Tasmania labelled the ‘diving death capital of Australia’ – ABC News

David Smart Tasmania has a dubious distinction of being the diving death capital of Australia. We have at least four times the national average of deaths underwater per capita. Now that doesn't take into account participation rates which may well be quite a bit higher in Tasmania because of the ability to catch recreational seafood. But certainly per capita we are four times the national average and about ten times the safest state. So there's a lot of I guess learnings that we need to take out of our scuba and hooker deaths and particular hookah deaths that could do with some improvement so that we can actually save the lives of more Tasmanians in the future and stop them from getting injured.

Leon Compton I mean you have operated our hyperbaric treatment centre for a long time. As a media we tend to talk about these stories when there are deaths involved David. But tell me about the rate of injury you see and what typically an injury looks like when people have had a mishap.

David Smart So injuries can range from just a minor ear squeeze where someone has a bruised eardrum right through to someone who's paraplegic or quadriplegic coming in from diving. So the spectrum is enormous. For every death we have in Tasmania there's essentially been one death per annum from diving but in the last 30 years and they're all recreational divers. There's no amongst that group there's no occupational divers. For every death there's probably 10 or 20 people get injured and some of the injuries are quite severe. An example was 12 years ago with a scallop, it was probably 15 years ago sorry with the scallop season down at the D'Entrecasteaux Channel. We had two divers come in with decompression sickness and two divers came in with burns from the one accident. And the people who got the burns were trying to refill a hookah compressor with petrol when it ran out of petrol and the divers had to rush to the surface because they had no air supply. They expected some support from the surface and the two guys in the boat who were actually expected to provide support were in the water with the boat on fire and a third boat came through to rescue them. So the accidents range in severity right through the spectrum to sometimes really unusual ones like that one.

Leon Compton The people I've spoken to before I've gone diving on a hookah with them have wanted to know that I have my dive ticket but is that an appropriate starting point or should there be a specific hookah focused dive training course that people should have to get Dr David Smart?

David Smart First comment is there are no hookah dive courses available and that is a gap in the market but also you can see why dive shops would not want to invest in it in an educational sense because they don't get any payback. The person takes their hookah away and then just keeps diving. A key component of hookah diving is that the owner is totally responsible for providing a safe air supply to the divers underwater. Hookah diving is actually more advanced than any scuba diving at basic level and advanced level largely because you're responsible for that equipment, the air supply, the air safety. Carbon monoxide poisoning can occur very easily. You can get oil down the line if it's not got appropriate filters and you can also get inappropriate gas supply where sometimes people would put two individuals on the one length of hose and they split it into a T or a Y which means that the diver who's at the shallowest depth steals the gas off the diver at the deepest depth. So as a result of that you can have accidents where the person down deep can't get enough air, races to the surface and then ends up with rupturing their lungs and having either a pneumo-mediastinum which is probably lucky if they get that or otherwise a gas embolism when they get gas straight up into the brain and they cry out and then go unconscious on the surface. So the hookah diving is particularly used for seafood. Abalone industry has a detailed course that they do for their divers to teach them about that sort of diving which extends beyond the basic recreational scuba diving and covers a lot of the issues that you have to have in the occupational setting. What happens really is with recreational seafood you're moving a heavy object through the water column and a lot of the disasters occur when people, particularly the scallop season, they might fill up a bag of 50 scallops which can weigh 20 kilos or so in Tasmania when you get good sized scallops. They try and move it through the water column and in moving it either they use too much gas and accelerate to the surface or they have too little buoyancy in their gear to get them to the surface and can end up with near drowning and a lot of incredible effort required. Or they can end up dropping the bag of scallops when they've got excessive buoyancy and going racing to the surface. So that leads the divers to have what's called pulmonary barotrauma and the shallowest I've seen someone get pulmonary barotrauma from is one and a half metres while training in a swimming pool. So if you hold your breath and you go to the surface with compressed air in your lungs you will rupture your lungs. And so doing that it either goes two ways, into the chest or up to the brain.

Leon Compton What if any extra regulation would you like to see in this space?

David Smart I'll start by saying that at the moment the recreational hookah diver falls between every crack. They're not occupational so they don't have occupational standards, they don't have the recreational training and there's also the capability of actually manufacturing your own hookah apparatus.

Leon Compton We haven't even talked about that yet, the actual fact that the thing providing you air is something that might well have been made at home and you might have bought it off Gumtree from someone who made it at home.

David Smart Or even worse it's about third hand and it's got to the point where it should actually be completely scrapped. So one of the regulation areas could be the sale of hookah apparatus in Tasmania that actually would at the point of purchase and that would include second hand gear the same way that they've actually moved with boats to actually have an agreed certification that the two people, the purchaser and the seller, actually agree that the boat is safe when they purchase it. That's part of the deal now and that sort of thing should be applied I think and extended to hookah apparatus. That would make a lot of people start to think twice. I have produced over the years for MAST educational material including a three minute video on hooker, another three minute video on carbon monoxide poisoning and also if you search on the MAST website, recreational hookah diving safety in Tasmania you can get it straight from the MAST website as well, about a ten page article there on things you should need to know. But that sort of stuff doesn't seem to be working. That was done by me about eight to ten years ago in my role with Royal Hobart Hospital and it's obvious that the message isn't getting through in relation to hookah apparatus and the actual enticement of collecting scallops off the bottom or catching seafood that we're famous for in Tasmania is still there and people are going to take risks. So I think some sort of point of sale regulations would actually make a big difference because it would stop second hand crap being sold on the market that could kill someone.

Leon Compton What advice do you have about learning to dive safely on hookah?

David Smart Get yourself a full diving health check. There's a number of doctors who are trained in diving medicine around Hobart in particular and around Tasmania generally and if we looked at a diving death study that myself and Juan Carlos Ascencio-Lane and John Lippman did publish in 2019, a key issue was diver health and certainly if people have got medical conditions they can impact on scuba diving and kill people and if you're not in good shape or good health you can have things like immersion pulmonary edema which can kill you. All of these things need to be looked at by a trained medical professional and at the moment it's not compulsory for recreational divers to get health checks if they tick no to everything on their little questionnaire whereas it is every year for occupational divers. There's been no occupational diving deaths in the last 30 years and there's been 30 recreational diving deaths.

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Tasmania labelled the 'diving death capital of Australia' - ABC News