Flying after diving: a questionnaire-based evaluation of pre-flight diving behaviour in a recreational diving cohort

Introduction: Divers are recommended to observe a pre-flight surface interval (PFSI) >= 24 hours before boarding a plane following a diving vacation. Decompression sickness (DCS) symptoms may occur during or post-flight. This study aimed to examine the adherence of PFSI >= 24 in vacationing divers, and if any perceived signs and symptoms of DCS during or after flight were experienced. Methods: An anonymous online survey was publicised through diving exhibitions and social media. Data included diver/diving demographics, PFSI before flight, flight details, and perceived signs and symptoms of DCS during or after flight. Results: Data from 316 divers were examined (31% female) with the age range 17-75 years (median 49). Divers recorded 4,356 dives in the week preceding the flight, range 1-36 (median 14). Overall, 251/316 (79%) respondents reported a PFSI of >= 24 hours. PFSIs of < 12 hours were reported by 6 respondents. Diagnosed and treated DCS developing during, and post flight was reported by 4 divers with PFSIs >= 24 hours and by 2 divers with PFSIs < 24 hours. Fifteen divers boarded a plane with perceived symptoms of DCS. Conclusions: These data suggest that most divers in this study observed the recommendations of a >= 24 hour PFSI with safe outcomes.