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Thread: Rebreather Accident Research Project

  1. #11
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    Re: Rebreather Accident Research Project

    We can do whatever is needed



    Quote Originally Posted by SteveJ  View Original Post
    Thanks Curt.

    I'm hoping to have a data entry form on a standalone website but with links to it from RBW, Decostop, NBD etc.

    The data has to be as secure and also trusted to be secure otherwise people will not entrust contact details and medical history etc.

    Support from RBW will be crucial. Both to encourage divers to submit accidents but also as a forum for feeding back information into the rebreather community.

    Could the mods make this thread sticky?

    Steve

  2. #12
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    Re: Rebreather Accident Research Project

    Quote Originally Posted by SteveJ  View Original Post
    The project is aimed more at looking at the human factors and health issues relating to accidents and is not intended to become 'unit bashing' exercise.
    ...
    For instance, it would be productive to look at general health/fitness/medication/alcohol of the diver together with equipment preparation/modification/maintenance and diver training/attitude/experience.
    ...
    2. Produce an internet based questionnaire for divers who have had a recent accident or incident to submit data (similar to Dr Harry's DIMS but more rebreather focused).
    ...
    6. Panel produce reports on trends to manufacturers, training organisations and wider rebreather community.
    Steve, these are great aims imo. I have a thought on one aspect of your proposal which might help tuning it. Bear with me for a bit...

    I am just about to get into CCR from OC. One of my first tasks was to try to ascertain whether CCR is more risky (death or serious injury) than OC, ditto deep vs less deep, and also looking at risk by age distribution and so on. I failed to find any comprehensive studies/stats from which to draw meaningful conclusions about my prospects for continued healthy living once on CCR (although there are helpful reports such as the annual DAN publication).

    Why is this? One of the main reasons (I think, very happy to be shot down and shown what I have not been able to locate so far!) is that, although there is some reasonable-ish data on incidents and accidents (the numerator), there is seemingly little data on total dive events from which the incidents and accidents are drawn (the denominator).

    So, for example, I cannot find good data on: "X out of Y dives on a CCR result in an incident/accident/whatever". X may be well known from reported incidents/accidents, but Y seems to be much less firm, because there is less data collection on problem-free dives (DAN's Project Dive Exploration maybe gets closest to this).

    And the deeper you go into breaking down the stats into sub-groups, the less clarity in the stats. So try finding out the X out of Y in terms of dive hours (coz CCR divers do it for longer, eh?). Or as above, broken down by:
    a. training/experience level.
    b. age
    c. geog location
    d. CCR model
    e. etc etc

    So, in the real world (the one in my head anyway), witness the following "two blokes in the pub talking CCR nonsense" conversation:

    Bloke A: "Everyone knows Acme Co units are the most dangerous because more incidents have occurred on them than any other"
    Bloke B: "Yeah, but Acme Co have sold more units than anyone else so probably more dives have been conducted using them, so you'd expect that, wouldn't you?"
    Bloke A: "Anyway, mine's a pint".

    So, Bloke A is focused on the numerator only, and his conclusions might be interesting but are not valid as a result. Bloke B gets a bit deeper into the denominator, but he too is constrained by his assumption that known data (unit sales) correlates well with unknown data (dives undertaken per unit sold).

    So what? So, if your study data focuses on the numerator (incident dives) and not the denomitator as well (total dives) then your ability to draw conclusions on prevalence and relative risk will be limited as a result. Maybe that's OK, but it might make your task 6 a bit difficult on the trend front.

    But I'm not trying to rain on the proposal, I think it's a great idea. It should work well if you tighten the scope to numerator, though it would be ab fab if you were able to get meaningful data on denominators too. Maybe RBW could be a vehicle for achieving that? You'd need some clever stats types to make it valid, and I'm not one of those.

    I hope that helps a bit. Best wishes with the proposal.

    Cheers

    Al
    Last edited by aplord; 25th November 2008 at 22:24.

  3. #13
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    Re: Rebreather Accident Research Project

    Quote Originally Posted by aplord  View Original Post
    Steve, these are great aims imo. I have a thought on one aspect of your proposal which might help tuning it. Bear with me for a bit...

    I am just about to get into CCR from OC. One of my first tasks was to try to ascertain whether CCR is more risky (death or serious injury) than OC, ditto deep vs less deep, and also looking at risk by age distribution and so on. I failed to find any comprehensive studies/stats from which to draw meaningful conclusions about my prospects for continued healthy living once on CCR (although there are helpful reports such as the annual DAN publication).

    Why is this? One of the main reasons (I think, very happy to be shot down and shown what I have not been able to locate so far!) is that, although there is some reasonable-ish data on incidents and accidents (the numerator), there is seemingly little data on total dive events from which the incidents and accidents are drawn (the denominator).

