Caisson disease in Thailand: Death rate

Caisson disease is an important condition that can be seen in diver. It is an important form of decompression illness that requires proper therapeutic management[1,2]. The problem can be sporadically seen in any coastal country. In Thailand, as a country with a long coastal line of more than one thousand kilometers, this problem can be seen. According to the recent report, this condition is an important consideration in maritime occupational health[3]. However, there are limited numbers of publications in caisson disease. Gold et al. published a paper on the illness in local diver but it is not specific to the caisson disease[4]. Here, the authors try to summarize the published paper on caisson disease in Thailand and try to find out the death rate in the cases. The authors use search engines as PubMed and Thai index medicus for searching. According to the searching, there are only 2 local publications on caisson disease[5,6]. In addition, the incomplete information can be seen in the published paper (due to the nature of local publication with low academic quality). Of interest, on the cases with available data, overall death rate of caisson disease in Thailand is equal to 100%. In fact, there are many explanations for the observed extremely high death rate. First, as note, due to the incomplete record and report, the available data might be only on the death cases. In fact, case recording and reporting is the critical step for proper disease surveillance for caisson disease[7,8]. Second, this might reflect the poor technology for management of caisson disease in Thailand. In fact, there are only few medical centers in Thailand that can care caisson disease. In Thailand, the available hyperbaric oxygen therapy is routinely used for other purposes, not for the management of caisson disease[9-11].