Sight Search

Caring For Your People

The DAN-SA Hazard Identification and Risk Assessment programme promotes a culture of safety at diving businesses. Learn about the importance of caring for your staff members and clients.
In the Autumn 2015 Alert Diver edition, we took a broad look at how the DAN-SA Hazard Identification and Risk Assessment (HIRA) programme intends to change the way in which diving businesses approach safety. The idea is to develop a culture of safety within diving businesses, rather than to simply provide an added service to fulfil a necessary obligation. We would like this to become an intrinsic value that diving customers will look out for specifically when choosing with whom they dive.

In a world where the customer is the top priority, can a business truly afford to invest in the safety of its own people without compromising the service to its clients? Then again, can a client truly come first if the employees and hired hands are at risk? How can a business apply the principles of the HIRA process in a way that serves both the clients and its own people?
In this article, we will focus on caring for your staff members as the core objective of the HIRA programme. We will use familiar concepts such as identifying the hazards, assessing the real risks, mitigating these risks and then monitoring the outcomes to provide an objective means to assess if the processes are effective. Once a foundational culture of safety is established amongst the staff, caring for the clients (the divers) becomes a natural extension of the culture, rather than simply a job.

Staff Member Health and Safety 

In many parts of the world, diving businesses employ freelance, contracted or migrant staff members. As a result, the period of employment is usually relatively short, and it may not be obvious or even seem sensible to make any special investment in the health of these staff members. Moreover, some of the most pristine and spectacular dive sites are located in the developing countries where statutory staff health and safety obligations are rarely enforced on the employer. This may create the impression that these obligations do not even exist. However, a quick glance at the website for the International Labour Organisation (ILO) at tells a very different story.

Almost all countries have accepted the obligations of the ILO constitution. This in turn implies that any person who could in any way be judged as deriving a benefit from the service of others would fall under the suitable provisions for employment even in the loosest sense of this word.

They, therefore, need to be protected against any form of unnecessary risk, abuse or mistreatment whilst under the responsibility of an employer.

It also clearly shows that whilst many business owners might claim that there are no such definitions, rules and responsibilities, these do actually exist even though they are perhaps not always easy to find. Most countries uphold the principle that the ignorance of the law is no excuse for breaking it. Therefore, attempting to justify negligence or the abuse of staff by claiming ignorance would be a very shaky excuse. It is true that the specifics may not be clear, but the onus remains on the beneficiary of the services, namely the employer, to find, understand and meet the legal requirements.

But, we are not here to discuss legal obligations. Rather, we want to understand the actual risks to the business and then figure out how best to mitigate them.
Staff Member Health and Safety Requirements

In most countries, there will be an existing set of requirements that needs to be complied with. These requirements are put in place to protect the health and welfare of any person who is employed in any fashion by another. It is thus imperative that you accept this requirement as a reality, take advice on what is required, and then to display the relevant legislation or make it available and known to all the staff members.

Remember that laws are there to protect both the employee and the business. If you follow the rules and something still happens, you have a good chance of mitigating responsibility. This is surely better than always being at the sharp edge of the sword.

Establishing a Health and Safety Policy

It is important to establish a clear, effective and appropriate health and safety policy within the business. Being proactive sends a very clear message to your staff members, and through them, to your clients.

The question of what such a policy should contain is dependent on the size, nature and scope of your activities, but the risks you need to cover here include, as a minimum:
  • Clearly spelling out the hazards that are inherent to the workplace;
  • Ensuring that employees are covered by a suitable form of compensation insurance as well as diving insurance;
  • Appointing a staff representative who is responsible for considering and speaking-up on safety matters;
  • Establishing a staff medical surveillance programme; and
  • Providing suitable protection against all identified workplace hazards.
To tie this all together, we need to illustrate the utmost importance of monitoring health and safety policies. It is not sufficient to simply tell your staff members about a hazard (sun) and to then simply provide them with some protection (sunscreen), as you are legally obligated to ensure that such a work-request is implemented. So, yes, this would actually mean writing up a member of staff who fails to heed your health and safety warnings.

