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Mental health in the workplace is becoming of ever greater importance. General occupational health surveillance programmes are already in widespread use, with established referral systems for treatment and rehabilitation, and the same mechanisms could be expanded to include mental health screening and intervention. This study aimed to develop a concise composite mental health screening tool, based on analysis of existing data, for application in routine occupational health surveillance in South Africa. Data from workplace occupational health surveillance programs from 2,303 participants were analysed. Participants completed a number of questions/scaled items collated into a survey format, and partook in an interview with a psychologist. The data was analysed using frequency of positive self-reports, Chi square to calculate associations with outcomes, Receiver Operator Characteristic curve analysis to explore predictive ability, and binomial logistic regression to calculate the relative contribution of markers to outcomes. An exploratory factor analysis was further conducted on identified items. A general workplace model with 14 markers (and a maritime workplace model with 17 markers) were identified. The factor analysis suggested their organisation into five domains (similar for both models), namely neurocognitive health, common mental disorders, history of adaptation in occupational specific contexts, family-work interface, and stress overload. The study's data-driven approach proposed a concise composite screener with less than 50 items, comprising five domains. This tool appears useful in identifying employees at risk for workplace injuries or poor mental health outcomes, and could be applied to related workplace settings in South Africa., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Van Wijk, Martin and Meintjes.)

Objective: Adult ADHD (A-ADHD) has been associated with an increased risk of accidents and workplace injuries. ADHD within professional diving may have major potential occupational health and safety implications, as accidents underwater may have severe consequences. The study investigated any association of increased risk for adverse underwater incidents with an ADHD diagnosis. Method: This analysis used retrospective records from 156 navy divers and computed an odds ratio using cases of ADHD and cases of underwater accidents. Results: Although the odds ratio was increased, it failed to reach significance. Conclusion: We do not yet have statistical evidence suggesting that the risk for adverse underwater events is significantly increased among the ADHD group in this sample of navy divers. Sufficiently powered studies are required to further address the potential risk of A-ADHD in working divers.

Introduction: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with increased chance of workplace accidents, psychiatric comorbidities, other risky behaviours and sophisticated psychopharmacological treatment. These factors all contribute to a potentially complex risk profile within the commercial diving context. In order to make informed decisions regarding ADHD and commercial diving, further description of this condition among commercial divers is required. This paper reports on a study that aimed to determine the prevalence of adult ADHD among commercial divers., Methods: The study used a self-reporting survey-type questionnaire to determine likely diagnosis, based on Diagnostic and Statistical Manual of Mental Disorders, 5th ed. criteria, in a group of 245 commercial divers in South Africa., Results: Fourteen cases (5.7% of the sample) met criteria for ADHD. The majority of the cases presented with combined type, and reflected mild forms of ADHD. Adult ADHD did not appear to occur in significantly different proportions across the biographical variables of age, education or diving qualification., Conlcusion: Based on this small survey, adult ADHD may be over-represented in commercial diving in South Africa, compared to general workplace populations. However, ADHD may not necessarily be a contra-indication to commercial diving., (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)

Hyperbaric medicine is a relatively young specialty that remains in the blind spot of most doctors' awareness. This study endeavors to identify the level of awareness of the indications for hyperbaric oxygen (HBO2) therapy among a doctor population in a developed country and factors which may improve referral rates. An anonymized questionnaire was distributed to doctors licensed to practice in Malta. Questions included physician specialty, demographics and previous exposure to diving and/or hyperbaric medicine. Moreover, two scoring systems were used to score subjects on HBO2-related topics. Binomial logistic regression models and generalized linear models were used in the statistical analysis. A total of 152 full replies were obtained and analyzed. Respondents who had visited a hyperbaric unit (HBU) (p=0.002) or attended a lecture on HBO2 (p=0.006) scored better than their counterparts, indicating better awareness of HBO2 indications and local chamber location. A previous HBU visit (p=0.001), being a hospital-based doctor (p=0.027) and a history of scuba diving (p=0.03) were associated with willingness to refer patients for HBO2 in the future. Encouraging visits to an HBU has been shown to be associated with multiple factors, which are expected to result in improved referral rates. Targeted educational sessions to doctors and medical students are likely to be beneficial in improving correct referral of patients for HBO2. The findings from this study may prove useful in improving appropriate referral rates of patients who may benefit from this useful treatment modality., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission., (Copyright© Undersea and Hyperbaric Medical Society.)

Introduction: Scuba diving is a big part of the tourism sector in Malta, and all the cases of decompression illness (DCI)are treated within the single hyperbaric referral centre in the country., Methods: This retrospective analysis reviews all the medical records of divers with DCI in Malta within the 30-year period between 1987 to 2017 who required recompression therapy with hyperbaric oxygen., Results: There were 437 discrete cases of DCI managed with recompression therapy. Amongst DCI subtypes, the prevalence of musculo-skeletal DCI is decreasing, whereas that of vestibulo-cochlear DCI is increasing., Conclusion: The increasing prevalence of vestibulo-cochlear DCI may be due to a change in diving practices in Malta., (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)

Introduction: While otic barotrauma (OBT) is a common condition experienced by divers, data related to military divers is limited. This study aimed to determine the incidence of OBT in Canadian armed forces (CAF) shallow-water diver (SWD) students trained through the Fleet Dive Unit (Atlantic) (FDU[A]) between 2011-2015., Methods: A retrospective cohort evaluation was performed. The study group consisted of all SWD candidates who embarked on an SWD course through FDU(A) between 2011-2015. A total of 241 subjects comprised the final data analysis., Results: A total of 56 individuals (23.2%) suffered 60 instances of OBT, yielding an incidence density rate of 8.68 per 1,000 person-days on course. A total of 73 diving days (10.44 per 1,000 planned person-course days, or 4.87 diving days per course) were lost due to OBT. Of the reported OBT cases, 18% resulted in cessation of training, 72% in temporary removal from diving. There was no statistically significant association between sex, history of environmental allergies, previous dive qualification, age or rank and the development of OBT., Conclusions: This study reveals that OBT is prevalent among CAF SWD candidates, with operational impact due to missed diving days. This study is limited, and further prospective study is recommended., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission., (Copyright© Undersea and Hyperbaric Medical Society.)