Hyperthermia

Elevated body temperature due to failed thermoregulation

This article is about hyperthermia as a condition. For hyperthermia as a treatment, see hyperthermia therapy.

Not to be confused with hypothermia or fever.

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Medical condition

Hyperthermia

Other names| Overheating
An analog medical thermometer showing a temperature of 38.7 °C (101.7 °F)
Specialty| Critical care medicine
Symptoms| Lack of perspiration, confusion, delirium, decreased blood pressure, increased heart rate and respiration rate, symptoms of dehydration
Complications| Organ failure, unconsciousness
Causes| Heat stroke[1]
Risk factors| Exposure to hot and/or humid environments, physical exertion, wearing personal protective equipment that covers the body, heatwaves
Diagnostic method| Based on symptoms or body temperature above 37.7 °C (99.9 °F)[2]
Differential diagnosis| Fever[3]
Prevention| Maintaining a moderate temperature, regular hydration, taking regular breaks
Treatment| Mild: Staying away from hot environments, rehydrating oneself, mechanical cooling, use of a dehumidifier
Severe: intravenous hydration, gastric lavage with iced saline, hemodialysis, immersing in ice water

Hyperthermia, also known simply as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation. The person's body produces or absorbs more heat than it dissipates. When extreme temperature elevation occurs, it becomes a medical emergency requiring immediate treatment to prevent disability or death.[citation needed] Almost half a million deaths are recorded every year from hyperthermia.[citation needed]

The most common causes include heat stroke and adverse reactions to drugs. Heat stroke is an acute temperature elevation caused by exposure to excessive heat, or combination of heat and humidity, that overwhelms the heat-regulating mechanisms of the body. The latter is a relatively rare side effect of many drugs, particularly those that affect the central nervous system. Malignant hyperthermia is a rare complication of some types of general anesthesia. Hyperthermia can also be caused by a traumatic brain injury.[4][5][6]

Hyperthermia differs from fever in that the body's temperature set point remains unchanged. The opposite is hypothermia, which occurs when the temperature drops below that required to maintain normal metabolism. The term is from Greek ὑπέρ, hyper, meaning "above", and θέρμος, thermos, meaning "heat".

## Classification

[edit]

Temperature classification

| |  Core (rectal, esophageal, etc.)

|

Hypothermia|  <35.0 °C (95.0 °F)[7]
Normal|  36.5–37.5 °C (97.7–99.5 °F)[8][9]
Fever|  >37.5 or 38.3 °C (99.5 or 100.9 °F)[3][10]
Hyperthermia|  >37.5 or 38.3 °C (99.5 or 100.9 °F)[3][10]
Hyperpyrexia|  >40.0 or 41.0 °C (104.0 or 105.8 °F)[11][12]
Note: The difference between fever and hyperthermia is the underlying mechanism. Different sources have different cut-offs for fever, hyperthermia and hyperpyrexia.

* v
* t
* e

In humans, hyperthermia is defined as a temperature greater than 37.5–38.3 °C (99.5–100.9 °F), depending on the reference used, that occurs without a change in the body's temperature set point.[3][10]

The normal human body temperature can be as high as 37.7 °C (99.9 °F) in the late afternoon.[2] Hyperthermia requires an elevation from the temperature that would otherwise be expected. Such elevations range from mild to extreme; body temperatures above 40 °C (104 °F) can be life-threatening.

## Signs and symptoms

[edit]

An early stage of hyperthermia can be "heat exhaustion" (or "heat prostration" or "heat stress"), whose symptoms can include heavy sweating, rapid breathing and a fast, weak pulse. If the condition progresses to heat stroke, then hot, dry skin is typical[2] as blood vessels dilate in an attempt to increase heat loss. An inability to cool the body through perspiration may cause dry skin. Hyperthermia from neurological disease may include little or no sweating, cardiovascular problems, and confusion or delirium.

Other signs and symptoms vary. Accompanying dehydration can produce nausea, vomiting, headaches, and low blood pressure and the latter can lead to fainting or dizziness, especially if the standing position is assumed quickly.

In severe heat stroke, confusion and aggressive behavior may be observed. Heart rate and respiration rate will increase (tachycardia and tachypnea) as blood pressure drops and the heart attempts to maintain adequate circulation. The decrease in blood pressure can then cause blood vessels to contract reflexively, resulting in a pale or bluish skin color in advanced cases. Young children, in particular, may have seizures. Eventually, organ failure, unconsciousness and death will result.

## Causes

[edit]

Heat stroke occurs when thermoregulation is overwhelmed by a combination of excessive metabolic production of heat (exertion), excessive environmental heat, and insufficient or impaired heat loss, resulting in an abnormally high body temperature.[2] In severe cases, temperatures can exceed 40 °C (104 °F).[13] Heat stroke may be non-exertional (classic) or exertional.

### Exertional

[edit]

Significant physical exertion in hot conditions can generate heat beyond the ability to cool, because, in addition to the heat, humidity of the environment may reduce the efficiency of the body's normal cooling mechanisms.[2] Human heat-loss mechanisms are limited primarily to sweating (which dissipates heat by evaporation, assuming sufficiently low humidity) and vasodilation of skin vessels (which dissipates heat by convection proportional to the temperature difference between the body and its surroundings, according to Newton's law of cooling). Other factors, such as insufficient water intake, consuming alcohol, or lack of air conditioning, can worsen the problem.

The increase in body temperature that results from a breakdown in thermoregulation affects the body biochemically. Enzymes involved in metabolic pathways within the body such as cellular respiration fail to work effectively at higher temperatures, and further increases can lead them to denature, reducing their ability to catalyse essential chemical reactions. This loss of enzymatic control affects the functioning of major organs with high energy demands such as the heart and brain.[14] Loss of fluid and electrolytes cause heat cramps – slow muscular contraction and severe muscular spasm lasting between one and three minutes. Almost all cases of heat cramps involve vigorous physical exertion. Body temperature may remain normal or a little higher than normal and cramps are concentrated in heavily used muscles.

### Situational

[edit]

Situational heat stroke occurs in the absence of exertion. It mostly affects the young and elderly. In the elderly in particular, it can be precipitated by medications that reduce vasodilation and sweating, such as anticholinergic drugs, antihistamines, and diuretics.[2] In this situation, the body's tolerance for high environmental temperature may be insufficient, even at rest.

Heat waves are often followed by a rise in the death rate, and these 'classical hyperthermia' deaths typically involve the elderly and infirm. This is partly because thermoregulation involves cardiovascular, respiratory and renal systems which may be inadequate for the additional stress because of the existing burden of aging and disease, further compromised by medications. During the July 1995 heatwave in Chicago, there were at least 700 heat-related deaths. The strongest risk factors were being confined to bed, and living alone, while the risk was reduced for those with working air conditioners and those with access to transportation. Even then, reported deaths may be underestimated as diagnosis can be mis-classified as stroke or heart attack.[15]

### Drugs

[edit]

Some drugs cause excessive internal heat production.[2] The rate of drug-induced hyperthermia is higher where use of these drugs is higher.[2]

* Many psychotropic medications, such as selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants, can cause hyperthermia.[2] Serotonin syndrome is a rare adverse reaction to overdose of these medications or the use of several simultaneously. Similarly, neuroleptic malignant syndrome is an uncommon reaction to neuroleptic agents.[16] These syndromes are differentiated by other associated symptoms, such as tremor in serotonin syndrome and "lead-pipe" muscle rigidity in neuroleptic malignant syndrome.[2]
* Recreational drugs such as amphetamines[17] and cocaine,[18] PCP, dextromethorphan, LSD, and MDMA may cause hyperthermia.[2]
* Malignant hyperthermia is a rare reaction to common anesthetic agents (such as halothane) or the paralytic agent succinylcholine. Those who have this reaction, which is potentially fatal, have a genetic predisposition.[2]
* The use of anticholinergics, more specifically muscarinic antagonists are thought to cause mild hyperthermic episodes due to its parasympatholytic effects. The sympathetic nervous system, also known as the "fight-or-flight response", dominates by raising catecholamine levels by the blocked action of the "rest and digest system".[19]
* Drugs that decouple oxidative phosphorylation may also cause hyperthermia. From this group of drugs the most well-known is 2,4-dinitrophenol which was used as a weight loss drug until dangers from its use became apparent.

### Personal protective equipment

[edit]

Those working in industry, in the military, or as first responders may be required to wear personal protective equipment (PPE) against hazards such as chemical agents, gases, fire, small arms and improvised explosive devices (IEDs). PPE includes a range of hazmat suits, firefighting turnout gear, body armor and bomb suits, among others. Depending on design, the wearer may be encapsulated in a microclimate,[20] due to an increase in thermal resistance and decrease in vapor permeability. As physical work is performed, the body's natural thermoregulation (i.e. sweating) becomes ineffective. This is compounded by increased work rates, high ambient temperature and humidity levels, and direct exposure to the sun. The net effect is that desired protection from some environmental threats inadvertently increases the threat of heat stress.