Staff Member Training and Certification

Any client would expect a business’ diving instructors and guides to be professionals, thus properly trained and competent. This requires a continuous staff training and evaluation system to ensure that all the staff members, especially in high staff-turnover situations, are familiar with all the aspects of the advertised diving excursions, and especially with any foreseeable emergency situations.

Of course there is more to it than this, as training for new staff members should not only focus on the diving aspects, but also on all other safety procedures, such as equipment handling and maintenance, legislative requirements and the necessary first responder skills.

So, what do we look for when assessing staff member training and certification? A diving business requires a formal staff training process where training logs and certifications are maintained, where a competent staff training person is either available at the business location, or at least dedicated to that business, and where all the required first responder skills are current and on record. We therefore advocate that, as a minimum, a diving business should be able to:
  • Provide first aid on site;
  • Provide basic life support on site;
  • Provide high-concentration oxygen on site;1
  • Perform a neurological examination on site; and
  • Preferably have the ability to utilise an automated external defibrillator (AED), especially for remote dive sites which are far from suitable resuscitation facilities.

Client Health and Safety

With a sound staff caring system in place, a business is better equipped and primed to provide at least the same level of care to its clients.

The most obvious aspects of client health and safety would include ensuring that all clients are certified divers, fit to dive and that any medical- or health-related issues are communicated to the diving guides prior to any diving excursion. This might even include special needs such as assistance for handicapped scuba divers. Clients also face several other health challenges, some of which are not directly related to diving. These health challenges may require that suitable travel advisory information is provided during their initial travel planning stage.

Thus, the dive operator needs to address the following client risks in advance:
  • The client needs to complete a comprehensive, formalised and confidential health questionnaire that focuses on any significant reasons why he or she might need further medical clearance. The dive operator then needs to ensure that only fit-to-dive clients are taken to the dive site.
  • The dive operator needs to check the availability and validity of the client’s appropriate dive medical insurance, together with the relevant contact details in the event of a medical or safety emergency.
  • The dive operator needs to record the client’s emergency contact details.
  • The client needs to sign a suitable indemnity form to protect the diving business from unnecessary or undeserved claims for losses or injury.
  • The dive operator needs to enjoy adequate indemnity insurance that is in place for both professional and public liability.
  • The dive operator needs to ensure that clients are certified divers and have some form of a dive logging system in place. This will aid the decision as to whether a diver needs a refresher course based on when their last dive was done.
  • The dive operator needs to brief clients as to the restricted areas both at the diving business site, such as compressor rooms, as well as at the dive sites or on-board the dive boat. Note that suitable signs are also needed to indicate the restricted areas.
  • The dive operator needs to explain the policy that is in place to restrict or even cancel a dive should excessive risks arise due to the weather, sea state, presence of hazardous marine life, the non-availability of safety equipment (such as oxygen), or where mandated by the local authorities.
Please remember that post-dive checks of both staff members and clients are essential. An appropriate level of vigilance should be maintained for any signs and symptoms of decompression illness (DCI) or any sudden or significant changes in a person’s health status, such as extreme fatigue, fever or malaise. 

All clients should be briefed with the following post-dive restrictions:
  • Divers must not be exposed to altitude (flying or driving over mountains) for
  • 18 to 24 hours after completing a dive.2
  • Divers must keep well hydrated (approximately 200 mℓ every 30 minutes or so).
  • Divers must not take part in any strenuous exercise for at least four hours after
  • no-decompression dives and more than eight hours for decompression dives.
  • Divers must keep the after-hours and emergency numbers on hand in order to contact the business or local medical facility, respectively, if they experience any signs or symptoms of DCI or any significant changes in their health status.

