Decompression Illness from Rapid Ascent or Repetitive Diving
HighDecompression illness (DCI) occurs when dissolved nitrogen in body tissues forms bubbles during ascent, causing symptoms ranging from joint pain to paralysis and death. Even swimming pool diving at 3-5 metres depth can cause DCI if multiple dives are performed without adequate surface intervals or if emergency ascents occur without decompression stops. The risk increases with depth, bottom time, repetitive dives within 24 hours, cold water exposure increasing gas absorption, strenuous underwater work increasing circulation and nitrogen uptake, and dehydration concentrating blood and reducing gas elimination. Symptoms may appear immediately on surfacing or be delayed up to 24 hours, including joint and muscle pain (the bends), skin rashes and itching, neurological symptoms such as numbness or paralysis, breathing difficulties and chest pain, dizziness and disorientation, and unconsciousness in severe cases. Treatment requires immediate recompression in a hyperbaric chamber with delays causing permanent damage. All diving operations must follow decompression tables or dive computer limits, implement conservative ascent rates not exceeding 9 metres per minute, provide surface intervals between repetitive dives, ensure access to recompression facilities within evacuation timeframes, and maintain emergency oxygen administration capability.
Consequence: Permanent neurological damage including paralysis, brain damage from arterial gas embolism, respiratory failure, or death. Delayed treatment significantly worsens outcomes with potential for permanent disability.
Drowning from Equipment Failure or Entanglement
HighDrowning represents the immediate cause of death in most diving fatalities, resulting from breathing gas supply interruption, regulator failure, entanglement preventing surface access, loss of consciousness from other causes, or panic-induced breath-holding. Swimming pool environments present specific drowning hazards including entanglement in pool cleaning equipment, suction by main drains or return lines, entrapment in confined spaces such as pipe chases, disorientation in murky water or confined areas, and rapid unconsciousness from breathing gas contamination. Unlike open water, pool diving offers limited escape routes with walls, equipment, and structures restricting movement. Main drain suction can trap divers or remove masks and regulators. Pool equipment including automatic cleaners, heating system pipework, and filtration components create entanglement hazards. Cold water in unheated pools or outdoor facilities causes rapid hypothermia reducing cognitive function and physical capability. The presence of chemicals affects buoyancy and visibility. Rescue is complicated by confined access, chemical exposure to rescuers, and the need for immediate emergency ascent capability. Prevention requires pre-dive surveys identifying entanglement hazards, isolation of all suction systems during diving operations, use of tethering lines for navigation in confined or low-visibility environments, standby diver suited and ready for immediate water entry, and emergency breathing gas supplies for redundancy.
Consequence: Death by drowning within 3-5 minutes of breathing gas loss, permanent brain damage from hypoxia if rescue is delayed, or severe injury from emergency ascent attempts in entanglement scenarios.
Breathing Gas Contamination and Oxygen Toxicity
HighBreathing gas quality defects can cause rapid unconsciousness and death underwater with minimal warning. Carbon monoxide contamination from compressor intake near vehicle exhausts, engine emissions, or combustion sources causes CO poisoning symptoms including headache, confusion, and loss of consciousness. Underwater, even low CO levels become rapidly fatal as partial pressure increases with depth. Oil contamination from compressor maintenance deficiencies creates respiratory irritation and potential aspiration pneumonia. Moisture in breathing gas can freeze at pressure restricting gas flow. Oxygen content variations from improper filling procedures can cause hypoxia if oxygen is too low or oxygen toxicity seizures if oxygen partial pressure exceeds safe limits. Oxygen toxicity causes convulsions resulting in regulator loss and drowning. The risk increases with depth where oxygen partial pressure rises, strenuous work increasing oxygen consumption, cold exposure increasing susceptibility, and carbon dioxide buildup from breathing resistance or exertion. All breathing gas must be analyzed before use verifying oxygen content 20-22%, carbon monoxide less than 5 ppm, carbon dioxide less than 500 ppm, moisture content within specifications, and absence of oil contamination or odors. Compressors must have intake filters positioned away from contamination sources, regular maintenance schedules documented, and breathing air quality testing at specified intervals. Divers must recognize symptoms of gas contamination and implement immediate ascent and emergency procedures if breathing gas quality is suspect.
Consequence: Sudden unconsciousness and drowning from carbon monoxide poisoning, convulsions and drowning from oxygen toxicity, or respiratory distress and long-term lung damage from contaminated breathing gas.
