I – AGE
Underwater or pressurized work will only be allowed for workers who are at least 18 (eighteen) years old.
II – ANAMNESIS
Candidates will be disqualified from diving activities if they have or are found to have the following conditions: epilepsy, meningitis, tuberculosis, asthma, and any chronic pulmonary disease; chronic or repeated sinusitis; chronic otitis media and otitis externa; disabling conditions of the musculoskeletal system; chronic or repeated gastrointestinal disorders; chronic alcoholism and syphilis (unless properly treated and without persistent symptoms); other conditions at the discretion of a medical professional.
III – MEDICAL EXAMINATION
1. BIOMETRICS
Weight: Candidates for diving activities will be selected based on their body type and potential future obesity. Those who exceed the standard weight-age-height tables by more than 10 (ten) percent may be disqualified at the discretion of a medical professional.
2. CIRCULATORY SYSTEM
The integrity of the circulatory system will be verified through clinical examination, X-ray, and electrocardiogram; systolic blood pressure must not exceed 145 mm/Hg and diastolic pressure must not exceed 90 mm/Hg, with no hemodynamic repercussions. Peripheral venous circulation disorders (varicose veins and hemorrhoids) will lead to disqualification.
3. RESPIRATORY SYSTEM
The clinical and radiological integrity of the respiratory system will be verified:
a) Anatomical integrity of the thoracic cage;
b) Special attention should be given to the possibility of tuberculosis and other pulmonary diseases through chest X-ray and tuberculin reaction, when indicated;
c) Any pulmonary disease or other condition that impairs pulmonary ventilation will lead to disqualification;
d) Candidates with chronic inflammatory diseases such as tuberculosis, histoplasmosis, bronchiectasis, bronchial asthma, emphysema, pneumothorax, pleural thickening, and sequelae from thoracic surgery will be disqualified.
4. DIGESTIVE SYSTEM
The anatomical and functional integrity of the digestive system and its annexes will be verified:
a) Candidates with manifestations of colitis, peptic ulcer, constipation, chronic diarrhea, gastrointestinal tract perforation, or digestive hemorrhage will be disqualified;
b) Teeth: Candidates must have a sufficient number of natural or artificial teeth with good occlusion to ensure satisfactory chewing. Oral cavity diseases, carious teeth, or teeth compromised by infection can also be causes of disqualification.
Prostheses should preferably be fixed. Removable prostheses with clasps may be accepted provided they do not interfere with the effective use of autonomous (regulator valve, respirator) and dependent (narghile type) equipment. Candidates with this type of prosthesis should be advised to remove it during diving activities.
5. GENITOURINARY SYSTEM
Chronic or recurrent genitourinary diseases, as well as active or recurrent venereal diseases, disqualify the candidate.
6. ENDOCRINE SYSTEM
Metabolic, nutritional, or endocrine function disorders are disqualifying.
IV – OPHTHALMO-OTORHINOLARYNGOLOGICAL EXAMINATION
a) The absence of acute or chronic diseases in both eyes must be verified;
b) Visual acuity: 20/30 vision in both eyes, correctable to 20/20, is required;
c) Color sense: pronounced color vision deficiencies are disqualifying;
d) Hearing must be normal in both ears. Acute or chronic diseases of the external auditory canal, tympanic membrane, middle or inner ear disqualify the candidate. The Eustachian tubes must be open and free to balance pressure during barometric variations in dives;
e) Obstructions to breathing and chronic sinusitis are disqualifying. Chronically inflamed tonsils and all nasopharyngeal obstructions that hinder adequate ventilation should disqualify candidates.
V – NEURO-PSYCHIATRIC EXAMINATION
The anatomical and functional integrity of the nervous system will be verified:
a) The special nature of diving work requires careful evaluation of the candidates’ emotional, social, and intellectual adjustments;
b) A history of neuropsychiatric disorders or organic disease of the nervous system, epilepsy, or post-traumatic conditions disqualify candidates;
c) Neurotic tendencies, immaturity or emotional instability, antisocial behaviors, maladjustments, or maladaptations disqualify candidates.
VI – COMPLEMENTARY EXAMINATIONS
The following complementary examinations are required:
- Chest X-ray (AP view);
- Baseline electrocardiogram;
- Electroencephalogram;
- Urine: abnormal elements and sediment analysis;
- Feces: protozoan and helminth ova examination;
- Blood: serology for syphilis, glucose level, complete blood count, blood group, and Rh factor;
- X-ray of the scapulohumeral, hip, and knee joints (AP view);
- Audiometry.
VII – PRESSURE TESTS
All candidates must be subjected to a pressure of 6 ATA in the recompression chamber to verify the ability to equalize pressure in the middle ear and sinuses. Any sign of claustrophobia or individual susceptibility to nitrogen narcosis will disqualify the candidate.
VIII – OXYGEN TOLERANCE TEST
An oxygen tolerance test must be conducted, which involves having the candidate breathe pure oxygen under pressure (2.8 ATA) for a period of 30 (thirty) minutes in the recompression chamber. Any sign or symptom of oxygen toxicity will disqualify the candidate.
IX – PHYSICAL FITNESS TEST
All candidates must undergo the “Ruffier Test” (or similar), which consists of:
30 (thirty) squats in 45 (forty-five) seconds, with pulse readings taken:
- P1 – Diver’s pulse at rest;
- P2 – Pulse immediately after the exercise;
- P3 – Pulse after 1 (one) minute of rest.
Ruffier Index (RI) = (P1 + P2 + P3 – 200) / 10
The “Ruffier Index” must be below 10 (ten).