Travel and Health Advice for Clients

The final part of this puzzle is to provide clients with good advice well in advance about travelling to your destination. It inspires confidence and may avoid many difficulties or disappointments. There is quite a list of prompts that can be provided depending on your location, your situation and the health and associated risks of the region. By alerting your clients to plan carefully, it shows that you take health and safety issues seriously. It also avoids having to turn down individuals if they have disqualifying medical conditions and it assures that everybody knows that you have their safety and best interests at heart.

Below is a list of considerations to note of before travelling to your destination. These aspects are all based on the risks that might apply, together with the suitable risk mitigation steps:
  • Health and safety: This list could be long and may include advisories on recommended vaccinations, the risk of malaria or other relevant endemic diseases (like yellow fever)and the need for adequate travel insurance.
  • Associated health advice: Here we want to advise clients to pack appropriate medication; offer precautionary information about certain substances (for example the information about relevant drug law enforcement issues and the possible need for proof of a medical prescription for any controlled substances), sunscreens and insect repellents; help clients to understand the standard of local healthcare facilities and the availability of recompression facilities; and to be mindful of general and environmental concerns, such as the availability of drinking water, local foods, disease transmission and general hygiene issues.
  • Costs and general information: Although perhaps more a matter of convenience, let your clients know about the local currency, the availability of ATMs, the acceptability of credit cards versus cash, tipping practices, electricity supply and suitable electricity adapters, and also the fast-becoming essential issue of Internet or Wi-Fi access.
  • Visas, documents and customs formalities: Let your clients know well in advance what documentation they need to be able to visit a specific country, to drive, to show local and returning health authorities, and to clear their diving gear through customs. Also notify your clients about any baggage restrictions as some island-hopping flights have limited space and weight allowances.
  • Getting around locally: Inform your clients about the preferred and reliable local transport services, and which are less so; any considerations that might affect their travel insurance, such as unchartered flights or unlicensed transport services; and whether self-driving is recommended or not. Also, if relevant, you may want to make your clients aware of local annoyances such as petty theft and to be aware of personal security issues.
  • Weather: Perhaps all is fair and equal underwater, but there are definitely better times to travel weather-wise and therefore suitable clothing, rain protection and other appropriate attire certainly makes atmospheric malaise more manageable.
  • History and culture: Finally, some advice on what to wear to ensure that clients do not end up in awkward or perhaps even dangerous situations. Relay any cultural sensitivities or behaviour that is considered particularly unacceptable or offensive and even what languages are spoken or understood. 

In Conclusion

All successful businesses know that the true heart of a venture lies in its people. Managing or at least acknowledging the workplace stresses ensures that your clients arrive prepared. It also shows everyone that you have thought through the issues that might present themselves. This will not only reduce the likelihood of incidents or accidents, but it will also ensure that everybody feels truly cared for. Even if things do go wrong, being prepared does much to inspire confidence, reduce panic and mitigate any negative impact on the business. Indeed, there is no better advertisement for a sustainable diving business than to demonstrate a culture of safety awareness.