The effect of PPE on hyperthermia has been noted in fighting the 2014 Ebola virus epidemic in Western Africa. Doctors and healthcare workers were only able to work for 40 minutes at a time in their protective suits, fearing heat stroke.[21]

### Other

[edit]

Other rare causes of hyperthermia include thyrotoxicosis and an adrenal gland tumor, called pheochromocytoma, both of which can cause increased heat production.[2] Damage to the central nervous system from brain hemorrhage, traumatic brain injury, status epilepticus, and other kinds of injury to the hypothalamus can also cause hyperthermia.[2]

## Pathophysiology

[edit]

A summary of the differences between hyperthermia, hypothermia, and fever.
Hyperthermia: Characterized on the left. Normal body temperature (thermoregulatory set-point) is shown in green, while the hyperthermic temperature is shown in red. As can be seen, hyperthermia can be considered an increase above the thermoregulatory set-point.
Hypothermia: Characterized in the center: Normal body temperature is shown in green, while hypothermic temperature is shown in blue. As can be seen, hypothermia can be conceptualized as a decrease below the thermoregulatory set-point.
Fever: Characterized on the right: Normal body temperature is shown in green. It reads "New Normal" because the thermoregulatory set-point has risen. This has caused what was the normal body temperature (in blue) to be considered hypothermic.

A fever occurs when the core temperature is set higher, through the action of the pre-optic region of the anterior hypothalamus. For example, in response to a bacterial or viral infection, certain white blood cells within the blood will release pyrogens which have a direct effect on the anterior hypothalamus, causing body temperature to rise, much like raising the temperature setting on a thermostat.

In contrast, hyperthermia occurs when the body temperature rises without a change in the heat control centers.

Some of the gastrointestinal symptoms of acute exertional heatstroke, such as vomiting, diarrhea, and gastrointestinal bleeding, may be caused by barrier dysfunction and subsequent endotoxemia. Ultraendurance athletes have been found to have significantly increased plasma endotoxin levels. Endotoxin stimulates many inflammatory cytokines, which in turn may cause multiorgan dysfunction. Experimentally, monkeys treated with oral antibiotics prior to induction of heat stroke do not become endotoxemic.[22]

There is scientific support for the concept of a temperature set point; that is, maintenance of an optimal temperature for the metabolic processes that life depends on. Nervous activity in the preoptic-anterior hypothalamus of the brain triggers heat losing (sweating, etc.) or heat generating (shivering and muscle contraction, etc.) activities through stimulation of the autonomic nervous system. The pre-optic anterior hypothalamus has been shown to contain warm sensitive, cool sensitive, and temperature insensitive neurons, to determine the body's temperature setpoint. As the temperature that these neurons are exposed to rises above 37 °C (99 °F), the rate of electrical discharge of the warm-sensitive neurons increases progressively. Cold-sensitive neurons increase their rate of electrical discharge progressively below 37 °C (99 °F).[23]

## Diagnosis

[edit]

Hyperthermia is generally diagnosed by the combination of unexpectedly high body temperature and a history that supports hyperthermia instead of a fever.[2] Most commonly this means that the elevated temperature has occurred in a hot, humid environment (heat stroke) or in someone taking a drug for which hyperthermia is a known side effect (drug-induced hyperthermia). The presence of signs and symptoms related to hyperthermia syndromes, such as extrapyramidal symptoms characteristic of neuroleptic malignant syndrome, and the absence of signs and symptoms more commonly related to infection-related fevers, are also considered in making the diagnosis.

If fever-reducing drugs lower the body temperature, even if the temperature does not return entirely to normal, then hyperthermia is excluded.[2]

## Prevention

[edit]

When ambient temperature is excessive, humans and many other animals cool themselves below ambient by evaporative cooling of sweat (or other aqueous liquid; saliva in dogs, for example); this helps prevent potentially fatal hyperthermia. The effectiveness of evaporative cooling depends upon humidity. Wet-bulb temperature, which takes humidity into account, or more complex calculated quantities such as wet-bulb globe temperature (WBGT), which also takes solar radiation into account, give useful indications of the degree of heat stress and are used by several agencies as the basis for heat-stress prevention guidelines. (Wet-bulb temperature is essentially the lowest skin temperature attainable by evaporative cooling at a given ambient temperature and humidity.)

A sustained wet-bulb temperature exceeding 35 °C (95 °F) is likely to be fatal even to fit and healthy people unclothed in the shade next to a fan; at this temperature, environmental heat gain instead of loss occurs. As of 2012[update], wet-bulb temperatures only very rarely exceeded 30 °C (86 °F) anywhere, although significant global warming may change this.[24][25]

In cases of heat stress caused by physical exertion, hot environments, or protective equipment, prevention or mitigation by frequent rest breaks, careful hydration, and monitoring body temperature should be attempted.[26] However, in situations demanding one is exposed to a hot environment for a prolonged period or must wear protective equipment, a personal cooling system is required as a matter of health and safety. There are a variety of active or passive personal cooling systems;[20] these can be categorized by their power sources and whether they are person- or vehicle-mounted.

Because of the broad variety of operating conditions, these devices must meet specific requirements concerning their rate and duration of cooling, their power source, and their adherence to health and safety regulations. Among other criteria are the user's need for physical mobility and autonomy. For example, active-liquid systems operate by chilling water and circulating it through a garment; the skin surface area is thereby cooled through conduction. This type of system has proven successful in certain military, law enforcement, and industrial applications. Bomb-disposal technicians wearing special suits to protect against improvised explosive devices (IEDs) use a small, ice-based chiller unit that is strapped to one leg; a liquid-circulating garment, usually a vest, is worn over the torso to maintain a safe core body temperature. By contrast, soldiers traveling in combat vehicles can face microclimate temperatures in excess of 65 °C (149 °F) and require a multiple-user, vehicle-powered cooling system with rapid connection capabilities. Requirements for hazmat teams, the medical community, and workers in heavy industry vary further.

## Treatment

[edit]

The underlying cause must be removed. Mild hyperthemia caused by exertion on a hot day may be adequately treated through self-care measures, such as increased water consumption and resting in a cool place. Hyperthermia that results from drug exposure requires prompt cessation of that drug, and occasionally the use of other drugs as counter measures.

Antipyretics (e.g., acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heatstroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heatstroke. In this situation, antipyretics actually may be harmful in patients who develop hepatic, hematologic, and renal complications because they may aggravate bleeding tendencies.[27]

When body temperature is significantly elevated, mechanical cooling methods are used to remove heat and to restore the body's ability to regulate its own temperatures.[2] Passive cooling techniques, such as resting in a cool, shady area and removing clothing can be applied immediately. Active cooling methods, such as sponging the head, neck, and trunk with cool water, remove heat from the body and thereby speed the body's return to normal temperatures. When methods such as immersion are impractical, misting the body with water and using a fan have also been shown to be effective.[28]

Sitting in a bathtub of tepid or cool water (immersion method) can remove a significant amount of heat in a relatively short period of time. It was once thought that immersion in very cold water is counterproductive, as it causes vasoconstriction in the skin and thereby prevents heat from escaping the body core. However, a British analysis of various studies stated: "this has never been proven experimentally. Indeed, a recent study using normal volunteers has shown that cooling rates were fastest when the coldest water was used."[29] The analysis concluded that iced water immersion is the most-effective cooling technique for exertional heat stroke.[29] No superior cooling method has been found for non-exertional heat stroke.[30] Thus, aggressive ice-water immersion remains the gold standard for life-threatening heat stroke.[31][32]

When the body temperature reaches about 40 °C (104 °F), or if the affected person is unconscious or showing signs of confusion, hyperthermia is considered a medical emergency that requires treatment in a proper medical facility. A cardiopulmonary resuscitation (CPR) may be necessary if the person goes into cardiac arrest (stop of heart beats). Already in a hospital, more aggressive cooling measures are available, including intravenous hydration, gastric lavage with iced saline, and even hemodialysis to cool the blood.[2]

## Epidemiology

[edit]

Hyperthermia affects those who are unable to regulate their body heat, mainly due to environmental conditions. The main risk factor for hyperthermia is the lack of ability to sweat. People who are dehydrated or who are older may not produce the sweat they need to regulate their body temperature.[33] High heat conditions can put certain groups at risk for hyperthermia including: physically active individuals, soldiers, construction workers, landscapers and factory workers. Some people that do not have access to cooler living conditions, like people with lower socioeconomic status, may have a difficult time fighting the heat. People are at risk for hyperthermia during high heat and dry conditions, most commonly seen in the summer.

