Dysbaric osteonecrosis associated with decompression sickness in a fishing diver

Diving as a method of fishing is used worldwide in small-scale fisheries. However, one of the main causes of morbidity and mortality among fishermen is decompression sickness (DCS). We report the case of a 46-year-old male fisherman diver who presented with chronic inguinal pain that radiated to the lower left limb. Living and working in a fishing port in Yucatan, he had a prior history of DCS. A diagnosis of avascular necrosis in the left femoral head secondary to DCS was made via analysis of clinical and radiological findings. The necrosis was surgically resolved by a total hip arthroplasty. Dysbaric osteonecrosis is a more probable diagnosis. In this region fishermen undergo significant decompression stress in their daily fishing efforts. Further studies regarding prevalence of dysbaric osteonecrosis among small-scale fisheries divers are needed. In a community where DCS is endemic and has become an epidemic, as of late, the perception of this health risk remains low. Furthermore, training and decompression technique are lacking among the fishing communities.

Body mass index in association with decompression sickness events: cross-sectional study among small-scale fishermen-divers in southeast Mexico.

INTRODUCTION: Decompression sickness is endemic to small-scale fishermen-divers from coastal communities in southeast Mexico; overweight and obesity are also highly prevalent in the region. Existing literature suggests it is possible that fat tissue could play a role in decompression sickness pathophysiology. Our aim in this study is to describe the association between the number and severity of DCS events treated at the hyperbaric program and fishermen-diver body mass index. METHODS: In this cross-sectional study, we obtained anthropometric measurements of 105 fishermen-divers and reviewed clinical records of each participant at a hyperbaric program. RESULTS: Average BMI among participants was 34.5 ± 4.7, while 9.5% (n=10) were healthy-weighted, 28.6% (n=30) were overweight and 42.8% (n=65) were obese. Number of DCS events per diver was associated with BMI and severity of DCS in linear regression models. CONCLUSIONS: Overweight and obesity are highly preventable health problems; our results suggest that an association between these conditions and the frequency and the severity of DCS are an important topic to be further considered in longitudinal prospective studies.