British Thoracic Society guidelines on respiratory aspects of fitness for diving.

INTRODUCTION Need for recommendations on respiratory aspects of fitness to dive Diving has long been performed for commercial and military purposes but it has undergone a dramatic increase in popularity as a leisure pursuit over the past 30 years. It is estimated that, in the United Kingdom, 100 000 individuals participate in diving activities. In addition, diving technology has evolved rapidly, allowing divers to descend to greater depths and to dive in places which would previously have been impossible. As a sport, diving can be physically and emotionally demanding, and is associated with some specific risks. Medical practitioners are increasingly likely to be faced with requests to comment on fitness to undertake diving. Many of these requests relate to respiratory aspects of fitness. A number of existing guidelines or discussion papers on respiratory aspects of fitness to dive are in existence. However, the advice given in these is not consistent and these documents may not be readily available to the practising physician or general practitioner. The British Thoracic Society (BTS) Standards of Care Committee therefore established a Working Party to formulate national recommendations for assessing respiratory fitness to dive. This guideline is intended to provide respiratory physicians and physicians interested in diving medicine with a practical framework on which to base advice. The UK Sport Medical Diving Committee advises the British Sub Aqua Club, the Sub Aqua Association, and the Scottish Sub Aqua Club on aspects of fitness to dive. It has recently introduced a questionnaire-based declaration of fitness for prospective members of these organisations and advises that medical examination is required only when positive responses to the questionnaire are obtained. Commercial and military diving are subject to additional specific regulations.