Chemical Exposure from Pool Water Contamination
MediumSwimming pool water contains chlorine, bromine, acids, algaecides, and other treatment chemicals at concentrations that cause skin irritation, respiratory problems, and potential toxicity during prolonged diving exposure. Chlorine concentrations of 1-3 ppm standard in pools cause eye irritation, skin sensitization, and respiratory tract irritation when water is aspirated or splashed. Combined chlorines and chloramines formed from organic contamination create stronger irritation and respiratory effects. pH-adjusting acids can cause chemical burns if accidentally released during diving operations. Algaecides and specialty chemicals present varying toxicity profiles. Divers experience prolonged whole-body immersion with chemical contact to skin, eyes if mask leaks, and respiratory exposure if water is aspirated. Wetsuits and exposure suits provide some protection but chemical penetration occurs during extended dives. The risk intensifies during chemical dosing operations, after recent shock treatments with elevated chemical levels, in poorly circulated or stagnant areas where chemicals concentrate, and when treatment system malfunctions create chemical spills or concentrated zones. Divers must verify recent water chemistry results before diving, delay diving operations for appropriate periods after chemical treatment (typically 24 hours after shock treatments), use complete exposure protection including full-face masks in highly contaminated environments, implement decontamination procedures including thorough freshwater rinsing post-dive, and monitor for symptoms of chemical exposure including skin rashes, respiratory irritation, or eye inflammation requiring medical assessment.
Consequence: Chemical burns to skin and eyes, respiratory irritation and potential chemical pneumonitis from aspiration, allergic sensitization requiring future exposure avoidance, and long-term respiratory problems from repeated exposure.
Hypothermia and Cold Water Exposure
MediumWater conducts heat 25 times faster than air, causing rapid body heat loss during diving operations. Swimming pool temperatures vary from 26-28°C for lap pools to 18-22°C for outdoor pools or unheated facilities, with water treatment plant structures often containing water at 10-15°C. Prolonged immersion causes progressive hypothermia with core temperature drop leading to shivering, loss of dexterity, cognitive impairment, loss of consciousness, and cardiac arrest in severe cases. Even mildly cool water causes hypothermia during extended diving operations of 30 minutes or more. Cognitive impairment from cold reduces judgment, problem-solving ability, and emergency response capability. Loss of manual dexterity affects equipment operation and self-rescue ability. Cold-induced diuresis increases dehydration worsening decompression illness risk. Peripheral vasoconstriction reduces circulation affecting decompression gas elimination. The risk increases with thin exposure suits inadequate for water temperature, extended dive duration exceeding thermal protection limits, small body mass and low body fat reducing thermal reserves, dehydration or fatigue, and environmental conditions including wind chill during surface intervals. Prevention requires exposure suits appropriate for water temperature and dive duration (wetsuits for water above 20°C, drysuits for colder water or extended operations), pre-dive thermal preparation avoiding chilling before entry, limiting dive duration based on exposure suit rating, heated facilities for warming between dives, warm fluids for rehydration, and monitoring for hypothermia symptoms requiring dive termination.
Consequence: Progressive hypothermia causing impaired judgment and increased error risk, loss of consciousness and drowning in severe cases, increased decompression illness risk from altered circulation, and delayed recovery requiring medical intervention.
Overhead Environments and Confined Space Entrapment
HighPool diving often occurs in overhead environments where direct vertical ascent to the surface is prevented by pool structures, covers, equipment, or facility architecture. Confined spaces including pipe chases, equipment chambers, valve pits, and underneath pool covers eliminate the fundamental diving safety principle of direct emergency ascent capability. Disorientation in low visibility or equipment-cluttered environments can prevent divers finding exits. Silt or sediment disturbance during work reduces visibility to zero creating complete spatial disorientation. Entanglement in pipework, cables, or pool equipment prevents movement. The psychological stress of confined overhead environments increases breathing rates depleting breathing gas faster and increasing carbon dioxide buildup. Navigation errors can lead divers deeper into confined areas rather than toward exits. Panic responses in confined spaces cause rapid gas consumption and irrational behavior. Unlike cave diving where specialized training and equipment are mandatory, pool facility diving often underestimates overhead environment risks. Prevention requires comprehensive pre-dive survey mapping all overhead obstacles and confined spaces, use of guidelines or tethers for navigation in confined or low-visibility areas, adequate reserve breathing gas for extended exit time from confined spaces, specialized training for overhead environment diving, buddy diving with continuous visual or physical contact, powerful dive lights for visibility, and prohibition of diving in confined overhead environments without specialist qualifications and equipment including redundant breathing gas and navigation aids.
Consequence: Entrapment and death in confined spaces from inability to locate exits, rapid breathing gas depletion from panic, disorientation causing deeper penetration into hazardous areas, and rescue complications from overhead obstacles.