Various cases of different types of hyperthermia have been reported. A research study was published in March 2019 that looked into multiple case reports of drug induced hyperthermia. The study concluded that psychotropic drugs such as anti-psychotics, antidepressants, and anxiolytics were associated with an increased heat-related mortality as opposed to the other drugs researched (anticholinergics, diuretics, cardiovascular agents, etc.).[34] A different study was published in June 2019 that examined the association between hyperthermia in older adults and the temperatures in the United States. Hospitalization records of elderly patients in the US between 1991 and 2006 were analyzed and concluded that cases of hyperthermia were observed to be highest in regions with arid climates. The study discussed finding a disproportionately high number of cases of hyperthermia in early seasonal heat waves indicating that people were not yet practicing proper techniques to stay cool and prevent overheating in the early presence of warm, dry weather.[35]

In urban areas people are at an increased susceptibility to hyperthermia. This is due to a phenomenon called the urban heat island effect.[36] Since the 20th century in the United States, the north-central region (Ohio, Indiana, Illinois, Missouri, Iowa, and Nebraska) was the region with the highest morbidity resulting from hyperthermia. Northeastern states had the next highest. Regions least affected by heat wave-related hyperthermia causing death were Southern and Pacific Coastal states.[37] Northern cities in the United States are at greater risk of hyperthermia during heat waves due to the fact that people tend to have a lower minimum mortality temperature at higher latitudes.[38] In contrast, cities residing in lower latitudes within the continental US typically have higher thresholds for ambient temperatures.[38] In India, hundreds die every year from summer heat waves,[39] including more than 2,500 in the year 2015.[40] Later that same summer, the 2015 Pakistani heat wave killed about 2,000 people.[41] An extreme 2003 European heat wave caused tens of thousands of deaths.[42]

Causes of hyperthermia include dehydration, use of certain medications, using cocaine and amphetamines or excessive alcohol use.[43] Bodily temperatures greater than 37.5–38.3 °C (99.5–100.9 °F) can be diagnosed as a hyperthermic case.[43] As body temperatures increase or excessive body temperatures persist, individuals are at a heightened risk of developing progressive conditions. Greater risk complications of hyperthermia include heat stroke, organ malfunction, organ failure, and death. There are two forms of heat stroke; classical heatstroke and exertional heatstroke. Classical heatstroke occurs from extreme environmental conditions, such as heat waves. Those who are most commonly affected by classical heatstroke are very young, elderly or chronically ill. Exertional heatstroke appears in individuals after vigorous physical activity. Exertional heatstroke is displayed most commonly in healthy 15-50 year old people. Sweating is often present in exertional heatstroke.[44] The associated mortality rate of heatstroke is 40 to 64%.[43]

## Research

[edit]

Hyperthermia can also be deliberately induced using drugs or medical devices, and is being studied and applied in clinical routine as a treatment of some kinds of cancer.[45] Research has shown that medically controlled hyperthermia can shrink tumours.[46][47] This occurs when a high body temperature damages cancerous cells by destroying proteins and structures within each cell.[48][46] Hyperthermia has also been researched to investigate whether it causes cancerous tumours to be more prone to radiation as a form of treatment; which as a result has allowed hyperthermia to be used to complement other forms of cancer therapy.[49][46] Various techniques of hyperthermia in the treatment of cancer include local or regional hyperthermia, as well as whole body techniques.[46]

## See also

[edit]

* Effects of climate change on human health
* Hot flash – Physiological symptom
* Occupational heat stress – Net heat load of a worker
* Rhabdomyolysis – Human disease (condition) in which damaged skeletal muscle breaks down rapidly
* Space blanket

## References

[edit]

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36. ^ Basu, Rupa; Samet, Jonathan M. (1 December 2002). "Relation between Elevated Ambient Temperature and Mortality: A Review of the Epidemiologic Evidence". Epidemiologic Reviews. 24 (2): 190–202\. doi:10.1093/epirev/mxf007. ISSN 0193-936X. PMID 12762092.
37. ^ Gover, Mary (1938). "Mortality during Periods of Excessive Temperature". Public Health Reports. 53 (27): 1122–1143\. doi:10.2307/4582590. ISSN 0094-6214. JSTOR 4582590.
38. ^ a b Curriero, Frank C.; Heiner, Karlyn S.; Samet, Jonathan M.; Zeger, Scott L.; Strug, Lisa; Patz, Jonathan A. (1 January 2002). "Temperature and Mortality in 11 Cities of the Eastern United States". American Journal of Epidemiology. 155 (1): 80–87\. doi:10.1093/aje/155.1.80. ISSN 0002-9262. PMID 11772788. "The authors also found a strong association of the temperature-mortality relation with latitude, with a greater effect of colder temperatures on mortality risk in more-southern cities and of warmer temperatures in more-northern cities."
39. ^ Mallapur, Chaitanya (27 May 2015). "61% Rise In Heat-Stroke Deaths Over Decade". IndiaSpend. Archived from the original on 29 June 2015. Retrieved 26 June 2015.
40. ^ "India heatwave: death toll passes 2,500 as victim families fight for compensation". Reuters. 2 June 2015. Archived from the original on 12 January 2022. Retrieved 26 June 2015.
41. ^ Haider, Kamran; Anis, Khurrum (24 June 2015). "Heat Wave Death Toll Rises to 2,000 in Pakistan's Financial Hub". Bloomberg News. Retrieved 3 August 2015.
42. ^ Robine, Jean-Marie; et al. (February 2008). "Death toll exceeded 70,000 in Europe during the summer of 2003". Comptes Rendus Biologies. 331 (2): 171–178\. doi:10.1016/j.crvi.2007.12.001. ISSN 1631-0691. PMID 18241810.
43. ^ a b c Walter, Edward James; Carraretto, Mike (2016). "The neurological and cognitive consequences of hyperthermia". Critical Care. 20 (1): 199. doi:10.1186/s13054-016-1376-4. ISSN 1364-8535. PMC 4944502. PMID 27411704.
44. ^ Leon, Lisa R.; Bouchama, Abderrezak (2015), "Heat Stroke", Comprehensive Physiology, 5 (2), American Cancer Society: 611–647, doi:10.1002/cphy.c140017, ISBN 978-0-470-65071-4, PMID 25880507
45. ^ "Hyperthermia in Cancer Treatment". National Cancer Institute. 31 August 2011. Retrieved 2 August 2015.
46. ^ a b c d Jha, Sheetal; Sharma, Pramod Kumar; Malviya, Rishabha (1 December 2016). "Hyperthermia: Role and Risk Factor for Cancer Treatment". Achievements in the Life Sciences. 10 (2): 161–167\. doi:10.1016/j.als.2016.11.004. ISSN 2078-1520.
47. ^ Wust, P; Hildebrandt, B; Sreenivasa, G; Rau, B; Gellermann, J; Riess, H; Felix, R; Schlag, PM (1 August 2002). "Hyperthermia in combined treatment of cancer". The Lancet Oncology. 3 (8): 487–497\. doi:10.1016/s1470-2045(02)00818-5. ISSN 1470-2045. PMID 12147435.
48. ^ van der Zee, Jacoba; González, Dionisio; van Rhoon, Gerard C; van Dijk, Jan DP; van Putten, Wim LJ; Hart, Augustinus AM (1 April 2000). "Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial". The Lancet. 355 (9210): 1119–1125\. doi:10.1016/s0140-6736(00)02059-6. ISSN 0140-6736. PMID 10791373. S2CID 25518938.
49. ^ Alexander, H. R. (1 January 2001). "Isolation perfusion". Cancer: Principles and Practice of Oncology. 1: 2.

## External links

[edit]

* Tips to Beat the Heat Archived 21 July 2014 at the Wayback Machine—American Red Cross
* Extreme Heat—CDC Emergency Preparedness and Response
* Workplace Safety and Health Topics: Heat Stress—CDC and NIOSH
* Excessive Heat Events Guidebook—US EPA
* Physiological Responses to Exercise in the Heat—US National Academies

Classification|

* ICD-10: R50
* ICD-9-CM: 780.6
* MeSH: D005334
* DiseasesDB: 18924

|

* v
* t
* e

Heat waves

* List
* 2018
* 2020
* 2021
* 2022
* 2023

Antarctica|

* 2024

Asia|

* 2002 (India)
* 2007
* 2010
* 2013 haze
* 2015
* India
* Pakistan
* 2016 (India)
* 2017 (Pakistan)
* 2018 (Northeast Asia)
* 2019 (India and Pakistan)
* 2022 (China)
* 2022 (India and Pakistan)
* 2022 (Japan)
* 2023
* China
* Pakistan
* 2024
* India
* Japan
* Pakistan
* Mecca, Saudi Arabia (Hajj)
* Southeast Asia
* 2025
* India and Pakistan
* List of Indian heat waves

Europe|

| Before 1950|

* 1540
* July 1757
* 1906 (UK)
* 1911 (UK)

|

1950–1999|

* 1955 (UK)
* 1976
* UK and Ireland
* 1990 (UK)
* 1995 (UK)

