Citation

Buzzacott P. Diving Hyperb. Med. 2015; 45(1): 61.

Affiliation

Director, Injury Monitoring and Prevention, Divers Alert Network, 6 West Colony Place, Durham, NC 27705, USA, Phone: +01-(0)919-684-2948 ext 627, Mobile: +01-(0)919 627-2666, E-mail: pbuzzacott@dan.org.

Copyright

(Copyright © 2015, South Pacific Underwater Medicine Society and European Underwater and Baromedical Society)

DOI

unavailable

PMID

25964042

Abstract

When recently submitting a manuscript to DHM, I noticed that three of our keywords contain the word accident, namely 'accidents', 'diving accidents' and 'scuba accidents'. 'Accident' is most strictly defined in the legal sense thus: "… the word accident is used only for events that occur without the intervention of a human being. This kind of accident also may be called an act of God. It is an event that no person caused or could have prevented - such as a tornado, a tidal wave, or an ice storm." In a review of cave diving fatalities, the medical examiner's cause of death in each case (n = 368) was considered and, from these and their extensive case files, case histories were traced back through the disabling injury to the triggering event. In the majority of cases there was a clear breach of established safe procedures. The number of 'accidents' where, for example, a cave unexpectedly collapsed was rare, by far the exception. Including these words in our approved list is at odds with the stable of British Medical Journal publications, (e.g., Injury Prevention) which have dissuaded use of the word 'accident' since 1993 and banned the word since 2001. Since 2004, at considerable expense, many former NHS hospital accident and emergency wards in the UK have steadily been renamed emergency departments. The Journal of Accident and Emergency Medicine has been renamed Emergency Medicine Journal and, as recently as last year, the New York Police Department changed the name of their Accident Investigation Squad to Collision Investigation Squad. They also no longer use the word 'accident' in their reports, following the lead of the US Department of Transportation's National Highway Traffic Safety Administration which stopped using the word in all its printed material in 1997, claiming it "…promotes the concept that these events are outside of human influence or control."(p.1.) There are many such examples of this subtle yet important change that is overtaking both western medicine and, in particular, public health. Rather than 'accident' the current trend is to accurately describe the cause of an injury. To illustrate, a submission formerly entitled 'Hot water accidents in Welsh children' would now more likely be titled 'Hot water burns in Welsh children'. The difference should be obvious; hot water burns in children are largely avoidable, (as are diving injuries). Therefore, I respectfully request we remove these key words from our journal's list. Hopefully this would not inconvenience some of our European colleagues for whom English is a second language, and this should be considered. In France, for example, decompression sickness (DCS) is known as an "accident de desaturation" and decompression illness (DCI, including arterial gas embolism), is initially described in French as an accident de decompression (ADD). After all signs and symptoms are identified, commonly at around 24 h, then the injury is termed a "maladie de decompression" (MDD). The Canadian Government department responsible for aviation, Transports Canada, also refer to DCS/DCI as MDD. The BMJ makes exceptions, e.g., if the word appears in a formal title such as Child Accident Prevention Trust. Regarding ADD however, may I respectfully suggest to my French colleagues they consider adopting "blessure de décompression" (BDD)? In diving research at least, the leading hypothesis is that DCS may be prevented through better understanding of the mechanisms of this protean disease. That DCS is an 'accident' is the null hypothesis.

Language: en