Diving Safety Lines 2ND Quarter 2000 1. Safety Center Personnel 2. Corrective Eye Surgery (Refractive Surgery) for Divers 3. Master Diver's Corner 4. Diving Mishap Statistics 5. Wrong Diving Apparatus 6. DRS 7. DSWS 1. Safety Center Personnel The following is a roster of the Diving and Salvage Division (Code 37) at the Safety Center. Names are followed by area of responsibility and phone extension. CDR Sutton DIVING/SALVAGE DIV HEAD 7088 LT Nelson DIVING/SALVAGE ASSISTANT 7085 HTCM(DSW/SW) Matteoni MASTER DIVER 7082 SENIOR DIVING/SALVAGE ANALYST BMC(SW/DV) Vitez DIVING MISHAPS 7087 SURVEY CHECKLIST COORDINATOR 3M/TECHNICAL COORDINATOR MMC(SS/DV) Gest DIVE REPORTING SYSTEM 7103 DIVE HISTORIES ENC(SW/DV) Birmingham DIVING SURVEY SCHEDULER 7081 SFC Wheelock SPECWAR/USA/USMC/USAF LIAISON 7104 All Divers Group Ring 7084 2. Corrective Eye Surgery (Refractive Surgery) for Divers Before I begin, let me first explain what refractive surgery is. Corneal refractive surgical procedures change the shape of the cornea to correct myopia (near sightedness), hyperopia (far sightedness), and some types of astigmatism (irregular curvature of the cornea). The various types of procedures differ in how they actually change the shape of the cornea. These procedures offer the potential to reduce or eliminate the need for glasses and contact lenses. It should be noted that, in most cases, these procedures do not correct presbyopia, the need to wear glasses for reading after middle age. There are four types of surgical procedures available: Radial keratotomy (RK), photorefractive keraectomy (PRK), laser in-situ keratomileusis (LASIK), and intracorneal rings. I will discuss PRK since it is the only procedure that is not disqualifying for Diving/Special Warfare duty. PRK is one of two, FDA-approved procedures for reshaping the cornea. An excimer laser uses an ultraviolet wavelength to deliver pulses of energy that remove a small, disc-shaped sliver of the central cornea. To accomplish this, the surface layer of the cornea must also be removed, but it grows back in place within a few days after the surgery. As with everything we do, there are some disadvantages and risks associated with the procedure. Active duty personnel who undergo PRK may lose time from work and incur possible TAD expenses associated with travel to a designated medical center performing the procedure. There also may be side effects and complications, most of which are short term and resolved within a few weeks after the procedure. However, some may take longer to resolve, and, in a small percentage of cases, could be permanent. These side effects include decreased night vision, glare sensitivity, and/or worsening of the pre-operation, best vision due to scar formation and other effects of the healing process. In addition, about ten percent of PRK patients require re-treatment with the laser to "fine tune" the desired corrective effects of the procedure. So, what is the Navy's policy on refractive surgery for personnel applying for or already designated in the Diving/Special Warfare community? As mentioned before, PRK is the only procedure that is not disqualifying; all other procedures are disqualifying and waiver recommendations will normally not be considered. Applicants for entry into diving duty, including special operations and special warfare, must have a three-month waiting period following their most recent corneal surgery prior to their qualifying examination. An ophthalmologist or optometrist and an undersea medical officer will determine when designated diving and special warfare personnel may return to full duty following corneal surgery. Personnel electing to have PRK must receive authorization from their commanding officer (CO) prior to the surgery. PRK is currently available on a limited basis at Naval Medical Center, San Diego, CA, and Naval Hospital, Portsmouth, VA. These facilities will provide refractive surgery to active duty operational forces with priority given to those with a special need in warfare communities. The service member's CO must determine the priority level merited based on operational need, probability of mission performance enhancement, and issues of personal safety in the performance of their military duties. Active duty personnel who have refractive surgery performed at Navy laser centers will not be charged any fees for the