2000–present|

* 2003
* 2006
* 2007
* 2010
* 2013 (UK)
* 2014 (Sweden)
* 2018
* UK
* Europe
* 2019
* 2021 (UK and Ireland)
* 2022
* Europe
* UK
* Drought
* 2023
* Drought
* Heat waves
* Cerberus
* 2024

North America|

| Before 1950|

* 1896 (East)
* 1901 (East)
* 1911 (East)
* 1934 and 1935
* 1936

|

1950–1999|

* 1980 (US)
* 1983-1985 drought
* 1988–1990 drought
* 1995 (Chicago)

2000–present|

* 2000 (Southern US)
* 2001 (East)
* 2006
* 2007
* 2010
* 2011
* 2012
* March
* Summer
* 2018
* 2020-2023 drought
* 2021 (West)
* 2022
* 2023
* 2023 (Caribbean)
* 2024

Oceania|

* Australian flying fox die-offs
* 2000s drought
* 2008–2009 (SE Aus.)
* 2012–2013 ("Angry Summer")
* 2024 (Australia)

South America|

* 2009 (Argentina)
* 2022
* 2023

Related|

* Cooling center
* Heat waves and climate change
* Hyperthermia
* List of droughts
* Marine heatwave

* v
* t
* e

Consequences of external causes

Temperature|

| Elevated|

* Burn
* Hyperthermia
* Heat syncope

|

Reduced|

* Hypothermia
* Immersion foot syndromes
* Trench foot
* Tropical immersion foot
* Warm water immersion foot
* Non-freezing cold injury
* Chilblains
* Frostbite
* Aerosol burn
* Cold intolerance
* Acrocyanosis
* Erythrocyanosis crurum

Radiation|

* Chronic radiation keratosis
* Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy
* Radiation acne
* Radiation burn
* Radiation-induced cancer
* Radiation-induced erythema multiforme
* Radiation-induced hypertrophic scar
* Radiation-induced keloid
* Radiation-induced morphea
* Radiation poisoning
* Radiation recall reaction
* Sunburn

Oxygen|

* Hypoxia/Asphyxia
* Oxygen toxicity

Pressure|

* Barotrauma
* Arterial gas embolism
* Aerosinusitis
* Middle ear barotrauma
* Pneumothorax
* Decompression sickness
* Inner ear decompression sickness
* High altitude
* Altitude sickness
* Chronic mountain sickness
* Death zone
* High-altitude pulmonary edema (HAPE)
* High-altitude cerebral edema (HACE)

Food|

* Starvation

Maltreatment|

* Physical abuse
* Sexual abuse
* Psychological abuse

Travel|

* Motion sickness
* Seasickness
* Airsickness
* Space adaptation syndrome

Adverse effect|

* Hypersensitivity
* Anaphylaxis
* Angioedema
* Allergy
* Arthus reaction

* Adverse drug reaction

Other|

* Electrical injury
* Lightning injuries
* Drowning

Ungrouped
skin conditions
resulting from
physical factors|

* Dermatosis neglecta
* Pinch mark
* Pseudoverrucous papules and nodules
* Sclerosing lymphangitis
* Tropical anhidrotic asthenia
* UV-sensitive syndrome
* environmental skin conditions
* Electrical burn
* frictional/traumatic/sports
* Black heel and palm
* Equestrian perniosis
* Fissure of the nipple
* Pulling boat hands
* Runner's rump
* Surfer's knots
* Tennis toe
* Vibration white finger
* Weathering nodule of ear
* Wrestler's ear
* Coral cut
* Painful fat herniation
* Uranium dermatosis
* iv use
* Skin pop scar
* Skin track
* Slap mark
* Pseudoacanthosis nigricans
* Narcotic dermopathy

* Category
* Commons
* Glossary
* Outline
* Portal

* v
* t
* e

Underwater diving

* Diving activities
* Diving modes
* Atmospheric pressure diving
* Freediving
* Saturation diving
* Scuba diving
* Snorkeling
* Surface oriented diving
* Surface-supplied diving
* Unmanned diving

Diving equipment

* Cleaning and disinfection of personal diving equipment
* Human factors in diving equipment design
* List of diving equipment manufacturers

| Basic equipment|

* Diving mask
* Snorkel
* Swimfin

|

Breathing gas|

* Bailout gas
* Bottom gas
* Breathing air
* Decompression gas
* Emergency gas supply
* Heliox
* Hydreliox
* Hydrox
* Nitrox
* Oxygen
* Travel gas
* Trimix

Buoyancy and
trim equipment|

* Avelo diving system
* Buoyancy compensator
* Power inflator
* Dump valve
* Variable buoyancy pressure vessel
* Diving weighting system
* Ankle weights
* Integrated weights
* Trim weights
* Weight belt

Decompression
equipment|

* Decompression buoy
* Decompression chamber
* Decompression cylinder
* Decompression trapeze
* Dive computer
* Diving bell
* Diving shot
* Diving stage
* Jersey upline
* Jonline

Diving suit|

* Atmospheric diving suit
* JIM suit
* Newtsuit
* Dry suit
* Sladen suit
* Standard diving suit
* Rash vest
* Wetsuit
* Dive skins
* Hot-water suit

Helmets
and masks|

* Anti-fog
* Diving helmet
* Free-flow helmet
* Lightweight demand helmet
* Orinasal mask
* Reclaim helmet
* Shallow water helmet
* Standard diving helmet
* Diving mask
* Band mask
* Full-face mask
* Half mask

Instrumentation|

* Bottom timer
* Depth gauge
* Dive computer
* Dive timer
* Diving watch
* Helium release valve
* Electro-galvanic oxygen sensor
* Pneumofathometer
* Submersible pressure gauge

Mobility
equipment|

* Diver propulsion vehicle
* Human torpedo
* Wet sub
* Diving bell
* Closed bell
* Wet bell
* Diving stage
* Swimfin
* Monofin
* PowerSwim
* Towboard

Safety
equipment|

* Alternative air source
* Octopus regulator
* Pony bottle
* Bolt snap
* Buddy line
* Dive light
* Diver's cutting tool
* Diver's knife
* Diver's telephone
* Through-water communications
* Underwater acoustic communication
* Diving bell
* Diving safety harness
* Emergency gas supply
* Bailout block
* Bailout bottle
* Lifeline
* Screw gate carabiner
* Emergency locator beacon
* Rescue tether
* Safety helmet
* Shark-proof cage
* Snoopy loop
* Navigation equipment
* Distance line
* Diving compass
* Dive reel
* Line marker
* Surface marker buoy
* Silt screw

Underwater
breathing
apparatus|

* Atmospheric diving suit
* Diving cylinder
* Burst disc
* Scuba cylinder valve
* Diving helmet
* Reclaim helmet
* Diving regulator
* Mechanism of diving regulators
* Regulator malfunction
* Regulator freeze
* Single-hose regulator
* Twin-hose regulator
* Full-face diving mask

| Open-circuit
scuba|

* Scuba set
* Bailout bottle
* Decompression cylinder
* Independent doubles
* Manifolded twin set
* Scuba manifold
* Pony bottle
* Scuba configuration
* Sidemount
* Sling cylinder

|

Diving rebreathers|

* Carbon dioxide scrubber
* Carleton CDBA
* Clearance Divers Life Support Equipment
* Cryogenic rebreather
* CUMA
* DSEA
* Dolphin
* Halcyon PVR-BASC
* Halcyon RB80
* IDA71
* Interspiro DCSC
* LAR-5
* LAR-6
* LAR-V
* LARU
* Mark IV Amphibian
* Porpoise
* Ray
* Siebe Gorman CDBA
* Salvus
* Siva

Surface-supplied
diving equipment|

* Air line
* Diver's umbilical
* Diving air compressor
* Gas panel
* Hookah
* Scuba replacement
* Snuba
* Standard diving dress

Diving
equipment
manufacturers|

* AP Diving
* Apeks
* Aqua Lung America
* Aqua Lung/La Spirotechnique
* Beuchat
* René Cavalero
* Cis-Lunar
* Cressi-Sub
* Dacor
* DESCO
* Dive Xtras
* Divex
* Diving Unlimited International
* Drägerwerk
* Faber
* Fenzy
* Maurice Fernez
* Technisub
* Oscar Gugen
* Heinke
* HeinrichsWeikamp
* Johnson Outdoors
* Mares
* Morse Diving
* Nemrod
* Oceanic Worldwide
* Porpoise
* Shearwater Research
* Siebe Gorman
* Submarine Products
* Suunto

