Gröger M, Ö ter S, Simkova V, Bolten M, Koch A, Warninghoff V, Georgieff M, Muth CM, Speit G, Radermacher P. DNA damage after long-term repetitive hyperbaric oxygen exposure. J Appl Physiol 106: 311-315, 2009. First published November 20, 2008 doi:10.1152/japplphysiol.90737.2008.-A single exposure to hyperbaric oxygen (HBO), i.e., pure oxygen breathing at supra-atmospheric pressures, causes oxidative DNA damage in humans in vivo as well as in isolated lymphocytes of human volunteers. These DNA lesions, however, are rapidly repaired, and an adaptive protection is triggered against further oxidative stress caused by HBO exposure. Therefore, we tested the hypothesis that long-term repetitive exposure to HBO would modify the degree of DNA damage. Combat swimmers and underwater demolition team divers were investigated because their diving practice comprises repetitive long-term exposure to HBO over years. Nondiving volunteers with and without endurance training served as controls. In addition to the measurement of DNA damage in peripheral blood (comet assay), blood antioxidant enzyme activities, and the ratio of oxidized and reduced glutathione content, we assessed the DNA damage and superoxide anion radical (O2•Ϫ ) production induced by a single ex vivo HBO exposure of isolated lymphocytes. All parameters of oxidative stress and antioxidative capacity in vivo were comparable in the four different groups. Exposure to HBO increased both the level of DNA damage and O2•Ϫ production in lymphocytes, and this response was significantly more pronounced in the cells obtained from the combat swimmers than in all the other groups. However, in all groups, DNA damage was completely removed within 1 h. We conclude that, at least in healthy volunteers with endurance training, long-term repetitive exposure to HBO does not modify the basal blood antioxidant capacity or the basal level of DNA strand breaks. The increased ex vivo HBO-related DNA damage in isolated lymphocytes from these subjects, however, may reflect enhanced susceptibility to oxidative DNA damage. combat swimmers; underwater demolition team divers; endurance training; comet assay; superoxide radical; superoxide dismutase; catalase; glutathione peroxidase EXPOSURE TO HYPERBARIC OXYGEN (HBO), i.e., pure oxygen breathing at supra-atmospheric pressures, increases the formation of oxygen radical species (21, 27), which in turn results in consumption of antioxidants (2, 23) and reduces antioxidant enzyme activity (4), ultimately causing lipid peroxidation (3, 4, 26, 31), organ injury (5), and DNA damage (10, 11, 17, 20, 26, 32-37, 39 -42). On the other hand, HBO was reported to promote protective preconditioning against ischemia-reperfusion-induced oxidative organ injury in the brain, spinal cord, heart, and liver (16,28,45,46). Furthermore, in healthy volunteers, the HBO-induced DNA damage not only rapidly disappeared after the end of the HBO exposure, but a subsequent exposure did not cause oxidative DNA damage any more (10), indicating the induction of antioxidant de...