DAN Medical Frequently Asked Questions

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Sickle Cell Anemia

Shortly I will be returning to the U.S. to take a coastal biology job in Florida. I enjoy snorkeling but have not taken up scuba because of a possible medical problem. I am a carrier (heterozygous) for sickle cell anemia and have been cautioned not to place myself into situations with possible low oxygen availability because some of my red blood cells may sickle. Is scuba possible in this situation?

Sickle cell traits indicate that an individual has hemoglobin types A and S present in the red blood cell. This situation is usually asymptomatic under ordinary circumstances. Because it is possible for these red cells to sickle under situations of very low oxygen tension, some concern has been expressed for these individuals in flying and diving.
Several years ago, considerable controversy developed about this concern, but at present the issue seems to be settled. Should an individual with this problem not have a source of oxygen while diving (out of air, drowning, equipment failure, etc.), then the cells would sickle. However, the low-oxygen tensions necessary to produce this phenomenon would have caused brain damage long before the red cells were involved. The person with sickle cell trait then is not at any greater risk from hypoxia (oxygen deficiency in body tissues) than the ordinary diver and is qualified for diving (if trained and physically fit otherwise). There are other blood disorders, such as hemoglobin C disease, hemoglobin D disease, thalassemia and others. Some of these patients are usually in good health and others are not. The decision to dive in these conditions has to be individualized.