A survey of a cohort of diving fishermen on the Yucatan Peninsula.

Jorge Garcia Torres

1
, Dan Godfrey
2
, Gabriella Dvorak
3
, Maurice Cross
2
The Diving
Fishermen Project, Plymouth UK.

We have studied a sample population of the diving fishermen why work on or near on the
Island of Mujeres on the Yucatan Peninsula. Typically the divers work using hookah or
surface-supplied equipment and functionally organised into co-operatives. They operate
typically as 2-3 divers per boat and unlike many diving fishing communities operate single-
diver. We studied a cohort of 63 divers who received questionnaires regarding their
demography, diving practices, perceived risks and medical history. They then underwent a
simple and highly directed clinical evaluation which included an ataxia battery. There were a
small number of incomplete examinations or questionnaires. A retrospective study of
records found 8 deaths directly attributable to diving-related illness in the past 10 years. A
much lower number than might be expected.
Demography. All 63 divers studied were males with a mean age of 32.7years (range 17 -
54). The mean age of starting as a diver was 20 years but one started as young as 10 and
the oldest starter was 35, the mean years of experience of the cohort was 12.7 years. Most
men did 2 3 dives per day during the season which runs from February to October and the
average number of diving exposures per year was 300 with a range from 2 to 750 dives per
year. The lower figure is distorted by a few boat owners who dive very occasionally. The
mode value was 300 dives per annum. To assess the exposure, divers were asked the depth
of their last dive and their career maximum depth. In the cohort studied the last-dive-depth
was 94.2ft (SD=5.0) and the career maximum was 135ft (SD=5.0) Thus we have a
population at high risk of decompression illness. Although all men should be performing
decompression procedures, 17/67 men denied taking these precautions.
Medical history. At the time of writing this abstract, a medical history was available on 57 of
the divers and approximately half (30/57) had experienced decompression sickness when this
was determined by direct questioning. When asked of they experienced pain after diving,
affirmative answers were obtained from 37/59 which suggests that they mostly correctly
associate the pain with decompression sickness. Most men associated their work with a risk
of death.
Clinical examination. The incidence of morbidity is high. Of the 45 men who had a complete
clinical examination according to the protocol. only 7 men were ranked as totally normal in
every respect. The principal abnormalities reported was the finding of degrees of sensory
impairment in 17/44 men studied and ataxia as determined by an ataxia battery of three
tests. In this battery the ataxia score was determined on a scale of 1 4 for each observation;
the scores were then added so that a normal individual in every respect would have a score
of 3 and a highly abnormal individual one of 12. Scores of greater than 6 were considered
abnormal. Scores of greater than 6 were obtained in 23/43 (53%) of the complete results
obtained suggesting a high level of posterior column injury. Radiological examination of the
divers was not possible however palpable crepitus was detected in the shoulders of 27/43
men examined. This may arise from a number of causes however it points to a high probably
incidence of aseptic necrosis of bone with joint disruption. Typically an incidence of about
33% is found in formal studies of such communities as these so the results of the simple
examination are supportive of a similar incidence.