Long-Term Survival of Divers Compared to the Non-Diving Population in the Czech Republic

Background Scuba diving involves unique physiological stressors and environmental exposures that may affect health outcomes. Long-term survival among divers results from a complex interaction between potentially harmful exposures related to the hyperbaric environment and oxidative stress, diving-related accidents, as well as protective factors such as physical fitness, psychological resilience, and socioeconomic status. The purpose of the study is to evaluate long-term survival among Czech divers compared to an age- and sex-matched non-diving population. Methods Data from 1,076 divers registered in the DIVE-PFO Registry (2005–2024) were linked with the National Health Information System to determine mortality and causes of death. Observed survival was estimated using the Kaplan–Meier method; expected survival was based on national life tables to calculate relative survival via the Pohar-Perme method. Results Over 10,294 person-years of follow-up, there were 15 deaths (1.4%) among divers, of which four (26.7%) were classified as probably diving-related. No vascular deaths were recorded. The annual diving-related mortality rate was 38.9 per 100,000 divers. Compared with the general population, divers had significantly higher 10-year relative survival (101.9%, 95% CI 101.2–103.0). Divers also showed a lower prevalence of obesity, hypertension, and smoking compared to non-divers. Conclusions Czech divers demonstrate higher long-term survival than the general population, likely due to better overall health and lifestyle. However, diving-related fatality rates appear to be higher than those reported in other regions.