Installment Three of “DAN’s Most Wanted List”: Diver Health

Hi Friends!

Today is our final blog post on the DAN (Divers Alert Network) 2016 annual diving report. (For more information, see our March 30 post, DAN Publishes Annual Report.) The focus of this series has been the “Ten Most Wanted Improvements in Scuba” list and thus far we’ve talked about how the list addressed dive gear and dive planning. Today’s theme is diver health. Let’s take a closer look at some of the “most wanted” improvements with respect to your health and safety.

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#1: Improved Cardiovascular Health in Divers

If there’s one thing that the latest DAN report does well, it’s outlining the links between age, cardiovascular health, and dive safety. Take the following passage, for example:

That more than half of all recreational diving fatalities [in the report] were aged 50 or over highlights the importance of maintaining fitness to dive as divers age. High blood pressure and heart disease were the most common pre-existing health conditions known among 2014 diving fatalities, and obesity was more common at 51% than found in the general living population at 35% (DAN 2016: 21).

While there’s not much that can be done do to prevent getting older, maintaining good cardiovascular health, regular checkups, and preparation can all go a long way in keeping you safe in the water. Read on for some tips.

  • Time for a little mo’ cardio

SCUBA is often considered a leisure activity, more so than a sport. While this is true some of the time, the fact that almost 1/3 of dive fatalities are associated with an accute cardiac event indicates divers should not be complacent about their health. Divers need to be physically prepared for situations that require increased cardiovascular output, such as diving against current or participating in a rescue, in order to keep themselves and those around them safe.

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The type of shape you should be in to dive depends on myriad factors, and because there are no “official” exercise regimens in SCUBA, how you decide to keep in shape is largely up to you. If you are looking for ideas, this article is a good start. As always, consult with your physician if you are starting a new regimen.

  • Make regular checkups part of your dive MO

An unfortunate reality of the dive industry is that while most certification agencies require new divers to fill out a health form and get a checkup before going through basic certification, very few require periodic checkups afterward, instead leaving those as the responsibility of individual divers. Since fitness level, general health, and medications change over time, dive physicals shouldn’t be treated as a “one and done” affair. Curious about how often you should schedule physicals? There aren’t any hard and fast rules, so consult with your doctor to find a plan that’s right for your individual health needs.

Also, while it’s no replacement for an actual face-to-face meeting with your physician, it’s a good idea to looking over this list to make sure no new health conditions have developed up since you were last in the water. If any of these questions can be answered with a “yes,” then avoid SCUBA until you obtain medical clearance.

  • Understand risk factors and be prepared

The DAN report makes clear what many of us probably already guessed intuitively: aging, preexisting heart and cardiovascular conditions, and being overweight increase the risk of death or injury while diving (DAN 2016: 21). However, it’s important to remember that these are simply risk factors, and if managed correctly, don’t necessarily preclude diving. Like any other activity, you need to determine your own limits and dive within them. Always alert your dive master and/or buddy to your personal limits and don’t be ashamed to ask for accommodations. For example, something as simple as donning your gear in the water can help prevent fatigue or stress.

Another way to manage risk is to have plans in place in case you suffer a dive-related injury. Always double check what your regular health insurance will cover in the event of a SCUBA-related injury and consider supplemental DAN insurance. Since a dive emergency often requires plane transport, consider getting insurance for air transport.

#2: Fewer Equalizing Injuries

When people think of SCUBA injuries, their minds frequently wander to dark places: shark attacks, abandonment à la the film Open Water, and, of course, running out of air. The reality is the most common injury is a lot more banal than any of those: its barotrauma to the ear. That’s great news because, in addition to being far less scary than the aforementioned scenarios, ear injuries are much easier to prevent. Read on for some tips on how to make sure you don’t become part of a common, yet avoidable, dive statistic.

  • Review where and when you need to equalize

“Equalize early and often” is an oft-repeated mantra on any dive boat, yet is easily forgotten if it’s been a while since you’ve been in the water. While equalization is typically associated with the ears, remember that your sinuses, facemask, and lungs are just as important. Looking for a refresher on equalization? This article is a great place to start.

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Not a good look for anybody

While good equalization usually comes down to proper execution, a proper-fitting mask is also important. The Kona Honu Divers shop staff are awesome at matching masks to individual faces, and our store has a great selection of scuba and low-profile freediving masks.

