Interview with

Marco Bordieri, September 2024          

With so much to enjoy underwater, it’s not surprising that divers are more prone to talk about their positive experiences rather than all the possible incidents and health issues. We take each dive as it comes, taking it for granted but at some point ageing, medical conditions or incidents require us to seek support to reassess the situation with the heartfelt hope to be cleared for diving.
But who ya gonna call then?

DAN (Divers Alert network) has been at the forefront of diving safety for a long time, and we have a number of questions for the local representative of DAN:  Ms. Mel Cefai, Regional Director for DAN World, based in Queensland.

Services

Some of us get in touch with DAN when booking an international diving holiday and must (or prefer) to purchase an insurance for dive accidents, but DAN has more to offer and we would like to understand what services are available to the recreational diver (freediver or SCUBA), could you elaborate?

That is a great question, because there is a lot about DAN that divers may not know. Firstly, DAN is the world’s largest and most trusted diving health and safety organisation. DAN’s mission is to improve diver health and safety and make every dive accident- and injury-free. Part of what we offer the diving community is DAN Membership and an insurance product, but that is just one small part of what we do. Here’s an overview:

Health & Medicine: DAN’s in-house medical team provides medical information and support for the diving community (divers, dive professionals, and health care providers). We have a Medical Information Line and an “Ask a Medic” form on our website, two channels that enable divers to contact DAN for non-emergency support. Our team is regularly creating content to help keep divers informed and to increase their knowledge base (Dive Medical References, Health & Safety Guidelines, Fact Sheets, and much more), and of course the team offers 24/7 emergency assistance via the DAN Emergency Hotline.

Safety & Prevention: Our Safety Services department is continually working on developing resources for diver safety, dive operation safety, and chamber safety.

DAN Research: Our research department collaborates with leading scientists and research institutions to address ongoing questions about the safety of underwater exploration. DAN has played a pivotal role in the development of numerous groundbreaking innovations that help keep divers safe: stress in diving, flying after diving guidelines, fitness to dive, best treatment practices for diving injuries, and more.

Education: DAN offers a range of first aid training courses, including Oxygen First Aid for Scuba Diving Injuries, and we have developed an e-learning platform that provides many courses (at no cost) that are targeted to divers, dive professionals, and dive operators. And these courses are available to the community at large, not only DAN members.

Investing in Dive Safety: Divers probably don’t know that profits from DAN’s programs are reinvested in The DAN Foundation, which supports the 24/7 DAN Emergency Hotline, DAN research, the Recompression Chamber Assistance Program, first aid training, oxygen unit grants, and continuing medical education courses for medical professionals who specialise in dive medicine. 

DIVE DOCTORS

DAN maintains a worldwide network of doctors who serve the diving public. Upon request, DAN will provide divers with the contact information for physicians trained in dive medicine. Divers can contact these doctors directly; a referral from their GP is not required.

Like any specialist in their field, we seek out their expertise based on the need. When a diver has a pre-existing medical condition, is recovering from a procedure or illness, or is taking specific medications, it’s important they seek out a doctor trained in diving medicine. These doctors understand the nature of diving and its impact on the body. They are the best resource for a diver to undergo a diving medical exam and receive medical clearance to dive. This is important for their own health and safety before they get back in the water. 

HELPLINE

The DAN Emergency Hotline is a resource available to the entire diving community, and it’s available 24 hours a day, 365 days a year to provide information, coordinate care, and facilitate evacuations. When you call DAN for assistance, you are connected with DAN’s medical services staff of physicians, nurses, emergency medical technicians (EMTs), paramedics, and other medical professionals. Divers facing a medical emergency know they can call the DAN Emergency Hotline any time, day or night.  

DAN is the only dive safety organisation with an in-house 24/7 emergency hotline. Today our emergency hotline fields an average of 5,200 calls per year.

No other dive accident insurance program offers such a service. While all insurance companies are legally obligated to pay claims, only DAN provides a 24/7/365 dive emergency hotline staffed by the best in dive medicine. 

To date, this service has helped thousands of injured divers — members and nonmembers alike. 

DAN assists all divers who call the emergency hotline, but DAN cannot organise an emergency medical evacuation or coordinate treatment and pay for associated costs for nonmembers. DAN will always provide advice and support to any diver, dive operator, or medical facility that requires support and advice following a diving incident. 

The DAN Emergency Hotline is the cornerstone of our service to DAN members and the entire diving community. Whatever the situation, no matter where you are in the world, help is just a phone call away. 

