HSE Medicals

[TonyG]

I recently had my annual HSE medical, and I was not suprised to hear that I had put on weight, as a knee injury had put me out of action for several months.What did surprise me was that recreational instructors are being treated exactly the same as commercial divers (www.hse.gov.uk/diving/information.htm) extract below. Anyway I got an expensive wake up call six months certification, and then retake the medical and pay again. I will either have to lose weight (and body fat) or grow about 2 foot to reduce my Superior Body Mass!


E. OBESITY
E1. Obesity is important in diving because of its relationship to fitness, risk of decompression
illness, and fit of wetsuit and weights and co-existing disease such as diabetes, hypertension
and sleep apnoea.
E2. The height and weight of the diver measured in underwear and bare feet should be measured
and recorded at every medical examination and the Body Mass Index (BMI or kg/m2)
calculated.
E3. Dietary and fitness advice at BMIs>27 is recommended in the hope of pre-empting restriction
when BMI 30 is reached.
E4. Where the BMI reaches 30 further estimation of fat content should be made using suitable
means such as skin calipers or skin impedance. A body fat content in excess of 30% may be
considered a reason for rejection until weight has been satisfactorily reduced, particularly if
associated with a lack of overall physical fitness.
E5. Use of a restricted duration of Certification (such as 6 months) may be appropriate if used to
warn the diver of the significance of the current BMI and trend and if it would act to motivate a
reduction in weight through dietary and lifestyle changes. Discretion is appropriate if the
elevated BMI is associated with increased lean body mass.

[chrisch]

Hi Tony, hope it all goes well with the exercise and your knee gets better.

This set me thinking over my cornflakes....

What is the protocol for people with a naturaly high BMI? Does the doctor (for example) take waist measurement into consideration?

The HSE take the view that at 30 you are too overweight to be a commercial diver or instructor??? My mate is an instructor and I hate to think what his BMI is but he's a fit strong bloke and a good diver of many years standing.

I've put some weight on since we have been here (food is just too good and beer, wine and chocolate are cheap!) and must now be nudging 29-30, but that's 'cos I'm short... If you look at http://nhlbisupport.com/bmi/ it admits that

"BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The score is valid for both men and women but it does have some limits. The limits are:

* It may overestimate body fat in athletes and others who have a muscular build.
* It may underestimate body fat in older persons and others who have lost muscle mass."

So how rigid is the HSE thing and can the doctor apply the commonsense factor??

Chris

[nigelH]

Originally Posted by chrisch

The HSE take the view that at 30 you are too overweight to be a commercial diver or instructor??? My mate is an instructor and I hate to think what his BMI is but he's a fit strong bloke and a good diver of many years standing.

As I read the quote if you hit 30 the Doctor starts to measure fat with callipers but you failed and he is now wondering if he should make an exception and pass you.

I'm a total fail. I have had a heart attack. No HSE medical. End of story.

This afternoon I shall be at the Cardiac department running on a treadmill wired to a 12 lead ECG. I can usually score better on that than a lot of people who are 'fit' but if all goes well my diving is in the clear (recreational only) for another few years.

[chrisch]

Best wishes with it Nigel.

Chris

[TonyG]

Good luck Nigel I hope it all goes well

[TonyG]

Originally Posted by chrisch

Hi Tony, hope it all goes well with the exercise and your knee gets better.

This set me thinking over my cornflakes....

What is the protocol for people with a naturaly high BMI? Does the doctor (for example) take waist measurement into consideration?

The HSE take the view that at 30 you are too overweight to be a commercial diver or instructor??? My mate is an instructor and I hate to think what his BMI is but he's a fit strong bloke and a good diver of many years standing.

I've put some weight on since we have been here (food is just too good and beer, wine and chocolate are cheap!) and must now be nudging 29-30, but that's 'cos I'm short... If you look at http://nhlbisupport.com/bmi/ it admits that

"BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The score is valid for both men and women but it does have some limits. The limits are:

* It may overestimate body fat in athletes and others who have a muscular build.
* It may underestimate body fat in older persons and others who have lost muscle mass."

So how rigid is the HSE thing and can the doctor apply the commonsense factor??

Chris

I'm not sure how rigid it is Chris, a fellow part time instructor who took his medical on the same day as me (similar size / weight) got only 3 months, I honestly believe that my arguments with the doc over the validity of BMI as an indicator of fitness, got me the extra 3 months. The doc told me that when I go back, I will be exposed to the full commercial diver medical (at full cost). With PADI fees, Insurance, and Hse medicals, I am paying a high price to teach others for no or little reward. Gripe Over!

[Dr T]

oh. poo. looks like i will have to lose a stone or so in the next 8 weeks then.

got away with a bmi of 30 last year but if the rules are tightening then i suppose my belt had better !!

no more flapjacks then !!

a

[chrisch]

Originally Posted by TonyG

... With PADI fees, Insurance, and Hse medicals, I am paying a high price to teach others for no or little reward. Gripe Over!

LOL that's for sure. My mate gave up with UK training and only ever ran courses in Egypt. He's packed it in altogether now and I think since retirement his BMI is up a bit too

As a complete aside another friend of mine is fat and often on a diet of some type. He bought some weigh scales that have electrodes on the platform that measure resistance (so they claim). You input your height and it tells you your body fat as a %age.

I put my height in and it gave me the same % as my friend (which unless you are blind is total shite...) It made me laugh, but he actually believed it

Snake oil science.

Chris

[chrisch]

Originally Posted by Dr T

no more flapjacks then !!

A bit harsh...

Have this by way of compensation



Chris

[ChrisP]

Originally Posted by nigelH

As I read the quote if you hit 30 the Doctor starts to measure fat with callipers but you failed and he is now wondering if he should make an exception and pass you.

You are absolutely correct Nigel. Most people with a BMI over 30 have excess fat but not all. Abdominal circumference is a useful measurement as central obesity is a marker for heart disease. It is this link with heart disease that is the particular reason that HSE is so hot on this.
HSE recently wrote to all their doctors reminding them of the weight requirements and that they applied to "working" recreational instructors too. You are likely to find many more time restricted medicals and even failures in the future.