De l'étude des effets à long terme de la plongée sous-marine sur les paramètres de l'exploration fonctionnelle respiratoire en plongée militaire

Abstract : Background: Scuba-diving exposes the lungs to numerous constraints due to the improvement of the ambient pressure forcing modifications of the air flow in the bronchi. Several studies showed modifications of the pulmonary function tests (PFT) in experienced civilian professional scuba-divers. The objective of this study is to compare the evolution of PFTs in military divers after 16 years of practice with their initial results. Methods: This retrospective cohort study included 103 military divers, divided in 2 groups : 59 in 1st category (CAT1), diving with air only and staying above a depth of 20m and 44 in 2nd category (CAT2), diving to a depth of 80m and using enhanced O2 concentrations in their gas mixtures or air recycling devices. Their medical monitoring required a PFT every 4 year. The PFT of the inclusion visit has been compared with the one obtained at the 4th follow-up consultation 16 years later. The studied parameters were FEV1, FVC, FEV1/FVC, MEF 50 and MMEF. They were then compared with the values given by the Global lung initiative (GLI) equations. Results: This study shows that FEV1/FVC, MEF50 and MMEF decreased significatively in the overall population of the study and in CAT1 group after 16 years of diving practice. There is no evolution concerning FEV1 and FVC. There is also no evolution of the PFTs in CAT2 group during follow up. There is no difference with the theoretical values at the inclusion visit but after 16 years, FEV1, FVC and MMEF values are significantly higher in the overall population and the 2 groups, whereas there is no variation of the FEV1/FVC ratio. Conclusion: Military divers seem to have a conservation of their respiratory capacities with an age-related loss slower than the general population. The explanation may be the training of the respiratory muscles. Indeed CAT2 divers with more diving experience and deeper dives showed no evolution of their PFTs contrary to CAT1 divers. There seem to be no effect of oxygen toxicity on the lungs but no DLCO data were available. With these results, the utility of realizing systematic PFTs to military divers during follow up can be questioned.
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Submitted on : Tuesday, January 8, 2019 - 3:52:30 PM
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Fabien Chadelaud. De l'étude des effets à long terme de la plongée sous-marine sur les paramètres de l'exploration fonctionnelle respiratoire en plongée militaire. Sciences du Vivant [q-bio]. 2018. ⟨dumas-01974134⟩



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