    So, for example, I cannot find good data on: "X out of Y dives on a CCR result in an incident/accident/whatever". X may be well known from reported incidents/accidents, but Y seems to be much less firm, because there is less data collection on problem-free dives (DAN's Project Dive Exploration maybe gets closest to this).

    And the deeper you go into breaking down the stats into sub-groups, the less clarity in the stats. So try finding out the X out of Y in terms of dive hours (coz CCR divers do it for longer, eh?). Or as above, broken down by:
    a. training/experience level.
    b. age
    c. geog location
    d. CCR model
    e. etc etc

    So, in the real world (the one in my head anyway), witness the following "two blokes in the pub talking CCR nonsense" conversation:

    Bloke A: "Everyone knows Acme Co units are the most dangerous because more incidents have occurred on them than any other"
    Bloke B: "Yeah, but Acme Co have sold more units than anyone else so probably more dives have been conducted using them, so you'd expect that, wouldn't you?"
    Bloke A: "Anyway, mine's a pint".

    So, Bloke A is focused on the numerator only, and his conclusions might be interesting but are not valid as a result. Bloke B gets a bit deeper into the denominator, but he too is constrained by his assumption that known data (unit sales) correlates well with unknown data (dives undertaken per unit sold).

    So what? So, if your study data focuses on the numerator (incident dives) and not the denomitator as well (total dives) then your ability to draw conclusions on prevalence and relative risk will be limited as a result. Maybe that's OK, but it might make your task 6 a bit difficult on the trend front.

    But I'm not trying to rain on the proposal, I think it's a great idea. It should work well if you tighten the scope to numerator, though it would be ab fab if you were able to get meaningful data on denominators too. Maybe RBW could be a vehicle for achieving that? You'd need some clever stats types to make it valid, and I'm not one of those.

    I hope that helps a bit. Best wishes with the proposal.

    Cheers

    Al
    Top post ;)

    Attempts have been made in the past to get at the denominator and you get a wide distribution of answers.

    For ALL recrational divers (OC, tech, CCR) the mortality rate is around 1 - 2 deaths per 10,000 divers per year (DAN and BSAC figures). There have been in the order of 130 rebreather fatalities since 1997(reported in English speaking literature). Various complicated but probably inaccurate estimates of the numbers of active rebreather divers have been made ranging from a low of 3000 to a high of 10,000. Assuming 10,000 rebreather divers (in Europe, US and Australasia) in 2007 and starting from a base of a few dozens in 1997 then my estimate for mortality in rebreather divers is in the order of 23 deaths per 10,000 divers per year. Others will argue that there are far fewer active rebreather divers hence significantly increasing the comparative mortality.

    To further complicate matters, the ALL divers mortality must include a lot of holiday divers who only dive 10 times a year which is probably much less than the committed rebreather diver.

    So, yes, finding out more about the amount and type of diving done on rebreathers is a vital part.

    Thanks for you post.

    Steve

  4. #14
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    Re: Rebreather Accident Research Project

    Quote Originally Posted by SteveJ  View Original Post
    For some time, I and others, have been developing a plan to look at non-fatal rebreather accidents and incident.

    Hi there Steve

    It is a noble goal you speak of. There are several other groups doing such tasks, it would too be useful to join a link with them.

    Will you use a specialist panel of equipment analysts?

  5. #15
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    Re: Rebreather Accident Research Project

    Quote Originally Posted by SteveJ  View Original Post
    Attempts have been made in the past to get at the denominator and you get a wide distribution of answers...
    For ALL recrational divers (OC, tech, CCR) the mortality rate is around 1 - 2 deaths per 10,000 divers per year (DAN and BSAC figures)...
    my estimate for mortality in rebreather divers is in the order of 23 deaths per 10,000 divers per year.
    Gadzooks! Thanks Steve, that's more by way of denominators than I have seen written down before! Yes, a wide potential variation emerges depending on the assumptions made in the calcs... None of them seem to tend towards suggesting that CCR is a safer way to fly. Though one can make perfectly logical arguments that they could be safer in a given set of circumstances, and perhaps in some situations they are safer.

    If your research was able to identify the most important risk/survival factors, and provide a statistical basis for this, then that in turn would provide CCR divers with something to aim for. Especially if the evidence concludes that CCR is safer than rec/OC diving if you are an old fat beer swilling git... :) Thanks again for the numbers!

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    Re: Rebreather Accident Research Project

    PM sent

    BTW Doug, I think we've decided on Fiji for the next one, hope you can make it.

    Alan Lewis

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    Re: Rebreather Accident Research Project

    Excellent Steve! Please let me know if there is anything Rubicon can assist with.

