Is a diving fitness test really NECESSARY?
A diving fitness examination is not mandatory for recreational divers, but is strongly recommended. This is a measure to prevent diving accidents. Physicians Physicians agree that the stay of people in an extreme environment is associated with health risks (e.g.: diving sickness). In order to keep these as low as possible, both the health and the general condition of the diver are examined in detail during the diving fitness examination.
Definition: Diving suitability examination
A fitness to dive examination is a medical examination to ensure that diving does not pose a health risk to the person concerned. Physical health is equally important for professional and recreational divers and should therefore be clarified in advance by a diving doctor. The concept of fitness to dive originated in military and commercial diving. If you take this thought further, it means that the examination for fitness to dive is influenced and regulated both by military service regulations and by trade association principles and laws. However, these regulations do not apply to scuba diving. In this context, it is more a preventive examination that aims to assess hyperbaric medical risks for the diver.
Necessity of a diving suitability examination
Diving accidents can be avoided with a diving fitness examination. However, this can only be limited to diving accidents that can be traced back to hyperbaric medical causes. Since diving entails health risks for the body, physical performance should be assessed in advance. In particular, if there are previous illnesses, a diving suitability examination should not be dispensed with. Pre-existing conditions that can limit diving fitness include, for example, asthma or diabetes. If there are previous illnesses, it must be checked in each individual case whether a certificate of fitness to dive can be issued. They are therefore used for prevention, which is why every diver should have such a diving fitness certificate. A diving fitness examination determines whether diving is possible for the person or whether the risk from a health point of view is too high. Even dive candidates with test scores that are less than perfect can pursue scuba diving. The limit values determine the range within which the results must move so that a certificate of fitness for diving can be issued. If, during the examination, the doctor finds limitations to the normal diving fitness, he can, for example, reduce the recommended maximum diving depth of the diver or otherwise adjust the dive profile. So he has the possibilities to minimize the risks that a diver could be exposed to.
How is a diving fitness examination carried out?
As a rule, a fitness to dive examination is a combination of different examination methods. At the beginning of the examination, a detailed questioning of the diving candidate is carried out, through which different factors play a role. In addition, a questionnaire is processed, with which various aspects from different areas are queried.
What is examined during a diving fitness examination?
In a diving fitness examination, the physical health of the diving candidate is examined in addition to personal and mental attributes. The focus is on the anamnesis, i.e. the questioning of the medical history. This procedure enables the doctor to get an accurate impression of the general state of health of the diving candidate.
Examination of physical health
After the medical history has been discussed in detail with the doctor, it is now a matter of assessing the current condition of the diving candidate. This involves looking for health disorders that can increase the risk of a diving accident. Ideally, the physical examination covers all organ systems. The eardrum and the auditory canals are also examined in detail in this step, as they are exposed to enormous stress during a dive due to the constant pressure equalization. Pressure equalization in particular is one of the most important skills when diving and, if not performed, can lead to a rupture of the eardrum. Overall, the physical examination includes the following areas:
• The heart
• The lungs
• The ears and sinuses
• The performance
Depending on the age and weight of the person concerned, additional examinations may be necessary to rule out that age or weight-related factors could limit the fitness to dive. In appropriate cases, X-ray examinations of the chest can be ordered, for example, in order to be able to assess the functionality more precisely. In addition to the physical examinations, the questionnaire also addresses the physical health of the dive candidate. Among other things, the following aspects are taken into account:
• Is the diving candidate physically able to swim longer distances?
• Does the dive candidate have a medical condition or condition that can be aggravated by diving?
• Are there physical causes that favor barotrauma?
Mental Health Examination
Not only physical, but also mental stability is important for diving. Since the body is exposed to a stressful situation, especially in diving beginners, the psychological anamnesis should ensure that the diving candidate can also react appropriately and rationally in such situations.
• Can the dive candidate communicate appropriately and clearly with others?
• Does he have the necessary degree of mental maturity and personal responsibility?
• Are there reasons that sudden panic could arise?
Can any doctor carry out a medical examination?
In Germany, Austria and Switzerland there are no special diving doctors. Therefore, from a legal point of view, there are no fixed requirements for a medical examination by a diving doctor. For this reason, every family doctor is authorized to carry out an appropriate diving fitness examination. Divers can therefore have their family doctor issue a certificate of fitness for diving. Any GP who conducts an investigation should focus on uncovering potential risk factors that may increase a diving accident. A conscientious anamnesis is the be-all and end-all and should definitely cover diving-specific risk factors. This includes aspects such as complaints of clouding of consciousness or possible disorientation. Divers therefore have the choice of which doctor to have their suitability for diving confirmed by them, as there are no statutory regulations. When choosing a diving doctor, however, you should be aware that a diving doctor can make much more qualified statements and better assess individual situations due to his special training and experience. In order to specialize in the field of diving medicine, the German Medical Association offers further training courses on the subject of diving, in which doctors can deepen their knowledge of diving medicine.
How long is a diving certificate valid and what does the GTÜM recommend?
How long a diving certificate is valid is not generally regulated. However, since the state of health can change at any time, it is recommended to repeat the fitness examination at regular intervals. There is only a legal regulation for the intervals for commercial divers. You are required to have your fitness to dive tested annually. Even after a long illness, professional divers have to undergo a new diving fitness examination. Only recommendations are made for recreational divers. The recommended examination interval for recreational divers depends on their age. Before the age of 18 and from the age of 40 an annual diving fitness examination is recommended. The fact that the examination intervals become shorter with age is because the risk of developing cardiovascular and metabolic diseases increases. However, these are only recommendations. If there are any abnormalities during the diving medical examinations, this could result in further clarifications before the ability to dive can be certified. However, since it is your own health and, in case of doubt, your own life, for which a fitness to dive examination can be decisive, the recommendations of the Society for Diving and Hyperbaric Medicine (GTÜM) should always be followed.
Is a diving fitness examination really necessary?
Yes. Even if you left your own health aside, you would be more or less forced to undergo a medical examination. Diving schools and diving centers usually require a medical certificate before offering their services. Diving schools and diving centers can legally protect themselves with a currently valid diving suitability examination. Most dive centers around the world now require divers to have a medical certificate. The same applies to a large number of tour operators. Corresponding institutions have the opportunity to assert liability exclusions in the event of possible accidents. Despite the danger that comes with it, for some dive centers it is sufficient if the physical health is confirmed by the diver himself. In such a case, the risk associated with the dive passes entirely to the diver, and insurance companies may reclaim medical expenses or refuse to pay out in the event of an accident.
How much does a diving fitness examination cost?
Anyone who undergoes a diving medical examination should be aware of the fact that this is basically an individual health service. This means that the health insurance company does not pay for such an examination. This applies equally to those with statutory and private insurance. The price for a diving suitability examination cannot be fixed as a lump sum. In particular, the not inconsiderable effort for the diving doctor, but also possible additional examinations, according to the Society for Diving and Hyperbaric Medicine (GTÜM), should be sufficiently taken into account when calculating the costs. The scope of the investigation is therefore decisive for the costs. On average, the costs are between 70€ and 110€. At first glance, this may seem like a lot of money for an investigation. However, everyone affected should ask themselves how much more valuable their own life is and therefore show willingness to pay the price for such an examination. Accidents while diving are still rare. If they do happen, they are usually due to health problems that a diving doctor could have pointed out during an examination.
We have put together a list of doctors in Berlin where you can have your diving suitability examination carried out.
