{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:17:37Z","timestamp":1780525057658,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,10,12]],"date-time":"2016-10-12T00:00:00Z","timestamp":1476230400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The value of the commonly required routine annual medical examination of occupational divers has been questioned, and there is a need for a robust, evidence\u2010based system of health surveillance for this group of workers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine whether the medical examination and investigation component of occupational divers\u2019 routine comprehensive health surveillance adds significantly to the information gained from the questionnaire component in determining fitness for diving.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An occupational diver database was interrogated to identify divers issued with a \u2018limited\u2019 medical clearance or considered \u2018unfit\u2019 for diving over a 5\u2010year period. Reasons for the \u2018unfit\u2019 or \u2018limited\u2019 designation and the source of the critical information, whether the annual health questionnaire or the medical examination or questionnaire component (or both) of the initial or 5\u2010yearly comprehensive medical evaluation, was recorded. For divers completing the 5\u2010yearly repeat comprehensive medical evaluation, the sensitivity and specificity of the questionnaire alone for determining unfitness for diving was compared with that of a nominal \u2018gold standard\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 5178 certificates issued to 2187 divers over a 5\u2010year period, 158 (3%) were provisionally designated as either \u2018limited\u2019 or \u2018unfit\u2019. Of nine divers identified by the examination component of the 5\u2010yearly comprehensive medical evaluation, four were eventually designated \u2018fit\u2019, two \u2018limited\u2019, and three were lost to follow up. None who had completed subsequent investigations remained \u2018unfit\u2019. The sensitivity and specificity of the questionnaire to detect unfit divers compared with the gold standard were 84.6 and 99.3%, respectively, and its accuracy was 98.9%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current New Zealand occupational diver medical certification process, comprising annual health questionnaires and 5\u2010yearly full examinations, detects all health issues critical to the determination of fitness to dive.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13204","type":"journal-article","created":{"date-parts":[[2016,8,10]],"date-time":"2016-08-10T08:04:43Z","timestamp":1470816283000},"page":"1146-1152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An evidence\u2010based system for health surveillance of occupational divers"],"prefix":"10.1111","volume":"46","author":[{"given":"C.","family":"Sames","sequence":"first","affiliation":[{"name":"Slark Hyperbaric Unit Waitemata District Health Board  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Gorman","sequence":"additional","affiliation":[{"name":"School of Medicine University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Sandiford","sequence":"additional","affiliation":[{"name":"Department of Health Gain Waitemata and Auckland District Health Boards  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,12]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Occupational Diving Operations \u2013 Part 1: Standard Operational Practice (AS\/NZS 2299.1:2015)","author":"Australian\/New Zealand Standard","year":"2015"},{"key":"e_1_2_7_3_1","unstructured":"The Diving at Work Regulations 1997 SI 1997\/2776. The Stationery Office.1997[cited 2016 Jan 25]. Available from URLwww.legislation.gov.uk\/uksi\/1997\/2776\/contents\/made"},{"key":"e_1_2_7_4_1","unstructured":"The Medical Examination and Assessment of Commercial Divers (MA1).2015[cited 2016 Jan 25]. Available from URLwww.hse.gov.uk\/pubns\/ma1.htm"},{"key":"e_1_2_7_5_1","unstructured":"OSHA Standards and Directives Related to Commercial Diving. [cited 2016 Jan 25]. Available from URLwww.osha.gov\/SLTC\/commercialdiving\/standards.html"},{"key":"e_1_2_7_6_1","first-page":"182","article-title":"The predictive power of initial fitness\u2010to\u2010dive certification procedures for occupational divers in New Zealand","volume":"33","author":"Greig P","year":"2003","journal-title":"SPUMS J"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2009.02055.x"},{"key":"e_1_2_7_8_1","unstructured":"BloomfieldHE WiltTJ. Evidence brief: role of the annual comprehensive physical examination in the asymptomatic adult. VA\u2010ESP Project #09\u2010009;2011."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-136-9-200205070-00007"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.12.1347"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-4-200702200-00008"},{"key":"e_1_2_7_12_1","first-page":"71","article-title":"Review of scuba diving fatalities and decompression illness in Australia","volume":"38","author":"Lippmann J","year":"2008","journal-title":"Diving Hyperb Med"},{"key":"e_1_2_7_13_1","first-page":"70","article-title":"Snorkelling and scuba diving deaths in New Zealand, 1980\u20102000","volume":"32","author":"Davis M","year":"2002","journal-title":"SPUMS J"},{"key":"e_1_2_7_14_1","first-page":"174","article-title":"Diving\u2010related deaths in New Zealand 2000\u20102006","volume":"37","author":"McClelland A","year":"2007","journal-title":"Diving Hyperb Med"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.34.5.375"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2003.008987"},{"key":"e_1_2_7_17_1","first-page":"119","article-title":"Medical assessment of fitness to dive \u2013 comparing a questionnaire and a medical interview\u2010based approach","volume":"40","author":"Meehan CA","year":"2010","journal-title":"Diving Hyperb Med"},{"key":"e_1_2_7_18_1","first-page":"709","article-title":"Per\u2010capita claims rates for decompression sickness among insured Divers Alert Network members","volume":"39","author":"Denoble PJ","year":"2012","journal-title":"Undersea Hyperb Med"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.5694\/j.1326-5377.1999.tb123812.x","article-title":"Scuba diving medical examinations in practice: a postal survey","volume":"171","author":"Simpson G","year":"1999","journal-title":"Med J Aust"},{"key":"e_1_2_7_20_1","first-page":"24","article-title":"Postal survey of fitness\u2010to\u2010dive opinions of diving doctors and general practitioners","volume":"42","author":"Sames C","year":"2012","journal-title":"Diving Hyperb Med"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13204","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T20:54:28Z","timestamp":1696280068000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/imj.13204"],"URL":"https:\/\/doi.org\/10.1111\/imj.13204","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10]]},"assertion":[{"value":"2016-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}