Divers Beware: Training Dives 

Present Serious Hazards to Fire 

Fighters 

Summary 

Fire fighters who participate in dive training risk 

lung damage, illness, or 

drowning. NIOSH investigated fatalities that 

have occurred during 

these training exercises 

and developed recommendations to decrease 

these risks. 

Description of 

Exposure 

Fire fighters may be called on 

to perform public safety diving actions, including search 

and rescue and recovery missions. Fire departments and 

fire fighters preparing for underwater operations must be 

aware that dive training can be 

hazardous. Diving hazards include entanglement, running 

out of air, lung overexpansion 

injury, panic attacks, and decompression sickness. 

Entanglement in rope or aquatic plants is an extremely serious 

hazard that can prevent divers 

from returning to the surface 

[Hendrick et al. 2000]. 

Lung overexpansion most commonly occurs when divers panic and make rapid ascent holding their breath. No sensation 

of discomfort provides a warning when overexpansion is 

about to occur [NAUI 2000]. 

New divers may hold their 

breath when first learning to 

use SCUBA equipment [PADI 

1990]. Lung overexpansion 

can result in pulmonary barotraumas causing serious damage to the lungs, including collapse [Bookspan 1995], even 

when ascending from relatively shallow depths and on relatively short dives. 

Panic attacks while diving may 

be provoked by situations such 

as entanglement, running out of 

air, or reasons unknown. Panic 

attacks occur among both veteran and novice divers. Adequate 

attention to panic and anxiety 

attacks should be given during 

diver training. More than half of 

experienced divers surveyed report having panic episodes while 

SCUBA diving [Morgan 1995]. 

Decompression sickness (“the 

bends”) occurs after extended 

periods of time at depth followed by ascending too quickly, thus preventing nitrogen gas 

accumulated in the diver’s tissues from dissipating properly. Symptoms of decompression 

sickness can range from skin rash, 

extreme fatigue, coughing, and 

painful joints to paralysis and unconsciousness [NAUI 2000]. 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health 
 

 

 

Case Studies 

Case 1 

On July 15, 1999, a 25-year-old male career 

fire fighter/paramedic/rescue diver drowned 

during a circular search training exercise at a 

lake [NIOSH 1999]. Acting as the pivot diver, 

the victim descended and maintained a fixed 

location while extending a length of rope to the 

pattern diver. The pattern diver swam increasingly larger circles around him while holding 

onto the rope. 

About 2 minutes after the victim entered the 

water, his rope bag surfaced. The pattern diver surfaced and was instructed by the lead diver to retrieve the victim, but was unsuccessful. 

The boat driver radioed for emergency assistance. A rescue search was initiated, and the 

victim was found and brought to the surface. 

The victim’s air regulator was not in his mouth 

and he was cyanotic and unresponsive. The victim was transported by helicopter to a regional 

trauma center, where he was pronounced dead. 

The cause of death was listed as drowning. 

Case 2 

On August 13, 2000, a 28-year-old male career 

fire fighter/SCUBA diver died during a search 

and rescue training exercise at a lake [NIOSH 

2000]. During the exercise, a circular search 

pattern was used from a buoy line. The victim’s 

partner lost the search line and became separated from the victim. The partner was equipped 

with a conventional regulator and had no electronic communications with the other divers. 

Another diver saw the victim, who was distressed and frantically screaming and moving 

around, and knocked off the other diver’s face 

piece. The victim, who was entangled in the 

buoy line, was pulled to the surface by the buoy 

line. The victim received medical assistance and 

was then transported by helicopter to a nearby 

trauma center where he was pronounced dead. 

The cause of death was stated as pulmonary 

barotrauma. 

Controls 

To minimize the risk when participating in dive 

training, NIOSH recommends that fire departments and fire fighters take the following precautions: 

Fire departments should do the following: 

n Establish, implement, and enforce standard 

operating procedures (SOPs) regarding diver training. 

n Ensure that divers maintain positive communication with each other and with personnel who remain on the surface. 

n Develop a pre-dive checklist for all diving 

situations, including diver training, equipment function, and diver experience, which 

should match the difficulty of the intended 

dive. 

n Ensure that backup divers are trained to perform rescue operations for other divers who 

may be in distress. 

n Ensure that an experienced backup diver 

and a ninety-percent-ready diver are in position to help. 

n Provide divers with refresher training on the 

hazards and prevention measures of lung 

overexpansion injuries, entanglement, decompression, and panic attacks. 

n Practice the training exercise in a closed environment such as a swimming pool before 

attempting it in open water. 
 

