Saturday, December 10, 2005

Hemochromatosis and Diving?



can you please provide advice regarding any precautions and/ or risks accociated with a person scuba diving who has hemochromatosis.




Hello John:

Simply put, hemochromatosis is the condition caused by excessive iron stores in the body. The condition causes some symptoms, none of which are adverse to diving, unless in the last stages of the condition. (fatigue, joint pain, abdominal pain, or organ damage.)
More about hemochromatosis.

The treatment of the condition is 'phlebotomy' (blood donation), as often as twice weekly for the about the first year of treatment then periodically thereafter, depending on the rapidity of the rebuild of the red blood cells
(about 120 days in most individuals) and the serum ferritin (iron) and TIBC (iron binding capacity).

Phlebotomy can cause temporary decrease in blood volume, which is thought to increase the risk of decompression sickness. It generally takes about 24 hours for the actively hydrating individual to get his blood volume back to what it was before the donation - so one would be advised not to dive for about that period of time.

Also, some individuals have feelings of faintness, nausea and weakness after donating. Of course, if present, these would be inimical to the diver.

I hope this is helpful!

Ern Campbell, MD
Scubadoc's Diving Medicine

* A prominent diving medicine physician has the following comment that I feel is pertinent to a proper answer to this question:

"I would suggest that you ask your diver when responding to his question on hemochromatosis a) his age and b) whether the diagnosis of hemochromatosis is primary or secondary. If the disease is primary, there is a risk of malignant change. If the disease is secondary, then it could be due to a number of causes, such as excessive alcohol intake, in which case one would probably not wish to dive with him. There are also secondary problems of hemochromatosis, such as diabetes, pancreatitis etc which would require careful consideration."