PLEASE NOTE: COVID-19 CAN HAVE SIGNIFICANT IMPLICATIONS FOR DIVING. INDIVIDUALS CAN HAVE COVID-19 WITHOUT BEING AWARE OF IT; SEE Q18 AND THE COIVD-19 SECTION OF THIS WEBSITE FOR MORE DETAILS DIVERS ARE WELCOME TO DISCUSS ANY CONCERNS WITH A UKDMC MEDICAL REFEREE.
1. What if a diver signs the form stating that all is OK, but is hiding a past illness?
The form is a legal declaration. If a diver is found to have been untruthful and an accident occurs then that diver is likely to be uninsured and may be held liable for the consequences.
2. I have an old form that has already been signed by a UKDMC Medical Referee indicating it is valid for more than a year or indefinitely. Provided I have no new health condition Do I have to get a new form signed?
Please note: the diver now also needs to consider whether they have had COVID-19. The original self certificate forms were laid out such that the club member who oversees the forms can see which questions the diver is answering “yes” to, which is one of the reasons the forms had been changed in 2016 to protect confidentiality. Further changes were required in 2020 in view of the COVID-19 pandemic and a need to streamline the forms (further update 2021). The diver still has to complete Page 1 of the new (2021) Recreational Diver Medical Declaration Form annually to be sure there are no new conditions (including COVID-19) but where there are NO new health problems they can attach the old signed Page 3 of the Medical Referee Form as proof the condition that was previously declared is not an issue. Please note the 2021 version includes spaces on Page 3 for the diver to certify there is no change in or no new medical conditions and no change in any of their treatments/medication, therefore confirming a new form is not required. The diver should photocopy this, giving the copy to their Diving Officer or equivalent, keeping the original to sign each year if there is no change until the certificate expires. If the diver has an old form and would like to have a new form signed by a UKDMC Medical Referee they are welcome to do this at their own cost. The diver does not have to get a new UKDMC Medical Referee signature each year if the form indicates the signature is valid for longer, unless they have developed a new condition, a significant change in an ongoing condition or change in medication/treatment, in which case they need to discuss this with a UKDMC Medical Referee. Similarly all divers who are answering “no” to all the questions need to complete the new Recreational Diver Medical Declaration Form annually to be sure there are no new conditions or treatments (this is a requirement of BSAC and SAA) as described above. Please note near the top of page 1 of the 2021 form, it makes it clear that should a diver develop a new health problem that results in a new “Yes” response to the questions on the form they must contact a UKDMC Medical Referee for advice straight away and not simply wait until the next annual review as the new problem may have implications for diving.
3. Who do I speak to if I am unsure about whether a current or past illness will stop me diving?
Telephone or email your local UKDMC Medical Referee. Check the UK Diving Medical Committee’s website (ukdmc.org) for the most up-to-date list of Referees. The telephone/email enquiry to a UKDMC Medical Referee may result in:
a) From the information you give, the UKDMC Medical Referee confirm the answers are “No” as the issue is so trivial it need not even be declared (such as athlete’s foot).
b) From the information you give the UKDMC Medical Referee you will also need to download and complete pages 2 and 3 of the Medical Declaration form, sending all pages of the form to the UKDMC Medical Referee (keeping copies for your own records of Pages 1 and 2) with the required fee and a stamped addressed envelope for the return of Page 3. If the information supplied is sufficient for the UKDMC Medical Referee to make a decision re fitness, the form will be signed and returned. The 2021 version includes spaces on Page 3 for the diver to certify there is no change in or no new medical conditions/treatments and no change in any of their treatments/medication when reviewing Page 1 in subsequent years. The diver should photocopy Page 3, giving the copy to their Diving Officer or equivalent, keeping the original to sign each year if there is no change until the certificate expires. If the diver has an old form and would like to have a new form signed by a UKDMC Medical Referee they are welcome to do this at their own cost.
c) The UKDMC Medical Referee may need to contact your own doctor or specialist for further information with your consent and on obtaining this may sign Page 3 as above, although the fee is likely to be greater.
d) The UKDMC Medical Referee will require you to visit for a medical examination before a signed Page 3 can be issued.
4. What if I have attended my GP for a medical to be able to undertake a job or for screening or insurance purposes?
This would also not need to be declared unless a medical issue had been detected.