Download the HIRA guide

No Comments


Aqua Pool Noodle ExercisesUnderwater Photographer and DAN Member Madelein Wolfaardt10 Simple Things You Can Do to Improve Your Underwater PhotographyCOVID-19 and Diving: March 2021 UpdateDiver Return After COVID-19 Infection (DRACO): A Longitudinal AssessmentGuidelines for Lifelong Medical Fitness to DiveExperienceFitness Myth or Fitness Fact?The Safety of Sports for Athletes With Implantable Cardioverter-DefibrillatorsCardiovascular Fitness and DivingHypertensionPatent Foramen Ovale (PFO)Headaches and DivingMiddle-Ear Barotrauma (MEBT)O’Neill Grading SystemMask Squeeze (Facial Barotrauma)Sinus BarotraumaInner-Ear Barotrauma (IEBT)Middle-Ear EqualisationAlternobaric VertigoDecompression IllnessOn-Site Neurological ExaminationTreating Decompression Sickness (The Bends)Top 5 Factors That Increase Your Risk of the BendsHow to Avoid Rapid Ascents and Arterial Gas EmbolismUnintended Rapid Ascent Due to Uncontrolled InflationUnexpected Weight LossFlying After DivingWisdom Tooth Extraction and DivingYour Lungs and DivingScuba Diving and DiabetesDiving after COVID-19: What We Know TodaySwimmer’s Ear (Otitis Externa)Motion SicknessFitness for DivingDiving After Bariatric SurgeryWhen to Consult a Health-Care Provider Before Engaging in Physical ActivitiesFinding Your FitnessHealth Concerns for Divers Over 50Risk Factors For Heart DiseaseJuggling Physical Exercise and DivingSeasickness Prevention and TreatmentMember to Member: Guidelines for SeniorsHigh-Pressure OphthalmologyOver-the-Counter Medications
immersion and bubble formation Accidents Acid reflux Acute ailments After anaesthesia Air Quality Air exchange centre Air hose failure Air supply Airway control Air Alert Diver Magazine Alternative gas mix Altitude changes Altitude diving Altitude sickness Aluminium Oxide Ama divers Amino acids Anaerobic Metabolism Animal life Annual renewal Apnea Apnoea Aquatic life Aquatics and Scuba Diving Archaeology Arterial Gas Embolisms Arterial gas embolism Arthroscopic surgery Aspirin Aurel hygiene BCD BHP BLS BWARF Back adjustment Back pain Back treatment Backextensors Badages Bag valve mask Bahamas Balancing Bandaids Barbell back squat Barometric pressure Barotrauma Basic Life Support Batteries Becky Kagan Schott Bench press Benign prostate hyperplasia Benzophenones Beth Neale Beyond Standards Bilikiki Tours Biophysics Black Blood flow Blood thinners Blue Wilderness Blue economy Blurred vision Boat safety Boesmans gat Boesmansgat Bone fractures Bouyancy compensators Boyle's Law Boyle\'s Law Bradycardia Brain Breast Cancer Breath Hold Diving Breath holding Breath hold Breath-hold Breathing Gas Breathing gas contamination Breathing Breathold diving Bright Bank Broken bones Bruising Bubbleformation Buddy Exercise Buddy checks Buoyancy Burnshield CGASA CMAS CO2 COVID-19 Updates COVID-19 COVID CPR Cabin pressure Caissons diseas California Camera equipment Camera settings Cameras Cancer Remission Cancer treatments Cancer Cannabis and diving Cannabis Cape Town Dive Festival Cape Town Dive Sites Cape Town CapeTown Carbon Monoxide Carbon dioxide Cardio health Cardiological Cardiomyopathy Caribbean Carmel Bay Catalina Island Cave diving Challenging Environments Chamber Safety Chamber science Charging batteries Charles' Law Charles\' Law Charles\\\' Law Charles\\\\\\\' Law Charles\\\\\\\\\\\\\\\' Law Charlie Warland Chemotherapy Chest compressions Children diving Chiropractic Chlorophll Christina Mittermeier Citizen Conservation Cleaning products Closed Circuit Rebreathers Cmmunity partnership Coastalexcursion Cold Water Cold care ColdWater Cold Commercial Fishing Commercial diving Commercial schools Composition Compressed Air Compressed gas Consercation Conservation Photographer Conservation photography Conservation Contact lenses Contaminants Contaminated air Coral Conservation Coral Reefs Coral Restoration Coral bleaching CoralGroupers Corals