Diving support equipment

| Access equipment|

* Boarding stirrup
* Diver lift
* Diving bell
* Diving ladder
* Diving platform (scuba)
* Diving stage
* Downline
* Jackstay
* Launch and recovery system
* Messenger line
* Moon pool

|

Breathing gas
handling|

* Air filtration
* Activated carbon
* Hopcalite
* Molecular sieve
* Silica gel
* Booster pump
* Carbon dioxide scrubber
* Cascade filling system
* Diver's pump
* Diving air compressor
* Diving air filter
* Water separator
* High pressure breathing air compressor
* Low pressure breathing air compressor
* Gas blending
* Gas blending for scuba diving
* Gas panel
* Gas reclaim system
* Gas storage bank
* Gas storage quad
* Gas storage tube
* Helium analyzer
* Nitrox production
* Membrane gas separation
* Pressure swing adsorption
* Oxygen analyser
* Electro-galvanic oxygen sensor
* Oxygen compatibility

Decompression
equipment|

* Air-lock
* Built-in breathing system
* Decompression tables
* Diving bell
* Bell cursor
* Closed bell
* Clump weight
* Launch and recovery system
* Wet bell
* Diving chamber
* Diving stage
* Recreational Dive Planner
* Saturation system

Platforms|

* Dive boat
* Canoe and kayak diving
* Combat rubber raiding craft
* Liveaboard
* Subskimmer
* Diving support vessel
* HMS Challenger (K07)

| Underwater
habitat|

* Aquarius Reef Base
* Continental Shelf Station Two
* Helgoland Habitat
* Scott Carpenter Space Analog Station
* SEALAB
* Tektite habitat

|

Remotely operated
underwater vehicles|

* 8A4-class ROUV
* ABISMO
* Atlantis ROV Team
* COTSBot
* CURV
* Deep Drone
* Épaulard
* Global Explorer ROV
* Goldfish-class ROUV
* Kaikō ROV
* Kaşif ROUV
* Long-Term Mine Reconnaissance System
* Mini Rover ROV
* OpenROV
* ROV KIEL 6000
* ROV PHOCA
* Scorpio ROV
* Sea Dragon-class ROV
* Seabed tractor
* Seafox drone
* SeaPerch
* SJT-class ROUV
* T1200 Trenching Unit
* VideoRay UROVs

Safety equipment|

* Diver down flag
* Diving shot
* ENOS Rescue-System
* Hyperbaric lifeboat
* Hyperbaric stretcher
* Jackstay
* Jonline
* Reserve gas supply

General|

* Diving spread
* Air spread
* Saturation spread
* Hot water system
* Sonar
* Underwater acoustic positioning system
* Underwater acoustic communication

Freediving

| Activities|

* Aquathlon
* Apnoea finswimming
* Freediving
* Haenyeo
* Pearl hunting
* Ama
* Snorkeling
* Spearfishing
* Underwater football
* Underwater hockey
* Underwater rugby
* Underwater target shooting

|

Competitions|

* Nordic Deep
* Vertical Blue
* Disciplines
* Constant weight (CWT)
* Constant weight bi-fins (CWTB)
* Constant weight without fins (CNF)
* Dynamic apnea (DYN)
* Dynamic apnea without fins (DNF)
* Free immersion (FIM)
* No-limits apnea (NLT)
* Static apnea (STA)
* Skandalopetra diving
* Variable weight apnea (VWT)
* Variable weight apnea without fins

Equipment|

* Diving mask
* Diving suit
* Hawaiian sling
* Polespear
* Snorkel (swimming)
* Speargun
* Swimfins
* Monofin
* Water polo cap

Freedivers|

* Deborah Andollo
* Simone Arrigoni
* Peppo Biscarini
* Michael Board
* Sara Campbell
* Derya Can Göçen
* Goran Čolak
* Carlos Coste
* Robert Croft
* Mandy-Rae Cruickshank
* Yasemin Dalkılıç
* Leonardo D'Imporzano
* Flavia Eberhard
* Şahika Ercümen
* Emma Farrell
* Francisco Ferreras
* Pierre Frolla
* Flavia Eberhard
* Mehgan Heaney-Grier
* Elisabeth Kristoffersen
* Andriy Yevhenovych Khvetkevych
* Loïc Leferme
* Enzo Maiorca
* Jacques Mayol
* Audrey Mestre
* Karol Meyer
* Kate Middleton
* Stéphane Mifsud
* Alexey Molchanov
* Natalia Molchanova
* Dave Mullins
* Patrick Musimu
* Guillaume Néry
* Herbert Nitsch
* Umberto Pelizzari
* Liv Philip
* Annelie Pompe
* Stig Severinsen
* Tom Sietas
* Martin Štěpánek
* Walter Steyn
* Tanya Streeter
* William Trubridge
* Devrim Cenk Ulusoy
* Fatma Uruk
* Danai Varveri
* Alessia Zecchini
* Nataliia Zharkova
* Kateryna Sadurska

Hazards|

* Barotrauma
* Drowning
* Freediving blackout
* Deep-water blackout
* Shallow-water blackout
* Hypercapnia
* Hypothermia

Historical|

* Ama
* Octopus wrestling
* Swimming at the 1900 Summer Olympics – Men's underwater swimming

Organisations|

* AIDA International
* Scuba Schools International
* Australian Underwater Federation
* British Freediving Association
* Confédération Mondiale des Activités Subaquatiques
* Fédération Française d'Études et de Sports Sous-Marins
* Performance Freediving International

Professional diving

| Occupations|

* Ama
* Commercial diver
* Commercial offshore diver
* Hazmat diver
* Divemaster
* Diving instructor
* Diving safety officer
* Diving superintendent
* Diving supervisor
* Haenyeo
* Media diver
* Police diver
* Public safety diver
* Scientific diver
* Underwater archaeologist

| Military
diving|

* Army engineer diver
* Canadian Armed Forces Divers
* Clearance diver
* Frogman
* Minentaucher
* Royal Navy ships diver
* United States military divers
* U.S. Navy diver
* U.S.Navy master diver

| Military
diving
units|

* 7th Marine Brigade
* Clearance Diving Branch (RAN)
* Commando Hubert
* Combat Divers Service (Lithuania)
* Comando Raggruppamento Subacquei e Incursori Teseo Tesei
* Decima Flottiglia MAS
* Frogman Corps (Denmark)
* Fuerzas Especiales
* Fukuryu
* GRUMEC
* Grup Gerak Khas
* Jagdkommando
* JW Formoza
* JW GROM
* JW Komandosów
* Kommando Spezialkräfte Marine
* KOPASKA
* MARCOS
* Marine Commandos
* Marinejegerkommandoen
* Marine Raider Regiment
* Minedykkerkommandoen
* Namibian Marine Corps Operational Diving Unit
* Naval Diving Unit (Singapore)
* Naval Service Diving Section
* Naval Special Operations Command
* Operational Diving Division (SA Navy)
* Royal Engineers
* Russian commando frogmen
* Sappers Divers Group
* Shayetet 13
* Special Air Service
* Special Air Service Regiment
* Special Actions Detachment
* Special Boat Service
* Special Boat Squadron (Sri Lanka)
* Special Forces Command (Turkey)
* Special Forces Group (Belgium)
* Special Operations Battalion (Croatia)
* Special Service Group (Navy)
* Special Warfare Diving and Salvage
* Tactical Divers Group
* US Marine Corps Force Reconnaissance
* US Marine Corps Reconnaissance Battalions
* US Navy SEALs
* Underwater Construction Teams
* Underwater Demolition Command
* Underwater Demolition Team
* Underwater Offence (Turkish Armed Forces)
* UNGERIN

|

Underwater
work|

* Commercial offshore diving
* Dive leader
* Diver training
* Recreational diver training
* Hazmat diving
* Hyperbaric welding
* Marine construction
* Offshore construction
* Underwater construction
* Media diving
* Pearl hunting
* Police diving
* Potable water diving
* Public safety diving
* Scientific diving
* Ships husbandry
* Sponge diving
* Submarine pipeline
* Underwater archaeology
* Archaeology of shipwrecks
* Underwater cutting and welding
* Underwater demolition
* Underwater inspection
* Nondestructive testing
* Underwater logging
* Underwater photography
* Underwater search and recovery
* Underwater searches
* Underwater videography
* Underwater survey

| Salvage diving|

* SS Egypt
* Kronan
* La Belle
* SS Laurentic
* RMS Lusitania
* Mars
* Mary Rose
* USS Monitor
* HMS Royal George
* Vasa

|

Diving
contractors|

* COMEX
* Helix Energy Solutions Group
* International Marine Contractors Association

Tools and
equipment|

* Abrasive waterjet
* Airlift
* Baited remote underwater video
* In-water surface cleaning
* Brush cart
* Cavitation cleaning
* Pressure washing
* Pigging
* Hot stab
* Lifting bag
* Remotely operated underwater vehicle
* Thermal lance
* Tremie
* Water jetting

