Captain Terry Clymire NAUI #13529L

You have almost completed your pre-dive check with your buddy and are ready for another exciting day of scuba in an exciting locale like the Bay Islands of Honduras. Stop a minute and take a quick look around you. Besides all shapes and sizes of dive gear, some new, some old, there are also all shapes and sizes of young and old divers, some with many years of international experience, and some still rather dry behind the ears. These last represent an even greater spectrum of fitness-for-diving age considerations.

The outer limits of both young and old age groups present very interesting dive medical concerns. The common-sense questions that arise do have some factual answers with a little added conjecture. When is someone old enough to dive or too old not to dive?

With the rapid increase in popularity of scuba diving and dive travel worldwide, most of the major U.S.-based certification agencies, including NAUI, have set a minimum age standard of 12 years for junior divers, and 15 for basic non-conditional dive certification. Recommended, but not required, is a physical examination by a doctor to determine if potential students can meet the physical rigors of scuba diving. Highly recommended, but not required, is a physical examination if you are over 40.

The medical community believes that the bone and growth plates of a person not yet physically mature may be greatly affected as the result of pressure at depth during diving.

Epiphyseal plates are the sites at which new bone growth occurs. These plates, located at the ends of long bones, are very fragile, even delicate, and are very susceptible to damage or injury caused by rapid pressure build-up at depth or other possible barotrauma, such as DCI.

The sometimes disastrous results (including death) caused by diving-induced DCI are well-documented - by DAN (Divers Alert Network), Duke University, the military, and the commercial dive industry , among others. Even though hard evidence is still being compiled, Dr. Carl Edmonds, author of Diving and Subaquatic Medicine, known as a leader in hyperbaric medicine, recommends that young divers not go below 30 feet until some time after completing puberty when their epiphyseal plates have fused, thereby completing the growth process. This precaution minimizes the risk of bony deformities. As with the recommendations against scuba diving during pregnancy, it is better to use common sense and not dive rather than face the hard facts that may result. The only sure way to know that the epiphyseal plates have stabilized in any young person excited about becoming a scuba diver is to have a complete physical check-up that would include x-ray checks for the fusing. This concern is a reflection of the fact that dive training prerequisites have relaxed. In its earliest beginnings, diving was strictly for military or research. With the advent of sport diving, many of the rules about top physical condition were eased. This has been a continuing process. Many people who could not be trained to dive at some point in the past owing to medical conditions now have received medical clearance.

Another possible problem in young divers, seldom discussed, is the possibility of major lung problems. The most common of these is spontaneous pneumothorax. In this condition the lungs, which normally fill the chest cavity, experience a break in their surface, allowing air into the pleural (lung) cavity, causing one or both lungs to collapse. A thin fluid layer called the pleura normally holds the lungs to the chest cavity by a vacuum. When the pressure inside the chest cavity becomes negative, damage to the lining will force air to leak inside the cavity outside of the lungs, breaking the vacuum and continuing to fill the cavity with air, further collapsing the lungs. In this state, the lungs are unable to exchange air and shortness of air results. As the person breathes harder, it forces more air into the chest cavity and continues to collapse the lungs with each breath. Immediate medical treatment is required. Because of the separation of lungs, this condition rarely occurs to both lungs simultaneously.

This condition is called spontaneous pneumothorax because it can happen without warning. The person may be predisposed owing to a sport injury, congenital condition, or smoking. In young people, it can result from scuba diving without having fully developed lungs. With the increase of pressure at depth that comes with diving, their still fragile lungs collapse. On a recent trip to Guanaja, in the Bay Islands, I saw an Instructor conduct a resort course, with the father's knowledge, for an 11- and 15-year-old brother and sister and then take them on a wreck dive to 117 feet. Imagine my horror.

Setting an exact age limit to determine if a child is ready to begin the sport does not take into account individuals' actual physical and psychological growth. Kids must be sufficiently mature to handle emergency situations that may arise, and to thoroughly comprehend the rules of basic dive safety and the consequences of breaking them. They must also be sufficiently developed physically to ensure no special hazard from the effects of pressure. To address other concerns, such as judgment and rescue capability, it is strongly suggested that they buddy with a much more experienced older diver, ideally a parent.

The sport has caused some of us to become fanatics, and though benevolent ones with the best of motives, still possessed of the dangers latent in extremism. We cannot understand why a spouse, child, or even the rest of the world is not captivated by the sensation of weightlessness and the wonder of exploring the ocean depths. It could also happen that some dive instructors are not offering a class out of pure and honest altruistic concerns based on safe student evaluation - after all, money is involved. Make sure that your child or any loved one who does begin diving is doing so for their own personal reasons - not yours. Our loved ones are sometimes not able to express their own fears when faced with peer or family pressure, and someone participating in diving at the desire of others will not do it wholeheartedly and may well be at greater risk as a result.