The Effect of Temperature on Decompression and Decompression Sickness Risk: A Critical Review.

Abstract : There are long-held beliefs regarding temperature effects on dive outcome. One accepted tenet is that decompression sickness (DCS) risk increases during exposures to cold water. It is also commonly held that post-dive hot water showers encourage the onset of DCS. The question of thermal effects on DCS was raised most recently in response to observations of DCS cases after the introduction of hot water suits during the salvage effort for TWA Flight 800. We conducted a literature review using 4 biomedical reference databases to locate human and animal studies associated with diving, caisson work, and aviation. Studies were selected for inclusion if they examined the relationship between thermal conditions and DCS risk, the production of venous gas embolism, or inert gas exchange. We conducted a second search for the effects of showering on DCS and examined the Naval Medical Research Institute (NMRI) DCS database for cases of DCS associated with showering. Accepted epidemiological criteria for the evaluation of causal relationships were applied to the studies we found on the subject.