    In the mean time, it might be worth the time to contact the folks listed in this thread. The Diving Incident Monitoring Study (DIMS) has been productive for a while and they have learned quite a bit about how to conduct this type of research both from the standpoint of what works and what doesn't. Below are some publications from their project:

    Acott, CJ. (2003) Recreational scuba diving equipment problems, morbidity and mortality: an overview of the Diving Incident Monitoring Study and Project Stickybeak. SPUMS Journal Volume 33 Number 1. RRR ID: 7761

    Knight, J; Acott, CJ. (2003) Depth gauges, contents gauges and miscellaneous equipment problems reported in the Diving Incident Monitoring Study. SPUMS Journal Volume 33 Number 1. RRR ID: 7763

    Williams, G; Acott, CJ. (2003) Exposure suits: a review of thermal protection for the recreational diver. SPUMS Journal Volume 33 Number 1. RRR ID: 7764

    Acott, CJ. (2001) 457 Equipment incident reports. South Pacific Underwater Medicine Society Journal 31(4) RRR ID: 7743

    This one has a nice several nice tables that summarize the issues with each piece of equipment. Each table includes the problem defined with the major contributing factors associated with each issue. At the end the is a table of "Suggested strategies to minimise outcome associated with equipment problems".

    Acott, C. (1999) Equipment malfunction in 1,000 diving incidents. SPUMS Journal Volume 29 Number 3. RRR ID: 6009

    Acott, C. (1996) An evaluation of buoyancy jacket safety in 1,000 diving incidents. SPUMS Journal Volume 26 Number 2. RRR ID: 6288

    Acott, C. (1995) A pre-dive check; An evaluation of a safety procedure in recreational diving: Part 1. SPUMS Journal Volume 25 Number 2. RRR ID: 6411 (NOTE: I have not seen a "Part 2" of this article, we are still actively adding to this collection.)

    (Yes, we use "DIMS" as a keyword)



    Please check this out!

  8. #18
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    Re: Rebreather Accident Research Project

    Quote Originally Posted by Gene_Hobbs  View Original Post
    Excellent Steve! Please let me know if there is anything Rubicon can assist with.


    Thanks Gene,
    PM sent.

    Steve

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    Re: Rebreather Accident Research Project

    Quote Originally Posted by SteveJ  View Original Post
    For some time, I and others, have been developing a plan to look at non-fatal rebreather accidents and incident.

    The project is aimed more at looking at the human factors and health issues relating to accidents and is not intended to become 'unit bashing' exercise.

    For instance, it would be productive to look at general health/fitness/medication/alcohol of the diver together with equipment preparation/modification/maintenance and diver training/attitude/experience.

    The proposal is as follows and I am looking to gauge support and opinion from the wider rebreather community.


    The proposal:




    1. Gather a 'panel' of non-biased, open minded rebreather divers with expertise in training, dive medicine and statistics.

    2. Produce an internet based questionnaire for divers who have had a recent accident or incident to submit data (similar to Dr Harry's DIMS but more rebreather focused).

    3. Diver contacted by dive doctor from panel who conducts phone based interview about symptoms on dive and relevant health history (with full medical confidentiality assured).

    4. Diver contacted by trainer from panel who conducts phone based interview about dive, equipment preparation etc.

    5. Doctor and trainer produce anonymised summary to panel and feedback to diver.

    6. Panel produce reports on trends to manufacturers, training organisations and wider rebreather community.



    The obvious issues for me are:


    1. Expertise, getting the right people (I have expressions of interest from a number of people with appropriate expertise).


    2. Trust from divers and manufacturers (sensitive data).


    3. Independence from industry yet able to have meaningful dialogue with industry.


    4. Non adversarial. The goal is understanding accidents/incidents and learning from them rather than apportioning blame.



    About me... I'm no guru but am a rebreather diving UK GP with experience in dive medicine and a willingness to coerce and cajole better brains than mine into helping this project.

    Please add your comments (gently :))

    Best Wishes

    Steve

    Dr Steve Johnson
    North Yorkshire
    UK.
    Hi Steve,
    Great Idea, I always sustained that the CCR accidents alone won't explain the cause. The diver personal data are missed most of the time.
    I know that UWMadness (on this forum) did a work about Human Factor and also a presentation at the Eurotek. I think you could contact him.
    For whateverelse, if I can help on this project with my limited knowledge, let me know.

    Cheers
    Nad

  10. #20
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    Re: Rebreather Accident Research Project

    Quote Originally Posted by Nad  View Original Post
    Hi Steve,
    Great Idea, I always sustained that the CCR accidents alone won't explain the cause. The diver personal data are missed most of the time.
    I know that UWMadness (on this forum) did a work about Human Factor and also a presentation at the Eurotek. I think you could contact him.
    For whateverelse, if I can help on this project with my limited knowledge, let me know.

    Cheers
    Nad
    Thanks for your support NAD, will keep in touch.

    Steve

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