Underwater
weapons|

* Limpet mine
* Speargun
* Hawaiian sling
* Polespear

| Underwater
firearm|

* Gyrojet
* Mk 1 Underwater Defense Gun
* Powerhead
* Underwater pistols
* Heckler & Koch P11
* SPP-1 underwater pistol
* Underwater revolvers
* AAI underwater revolver
* Underwater rifles
* ADS amphibious rifle
* APS underwater rifle
* ASM-DT amphibious rifle
* QBS-06

|

Recreational diving

* Recreational dive sites
* Index of recreational dive sites
* List of wreck diving sites
* Outline of recreational dive sites

| Specialties|

* Altitude diving
* Cave diving
* Deep diving
* Ice diving
* Muck diving
* Open-water diving
* Rebreather diving
* Sidemount diving
* Solo diving
* Technical diving
* Underwater photography
* Wreck diving

|

Diver
organisations|

* British Sub-Aqua Club (BSAC)
* Cave Divers Association of Australia (CDAA)
* Cave Diving Group (CDG)
* Comhairle Fo-Thuinn (CFT)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* International Association for Handicapped Divers (IAHD)
* Quintana Roo Speleological Survey (QRSS)
* Woodville Karst Plain Project (WKPP)

Diving tourism
industry|

* Dive center
* Diving in Timor-Leste
* Diving in the Maldives
* Environmental impact of recreational diving
* Scuba diving tourism
* Scuba diving in the Cayman Islands
* Shark tourism
* Sinking ships for wreck diving sites
* Underwater diving in Guam

Diving events
and festivals|

* Diversnight
* Underwater Bike Race

Diving safety

* Human factors in diving equipment design
* Human factors in diving safety
* Life-support system
* Safety-critical system
* Scuba diving fatalities
* Underwater diving emergency
* Water safety
* Water surface searches

| Diving
hazards|

* List of diving hazards and precautions
* Environmental
* Current
* Delta-P
* Entanglement hazard
* Overhead
* Silt out
* Wave action
* Equipment
* Freeflow
* Use of breathing equipment in an underwater environment
* Failure of diving equipment other than breathing apparatus
* Single point of failure
* Physiological
* Cold shock response
* Decompression
* Nitrogen narcosis
* Oxygen toxicity
* Seasickness
* Uncontrolled decompression
* Diver behaviour and competence
* Lack of competence
* Overconfidence effect
* Panic
* Task loading
* Trait anxiety
* Willful violation

| Consequences|

* Barotrauma
* Decompression sickness
* Drowning
* Hypothermia
* Hypoxia
* Hypercapnia
* Hyperthermia
* Non-freezing cold injury

|

Diving
procedures|

* Ascending and descending
* Emergency ascent
* Boat diving
* Canoe and kayak diving
* Buddy diving
* buddy check
* Decompression
* Decompression practice
* Pyle stop
* Ratio decompression
* Dive briefing
* Dive log
* Dive planning
* Rule of thirds
* Scuba gas planning
* Diver communications
* Diver rescue
* Diver training
* Doing It Right
* Drift diving
* Gas blending for scuba diving
* Night diving
* Rebreather diving
* Scuba gas management
* Solo diving
* Wall diving

Risk
management|

* Checklist
* Hazard identification and risk assessment
* Hazard analysis
* Job safety analysis
* Risk assessment
* Hyperbaric evacuation and rescue
* Risk control
* Hierarchy of hazard controls
* Incident pit
* Lockout–tagout
* Permit To Work
* Redundancy
* Safety data sheet
* Situation awareness

| Diving team|

* Bellman
* Chamber operator
* Diver medical technician
* Diver's attendant
* Diving supervisor
* Diving systems technician
* Gas man
* Life support technician
* Stand-by diver

|

Equipment
safety|

* Breathing gas quality
* Testing and inspection of diving cylinders
* Hydrostatic test
* Sustained load cracking
* Diving regulator
* Breathing performance of regulators

Occupational
safety and
health|

* Association of Diving Contractors International
* International Marine Contractors Association
* Code of practice
* Contingency plan
* Diving regulations
* Emergency response plan
* Diving safety officer
* Diving superintendent
* Diving supervisor
* Operations manual
* Standard operating procedure

Diving medicine

| Diving
disorders|

* List of signs and symptoms of diving disorders
* Cramp
* Motion sickness
* Surfer's ear

| Pressure
related|

* Alternobaric vertigo
* Barostriction
* Barotrauma
* Air embolism
* Aerosinusitis
* Barodontalgia
* Dental barotrauma
* Middle ear barotrauma
* Pulmonary barotrauma
* Compression arthralgia
* Decompression illness
* Dysbarism

| Oxygen|

* Freediving blackout
* Hyperoxia
* Hypoxia
* Oxygen toxicity

|

Inert gases|

* Avascular necrosis
* Decompression sickness
* Dysbaric osteonecrosis
* Inner ear decompression sickness
* Isobaric counterdiffusion
* Taravana
* High-pressure nervous syndrome
* Hydrogen narcosis
* Nitrogen narcosis

Carbon dioxide|

* Hypercapnia
* Hypocapnia

Breathing gas
contaminants|

* Carbon monoxide poisoning

Immersion
related|

* Asphyxia
* Drowning
* Hypothermia
* Immersion diuresis
* Instinctive drowning response
* Laryngospasm
* Salt water aspiration syndrome
* Swimming-induced pulmonary edema

Treatment|

* Demand valve oxygen therapy
* First aid
* Hyperbaric medicine
* Hyperbaric treatment schedules
* In-water recompression
* Oxygen therapy
* Therapeutic recompression

Personnel|

* Diving Medical Examiner
* Diving Medical Practitioner
* Diving Medical Technician
* Hyperbaric nursing

Screening|

* Atrial septal defect
* Effects of drugs on fitness to dive
* Fitness to dive
* Psychological fitness to dive

Research|

| Researchers in
diving physiology
and medicine|

* Arthur J. Bachrach
* Albert R. Behnke
* Peter B. Bennett
* Paul Bert
* George F. Bond
* Robert Boyle
* Alf O. Brubakk
* Albert A. Bühlmann
* John R. Clarke
* Guybon Chesney Castell Damant
* Kenneth William Donald
* William Paul Fife
* John Scott Haldane
* Robert William Hamilton Jr.
* Henry Valence Hempleman
* Leonard Erskine Hill
* Brian Andrew Hills
* Felix Hoppe-Seyler
* Christian J. Lambertsen
* Simon Mitchell
* Charles Momsen
* Neal W. Pollock
* John Rawlins
* Charles Wesley Shilling
* Edward D. Thalmann
* Jacques Triger

|

Diving medical
research
organisations|

* Aerospace Medical Association
* Divers Alert Network (DAN)
* Diving Diseases Research Centre (DDRC)
* Diving Medical Advisory Council (DMAC)
* European Diving Technology Committee (EDTC)
* European Underwater and Baromedical Society (EUBS)
* National Board of Diving and Hyperbaric Medical Technology
* Naval Submarine Medical Research Laboratory
* Royal Australian Navy School of Underwater Medicine
* Rubicon Foundation
* South Pacific Underwater Medicine Society (SPUMS)
* Southern African Underwater and Hyperbaric Medical Association (SAUHMA)
* Undersea and Hyperbaric Medical Society (UHMS)
* United States Navy Experimental Diving Unit (NEDU)

Law

* Civil liability in recreational diving
* Diving regulations
* Duty of care
* List of legislation regulating underwater diving
* Investigation of diving accidents
* Convention on the Protection of the Underwater Cultural Heritage

History of underwater diving

* History of decompression research and development
* History of dive computers
* History of Diving Museum
* History of scuba diving
* List of researchers in underwater diving
* Lyons Maritime Museum
* Man in the Sea Museum
* Timeline of atmospheric diving suits
* Timeline of diving technology
* Pearling in Western Australia
* US Navy decompression models and tables

| Archeological
sites|

* SS Commodore
* USS Monitor
* Queen Anne's Revenge
* Whydah Gally

|

Underwater art
and artists|

* The Diver
* Jason deCaires Taylor

Engineers
and inventors|

* Jerónimo de Ayanz y Beaumont
* William Beebe
* Georges Beuchat
* Giovanni Alfonso Borelli
* Joseph-Martin Cabirol
* John R. Clarke
* Jacques Cousteau
* Charles Anthony Deane
* John Deane
* Louis de Corlieu
* Auguste Denayrouze
* Ted Eldred
* Henry Fleuss
* Émile Gagnan
* Karl Heinrich Klingert
* Peter Kreeft
* Christian J. Lambertsen
* Yves Le Prieur
* John Lethbridge
* Ernest William Moir
* Joseph Salim Peress
* Auguste Piccard
* Joe Savoie
* Willard Franklyn Searle
* Gordon Smith
* Augustus Siebe
* Pierre-Marie Touboulic
* Jacques Triger

