ĭCS is one of the work-related diseases among the haenyeos of Jeju, South Korea, being caused by complex interactions among multiple factors. Other possible treatment methods for DCS include administration of corticosteroids, lidocaine, tenoxicam, and diuretics but the pressure generated during diving lowers the effect of the medication, limiting the effectiveness of pharmacotherapy. In most cases, haenyeos have restrictions regarding HBO therapy as a treatment option since it is known to potentially cause changes in vision such as nearsightedness, pain in the teeth or lungs, substernal burning, cough, and other symptoms, leading to its discontinuation. Because most haenyeos have these underlying diseases, treatment is limited. Moreover, HBO therapy is limited in the case of lung, cardiovascular, and ear diseases based on a past or current medical history. The reason for the low frequency of use of HBO therapy is the problem of access to medical institutions. In Korea, HBO therapy is performed on haenyeos to treat DCS, but the number of haenyeos using HBO therapy has gradually decreased. The treatments for DCS can include normobaric oxygen therapy, hyperbaric oxygen (HBO) therapy, and high-flow oxygen therapy. The clinical manifestations of type 1 DCS may be seen within 24 h after diving in 98.0% of cases, but they tend to show quick recovery, whereas those of type 2 DCS are delayed and may lead to permanent damage. Type 2 symptoms typically fall into three categories of neurological, inner ear, and cardiopulmonary symptoms. Type 1 DCS is usually characterized by symptoms in the musculoskeletal system, skin, and fingers. Recently, because of concerns that it may be difficult to distinguish clinically between DCS and AGE in some cases, the collective term DCI has often been used in clinical studies. In addition, arterial gas embolism (AGE) can cause serious neurological manifestations. ĭecompression sickness is the most common effect based on symptomatology. Even small intravascular bubbles may have physical effects, with inflammatory and thrombogenic host responses. Divers absorb inert gas (nitrogen when air breathing) into tissues when breathing compressed gas during a dive, with more gas absorbed on deeper or longer dives. Thus, the DCS reported in the literature in pearl and ama divers has been attributed to this progressive accumulation of residual nitrogen that increases with repetitive dives until it reaches critical oversaturation, which allows the formation of bubbles. Breath-hold divers do not breathe pressurized air, and the only inert gas they take in is the nitrogen that remains in the lungs from the last breath before the dive. A particular case that is much less frequent and less well known from a pathophysiological point of view is breath-hold diving-related decompression sickness (DCS) symptoms. In their typical diving practices, haenyeos stay in the water for a total of 155–341 min a day and complete 15–31 dives per hour. Among the different types of divers, haenyeos refer to professional women divers who dive into the sea by implementing breath holds without any mechanical equipment to collect seafood. The workload of a haenyeo varies according to their diving ability. In general, haenyeos can dive from 50 s to 2 min, and the depth of the dive is about 7 m to 20 m. Rather than approaching the management of work-related diseases simply from the work environment perspective, it is important to increase the availability of health professionals who are capable of continuous health monitoring and management of women divers in their workplace.Īs of 2018, there were a total of 3820 haenyeos in Jeju, and the ages were very diverse. The health-related characteristics, menopausal period (χ 2 = 40.10, p < 0.001), body mass index (χ 2 = 14.80, p = 0.013), and fatigue level (χ 2 = 58.23, p < 0.001), showed a significant difference by latent class type. For work-related characteristics, diving experience (χ 2 = 29.99, p < 0.001) and break time (χ 2 = 9.32, p = 0.011) showed a significant difference by latent class type. For personal characteristics, age (χ 2 = 40.31, p < 0.001) and education level (χ 2 = 28.15, p < 0.001) showed a significant difference by latent class type. According to the results of the study, the latent classes were classified into type 1, type 2, and mixed symptoms groups (Akaike information criterion (AIC) = 6587.29, Bayesian information criterion (BIC) = 6698.23, sample size-adjusted BIC (saBIC) = 6615.70). A total of 527 haenyeos who received their certification in diving fishery from Jeju and were working from 15 March to were included in this study. This study aimed to investigate the types of clinical manifestations of decompression sickness among women divers (haenyeos) in Jeju using latent class analysis and to identify factors related to the condition.
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