Sports-related lung injury during breath-hold diving

Abstract

The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage. @ERSpublications Breath-hold diving may result in acute respiratory symptoms, but does not lead to chronic lung dysfunction http://ow.ly/D03r302uMOD

Physiology of static breath holding in elite apneists

“…The acute dangers associated with competitive apnoea are apparent and should not be underestimated, e.g. lung injury associated with glossopharyngeal insufflation (Chung et al, 2010;Mijacika & Dujic, 2016), barotrauma, syncope, drowning and shallow water blackout during depth dives (Lindholm & Lundgren, 2009); as well as cardiac arrest, especially when breath holds are performed in cold water (Hong, Song, Kim, & Suh, 1967). The longer-term health impacts of competitive static breath holding, however, remain less understood.…”

Environmental Physiology and Diving Medicine

“…Based on this concept, divers could not have reached more than 30–35 m depths, while in fact in 1903 a Greek sponge fisherman, Georgios Stattis, descended to 71 m holding his breath to recover the anchor of an Italian ship, the “Regina Margherita” ( Bosco et al, 2007 ). However, hemoptysis can occur during breath-hold diving, and fatal pulmonary hemorrhage has been described ( Mijacika and Dujic, 2016 ). Furthermore, rupture of the pulmonary capillaries can allow air to enter the vasculature and cause cerebral arterial gas embolism ( Kohshi et al, 2000 , 2005 ).…”

Evolution of the respiratory function of professional divers over 15 years

“…But it seems that it is useful to follow this parameter. Tezlaff et al [23] showed that expiratory flows at low pulmonary volumes are one of risk factors of pulmonary barotraumas [1,[23][24][25].…”