Historical
equipment|

* Aqua-Lung
* RV Calypso
* SP-350 Denise
* Magnesium torch
* Nikonos
* Porpoise regulator
* Standard diving dress
* Sub Marine Explorer
* Vintage scuba

| Diver
propulsion
vehicles|

* Advanced SEAL Delivery System
* Cosmos CE2F series
* Dry Combat Submersible
* Human torpedo
* Motorised Submersible Canoe
* Necker Nymph
* R-2 Mala-class swimmer delivery vehicle
* SEAL Delivery Vehicle
* Shallow Water Combat Submersible
* Siluro San Bartolomeo
* Welfreighter
* Wet Nellie

|

Military and
covert operations|

* Raid on Alexandria (1941)
* Sinking of the Rainbow Warrior

Scientific projects|

* 1992 cageless shark-diving expedition
* Mission 31

Awards and events|

* Hans Hass Award
* International Scuba Diving Hall of Fame
* London Diving Chamber Dive Lectures
* NOGI Awards
* Women Divers Hall of Fame

Incidents|

| Dive boat incidents|

* Sinking of MV Conception

|

Diver rescues|

* Alpazat cave rescue
* Tham Luang cave rescue

Early diving|

* John Day (carpenter)
* Charles Spalding
* Ebenezer Watson

Freediving fatalities|

* Stephen Keenan
* Loïc Leferme
* Audrey Mestre
* Nicholas Mevoli
* Natalia Molchanova

Offshore
diving incidents|

* Byford Dolphin diving bell accident
* Drill Master diving accident
* Star Canopus diving accident
* Stena Seaspread diving accident
* Venture One diving accident
* Waage Drill II diving accident
* Wildrake diving accident

Professional
diving fatalities|

* Roger Baldwin
* John Bennett
* Victor F. Guiel Jr.
* Francis P. Hammerberg
* Craig M. Hoffman
* Peter Henry Michael Holmes
* Johnson Sea Link accident
* Edwin Clayton Link
* Gerard Anthony Prangley
* Per Skipnes
* Robert John Smyth
* Albert D. Stover
* Richard A. Walker
* Lothar Michael Ward
* Joachim Wendler
* Bradley Westell
* Arne Zetterström

Scuba diving
fatalities|

* 1973 Mount Gambier cave diving accident
* Ricardo Armbruster
* Allan Bridge
* David Bright
* Berry L. Cannon
* Cotton Coulson
* Cláudio Coutinho
* E. Yale Dawson
* Deon Dreyer
* Milan Dufek
* Sheck Exley
* Maurice Fargues
* Fernando Garfella Palmer
* Guy Garman
* Steve Irwin
* death
* Jim Jones
* Henry Way Kendall
* Artur Kozłowski
* Yuri Lipski
* Kirsty MacColl
* Linnea Mills
* Agnes Milowka
* François de Roubaix
* Chris and Chrissy Rouse
* Dave Shaw
* Wesley C. Skiles
* Dewey Smith
* Rob Stewart
* Esbjörn Svensson
* Josef Velek

Publications

| Manuals|

* NOAA Diving Manual
* U.S. Navy Diving Manual
* Basic Cave Diving: A Blueprint for Survival
* Underwater Handbook
* Bennett and Elliott's physiology and medicine of diving
* Encyclopedia of Recreational Diving
* The new science of skin and scuba diving
* Professional Diver's Handbook
* Basic Scuba

|

Standards and
Codes of Practice|

* Code of Practice for Scientific Diving (UNESCO)
* DIN 7876
* IMCA Code of Practice for Offshore Diving
* ISO 24801 Recreational diving services — Requirements for the training of recreational scuba divers

General non-fiction|

* The Darkness Beckons
* Goldfinder
* The Last Dive
* Shadow Divers
* The Silent World: A Story of Undersea Discovery and Adventure

Research|

* List of Divers Alert Network publications

Dive guides|

Training and registration

| Diver
training|

* Competence and assessment
* Competency-based learning
* Refresher training
* Skill assessment
* Diver training standard
* Diving instructor
* Diving school
* Occupational diver training
* Commercial diver training
* Military diver training
* Public safety diver training
* Scientific diver training
* Recreational diver training
* Introductory diving
* ISO training standards
* Teaching method
* Muscle memory
* Overlearning
* Stress exposure training

| Skills|

* Combat sidestroke
* Diver navigation
* Diver trim
* Ear clearing
* Frenzel maneuver
* Valsalva maneuver
* Finning techniques
* Scuba skills
* Buddy breathing
* Low impact diving
* Diamond Reef System
* Surface-supplied diving skills
* Underwater searches

|

Recreational
scuba
certification
levels|

| Core diving skills|

* Advanced Open Water Diver
* Autonomous diver
* CMAS* scuba diver
* CMAS** scuba diver
* Introductory diving
* Low Impact Diver
* Master Scuba Diver
* Open Water Diver
* Supervised diver

|

Leadership skills|

* Dive leader
* Divemaster
* Diving instructor
* Master Instructor

Specialist skills|

* Rescue Diver
* Solo diver

Diver training
certification
and registration
organisations|

* European Underwater Federation (EUF)
* International Diving Regulators and Certifiers Forum (IDRCF)
* International Diving Schools Association (IDSA)
* International Marine Contractors Association (IMCA)
* List of diver certification organizations
* National Oceanic and Atmospheric Administration (NOAA)
* Nautical Archaeology Society
* Recreational diver course referral
* World Recreational Scuba Training Council (WRSTC)

| Commercial diver
certification
authorities|

* Australian Diver Accreditation Scheme (ADAS)
* Commercial diver registration in South Africa
* Divers Institute of Technology
* Health and Safety Executive (HSE)
* Department of Employment and Labour

|

Commercial diving
schools|

* Divers Academy International
* Norwegian diver school

Free-diving
certification
agencies|

* AIDA International (AIDA)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Performance Freediving International (PI)
* Scuba Schools International (SSI)

Recreational
scuba
certification
agencies|

* American Canadian Underwater Certifications (ACUC)
* American Nitrox Divers International (ANDI)
* Association nationale des moniteurs de plongée (ANMP)
* British Sub-Aqua Club (BSAC)
* Comhairle Fo-Thuinn (CFT)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* Federazione Italiana Attività Subacquee (FIAS)
* Global Underwater Explorers (GUE)
* International Association for Handicapped Divers (IAHD)
* International Association of Nitrox and Technical Divers (IANTD)
* International Life Saving Federation (ILS)
* Israeli Diving Federation (TIDF)
* National Academy of Scuba Educators (NASE)
* National Association of Underwater Instructors (NAUI)
* Nederlandse Onderwatersport Bond (NOB)
* Professional Association of Diving Instructors (PADI)
* Professional Diving Instructors Corporation (PDIC)
* Professional Technical and Recreational Diving (ProTec)
* Rebreather Association of International Divers (RAID)
* Sub-Aqua Association (SAA)
* Scuba Diving International (SDI)
* Scuba Educators International (SEI)
* Scuba Schools International (SSI)
* Türkiye Sualtı Sporları Federasyonu (TSSF)
* United Diving Instructors (UDI)
* YMCA SCUBA Program

Scientific diver
certification
authorities|

* American Academy of Underwater Sciences (AAUS)
* CMAS Scientific Committee

Technical diver
certification
agencies|

* American Nitrox Divers International (ANDI)
* British Sub-Aqua Club (BSAC)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Diving Science and Technology (DSAT)
* Federazione Italiana Attività Subacquee (FIAS)
* International Association of Nitrox and Technical Divers (IANTD)
* Professional Association of Diving Instructors (PADI)
* Professional Diving Instructors Corporation (PDIC)
* Professional Technical and Recreational Diving (ProTec)
* Rebreather Association of International Divers (RAID)
* Trimix Scuba Association (TSA)
* Technical Extended Range (TXR)

| Cave
diving|

* Cave Divers Association of Australia (CDAA)
* Cave Diving Group (CDG)
* Global Underwater Explorers (GUE)
* National Speleological Society#Cave Diving Group (CDG)
* National Association of Underwater Instructors (NAUI)
* Technical Diving International (TDI)

|

Military diver
training centres|

* Defence Diving School
* Navy Diving Salvage and Training Center
* Underwater Escape Training Unit

Military diver
training courses|

* United States Marine Corps Combatant Diver Course

Underwater sports

| Surface snorkeling|

* Finswimming

|

Snorkeling/breath-hold|

* Spearfishing
* Underwater football
* Underwater hockey
* Australia
* Turkey
* Underwater rugby
* Colombia
* United States
* Underwater target shooting

Breath-hold|

* Aquathlon
* Apnoea finswimming
* Freediving

Open Circuit Scuba|

* Immersion finswimming
* Sport diving
* Underwater cycling
* Underwater orienteering
* Underwater photography

