Water
Pollution
As our rivers, lakes
and shorelines
become more heavily populated, our diving population has to become more
aware of the potentially hazardous presence of pollution in the water.
Collectively, our waterways and the sea have been traditional dumping
grounds
for pollutants of many types and degrees of danger. In 1991,
a
Los Angeles Times article indicated that 2000 U.S. beaches were closed
due to sewage spills. California, as always, a leader had 745
closures
with 588 occurring just in southern California. This was quite
probably
only a fraction of the closures that would have occurred if consistent
and regular monitoring was being done across the board. The lack
of any standardized program for monitoring our waterways is clearly a
problem.
Flush
Areas?
Areas of special
concern are
harbors and similar areas which do not "flush" well; rivers,
especially
those with high levels of industry on the shores; sewage outfalls
which go out to sea but are often overloaded and areas which have their
deposits of soft, silty materials dropped as the currents reduce their
velocities in dispersal areas. Heavy metal contamination, for
example,
has caused a major problem with the dredging of a large marina entrance
due to the fact that hazardous levels of contaminants including heavy
metals,
have been identified in the silt and the material cannot be pumped or
dumped
deeper into the sea as is commonly done. It has been estimated that
there
are on the order of 15,000 chemical spills that enter our water areas
each
year in the U.S. alone. The contaminated areas are growing and
now
include many recreational diving areas as well as scientific study
sites
and search and rescue operations.
The health consequences
of
the water pollution have not been quantified by careful study but many
local health professionals are concerned with infectious and
immunosuppressed
patients who are ocean swimmers, lifeguards and divers. Until
adequate
epidemiologic data is available the recourse would appear to be
logically
focused upon conservative practices in selecting dive sites and
conditions.
This increase in areas
of pollution
is a worldwide problem and has effected many diving operations.
Diving
in polluted water requires additional precautions and, in many
instances,
sophisticated equipment and procedures. Avoiding diving in areas
with high potential for pollution, particularly after heavy rains is
fundamental
in urban or industrialized areas.
Microbial
and Chemical Hazards
The problem centers
around
the fact that microbial and chemical hazards can affect the human body
by skin contact, entry through orifices and invasion through the
skin.
The number of specific hazards and their relative severity is beyond
the
scope of this presentation. The following list was produced in
the
NOAA Manual and the details were obtained from the medical literature.
Vibrio - 34
species of this
family of bacteria are known and cholera and El Tor vibriones are among
those known to be pathogenic to man. Cholera vibriones have
recently
been found in Santa Monica Bay in California and have raised concerns
although
it is not known to have produced any disease. Other vibriones may be
anaerobic
and produce disease states such as purulent otitis, mastoiditis, and
pulmonary
gangrene. V. Proteus found in human fecal material is a common
cause
of diarrheal disease. V. Vulnificus is found in sea water.
Enterobacteria
Escherichia - found
widely
in nature, occasionally pathogenic to man, produces carotenoid pigments
and can often be recognized by the orangish pus. E. coli, which
has
some pathogenic strains is often found in fecal material, and can
produce
urinary tract infection and epidemic diarrheal disease.
Shigella -
produces dysentery
Salmonella - 1000
serotypes,
ingestion can produce gastroenteritis including food poisoning, typhoid
and paratyphoid.
Klebsiella - can
produce pneumonia,
rhinitis, respiratory infection.
Legionella -
causes Legionnaires
disease and Potomac fever. Perhaps inhibited in salt water.
Actinomycetes -
causes a "ray
fungus" actinomycosis an infectious disease in man which inflames lymph
nodes, develops abscesses, can drain into the mouth causing damage to
the
peritoneum, liver and lungs.
Pseudomonas -
pathogenic to
man, "blue pus" formed by some pseudomonas infections can lead to a
wide
variety of infections including wound sepsis, endocarditis, pneumonia,
meningitis. It is known to flourish in dark, warm, damp places, i.e.
inside
hoses, bladder compartments and similar places that are not cleansed
after
being infiltrated by contaminants.
Cryptosporidiosis is a gastrointestinal
disease caused by the parasite Cryptosporidiumparvum, It causes
severe diarrhea from getting the parasite in the mouth while drinking
or swimming.
Viruses -
infectious agents
which can result in fevers (frequently severe), mononucleosis, and a
wide
range of disease states.
There are seven
currently recognized
hepatic viruses:
Parasites
- many types
with all manner of effects, all bad, can are found in polluted water.
