The Urak Lawoi are indigenous fishermen on Thailand’s west coast. The population includes an estimated 400 divers who dive using surface-supplied compressed air. In a cross-sectional survey conducted among the 6 major communities of Urak Lawoi, questionnaire-based interviews were administered to active divers, ex-divers, and families or colleagues of divers who had died in the previous 5 years. Six deaths resulting from diving-related accidents were identified, indicating a diving-related mortality rate of approximately 300 per 100,000 person-years, while in the same 5-year period 11 divers had been disabled owing to diving-related events, indicating a diving-related disabling event rate of approximately 550 per 100,000 person-years. Among 342 active divers interviewed, one third reported having suffered from decompression illness, although based on reported current symptoms over 50% were classified as suffering from recurring non-disabling decompression illness. Physical examination conducted on a subset of 98 active divers revealed the presence of spinal injury (clonus, raised muscle tone, and heightened reflexes) and of joint damage (pain in one or more joint, crepitus, or restricted movement) in 24 and 30% respectively. Improved primary prevention and medical treatment are needed to reduce mortality and morbidity among this population.
Diving practices of a group of indigenous people living on Thailand’s west coast were investigated. Village chiefs were first interviewed using a questionnaire. Three hundred and forty-two active divers were then interviewed by health care workers using a second questionnaire. Field observation was used to further develop information and confirm diving practices. Divers in 6 villages, whose basic means of making a living is from diving for marine products such as fish and shellfish, have diving patterns that put them at substantial risk of decompression illness. Breathing air from a primitive compressor through approximately 100 m of air hose, these divers have long bottom times coupled with short surface intervals. Forty-six point two percent of the divers indicated that they would not make a stop during ascent from a long deep dive (40 m for 30 min). When comparing their previous day of diving to the U.S. Navy Standard Air Decompression Table (U.S. Navy, 1993), 72.1% exceeded the no-decompression limits set by the tables. Diving patterns point to a need for more in-depth research into the diving patterns of this indigenous group. Future research should include the use of dive logging devices to record depths and times. There is also a need to provide divers with information and training to reinforce positive practices and strengthen knowledge of the risks associated with their current diving practices.
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