Risk at work under pressure with medication- what do we know?

Medication has become an integral part of modern life, as well as in people working in hyperbaric conditions. However, our understanding of how drugs interact with pressure variations, gas compositions, physical exertion, and physiological changes in a hyperbaric environment is very limited. Firstly, the medical condition for which a medication is being taken must be evaluated in the context of fitness for occupational diving. Secondly, the desired or adverse effect of the medication needs to be evaluated in the context of occupational diving. Some potential adverse effects include changes in alertness and cardiovascular or pulmonary functions. These can affect the fitness to dive, increase the risk of decompression illness, or mimic its symptoms. Hence, special concern must be paid to medications affecting the cardiovascular, respiratory, and central nervous systems. The purpose of this work was to evaluate what is known about commonly used drugs in the setting of occupational diving. We found that most of the data available is either anecdotal or based on recreational diving and, therefore, needs to be cautiously adapted to the working environment.