Cercaria,
shistosomes are examples.
Chemicals
- There are
over 15,000 chemical spills in the U.S. waterways each year and many of
these are releasing chemicals that are incompatible with man and the
equipment
that is worn.
As detailed information
becomes
available on this issue the divers will become sensitized to the need
for
preventive measures before, during and after diving. At present
the
scientific and public safety diving communities are developing
techniques
for isolating the diver from the potential problems and decontaminating
all exposed elements of the diving equipment. It appears eminent that
the
recreational community will feel the need to exert greater care in the
future.
It is becoming
increasingly
important to develop an understanding of the variations in the local
conditions
to which individuals expose themselves. Some areas become particularly
hazardous following heavy rains, hot weather and windstorms.
Local
health authorities can usually be called for advice regarding any tests
that have been performed and the results. They should also be
able
to identify areas of high concentrations of pollutants that should be
avoided.
What
Measures
can be taken?
When diving in areas
where
pollution is suspected or expected the following issues are worthy of
evaluation.
1. The individual diver
should
consider the need for appropriate vaccinations and inoculations.
Many of the diseases can be avoided if the individual has taken the
appropriate
"shots". Some that should be considered are:
Hepatitis A, B and C.
(There
is no vaccine currently available for Hepatitis C).
Cholera,
Polio
Tetanus.
Typhoid, Smallpox and
Diphtheria
2. Pollution and
filth
are often associated. If the water contains obvious trash and
garbage
it is quite probably an unhealthful diving environment and another
location
should be selected. If the water looks nasty it probably is
nasty!!
3. Many diseases have
an incubation
period before they exhibit symptoms. Medical advice is as close
as
the phone and early diagnosis and treatment can sometimes be improved
if
the Doctor understands that an individual may have been submerged in
polluted
water.
4. Information on
chemical
spills can be obtained from the Chemical Transportation Emergency
Center
(1 800 424 9300 US).
5. "When in doubt-
Check about"
What
does
NOAA recommend?
A basic procedure if
one has
to dive in high risk water involves reducing the exposure of the
diver. NOAA has pioneered a sophisticated SOS (suit over suit)
system
that will virtually isolate the diver from any contact with the
water.
This system is somewhat complex inasmuch as it requires complete system
integrity from the times the diver dresses out until the system has
been
decontaminated following the dive. Strict procedures are followed
to ensure that the divers body does not contact the fluid in which it
is
immersed.
Previously, many public
safety
divers wore a single dry suit and a full face mask during their
dives.
However, Stephen Barsky now states that "Full-face
masks only provide minimal protection and should only be used in
environments
where the pollutants are known, and do not pose a threat of death or
permanent
disability. In environments where the pollutants are not known, or
where
they lead to death or permanent disability, a helmet should be worn
connected
to a mating dry suit with mating dry gloves. This is considered the
standard
today." (See Reference below)
If good seals are
involved
and the diver is effectively rinsed, scrubbed down and rinsed again
prior
to breaking any existing seals, the probability of exposure to the
pollutants
can be minimized. Special care must be taken to clear hoses and
fittings
that interface with the life support system. A failure to rinse
bladders
and hoses which may later be linked to the divers mouth or lungs could
provide a path to the host days after the dive. The use of
snorkels,
alternate air sources, oral inflation devices and hose connections
should
all be given careful attention since the can carry contaminants
directly
into the mouth. Positive pressure, "self bailing" breathing
systems
have definite advantages in that they resist flooding.
Recreational divers
maybe well
advised to place their regulator in their mouth and their mask over
their
nose before entering suspect water and keeping it there until they have
safely exited the water where they can remove the regulator without
needing
to replace it.
Polluted water is a
fact of
our lives. The degree of pollution can only be mitigated through
education and the "upstream" elimination of the sources of the
contaminants.
The attitude that careful rinsing of diving gear is a waste of time
"cuz
its just going to get wet again next time it is used" should probably
be
replaced with the attitude that one should begin every dive with clean
gear.
References:
Glen Egstrom,
Ph.D
Medical Seminars, Inc. 1992
Colwell, et.al.
Microbial
Hazards Of
Diving In Polluted Waters,
Maryland Sea Grant
Publication UM-SG-TS-82-01.
Diving in High-Risk
Environments,
3rd Edition
by Steven M. Barsky
Amazon.com
Paperback - 197 pages 3rd
edition (December 15, 1999)
Hammerhead Press; ISBN:
0967430518