5. I am concerned my personal medical information will be seen by my Diving Officer or club members.
If you are answering “No” to all the questions then you are not revealing any medical problem. However, if you are answering “Yes”, you will also need to download and complete Pages 2 and 3 which can be found at ukdmc.org and, after discussion with a UKDMC Medical Referee by telephone or email, send all pages of the form (keeping copies for your own records of Pages 1 and 2) with the required fee and a stamped addressed envelope. The UKDMC Medical Referee may proceed as in question 3 above depending on what is being declared. It is only Page 3 of the form that you need to give to your Diving Officer or member of the club who is responsible for overseeing the forms. There is no medical information on this section.
6. Is this just a means of UKDMC Medical Referees now being able to charge?
The UKDMC Medical Referees have diving medicine expertise and incur significant expense maintaining their knowledge, performing medicals or arranging investigation. There are significant costs to be able to undertake this work including premises, staff, equipment, course fees and medical defence insurance. The NHS does not cover this work. Until recently many did not charge for their time, but this is impossible to sustain because of the increasing number and complexity of referrals. The change to a self-declaration system has saved divers money, as an earlier system required everyone to have a full medical even if they were answering no. The UKDMC Medical Referee can also indicate on Page 3 of the Recreational Diver Medical Declaration Form that this is valid for more than a year or even indefinitely, so the charge made would not necessarily be required annually.
7. Why is the amount of the fee not stated?
We no longer quote what the level of charge is as this may vary depending on the amount and complexity of work required. For very straightforward forms this is likely to be small, but unlikely to be less than £25.
8. How does the Self-Declaration system affect my diving insurance?
The Self-Declaration process in conjunction with the UKDMC Medical Referee referral system has been approved by the diving organisation insurance companies. In terms of your own private diving insurance, if you have this, it would be wise to contact your insurer to check whether they will accept a self-declaration form or whether they require you to have a medical. Please also be aware that some countries require a signed certificate of fitness even if the diver is NOT answering “yes” to any of the questions. Please check if this is the case with the dive operator you plan to dive with in plenty of time to be able to arrange a medical if this is required.
9. At least I was always seen by a doctor for my diving medical in the past and feel I now might be missing out in some way.
You can continue to have medicals if you choose to do so in addition to the Self Declaration system – but you should not be falsely reassured by their screening value for diving fitness. Only doctors qualified in diving medicine can advise you about your fitness to dive.
10.Where can I seek general medical advice?
Check the medical standards on this website or contact your local UKDMC Medical Referee.
11.If I have a condition that warrants a visit to a UKDMC Medical Referee, is my own doctor informed?
You are free to pass on any information you wish to your own doctor. If something of significance is found that the UKDMC Medical Referee feels your doctor should know about they will ask for your permission to pass this on to your doctor. You are free to withhold this permission but the UKDMC Medical Referee will explain the possible risk to your own health by doing this so that you are able to make an informed decision.
12.Supposing different advice has been given from another medical source compared to a UKDMC Medical Referee or I do not agree with their opinion, who do I go to seek advice or clarification?
The UK Diving Medical Committee (UKDMC) is the final court of appeal for divers, and UKDMC Medical Referees are able to refer to the committee for advice. If you wish to appeal a decision contact the secretary of the UK Diving Medical Committee via the ‘Contact Us’ page of this website ukdmc.org (please put ‘Appeal’ in the Subject Heading).
13.What if the UKDMC Medical Referee wishes to discuss my case with other diving medical doctors?
This can only be undertaken with your consent. If it is thought to be necessary, the UKDMC Medical Referee will discuss this with you. They may either email or telephone another diving medical expert or post the query on the diving medicine forum. This is a closed, confidential forum which can only be accessed by approved diving doctors and your information is posted anonymously with only the minimum information required to answer the query. Although you are not referred to by name, in a small number of cases, the unique nature of the medical condition being discussed may make it possible for you to be identified. Posting on the forum can only be undertaken with your consent.
14.My Diving Officer does not agree with Self-Declaration system – will anyone from BSAC, SSAC or SAA be able to help with updating and giving them more information?
The Diving Officer should contact their respective organisation for a further response by their UK Diving Medical Committee representative.