procedures, regardless of the prioritization category to which they are assigned. If travel arrangements are required for the service member to have surgery, the travel and other expenses shall be borne either by the command (at the discretion of the CO) or by the individual. Service members should expect to stay in the vicinity of the PRK center for approximately three to five days. Active duty personnel interested in corneal refractive surgery may schedule a routine initial screening exam at the nearest military treatment facility (MTF) that has optometrists or ophthalmologists. These eye care providers will determine if the service member meets the minimum eligibility criteria for surgery. Eligible service members who qualify may then request approval by their CO to schedule surgery. The CO will also be responsible for determining their prioritization category for surgery. The completed consult form, CO's endorsement, and prioritization are then forwarded to the PRK center. The PRK center will coordinate directly with the service member for purposes of scheduling the final pre-operative screening exam and actual surgery. For more information about refractive procedures, call the Refractory Surgery Center, Naval Medical Center San Diego, at (619) 524-5515 or CAPT Murray, MED-21, Bureau of Medicine, at (202) 762-3449. Information from this article was taken from http://navymedicine.med.navy.mil and BUMED's message outlining corneal refractive surgery physical standards and waiver policy in the Navy-Marine Corps (BUMED 061344Z APR 00). POC: HMC(SW/DV) Keltner, Ext. 7118 tkeltner@safetycenter.navy.mil 3. Master Diver's Corner A few weeks ago, we heard some disturbing news about scuba pre-dive checklists. Most commands have a checklist that includes the verification and setting of the regulator over-bottom pressure prior to diving operations. However, there are some commands out there that do not perform this important check before a dive. The only time they check the settings is when PMS calls for it (annually). Presently, there is no formal requirement for verifying and setting the regulator over-bottom pressure before a dive, but NAVSEA 00C is looking into making it a pre-dive check. In the meantime, we recommend making this a pre-dive check as regulator settings tend to change as they sit on the shelf. It's a good practice to get into, and it just makes sense. POC: HTCM (DSW/SW) Matteoni, Ext. 7082 lmatteoni@safetycenter.navy.mil 4. Diving Mishap Statistics Here are more of the latest statistics on diving within the Department of Defense. These charts show the breakdown of mishaps by diving apparatus and calendar years 1995 through 2000 (data through 1 April 2000). MISHAP TYPE 1995 1996 1997 1998 1999 2000 5 YEAR TOTAL AIR EMBOLISM 13 10 5 9 10 1 48 BAROTRAUMA 1 1 0 1 0 0 3 CO POISONING 1 0 0 0 0 0 1 DCS I 10 8 4 7 8 2 39 DCS II 20 30 9 18 12 0 89 DROWNING 1 0 0 0 0 0 1 MECHANICAL INJURIES 1 1 1 1 3 1 8 MEDIASTINAL EMPHYSEMA 0 0 0 0 1 0 1 MISSED DECOMPRESSION 4 0 2 2 0 0 8 OTHER 0 0 0 0 1 0 1 TOTAL PER YEAR 51 50 21 38 35 4 199 MISHAP TYPE MK-20 SCUBA OPEN MK-16 LAR-5 MK-21 MOD 1 CHAMBER EXP FFM SCUBA TOTAL AIR EMBOLISM 3 26 6 7 4 2 0 0 48 BAROTRAUMA 0 2 1 0 0 0 0 0 3 CO POISONING 0 0 0 0 0 1 0 0 1 DCS I 3 6 2 0 7 17 4 0 39 DCS II 12 18 6 0 19 25 8 1 89 DROWNING 0 0 1 0 0 0 0 0 1 MECHANICAL INJURIES 0 3 1 0 4 0 0 0 8 MEDIASTINAL EMPHYSEMA 0 0 0 0 0 1 0 0 1 MISSED DECOMPRESSION 0 2 0 0 2 1 3 0 8 OTHER 0 1 0 0 0 0 0 0 1 TOTAL PER APPARATUS 18 58 17 7 36 47 15 1 199 As we mentioned last time, if there are other specific statistics that you or your command needs to have, please contact us with the details. We will attempt to retrieve the data for you as fast and as accurately as possible. POC: MMC(SS/DV) Gest, Ext. 7103 kgest@safetycenter.navy.mil 5. Wrong Diving Apparatus Recently, a non-saturation diving command requested statistics on the type and number of dives they made for calendar year 1999. We pulled the information from our database and discovered they had reported several Mk 21 Mod 0 dives. Realizing this was possibly incorrect data (the Mk 21 Mod 0 is a saturation, mixed-gas diving rig), we contacted the command to inquire about the probable discrepancy. After the command verified that the entries were, in fact, a mistake, we researched statistics for all Navy dives in 1999. This second data search yielded similar