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Msac.org.my

MEDICAL STANDARDS
These notes are included for the guidance of doctors who may be unfamiliar with requirements for diving.
DISQUALIFYING FACTORS
ALLOWABLE FACTORS
OTHER POINTS
Diving is not advised during pregnancy. Those who have dived before discovering they were pregnant are advised to contact a gynecologist.
Perforated eardrum in new entrants, chronic vestibular disease in Perforated eardrum known to have been present during several Valsalva test of drum mobility should be carried out and if doubtful, years of diving. Healed perforation, including "paper thin" scars. practical diving test in pool should be advised. For this purpose any wax obscuring a good view of the drum should be removed. Sinusitis if not adversely affected by diving.
Deafness -- at discretion of specialist the candidate may be restricted to diving with a fit companion Sinusitis may benefit from diving! Oral Cavity
Dentures must be retained in place on fully opening the mouth and not be dislodged by placing jaws together in any position, or by Applicants to be advised about bad teeth and fillings but these movement of one denture against the other. They should extend to the muco-buccal fold. If dentures do not satisfy these requirements, they should not be worn while diving, Cleft palate not acceptable without specialist's opinion.
Suspicion of active tuberculosis. Tuberculosis scars other than T.B. scars in established diver subject to specialist's opinion. A chest X-ray is not required on entry or at repeat medical healed primary focus in new entrants. History of spontaneous Traumatic pneumothorax not necessarily a disqualifying factor. Any examination unless there is a history of significant cardiovascular pneumothorax, lung cysts or bullae normally disqualifies. Possible surgical removal of lung tissue or any serious lung complaint to be disease, respiratory disease or occupational exposure (since the last surgical treatment should be discussed with a specialist. Old medical in the case of a repeat medical) or if the physical spontaneous pneumothorax in candidates over thirty should be Asthma in childhood with full remission by time of examination.
examination reveals an abnormality in the cardiovascular or respiratory systems. Doctors must see film or report before signing certificate. Asthma (except as under "Allowable"), surgical removal of lung tissue, chronic bronchitis or any other serious chest condition should always be referred to a specialist.
Clinical or where appropriate EGG evidence of ischaemic heart Minor asymptomatic heart disease other than ischaemic (subject to Post-exercise ECG recommended in the case of individuals with a disease, aortic valve disease. Evidence of heart disease other than more frequent medical checks). Persons with well controlled poor family history of coronary disease or hyperlipidaemia, lone systolic murmur, should be referred. Symptomatic or hypertension without evidence of end organ damage may be particularly if they smoke but needs to be interpreted with caution. pathological arrhythmia', systolic pressure over 160 mm Hg, diastolic permitted to dive. Intracardiac shunts should be referred to specialist.
pressure over 100 mm Hg in established divers and 90 mm Hg in Pacemaker to be referred to specialist.
new entrants, or other evidence of hypertensive disease. End organ damage from hypertension.
Haemotology
Haemophilia, sickle cell disease and polycythaemia will disqualify.
Mild anaemia but advise treatment. Tumours and leukaemia may be Sickle cell test only where clinically indicated.
allowable but should be referred to a specialist. Sickle cell trait.
Abdomen/UGS
Significant proteinuria, until the cause has been established.
Peptic ulcer, unless unduly active or troublesome. Abdominal hernias (but advise repair).
Nervous System and
History of confirmed epilepsy including post-traumatic fits, refer to Febrile convulsions but no other type of fit allowable. Multiple A single isolated fit or severe head injury to be referred to specialist. Sclerosis -- only stable patients acceptable.
Severe visual impairment to be reported to specialist. A long fit free Any serious head injury in past three months. Currently symptomatic period off anticonvulsants may be allowable. psychiatric or personality disorders. Any disease of CNS (MS, Polio Petit Mal, etc.) refer to specialist.
Endocrine
Diabetes with diabetic complications.
Referral to specialist is required for diabetics and for all other For diabetics, an annual medical is mandatory.
The use of the following disqualifies: Oral sympathomimetics (other Antihistamines and analgesics should only be used with caution. Oral If any psychotropic drug (including tranquillisers, sedatives and than proprietary nasal decongestants), oral steroids, muscle contraceptives and diuretics are aIIowable. Smoking is allowable but hypnotics) have been used, the canndidate should not dive for at relaxants, digoxin, psychotropic drugs - see comments in Other reduces fitness and predisposes to air embolism, pneumothorax and least 3 months after complete cessation of therapy without the coronary thrombosis. Inhaled sympathomimetics, such as Alcohol, drug or narcotic abuse to disqualify.
salbutamol, should not be used therapeutically within 24 hours of diving but may be used as a prophylactic measure by symptomless divers.
Decompression Illness
since last Medical
Disabilities
Disease, amputation or deformity excessively limiting ability to swim. Arthritis, amputation or arthrodesis not severely limiting ability to Anyone with a significant disability should be assessed by a (May be issued with a restricted certificate at discretion of a specialist). Learning disability sufficient to produce problems in understanding and remembering the theory and techniques of diving.

Source: http://msac.org.my/v2/wp-content/uploads/pdf/MSAC%20Medic%20Standards.pdf

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