Decompression sickness in indigenous diver: Case series from community survey in Lepi island, Thailand

Introduction
The living of indigenous people in Lepi island, Thailand depends on the marine creatures in the sea. Recently, their life styles have been changed due to lack of natural resources. Many of indigenous have turned to diving deeper and longer in order to bring home a sufficient catch. These situations may be risk of their health from atmosphere pressure

Methods
A community survey was conducted in a local village in Lepi Island in March 2010. Of 30 local people in each household were interviewed to identify decompression sickness cases. In suspicious cases, they were physical examination by an occupational physician. The observation of indigenous work was also performed for risk assessment.

Results
9 cases were possible decompression sickness occurred in past 10 years. Of these, 2 cases were died, 3 cases had disability and other had paresthesias. The symptoms occurred immediately after their work for fish catching. It varies from bends to unconscious. For risky work process from observation, indigenous people worked on long tail boats and used compressors with air lines attached to the divers. The compressors salvage from large trucks and driven by diesel engines. The major fishing technique was using underwater fish traps. Sometimes they drove exceed durations of 2hours and depths range more than 40 meters.

Discussion
Indigenous divers are risk of decompression sickness. The occupational health team should concern on this problem. Health education and information intervention should be developed to provoke drivers to aware and prevent their selves from such symptom.