results: Over one thousand Mk 21 Mod 0 dives were reported last year, several of which identified the dive purpose as "ship's husbandry/repair." Obviously, many commands were making the same mistake, but why? After talking to the command and looking at the DRS program, we came to the conclusion that the problem stems from the program user. When entering data into the field for "Diving Apparatus," the user must tab through the available options, the first of which is the Mk 21 Mod 0. Whether the person entering data is in a hurry or just plain lazy, he or she is stopping at this point and using Mod 0 as the dive apparatus regardless of whether they actually used this rig. For the majority of you, the proper choice should be the Mk 21 Mod 1 since this is the rig that most of you are using, especially on ship's husbandry and repair jobs. If you are conducting a saturation dive during a ship's husbandry job, perhaps you're doing a hull cleaning of the Titanic. The solution to this problem is simple: Slow down while you are entering diving data and ensure you select the proper diving apparatus when entering information into the DRS program. Our goal at the Safety Center is to maintain an accurate database. We can only do it with your help. POC: ENC (SW/DV) Birmingham, Ext. 7081 rbirmingham@safetycenter.navy.mil 6. DRS Time now for another DRS update. We are now receiving the majority of DRS reports via e-mail. To accommodate the increased load, I am consolidating my efforts and will only respond to reports on Wednesdays. If you don't receive an immediate response after sending in your report, do not be alarmed. However, if a Wednesday passes by without a "thumbs up," give us a call. Other DRS issues...A key to my effectiveness as the Naval Safety Center's DRS coordinator is the dependability and capability of each command's e-mail account. We continue to lose contact with commands that only maintain accounts associated with personnel ("name"@"domain".navy.mil) since these people inevitably transfer. Commands using an e-mail address for the diving locker ("dive" or "divlkr"@"domain".navy.mil) have successfully maintained continuity as DRS coordinators rotate. As for e-mail capability, the other stumbling block is the Internet service provider (ISP) that some of you use. Many divers find it easier to use home e-mail accounts (Yahoo!, AOL, MSN, etc.) to communicate with us concerning DRS. The problem with these accounts, however, is that they cannot handle receiving large files. Typically, files that exceed the download capacity of the ISP cause providers to terminate the user's connection during download. Because some commands are still upgrading to DRS Version 4.5, it is likely that we will need to send some of you very large files (over 1MB). If it's possible, utilize an e-mail account at your command. Most military accounts are more than capable of handling the large files we might send. Personally, I give all of you a big "Hoo Ya!" The number of DRS problems we see from the fleet has greatly diminished. I attribute this to the professionalism of the divers performing a job that appears unimportant compared to something like hooking into a downed aircraft at the bottom of the ocean. Remember, it's the tender that first notices no bubbles on the surface. Keep up the good work. POC: MMC(SS/SW/DV) Gest, Ext. 7103 kgest@safetycenter.navy.mil 7. DSWS In case you haven't heard the news, the Diving Salvage Warfare Specialist (DSWS) qualification was finally approved in April. OPNAVINST 1414.3 contains the requirements for qualification and designation of enlisted personnel as DSW specialists. The qualification recognizes the efforts of enlisted individuals trained in diving operations and is mandatory for all active duty E-5 and senior enlisted personnel who meet eligibility requirements. Active duty E-4 and junior personnel and enlisted selected reservists may qualify for DSWS if they meet the eligibility requirements. Eligibility to attain the DSWS designation is limited to the following NECs: 5341, 5346, 5342, 5311, 5343, 8493, 8494, 5931, and 5932. Current master divers are qualified by position and will be immediately designated DSWS. If you have any questions, reference the OPNAV or call ENCM(DSW) Davidson or HTCM(DSW) Young at NAVSEA, (703) 607-2766. POC: HTCM(DSW) Matteoni, Ext. 7082 lmatteoni@safetycenter.navy.mil 8 8