Medical fitness for diving

Many diving and snorkelling incidents involve the participant suffering a medical condition that may be made worse by the diving activity and/or the environment.

Key medical conditions include:

cardiac conditions (e.g. heart disease or high blood pressure)
respiratory illnesses and injuries (e.g. asthma, pneumothorax and congestion)
conditions that may result in a loss of consciousness (e.g. epilepsy and diabetes).

It is important that, as far as is reasonably practicable, participants have the necessary medical fitness for the different types of diving and snorkelling activities available.

A standard briefing and medical advice form for diving and snorkelling is available in English (PDF, 5.55 MB) and nine other languages.

General and high risk diving work (dive workers)

Diving workers must hold a current certificate of medical fitness, issued in accordance with the fitness criteria in AS/NZS 2299.1: 2015 Occupational diving operations – Standard operational practice. The diver must follow any conditions stated on the certificate.

The certificate must be issued by a medical practitioner with appropriate training in underwater medicine, which includes training for either occupational or recreational diver medicals.

The certificate must not be greater than 12 months old and must be kept for 12 months after the diving work finishes.

Prior to diving, workers should advise if they are suffering any relevant medical conditions such as colds, hay fever, ear infections or hangovers.

Recreational diving

Resort or introductory diving

All resort divers must complete a medical declaration – refer to page 52 of the Recreational Diving, Recreational Technical Diving and Snorkelling Code of Practice 2018 (PDF, 0.61 MB).

Using the completed medical declaration, an assessment must be made that it is reasonable to allow the person to dive. For example a declaration discloses a medical condition. The dive business then seeks medical advice. In accordance with the medical advice the duty holder decides that it is reasonable to allow the person to dive.

Resort divers should be at least 12 years of age. Parental or guardian consent is required for resort divers under 18 years

Entry level certificate diving

All entry level certificate trainee divers must complete a self assessed medical declaration – page 53 of the Recreational Diving, Recreational Technical Diving and Snorkelling Code of Practice 2018 (PDF, 0.61 MB). The trainee diver must declare if:

they have or have had any of the medical conditions mentioned in the medical declaration
they are over 45 years old
they have a body mass index over 30 and a waist circumference greater than 102 cm for males and 88 cm for females.

Trainee divers to whom these conditions apply must not commence their training unless they can provide a dive medical certificate by a doctor certifying that they are medically fit to dive.

The medical certificate should be provided in English, preferably by a medical practitioner with experience in diving medicine, within 90 days prior to the commencement of training.

Entry level certificate trainee divers should be at least 12 years of age. Parental or guardian consent is required for trainee divers under 18 years.

Certificated divers

The current medical fitness of certificated divers should be assessed. Examples of suitable assessment questions include:

Since completing your last dive medical assessment, have you suffered any illness or injury that may affect your ability to dive safely?
Are you currently suffering any illness or injury?
Are you currently taking any prescription medication, other than the contraceptive pill?

If the assessment reveals concerns about the diver's fitness, they should not dive unless medical advice is sought advising diving can be undertaken or a dive instructor/certified assistant accompanies the diver on each dive.

Snorkelling

Snorkellers must be given advice (PDF, 0.11 MB) about the risks while snorkelling of certain medical conditions, such as heart disease, asthma epilepsy and diabetes. Older snorkellers also may be at risk at cardiac related injuries. snorkellers should advise the snorkelling supervisor, lookout or guide about their medical conditions.

All snorkellers should be assessed to determine whether they may be 'at risk' of snorkelling activities exacerbating existing medical conditions before they enter the water.

The assessment is not intended to stop potential snorkellers from participating, but will allow the workers of the snorkelling business to give them additional attention, advice, equipment and supervision.

The snorkel workers should observe the participants and identify any who

Are an older or very young person
Are overweight
Appear to be in bad health (e.g. with respiratory problems or particularly unfit)
Exhibit stressed behaviour (e.g. appearing to be jumpy, hesitant, overly excited, fidgety or have shaking hands)
Have mobility issues
Have difficulties understanding instructions from the crew.

Snorkel workers can also identify potentially 'at risk' snorkellers by

Asking the participating group questions
Using an assessment form
Talking with participants individually

Once identified, the snorkel worker can ask the participant further questions to determine whether they are at risk, such as

Do you have any medical conditions?
Are you currently taking any prescribed medication?
Do you smoke?
Have you snorkelled before?
Can you swim well?
Are you feeling unwell?

Where a snorkel worker identifies that a participant is an at risk snorkeller, they may require the participant to complete a declaration (PDF, 0.05 MB) and ask the participant to advise them if they have any concerns about their medical conditions. The snorkel worker should consider the declaration to determine what advice, equipment and supervision should be given to the person to ensure they can participate safely, and make sure all members of the team know who the at risk participants are, why they are at risk, and the measures that are in place to assist them.

At risk snorkellers should be required to:

snorkel in a buddy pair or in a guided group
wear and/or use a flotation device
be easily identifiable in the water

If an at risk snorkeller refuses to cooperate with an instruction that would to allow them to participate safely, they can be refused entry into the water.

Read more about identifying and assessing at risk snorkellers in the Snorkel safety – a guide for workers (PDF, 3.3 MB) and industry case studies.

The video Snorkelling sense (with multilingual subtitles) shows medical advice being given to snorkellers.

For more information visit Mike Ball Dive Expeditions - a case study about managing the quick recovery of drifting divers.