Breath-hold Diving and Its Potential Health Risks
Main Article Content
Abstract
Breath-hold diving is the oldest form of diving, practiced commercially, competitively and recreationally. Recently, there has been a surge in its popularity in a wide range of the population, but the potential health risks are somewhat overlooked.
This article provides an overview of the physiological changes that occur during breath-hold diving, and how these changes can affect a diver’s well-being. Multiple organs are affected by the changes in pressures causing injury to a diver such as barotraumas, and in rare cases, “Taravara Syndrome”. Breath-hold divers are also exposed to the elements of nature which can be dangerous to the diver, capable of injuries and fatalities. These include strong and unpredictable currents, dangerous rocky terrains, and marine animals.
The objective of this article is to raise awareness among breath-hold divers, especially those who are new and inexperienced. As breath-hold diving is becoming more and more popular, knowledge of hazards and physiological change can be beneficial and key to the prevention of potential injuries and fatalities.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
National Oceanic and Atmospheric Administration. NOAA diving manual: diving for science and technology. 4th ed. Washington DC: Best Publishing; 2010.
Edmonds C, Bennett M, Lippmann J, Mitchell S. Diving and subaquatic medicine. Florida: CRC Press; 2015.
Muth CM, Ehrmann U, Radermacher P. Physiological and clinical aspects of apnea diving. Clin Chest Med 2005;26(3):381-94.
AIDA. AIDA official world records history. [Internet]. [cited 2024 Jan 28]. Available from: https://www.aidainternational.org/WorldRecords/History.
Boussuges A, Pinet C, Thomas P, Bergmann E, Jm S, Vervloët D. Haemoptysis after breath-hold diving. Eur Respir J 1999;13(3):697-9.
Gooden BA. Mechanism of the human diving response. Integr Physiol Behav Sci 1994;29(1):6-16.
Schagatay E. Predicting performance in competitive apnoea diving. Part I: static apnoea. Diving Hyperb Med 2009;39(2):88-99.
Foster GE, Sheel AW. The human diving response, its function, and its control. Scand J Med Sci Sports 2005;15(1):3-12.
British Sub-Aqua Club. Ocean diver module. [Internet]. [cited 2024 Jan 28]. Available from: https://www.bsac.com/advice-and-support/instructor-support/download-instructor-materials/diver-training-programme/ocean-diver-2017/.
Yanyongsatit P, Yongcharoen P, Khamonsri P. Middle ear barotrauma in hyperbaric oxygen therapy at Somdech Phra Pinklao Hospital, Naval Medical Department. RTN Med J 2022;49(2):265-74. (in Thai).
Meyer MF, Knezic K, Jansen S, Klünter HD, Pracht ED, Grosheva M. Effects of freediving on middle ear and eustachian tube function. Diving Hyperb Med 2020;50(4):350-5.
Kim CH, Shin JE. Hemorrhage within the tympanic membrane without perforation. J Otolaryngol Head Neck Surg 2018;47(1):66.
Mallen JR, Roberts DS. SCUBA medicine for otolaryngologists: part I. Diving into SCUBA physiology and injury prevention. Laryngoscope 2020;130(1):52-8.
Lanphier E, Rahn H. Alveolar gas exchange during breath-hold diving. J Appl Physiol 1963;18(3):471-7.
Van Hoesen KB, Lang MA. Diving medicine. In: Auerbach PS, editor. Auerbach’s wilderness medicine. 17th ed. Philadelphia: Elsevier; 2017. p. 1583-618.
Rusoke-Dierich O. Diving medicine. Cham: Springer; 2018.
Auerbach PS, Burgess GH, DiTullio AE. Injuries from nonvenomous aquatic animals. In: Auerbach PS, editor. Auerbach’s wilderness medicine. 17th ed. Philadelphia: Elsevier: 2017. p. 1636-78.
Cunha SA, Dinis-Oliveira RJ. Raising awareness on the clinical and forensic aspects of jellyfish stings: a worldwide increasing threat. Int J Environ Res Public Health 2022;19(14):8430.
Auerbach PS, DiTullio AE. Envenomation by aquatic invertebrates. In: Auerbach PS, editor. Auerbach’s wilderness medicine. 17th ed. Philadelphia: Elsevier; 2017. p. 1679-1720.
Kohshi K, Denoble PJ, Tamaki H, Morimatsu Y, Ishitake T, Lemaître F. Decompression Illness in repetitive breath-hold diving: why ischemic lesions involve the brain? Front Physiol 2021:12:711850.
Lindholm P, Lundgren CE. The physiology and pathophysiology of human breath-hold diving. J Appl Physiol (1985) 2009;106(1):284-92.
Ferrigno M, Lundgren CEG. Human breath-hold diving. In: Brubakk AO, Neuman TS, editors. Bennett and Elliott’s physiology and medicine of diving. 5th ed. Philadelphia: Saunders; 2003. p. 153-80.
International Association for the Development of Apnea (AIDA). Freediving education and safety standards. Geneva: AIDA International; 2022.