Rebreather Fatality Investigation.

Sixty-six representatives of rebreather manufacturers, training agencies, government agencies, rebreather users, and DAN met in November 2006 to discuss objectives for rebreather fatality investigations. DAN has collected information on 80 recreational diving rebreather deaths from 1998 through 2006. The annual number of rebreather fatalities appears to have tripled since 1998. The percentage of fatalities involving rebreathers among US and Canadian residents increased from about 1 to 5% of the total number of diving fatalities captured from 1998 through 2004. Rebreather fatality investigations attempt to reduce future occurrences by identifying causative factors, primarily focusing on three areas: medical, equipment, and procedural. Medical investigation dwells on diver health and final cause of death. Equipment investigation addresses potential hardware issues. Procedural problems appear to be more common than equipment problems but are often difficult to identify. Witness reports and 'black box' recordings of rebreather function could help untangle procedural and equipment issues. Enhanced international training and cooperation will facilitate effective incident investigation and, ultimately, the education of the diving community. Introduction This paper is a compilation of information from multiple sources: 1) a two-hour meeting before the 2006 Diving Equipment and Marketing Association (DEMA) Show in Orlando with 66 representatives from rebreather manufacturers, training agencies, government agencies, and rebreather users; 2) comments on a draft of the meeting report; and 3) a preliminary review of rebreather fatality data collected by the Divers Alert Network (DAN). The data are from recreational diving with open-circuit fatality data presented for comparison. The term rebreather is used to describe closed-circuit or semi-closed circuit mixed gas scuba. The paper attempts to give the reader a sense of the issues and potential opportunities. The Problem Figure 1 summarizes 80 rebreather deaths collected by DAN America for 1998 through 2006. The information was obtained from internet searches or sent to DAN by interested persons. This does not necessarily include all rebreather fatalities in the world, just those about which DAN has been informed. The total number of rebreather fatalities per year appears to have tripled since 1998. In general, annual fatalities among non-US or Canadian residents have been greater than among US and Canadian residents but both are increasing. The most likely explanation for the increase in rebreather fatalities is that rebreathers have become more popular, and manufacturers are selling more. We do not know this for sure, however. Sales data are not currently available.