Core strength Corona virus Coro Costamed Chamber Courtactions Cozumel Cristina Mittermeier Crohns disease Crowns Crystal build up Crystallizing hoses Cutaneous decompression Cylinder Ruptures Cylinder handwheel Cylinder valves DAN Courses DAN Profile DAN Researchers DAN medics DAN members DAN report DCI DCS Decompressions sickness DCS theories DCS DEMP DM training DNA DReams Dalton's Law Dalton\'s Law Dalton\\\'s Law Dalton\\\\\\\'s Law Dalton\\\\\\\\\\\\\\\'s Law Danel Wenzel Dangerous Marinelife Dauin island Dean's Blue Hole Dean\'s Blue Hole Deco dives Decompression Illness Decompression Sickness Decompression Stress Decompression illsnes Decompression treatment Decompression Decorator crabs Deep diving Deep water exploration Deepest SCUBA Dive Delayed Offgassing Dental Dever Health Diaphragms Diopter Diseases Disinfection Dive Buddy Dive Chamber Dive Computer Dive Destinations Dive H Dive Industry Dive Instruction Dive Instructor Dive Medical Form Dive Medical Dive Practices Dive Pros Dive Research Dive Safety Tips Dive South Africa Dive Training Dive Travel Wakatobi Dive Travel Dive accidents Dive buddies Dive computers Dive courses Dive excursions Dive exercise Dive experience Dive fitness Dive gear Dive heallth Dive health Dive medicals Dive medicines Dive medicine Dive operators Dive planning Dive procedures Dive safety 101 Dive safety Dive safe Dive skills Dive staff Dive travels DiveLIVE Diveleader training Diveleaders Diver Health Diver Profile Diver infliencers Diver on surface Divers Alert Divesites Diving Divas Diving Kids Diving Programs Diving Trauma Diving career Diving emergencies Diving emergency management Diving fit Diving guidelines Diving injuries Diving suspended Diving Dizziness Dolphins Domestic Donation Dowels Dr Rob Schneider Drift diving Drysuit diving Drysuit valves Drysuits Dyperbaric medicines EAPs EAP Ear pressure Ear wax Ears injuries Eco friendly Education Electronic Emergency action planning Emergency decompression Emergency plans Emergency underwater Oxygen Recompression Emergency Enviromental Protection Environmental factors Environmental impact Environmental managment Equalisation Equipment care Equipment failure Equipment inspection Evacuations Evacuation Evaluations Even Breath Exercise Exhaustion Exposure Protection Extended divetime Extinguisher Extreme treatments Eye injuries FAQ Factor V Leiden Failures FalseBay Diving Fatigue Faulty equipment Female divers Fetus development Fillings Fire Coral Fire Safety Firefighting First Aid Equipment First Aid Kit First Aid Training First Aid kits Fish Identification Fish Life Fish Fit to dive Fitness Training Fitness to dive Fitnesstrainng Fitness Flying Focus lights Foundations Fractures Francesca Diaco Francois Burman Fredive Free Student cover Free diving Free flow Freedive INstructor Freedive Training Freediver Freediving Instructors Freediving performance Freediving Gar Waterman Gas Density Gas consumption Gas laws Gas mixes GasPerformance Gases Gass bubbles Gastoeusophagus Gastric bypass Gastroenterologist Gear Servicing Germs Geyer Bank Giant Kelp Forest Giant Kelp Gobies Gordon Hiles Great White Sharks Guinness World Record Gutt irritations HCV HELP HIRA HMLI HMS Britanica Haemorhoid treatment Hazard Description Hazardous Marine life Hazardous marinelife Health practitioner Heart Attack Heart Health Heart Rate monitor Heart fitness Heart rates Heart rate Heart Heat stress Helium Hepatitis C Hepatitus B Hiatal Hernia High Pressure vessels High temperatures Hip strength Hip surgery Hippocampus History Hot Humans Hydrate Hydration Hydrogen Hydroids Hydrostatic pressure Hygiene Hyperbaric Chamber Hyperbaric research Hyperbarics Hypothermia Hypoxia I-52 found INclusivity IdentiFin Imaging Immersion Immine systems In Water Recompression Indemnity form Indian Ocean Indonesia Inert gas Infections Infra red Imaging Injections Inner ear Instinct Instruction Instructors Insurance