, it’s best to abstain from diving.
• Terminate your dive if you experience wheezing or breathing difficulties. You should not dive if you have active asthma, a significant reduction in maximum expiratory flow (>10% reduction from best values), or increased variability in maximum expiratory flow (>20% diurnal variation).
• Cold air during diving can worsen asthma symptoms, so consider water temperature.
• If you need daily rescue inhalers or have had chest symptoms within the last 48 hours, it’s best not to dive.
• If you have a cold or suffer from exercise-induced or emotion-induced asthma, it’s best not to dive. Finally, to prevent lung overinflation injuries, don’t ascend faster than the required ascent rate, especially in the last 25 feet.

Have fun, you can enjoy scuba diving with asthma if you do it with caution!