TABLE 2

Overview of longitudinal studies on lung function of divers

First author (year) [ref.]	Design	Diving exposure	Sample size n	Age at study entry years	Study period years	Results
Davey (1984) [39]	Retrospective registry database, controlled	Commercial divers, including saturation divers	255	28.2	>5	Change in FVC significantly correlated with change in maximal diving depth
Watt (1985) [54]	Retrospective cohort	Commercial divers, including saturation divers	347	30 (n=224) 33 (n=123)	3–4 (n=224) >5 (n=123)	Significant decrease in FVC of 240 mL (n=224) and 400 mL (n123); no correlation with diving indices
Thorsen (1993) [55]	Prospective follow-up after single deep dive	Saturation divers, controls	24	30.3	3	Significant reduction in FEV₁ of 210 mL after 1 year and 81 mL·year⁻¹ over 3 years; similar reduction in forced expiratory flows at low lung volumes
Bermon (1994) [56]	Retrospective controlled	Firemen divers using air scuba	20	33.1	8–9	Significant reduction in FVC (160 mL) and FEV₁ (310 mL); similar reduction in maximum mid-expiratory flows
Thorsen (1995) [57]	Prospective follow-up after single deep dive	Saturation divers	8	24	3	Significant reduction in maximal expiratory flows at low lung volume
Bermon (1997) [58]	Retrospective cohort	Firemen divers using air scuba	15	33.4	6	Significant reduction in D_LCO
Skogstad (2000) [59]	Prospective cohort	Professional scuba divers	87	25.2	3	Significant reduction in FEV₁ of 1.8% (100 mL) and of forced expiratory flows at low lung volume
Skogstad (2002) [60]	Prospective cohort, policemen controls	Professional scuba divers, including saturation divers	77	24.9	6	Significantly higher annual reduction in FVC and FEV₁ than in controls; reduction in maximal expiratory flow rates at low lung volumes correlated with cumulative dives
Fitzpatrick (2003) [61]	Prospective cohort	Working divers supporting astronaut training	43	31	3	Significant increase in FVC (6.3%) and FEV₁ (5.5%); cumulative dive hours associated with increases in FVC and FEV₁
Shykoff (2004) [62]	Retrospective cohort	US Navy divers	25	31–50	>1–>5	No significant changes in lung function
Lemaitre (2004) [63]	Prospective cohort	Recreational scuba divers	18	31.8	2.4	No significant changes in lung function
Tetzlaff (2005) [64]	Prospective cohort	German special forces divers	39	28.4	5.8	No significant changes in lung function
Tetzlaff (2006) [65]	Prospective cohort, submariner controls	German Navy divers	468	32	1–9	No significant difference in decline of FEV₁ between divers and controls
Skogstad (2008) [66]	Retrospective cohort	Singapore Navy divers	116	31.3	5	Significant increase in FVC and FEV₁
Chong (2008) [67]	Prospective cohort	Professional scuba divers,	37	24.6	12	Significant reduction in expiratory flows and volumes
Sames (2009) [68]	Retrospective cohort	New Zealand occupational divers	336	35.6	5.6	Significant change in FEV₁ % predicted and PEF
Pougnet (2013) [69]	Retrospective cohort	French professional divers	33	42	5–10	Significant decreases in forced expiratory flows at low lung volumes, FEV₁/FVC and D_LCO
Voortman (2016) [70]	Retrospective cohort	Royal Netherlands Navy divers	1260	26.2	>1–>16	No significant change in FEV₁ over time (decline of 7 mL·year⁻¹)

Data are presented as mean or range, unless otherwise stated. FVC: forced vital capacity; FEV₁: forced expiratory volume in 1 s; D_LCO: diffusing capacity of the lung for carbon monoxide; PEF: peak expiratory flow.