Integrated Physiology International travel International Interval training Irritation Irukandji Syndrome Isotta housing Joint pain Junior Open Water Diver KZN South Coast Karen van den Oever Kate Jonker KateJonker Kidneys Kids scubadiver Komati Springs KwaZulu Natal Labour laws Lake Huron Laryngospasm Lauren Arthur Learning to dive Legal Network Legal advice Legislation Lembeh Straights Lenses Leukemis Liability Risks Liability releases Liability Life expectancy Lifestyle Lightroom editing Live aboard diving Liver Toxicity Liver diseas Liz Louw Lost at sea Low blood pressure Low pressure deterioration Low volume masks Lung Irritation Lung function Lung injuries Lung squeeze Lung surgery Lung MOD Macro photography Maintenance Malaria Mammalian Dive Response Mammalian effect Mandarin Fish Marine Biology Marine Science Marine Scientists Marine conservation Marine parks Marinelife Masks Master scuba diver Maximum operating depth Medical Q Medical emergencies Medical questionaire Medical statement Medicalresearch Medication Mehgan Heaney-Grier Mermaid Danii Mesophotic Michael Aw Middle ear pressure Mike Bartick Military front press Misool Resort Raja Ampat Mixed Gas Mono Fins Mooring lines More pressure Motion sickness Mozambique Muscle pain Mycobacterium marinum National Geographic Nausea Nautilus Ndibranchs Neck pain Neoprene layers Neuro assessments Neurological assessments Nitrogen Narcosis Nitrogen build up Nitrox No-decompression Non-nano zinc oxide Non-rebreather Mask Nonrebreather masks Normal Air North Sulawesi Nosebleeds Nuno Gomes O2 providers O2 servicing OOxygen maintenance Ocean Projects Ocean Research Ocean pollution Oil contamination Open water divers Optical focus Orbital implants Oronasal mask Osteonecrosis Out and about Out of air Outer ears Outreach Overhead Envirenments Oxygen Administration Oxygen Cylinder Oxygen Units Oxygen deficit Oxygen deicit Oxygen dificiency Oxygen ears Oxygen equipment Oxygen masks Oxygen supplies Oxygen supply Oxygen systems Oxygen therapy Oxygen P J Prinsloo PADI Freedivers PFI PJP Tech Parentalsupervision Part 3 Partner Training Perspective Philippine Islands Philippines Phillipines Photographers Photography tips Photography Physical Fitness Physioball Physiology Physiotherapy Pills Pistons Planning Plastic Pneumonia Pneumothorax Poison Pollution Pool Diving Pool workout Post-dive Pre-dive Predive check Pregnancy Pregnant divers Preparation Prepared diver Press Release Preventions Professional rights Provider course Psycological Pulmanologist Pulmonary Barotrauma Pulmonary Bleb Pulmonary Edema Pulse Punture wounds Pure Apnea Purge RAID South Africa RCAP REEF Radio communications Range of motion Rashes Rebreather diving Rebreatherdive Rechargeable batteries. Recompression chamber Recompression treatment Recompression Recycle Reef Chcek Reef Conservation Reef safe Reef surveyors Refractive correction Regulator failure Regulators Regulator Remote areas Renewable Report incidents Rescue Divers Rescue Procedure Rescue breathing Rescue breaths Rescue training Rescue Resume diving Return To Diving Return to diving Risk Assessments Risk assesments Risk assessment Risk elements Risk management Roatan Marine Park Roatan SABS 019 SMB SafariLive Safety Gear Safety Stop Safety SaherSafe Barrier Salty Wanderer Sanitising Sara Andreotti Sardine Run Saturation Diving Save our seas Schrimps Science Scombroid Poisoning Scuba Air Quality Scuba Guru Scuba Injury Scuba Instructor Scuba children Scuba dive Scuba education Scuba health Scubalearners Scubalife Sea Horses Sea slugs Sealife Sea Shallow dives Shark Protection Shark Research Shark conservation Shark diving Sharks Shipwrecks Shoulder strength Sideplank Signs and Symptoms Sit-ups Skin Bends Skin outbreak Skin rash Snorkeling Snorkels Social Distancing Sodwana Bay Solomon Islands Sonnier bank South Africa Spinal bends Spinal cord DCS Spinal pain Splits Squeezes Squid Run