Diving children
I have had a few requests lately for 12 yo children to have diving medicals. If we are to succumb to these requests, what are the main issues I should address?
What evidence is there for the danger in 12yo vs 14yo children?
Regards
Johnny
Gidday Glen,
Everyone is entitled to their opinion and we must recognise that this thread contains nothing more than that. My own OPINION is that in the fulness of time (and as has been the case with asthma and diabetes) there will be increasing evidence that diving by children is just as safe as many of the other activities they indulge in, and that Australia will once again be isolated as the last bastion of baseless conservativism on this matter.
I would not have chosen to enter this debate were it not for the perpetration of the myth of growth plate injury in your post. Where is the evidence that this happens? "Children" between the ages of 14 and 18 have been diving for decades. Inevitably many will have suffered DCS. At that age the epiphyses are not closed and there is rapid growth. Despite this, I am not aware of a single case report of disorded bone growth in a child that has been attributed to diving. Nor am I aware of any animal evidence that supports the notion. This hoary old chestnut gets trundled out every time the subject of children in diving is raised, and I think it is time it was proven or put to bed.
Regards,
Simon Mitchell
Hi Simon,
I have to agree that like most things in diving, there is not a huge amount of evidence either way.
I would agree that there is no evidence as to the issue of bubble injury to growth plates however there is significant evidence as to bubble injury to long bone ends in commercial diving and as the growth plates are particularly susceptible to damage and blood flow disruption caution would be advised. I think its more a lack of data but possible mechanism rather than a defined statement. Also as stated the SPUMS medical does allow for 14y olds to dive with proper advice and supervision. The issue is the 8-14y olds that are being targetted specifically by training organisations in Scuba Rangers and Bubblemakers that is the slightly more difficult issue.
I am also not exactly sure how you could prove it. At the best of times it is hard to involve children in trials but I think due to parental pressure issues (vs adult right to accept risks in asthma and diabetes) we would be wise to be cautious on this particular issue.
Regards Glen
This helped me with patient explanation
I can only echo the remarks of Glen.
The SPUMS diving medical makes the society's position clear (as above), and I believe most of us are comfortable that this is a reasonable interpretation of the thin evidence and displays common sense.
Remember, there is no legal requirement to have a dive medical in any part of Australia except Queensland. Medicals are optional elsewhere, and you are in effect seeking a professional medical opinion. The professional you ask should have training in this area and be able to provide a reasoned and reasonable recommendation.
I hope it doesn't come down to succumbing to pressure!
Mike Bennett
Have just sent a sad girl home!
The reasons for not approving children to dive are two fold.
1) A child prior to puberty does not have the size or physical strength to manage the equipment and also manage any difficutlies with an adult dive buddy.
2) Psychologically there is a big difference between an adult and a child. For example why don;'t we let 12y olds drive a car? The issues are the same with diving. You have to have a maturity to make complex decisions and those under 16y are really not in that position.
A paper by Richard Smerz looking at Paediatric diver treatments in Hawaii showed that the main thing leading to the required treatment was essentially a poor decision making or a panic situation.
This doesn't even take into account the long term effects on growth plates of decompression bubbles.
As for direct evidence, there is very little as people under the age of 14y old are generally not allowed to dive.
Also please note that SPUMS does not support children under 14 y of age diving and 14-16y olds are not recommended but can be acceptable dependant on th maturity of the child and the parents permission
Cheers Glen