  • Master descents and ascents

I can’t emphasize how important it is to master slow and controlled descents and ascents, especially for those who need extra time to equalize. Unfortunately, the #1 resource divers have for this is often ignored: the descent/ascent line. These lines, which on Kona Honu dives are moorings, are super useful because they allow divers to easily adjust their depth and the rate. For guided dives, I always recommend you let the dive master know you are slow to equalize so they can get you in the water first and give you a head start to the bottom. It’s also important you review with your dive master and/or buddy the hand signals and protocols that will be in use if you are having trouble with your ears during descents/ascents.

  • Dive only when healthy

We get it: getting sick on vacation sucks, especially when you’ve got a bunch of dives planned. Still, it’s prudent to resist the urge to power through any colds, allergies, or other conditions that cause congestion. Diving with any of these conditions can result in serious injuries that could keep you out of the water way longer than if you would have just let nature take its course.

#3: Greater Attention to Diving Within Limits

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Even though a healthy lifestyle will definitely improve your diving, the common fitness trope of “pushing your limits” actually puts you at risk during SCUBA. Rather, safe diving is very much about knowing limits and staying within them. Read on to learn about how to determine your limits and apply them to your own diving practice.

  • Review altitude after diving rules

As you may or may not remember from certification, you have to observe special planning and procedures to go to altitude after diving. Commonly referred to as “flying after diving” rules, this term is somewhat of a misnomer because it’s not just flying that poses a risk, but going to any altitude above sea-level. This is particularly germane in a place like the Big Island of Hawai’i, where you can easily drive to altitudes thousands of feet above sea level in a relatively short amount of time.  This is easy to overlook, as evidenced by the common occurrence of people booking dives in Kona who are planning to drive back to Hilo the same day. Unfortunately, those divers are often caught off-guard by the fact that they can’t immediately return to their hotel because they were unaware that travel between the east and west sides of Hawai’i Island puts them above the altitude threshold.

Planning a little jaunt to Mauna Kea after your dive, are ya? Nope. No you are not.

So what counts as altitude? The DAN 2002 Consensus Guidelines for Flying After Recreational Diving apply to altitudes above 2,000 feet, so anything below that remains a gray level as far as risk of DCS is concerned, but generally is understood to have minimal risk. Anything above that, and the observance of the following *guidelines are strongly recommended:

-Single dives: No flying for at least 12 hours

-Multiple dives (more than one in a day or several days in a row): 18 hours

-Dives requiring decompression stops: 24 hours or more

So what’s that mean for diving in Kona? We recommend that you stay as close to sea level as you can for at least 18 hours after any of our tours. If you are curious about elevations on the BI, this map is a handy reference. Simply zoom to view the topography and elevation.

*It’s important to note that these guidelines are just that: guidelines. They aren’t absolute and there’s no guarantee that even with strict observance, you won’t get decompression sickness.

  • Invest in your own dive computer and make sure you understand it

One of the most valuable pieces of dive wisdom I’ve ever heard is that “There’s no such thing a ‘trust me’ dive.” Unfortunately, that’s exactly what a lot of people do every time they ignore their computer and opt for the cross-your-fingers-method of relying on their buddy or dive guide to keep them out of decompression. The problem with that is computers are individual pieces of equipment, and even small differences in dive profiles can influence nitrogen absorption. The good news is that dive computers are relatively simple compared to their on-land counterparts and are getting less and less expensive every year. Kona Honu Divers has a great selection at a variety of price points that should meet the needs of most divers. If you opt to rent a computer on our dives, feel free to ask any of the guides how to use them–that’s what we’re here for.

  • Take a course

Last, but not least, consider continuing education, especially if you want to do more diving on your own. I can’t recommend getting EAN (Nitrox) certified enough: your theoretical understanding of gas absorption will grow beyond what you learned in the Open Water Course and using Nitrox has ton of benefits in the water. Kona Honu also offers Advanced Open Water Certification, which includes instruction on deep diving and will increase your proficiency and confidence in planning dives.


Managing diver health is a complex exercise that is part art and part science; while statistics and dive medicine give us insight into risk factors and prevention, it’s up to every diver to translate this knowledge, along with his or her own intuition, into practice. As with anything SCUBA related, increasing your personal dive fitness is best approached through good training, the right gear, and proper theoretical knowledge.

Now that this series on the “Ten Most Wanted Improvements” is over, I’d love to hear if the suggestions have been helpful and if you’ve been inspired to make any changes to how you approach your diving. As always, feel free to comment and share.

Happy Diving!



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