Scuba Diving Concerns With Asthma

If your asthma is well-controlled and you are prepared to follow your asthma action plan, you can try out virtually any activity. Special care must be taken when considering scuba diving, however. Changes in pressure pose a small risk of lung injury for anyone scuba diving, but this is heightened if you have any respiratory disease like asthma. Scuba diving can also expose you to asthma attack triggers.

While experts warn that scuba diving can pose these potentially life-threatening potentials if you have asthma, that doesn't necessarily mean that you can't do it at all. An asthma assessment can help you and your doctors gauge whether or not scuba diving is advisable or not.

Scuba Diving With Asthma Risks

Theresa Chiechi / Verywell

Risks of Scuba Diving

Because of your asthma, your lungs are already compromised due to the chronic inflammation characteristic of your disease. This is what impairs regularly breathing and leads to asthma attacks.

Pressure changes and triggers you are exposed to when scuba diving can amplify the risk of these concerns and compound their effects.

Pulmonary Events

When you scuba dive, your blood vessels, heart, and lungs have to adjust to the changes in gas pressure that occur when ascending and descending in the water. That's why novice divers shouldn't dive very deep and experienced divers train to safely adjust their depths and speed of ascent and descent.

Divers with asthma have the same types of injuries related to these changes as divers who don't have asthma—it's the risk of them occurring that is different.

That's because asthma often causes overexpansion and trapped air in the airways, and diving can further exacerbate this. And, if your lungs have been damaged from recurrent inflammation, issues that might not affect perfectly healthy lungs can have an impact on you.

Dangers of scuba diving when you have asthma include: 

  • Reduction in pulmonary function
  • Bronchospasm: Sudden narrowing of the airways
  • Pulmonary barotrauma: Lung injury due to air pressure
  • Pneumothorax: Air in the lungs
  • Pneumomediastinum: Air leak from the lungs into the chest
  • Arterial gas embolism: Air bubbles in the blood vessels
  • Decompression sickness: Air bubbles in the bones

Asthma Attacks

There are several factors that can trigger an asthma attack when you are scuba diving.

You might already know if you have a predisposition to asthma attacks when you are in cold temperatures, and that is often unavoidable when diving.

And if you have exercise-induced asthma, the physical exertion of diving could trigger an asthma attack.

Additionally, new exposures or experiences could trigger an asthma attack when you're scuba diving.

Potential triggers include:

  • Chemicals, such as gear cleaning solutions
  • Environmental materials, such as plants or pollen
  • Stress due to the unfamiliar environment

Asthma Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Asthma Doctor Discussion Guide

Pre-Diving Assessment

You might be required to obtain medical clearance before taking diving lessons or obtaining diving certification. Of course, even if such clearance is not required, seeing your doctor is a good idea.

Safe diving with asthma involves several important considerations. This includes making sure your asthma is well controlled, having diagnostic tests to assess your risk of complications, and taking preventative measures if necessary.

Your asthma control is determined based on whether you have trouble breathing, experience asthma attacks, and how much (if any) rescue inhaler you need. You might also have pulmonary function tests that measure your breathing ability.

Spirometry Testing

Spirometry is a test that measures the air that you inhale and exhale. Your doctors can use this test to find out your forced vital capacity (FVC), which is the amount of air you can forcibly exhale after taking a deep breath. You might also have a test for forced expiratory volume in one second (FEV1), which is the amount of air you can exhale in one second with maximal effort after a full inhalation.

Additional tests include a challenge test, which measures your results before and after an asthma trigger, like exercise or mannitol. In one study, researchers concluded that asthma patients with less than 10% decline in FEV1 after administration of mannitol were classified as having no medical contraindications to scuba diving.

Clearance Guidelines

There have not been any strict international rules regarding the safety of diving with asthma, but several helpful guidelines have emerged.

French, British, American, Spanish, and Australian medical pulmonary societies consider diving to be unsafe for patients with:

  • Moderate to severe persistent asthma
  • FEV1<80% of normal
  • Active asthma in the last 48 hours
  • Exercise or cold-induced asthma
  • Poor physical fitness

According to the Diver's Alert Network, one of the leading international diver's associations, the U.K. diving guidelines suggest that people with asthma shouldn't dive if they have needed a bronchodilator within 48 hours or if they have cold, exercise, or emotion-induced asthma.

Similarly, Australian scuba diving organizations suggest that divers pass a lung function test to exclude asthma prior to obtaining diving certification.

Only your doctor can determine your personal risk and whether or not it's considered safe for you to dive.

Safety Precautions

If you are cleared to dive, talk to your doctor about whether using a rescue inhaler shortly before taking the plunge might be beneficial for you.

When you head out, make sure you have your rescue medication on the boat (or nearby onshore). But remember: You cannot use your rescue medication underwater, and there is a good chance you could be far from the water's surface if you have an asthma attack while driving.

Be sure your companions who go out to sea with you know what to do if you become short of breath—both underwater and once you've surfaced.

When you start diving, be sure to take it slow. Advance gradually and consider monitoring your breathing with a spirometer afterward to see if you have any decline in your peak flow.

When to Put Off a Dive

If you are experiencing an increase in your asthma symptoms, or if you needed to use a rescue inhaler in the past few days prior to a planned dive, you should not dive.

Likewise, a recent illness or infection could make you more susceptible to having an asthma attack or experiencing lung damage.

And if cold temperature is a known trigger of your asthma attacks, skip your dive if the water is not warm. Note, however, that water gets colder the further down you go.

A Word From Verywell

You can lead an active, healthy life, including participating in many different sports and activities if you have asthma. But you need to consider your condition and estimate your risk when it comes to any activity that could harm your lungs.

Scuba diving might be an option for you, especially if you make sure you have good asthma control. But checking with your doctor and listening to your body are the only ways to know for sure.

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Article Sources
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