Diving in Polluted Waters
The Problem
Over the past ten to fifteen years the
diving population has become sensitized to the potentially hazardous
presence
of pollution in the sea. The ocean has been a traditional dumping
ground for many types and degrees of pollutants. Several years
ago
a Los Angeles Times article indicated that 2000 U.S. beaches were
closed
due to sewage spills.(1993). California, as usual a leader, had
745
closures with 588 occurring in Southern California. Consistent
and
regular monitoring would have probably fond many more
contaminated
beaches needing closure. There is a definite lack of any
standardized
program for monitoring our waterways; particular areas of 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 the deposits of soft,
silty materials dropped as the currents reduce their velocities in
dispersal
areas. 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 carcinogenic disease potential for
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 affected many diving operations. Diving in
polluted water requires that certain precautions be taken, and, in some
instances, the use of sophisticated equipment and procedures.
Avoiding
diving in areas with high potential for pollution, particularly after
heavy
rains is fundamental in urban or industrialized areas.
The main problem centers around the
fact
that bacterial, viral and chemical hazards can affect the human body by
skin contact and entry through orifices. 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. This can lead to a wide variety
of infections including wound sepsis, endocarditis, pneumonia and
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.
Viruses
- infectious agents which can result
in fevers (frequently severe), mononucleosis, and a wide range of
disease
states.
Parasites
- many types with all manner
of effects, all bad, can are found in polluted water.
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.
Prevention
As detailed information becomes available
on this issue 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.
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".
A few that appear worthy of consideration:
Hepatitis A and B
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"
A basic procedure if one feels they
must
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.
LINKS To Pollutant Testing
Utah Bureau of Environmental Chemistry
and Toxicology
http://hlunix.hl.state.ut.us/els/chemistry/
Adapted from Glen
Egstrom,
Ph.D
Medical Seminars, Inc. 1992
Other References:
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