 

 

 

n Obtain and update appropriate medical 

fitness evaluations for SCUBA divers 

annually. 

n Ensure that equipment checks are performed on a scheduled basis and defective 

equipment is repaired or replaced before a 

dive takes place. 

n Supply divers with an alternative backup air 

source such as pony bottles. 

n Ensure that instructors and divers are certified for SCUBA diving, dive training, and 

dive rescue operations by a nationally recognized organization. 

n Ensure that a medical unit is on site with oxygen in case of an emergency. 

n Ensure that dive coordinators stay informed 

about each diver’s rate of air consumption. 

Fire fighters/divers should do the following: 

n Follow all SOPs. 

n Maintain continuous visual, verbal, or physical contact with their dive partner. 

n Perform equipment checks before each dive. 

Equipment checks should be verified by the 

dive coordinator. 

n Ensure that underwater search teams operate individually to avoid rope entanglement. 

n Regularly monitor their air consumption. 

n Consider performing at least 12 dives per 

year to maintain skills. 

REFERENCES 

Bookspan J [1995]. Diving physiology in plain 

English. Kensington, MD: Undersea and Hyperbaric Medical Society, Inc. 

Hendrick W, Zaferes A, Nelson C [2000]. Public safety diving. Saddle Brook, NJ: Fire Engineering Books and Videos. 

Morgan WP [1995]. Anxiety and panic in recreational scuba divers. Sports Med 20(6):398– 

421. 

PADI [1990]. PADI open water diver manual. Santa Ana, CA: Professional Association of 

Diving Instructors. 

NAUI [2000]. NAUI scuba diver manual. Tampa, FL: National Association of Underwater Instructors. 

NIOSH [1999]. Fire fighter/paramedic drowns 

during an underwater SCUBA training drill— 

Missouri. Cincinnati, OH: U.S. Department of 

Health and Human Services, Centers for Disease Control and Prevention, National Institute 

for Occupational Safety and Health, DHHS 

(NIOSH) Publication No. 99F–29. 

NIOSH [2000]. Fire fighter/SCUBA diver dies 

during training evolution—Indiana. Cincinnati, 

OH: U.S. Department of Health and Human 

Services, Centers for Disease Control and Prevention, National Institute for Occupational 

Safety and Health, DHHS (NIOSH) Publication No. F2000–38. 

Additional resources regarding scuba diving include the following: 

NFPA 1670—Standard on operations and training for technical rescue incidents. 

NFPA 1006—Standard for rescue technician 

professional qualifications. 

ACKNOWLEDGEMENTS 

The principal contributors to this publication 

were Jay L. Tarley, Edward L. Husting, and Steven L. Proudfoot, Division of Safety Research, 

NIOSH. 
For More Information 

The information in this document is based on fatality 

investigations, literature and expert review. More information about the Fire Fighter Fatality Investigation 

and Prevention Program is available at www.cdc.gov/ 

niosh/firehome.html 

Contact the Divers Alert Network (DAN) 24 hour 

hotline at (919) 684–8111 in the event of a diving 

emergency or for questions about a diving injury. 

To receive more information about occupational safety 

and health topics, contact NIOSH at 

NIOSH 

Publications Dissemination 

4676 Columbia Parkway 

Cincinnati, OH 45226–1998 

Telephone: 1–800–35–NIOSH (1–800–356–4674) 

Fax: 513–533–8573 § E-mail: pubstaft@cdc.gov 

or visit the NIOSH Web site at www.cdc.gov/niosh

Divers Beware: Training Dives Present 

Serious Hazards to Fire Fighters 

For a monthly update on news at NIOSH, subscribe to 

NIOSH eNews by visiting www.cdc.gov/niosh/eNews. 

Mention of any company or product does not constitute 

endorsement by NIOSH. In addition, citations to Web 

sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites. 

This document is in the public domain and may be 

freely copied or reprinted. NIOSH encourages all 

readers of the Workplace Solutions to make them 

available to all interested employers and workers. 

As part of the Centers for Disease Control and Prevention, NIOSH is the Federal agency responsible for 

conducting research and making recommendations to 

prevent work-related illnesses and injuries. All Workplace Solutions are based on research studies that 

show how worker exposures to hazardous agents or 

activities can be significantly reduced. 

DHHS (NIOSH) Publication No. 2004–152 

Safer • healthier • Peopletm June 2004 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health 

4676 Columbia Parkway 

Cincinnati, OH 45226–1998