Stability exercise Standars Stay Fit Stents Step ups Stephen Frink Stepping up Strobe Lighting Stroke Submerge tech Submerged Sudafed Sulawesi Sun protection Sunscreen Supplemental oxygen Surface Marker Buoys Surface supplied Air Surfaced Surgeries Surgery Suspension training Symbiosis TRavel safety Tabata protocol Talya Davidoff Tattoes Tec Clark Technical Diving Technical divng The Bends The greatest Shoal The truth Thermal Notions Thunder Bay National Marine Sanctuary Tides Tips and trick Tooth squeeze Transplants Travel smarter Travel tips Travel Tropical Coastal Management Tunnelling Tweezers Ultrsound Umkomaas Unconsciousness Underground work Underseaa world Underwaater Photos Underwater floral Gardens Underwater hockey Underwater photographer Underwater photography Underwater pho Underwater University of Stellenbosch Urinary retention. Vaccines Vagus nerve Valsalva manoeuvers Valve stem seals Vape Vaping Vasopressors Vasvagal Syncope Venting Verna van Schak Virus infections Volatile fuels WWII wrecks War stories Washout treatments Wastewater Watchman device Water Resistance Water Weakness Weigang Xu Weights West Papua Western Cape Diving Wet Lenses Wet diving bell Wetsuit fitting Wetsuites Wetsuits White balance Wide Angle Photos Wide angles Wildlife Winter Wits Underwater Club Woman in diving Womans health Woman Women In Diving SA Women and Diving Women in diving Womens health Work of Breathing Workout World Deeepst Dive Record World Records Wound dressings Wreck divers Wreck dive Wreck diving Wreckdiving Wrecks Yoga Youth diver Zandile Ndholvu Zoology abrasion absolute pressure acoustic neuroma excision adverse seas air-cushioned alert diver altitude alveolar walls anemia antibiotics anticoagulants antiseptics bandages barodontalgia bent-over barbell rows bioassays body art breathing air calories burn carbon dioxide toxicity cardiovascular cerebrospinal fluid cervical spine checklist chemo port children child chronic obstructive pulmonary disease clearances closed circuit scuba corrective lenses currents cuts dead lift decompression algorithms decongestants decongestion dehydration dive injuries dive medicing dive ready child dive reflex dive tribe diver in distress diver rescue diver training dive diving attraction doctors domestic travel dri-suits drowning dry mucous membranes dry suits dry e-cigarettes ear spaces elearning electrolyte imbalance electroytes emergency action plans emergency assessment emergency training environmentally friendly equalising equalizing exposure injuries eyes fEMAL DIVERS fire rescue fitnes flexible tubing frediving freedivers gas bubble gas poisoning gastric acid gene expression health heartburn histidine hospital humidity immersion and bubble formation immersion pulmonary edema (IPE informal education isopropyl alcohol jaundice join DAN knee laparoscopic surgery longevity lower stress malaise marielife marine pathogens medical issues medical procedures medical risk assesment medications mental challenge mental preparedness micro-organisims micro minor illness mucous membranes nasal steroids nasal near drowning nematocysts neurological newdivers nitrogen bubbles off-gassed operating theatre operations orthopeadic otitis media outgas pain perforation phillippines phrenic nerve physical challenges pinched nerves plasters pneumoperitoneum polyester-TPU polyether-TPU post dive posture prescription mask preserve prevention proper equalization psychoactive pulmonary barotrauma. pulmonary injury. pulmunary barotrauma radiation rebreather mask rebreathers retinal detachment risk areas safety stops saturation scissors scuba equipment scuba single use sinus infections smoking snorkeling. spearfishing sterilising stings strength sub-aquatic sunscreen lotion swimmers ears tattoo care tecnical diver thermal protection tissue damage toxicity training trimix unified standards upwelling vision impaired warmers water quality zinc oxide