Non-emergency Line

The DAN Medical Information Line (and the Ask a Medic online form) is a core component of DAN’s service to its members and the broader community, and it has been in operation for more than 40 years. This is another free service available to the diving community. 

DIVE INCIDENT ANALYSIS AND OUTCOMES

Diving incidents are not a popular subject in the diving industry, especially when an operator is involved, a curtain of silence drops and news is spread via unreliable word of mouth.  Every year in Sydney there is at least a fatal diving incident, but under the justification of “respect of the memory of the diver”, “sensitivity towards the relatives” or “there’s an ongoing inquiry” the general public never gets to know the cause of the incident and how to prevent it.  All we know is the limited information published by the media the day it had happened, the next day it’s old news and we just move on and forget. 

I know DAN has been collecting these incidents and creating statistics, can we know a bit more about what data is collected? Incident reports? Coroner’s findings?

DAN has a number of tools we use for incident analysis. We have our self-reporting online tool, the Diving Incident Reporting System, where divers and non-divers can report incidents they witnessed or were involved in and we monitor news alerts and social media. We ideally collect witness statements, dive computer profiles, coroner/medical examiner reports, investigative reports and any other information relevant to that incident, although this information is not always complete or available. For statistical analysis we try to get confirmation of the diver's certification, how often they've been diving in the past year and their past medical history (if known) as well as any equipment analysis findings to identify any trends or deviations.

What policies/recommendation changes are then implemented as a result of this collection? 

DAN has had an integral part in making suggestions to the industry for better and safer diving practices, such as what not to do before a dive (rigorous exercise, over hydrate etc.) and how soon a diver can fly after diving. We are also available to answer any questions surrounding medicine and diving with our non-emergency hotline.

How does this evolving knowledge feed into policies of the various diving agencies? 

Over the last few decades, we've become a trusted partner in the industry and our research continues to grow and we investigate common issues among divers. The industry is also growing and changing so between our medical services, our membership benefits and our ongoing research divers, instructors and agencies often call DAN for advice on best practices.

And how are these new findings shared with the majority of the divers who have already their certification and have no contacts with the dive schools?

We have hosted webinars covering various topics, and we also regularly attend industry conferences and events as well as scientific conferences and events to continue to grow and showcase our resources.

In the early days of diving, fatalities and serious injuries were not uncommon. Today they are rare and are often associated with unsafe behaviour or hazardous conditions, but they can also occur without apparent cause. 

The first step in reducing incidents and injuries is to identify them, and the next step is to understand the contributing factors. Recognising how and why injuries and fatalities occur leads to safer diving by allowing the dive community to benefit from individual lessons learned. First published in 1988, DAN's Annual Diving Report exists to further this understanding by raising awareness of the risks and hazards associated with diving and to promote safer practices. 

DAN Research uses an extensive network of internal and external sources to collect and analyse dive incident, injury, and fatality data. We then publish this information and make it available to the dive community at no cost, conducting analysis that illuminates why accidents happen. All issues of the DAN Annual Diving Report are available in the DAN Publication Library.

Giving divers the knowledge they need to make safe decisions above and below the surface is at the core of DAN's mission. The case studies provided in these annual reports give insight into divers' behaviour and highlight the importance of safe diving practices. 

When you take a close look at the DAN Annual Diving Report data, you will see that many injured divers decided to broaden their range of dive activities without considering their training, experience, or equipment. Pushing to the very edge of the envelope can be a dangerous endeavour — for the diver and those who dive with them. A person must always understand their strengths and limitations and proceed accordingly. Being aware of and actively avoiding practices and patterns that elevate risk can prevent unmanageable conditions from arising. 

Divers must maintain medical, physical, and psychological fitness to dive. Maturity and sound judgement are critical for safe diving, and the ability to resist peer pressure is particularly important. It is the responsibility of the diver to be prepared for whatever diving is to be undertaken. The range of incidents and victims described in the reports should remind readers that accidents can occur anytime, anywhere, and to anyone. 

DAN shares diving incident summaries - DAN World, in the dive media, and in our member communications. Being aware of incidents is important in making divers more conscious that incidents can happen. 

DAN is exhibiting at the Go Diving Show taking place 28-29 September in Sydney. Along with the DAN World Team, DAN’s Medical Director, Dr Matias Nochetto, will be available at the DAN Booth to answer your diving health and medical questions. He will also present a selection of topics, including Remote Diving Accidents (Challenges and Case Examples) and Common Diving Injuries (Symptoms, First Aid, Treatment) on the ANZ Stage from 1pm on Sunday. If you’re looking to join DAN, the Show provides a great opportunity to have any questions answered. Be sure to visit Booths 51-52.