15. Isn’t the use of Self-Declaration system by BSAC, SSAC and SAA because everyone else is looking at or accepting self-declarations?
The UKDMC continually monitors the safety of diving in the UK and it is because of the ongoing research programme that this change was originally made. Other organisations use questionnaires but the UKDMC system is based on published evidence and has been continually monitored since 2001.
16.Can I get hold of the paper referred to on the UK Diving Medical Committee’s website?
This was published in the British Journal of Sports Medicine 2000; 34: 375-378, “Medical supervision of sport diving in Scotland: reassessing the need for routine medical examinations” Glen S, White S and Douglas J. Reprints are available from the British Journal of Sports Medicine, BMJ Publishing Group, BMA House, Tavistock Square, London, WC1H 9JR, UK. See the article abstract.
17.Why do I have to go through a medical for a job, but not always for diving, which may be perceived as more dangerous?
Employment medicals are a different situation entirely because of the concern of employer liability. Although some employers insist on screening medicals there may be little supporting evidence for this for most types of employment. Some types of employment require statutory medicals.
18. What are the implications of COVID-19?
Divers need to be aware that this condition can result in significant heart, lung, kidney and clotting problems. As this is a new condition we do not yet know the full extent of these problems and the likelihood of any resolution. It is likely that the more severely ill patient will have significant problems even when recovered from the initial infection. It is known, however, that some totally asymptomatic individuals who are not even aware they have had COVID-19 can have organ damage that could be potentially fatal when diving. The UKDMC has guidance on this, which is to be updated as more is known about this condition. Any diver who is concerned, even if they are not aware of having had COVID-19, can discuss the implications with a UKDMC Medical Referee so a risk assessment can be made and the diver make a more informed decision about how to proceed.
19.What about the body mass index (BMI)?
Obesity may exclude a candidate from diving as it frequently betrays a lack of general physical fitness. Additionally it may create difficulties when conducting a rescue either with the obese diver attempting to tow with an unconscious diver or when a diver is attempting to get an obese diver into the boat or to another place of safety. A BMI (Body Mass Index) of more than 39.9 should exclude diving. Due regard should be taken to weight distribution, obesity concentrated in the abdomen should be less acceptable than evenly distributed fat and due allowance should be given to the individual whose excess weight is visibly muscular. Enquiry should be made as to the amount of exercise taken. A BMI between 30 and 39.9 is not ideal but may be acceptable. The formula tends to discriminate against tall or muscular individuals. In these circumstances taking account of waist measurement may be helpful. A waist measurement in men of greater than 105cms and in women of greater than 90cms is a cause for concern and should be discussed with a Diving Medical Referee. Qualified divers with a borderline BMI may be given a provisional pass for two or three months when they would be required to produce evidence of improvement to have their certificate extended. To calculate BMI go to BMI www.nhs.uk and put BMI in the search box at the top right of the page or use the formula body mass index= weight (kg) / (height in metres)²
20.What about medical conditions such as high blood pressure (hypertension), mental problems or substance abuse that may be missed by using self-declaration?
These are listed on the form and should be declared by the diver. We have had instances of hypertensive divers developing acute pulmonary oedema (fluid on the lungs) from left ventricular failure when diving in cold water. This was mostly in the days of the neoprene wet suit. Now that dry suits are more common, this is less often a problem. The current medical system does not prevent the occasional diver developing pulmonary oedema. However, if the diver has treated hypertension they should contact a UK Diving Medical Referee in any case. Mental health problems significant in a diving context would normally be detected during training, but a question about any history of this is on Page 1 of the form. Substance abuse is a fact of life these days and a medical examination would not normally detect it. Do not forget that by far the commonest drug to be abused is alcohol, and the night in the pub before diving is often a silent contributing factor to diving accidents the following day.
21.What is meant by “a mild self limiting illness” and the comment “Please discuss any symptoms of the upper or lower respiratory tract with a UKDMC Medical Referee”?
This is any self-limiting condition requiring no or minimal medical input such as athlete’s foot, a simple boil or minor skin condition. If unsure, telephone or email a UK Diving Medical Referee for advice. There is now the advice to contact a UK Diving Medical Referee if a diver has had any upper or lower respiratory tract symptoms since 1.1.2020 in view of the information in question 18.