Rebreather|

* Underwater photography

Sports governing
organisations
and federations|

* International
* AIDA International
* Confédération Mondiale des Activités Subaquatiques)
* National
* AIDA Hellas
* Australian Underwater Federation
* British Freediving Association
* British Octopush Association
* British Underwater Sports Association
* Comhairle Fo-Thuinn
* Federación Española de Actividades Subacuáticas
* Fédération Française d'Études et de Sports Sous-Marins
* South African Underwater Sports Federation
* Türkiye Sualtı Sporları Federasyonu
* Underwater Society of America)

Competitions|

* 14th CMAS Underwater Photography World Championship
* Underwater Hockey World Championships
* Underwater Orienteering World Championships
* Underwater Rugby World Championships

Underwater divers

| Pioneers
of diving|

* Eduard Admetlla i Lázaro
* Aquanaut
* Mary Bonnin
* Amelia Behrens-Furniss
* James F. Cahill
* Jacques Cousteau
* Billy Deans
* Dottie Frazier
* Trevor Hampton
* Hans Hass
* Hannes Keller
* Dick Rutkowski
* Teseo Tesei
* Arne Zetterström

|

Underwater
scientists
archaeologists and
environmentalists|

* Michael Arbuthnot
* Robert Ballard
* George Bass
* Mensun Bound
* Louis Boutan
* Jeffrey Bozanic
* Hugh Bradner
* Cathy Church
* Eugenie Clark
* James P. Delgado
* Sylvia Earle
* John Christopher Fine
* George R. Fischer
* Anders Franzén
* Honor Frost
* Fernando Garfella Palmer
* David Gibbins
* Graham Jessop
* Swietenia Puspa Lestari
* Pilar Luna
* Robert F. Marx
* Anna Marguerite McCann
* Innes McCartney
* Charles T. Meide
* Mark M. Newell
* Lyuba Ognenova-Marinova
* John Peter Oleson
* Mendel L. Peterson
* Richard Pyle
* Andreas Rechnitzer
* William R. Royal
* Margaret Rule
* Gunter Schöbel
* Stephanie Schwabe
* Myriam Seco
* E. Lee Spence
* Robert Sténuit
* Peter Throckmorton
* Cristina Zenato

Scuba record
holders|

* Pascal Bernabé
* Jim Bowden
* Mark Ellyatt
* Sheck Exley
* Nuno Gomes
* Claudia Serpieri
* Krzysztof Starnawski

Underwater
filmmakers
and presenters|

* Samir Alhafith
* David Attenborough
* Ramón Bravo
* Jean-Michel Cousteau
* Richie Kohler
* Paul Rose
* Andy Torbet
* Ivan Tors
* Andrew Wight
* James Cameron

Underwater
photographers|

* Doug Allan
* Tamara Benitez
* Georges Beuchat
* Adrian Biddle
* Jonathan Bird
* Eric Cheng
* Neville Coleman
* Jacques Cousteau
* John D. Craig
* Ben Cropp
* Bernard Delemotte
* David Doubilet
* Candice Farmer
* John Christopher Fine
* Rodney Fox
* Ric Frazier
* Stephen Frink
* Peter Gimbel
* Monty Halls
* Hans Hass
* Henry Way Kendall
* Rudie Kuiter
* Joseph B. MacInnis
* Luis Marden
* Agnes Milowka
* Noel Monkman
* Pete Oxford
* Steve Parish
* Zale Parry
* Pierre Petit
* Leni Riefenstahl
* Peter Scoones
* Brian Skerry
* Wesley C. Skiles
* E. Lee Spence
* Philippe Tailliez
* Ron Taylor
* Valerie Taylor
* Albert Tillman
* John Veltri
* Stan Waterman
* Michele Westmorland
* John Ernest Williamson
* J. Lamar Worzel

Underwater
explorers|

* Caves
* Graham Balcombe
* Sheck Exley
* Martyn Farr
* Jochen Hasenmayer
* Jill Heinerth
* Jarrod Jablonski
* Brian Kakuk
* William Hogarth Main
* Tom Mount
* Jack Sheppard
* Bill Stone
* Reefs
* Arthur C. Clarke
* Wrecks
* Leigh Bishop
* John Chatterton
* Clive Cussler
* Bill Nagle
* Valerie van Heest
* Aristotelis Zervoudis

Aquanauts|

* Andrew Abercromby
* Joseph M. Acaba
* Clayton Anderson
* Richard R. Arnold
* Serena Auñón-Chancellor
* Michael Barratt (astronaut)
* Robert A. Barth
* Robert L. Behnken
* Randolph Bresnik
* Timothy J. Broderick
* Justin Brown
* Berry L. Cannon
* Scott Carpenter
* Gregory Chamitoff
* Steve Chappell
* Catherine Coleman
* Robin Cook
* Craig B. Cooper
* Fabien Cousteau
* Philippe Cousteau
* Timothy Creamer
* Jonathan Dory
* Pedro Duque
* Sylvia Earle
* Jeanette Epps
* Sheck Exley
* Albert Falco
* Andrew J. Feustel
* Michael Fincke
* Satoshi Furukawa
* Ronald J. Garan Jr.
* Michael L. Gernhardt
* Christopher E. Gerty
* David Gruber
* Chris Hadfield
* Jeremy Hansen
* José M. Hernández
* John Herrington
* Paul Hill
* Akihiko Hoshide
* Mark Hulsbeck
* Emma Hwang
* Norishige Kanai
* Les Kaufman
* Scott Kelly
* Karen Kohanowich
* Timothy Kopra
* Dominic Landucci
* Jon Lindbergh
* Kjell N. Lindgren
* Michael López-Alegría
* Joseph B. MacInnis
* Sandra Magnus
* Thomas Marshburn
* Matthias Maurer
* K. Megan McArthur
* Craig McKinley
* Jessica Meir
* Simone Melchior
* Dorothy Metcalf-Lindenburger
* Andreas Mogensen
* Karen Nyberg
* John D. Olivas
* Takuya Onishi
* Luca Parmitano
* Nicholas Patrick
* Tim Peake
* Thomas Pesquet
* Marc Reagan
* Garrett Reisman
* Kathleen Rubins
* Dick Rutkowski
* Tara Ruttley
* David Saint-Jacques
* Josef Schmid
* Robert Sheats
* Dewey Smith
* Steve Squyres
* Heidemarie Stefanyshyn-Piper
* Robert Sténuit
* Hervé Stevenin
* Nicole Stott
* James Talacek
* Daniel M. Tani
* Robert Thirsk
* Bill Todd
* Mark T. Vande Hei
* Koichi Wakata
* Rex J. Walheim
* Shannon Walker
* John Morgan Wells
* Joachim Wendler
* Douglas H. Wheelock
* Peggy Whitson
* Dafydd Williams
* Jeffrey Williams
* Sunita Williams
* Reid Wiseman
* Kimiya Yui

Writers and journalists|

* Michael C. Barnette
* Victor Berge
* Philippe Diolé
* Gary Gentile
* Bret Gilliam
* Bob Halstead
* Hillary Hauser
* Trevor Jackson
* Steve Lewis
* John Mattera

Rescuers|

* Craig Challen
* Richard Harris
* Rick Stanton
* John Volanthen

Frogmen|

* Lionel Crabb
* Ian Edward Fraser
* Sydney Knowles
* James Joseph Magennis

Commercial salvors|

* Keith Jessop

Science of underwater diving

* List of researchers in underwater diving

| Diving
physics|

* Metre sea water
* Neutral buoyancy
* Underwater acoustics
* Modulated ultrasound
* Underwater vision
* Underwater computer vision

|

Diving
physiology|

* Blood shift
* Cold shock response
* Diving reflex
* Equivalent narcotic depth
* Maximum operating depth
* Physiological response to water immersion
* Thermal balance of the underwater diver
* Underwater vision
* Work of breathing

| Decompression
theory|

* Decompression models:
* Bühlmann decompression algorithm
* Haldane's decompression model
* Reduced gradient bubble model
* Thalmann algorithm
* Thermodynamic model of decompression
* Varying Permeability Model
* Equivalent air depth
* Oxygen window
* Physiology of decompression

|

Diving
environments|

* Underwater exploration
* Deep-sea exploration

| Classification|

* List of diving environments by type
* Altitude diving
* Benign water diving
* Confined water diving
* Deep diving
* Inland diving
* Inshore diving
* Muck diving
* Night diving
* Open-water diving
* Black-water diving
* Blue-water diving
* Penetration diving
* Cave diving
* Torricellian chamber
* Ice diving
* Wreck diving
* Recreational dive sites
* Underwater environment
* Underwater diving environment

|

Impact|

* Environmental impact of recreational diving
* Low impact diving

Other

* Bathysphere
* Defense against swimmer incursions
* Diver detection sonar
* Offshore survey
* Rugged compact camera
* Underwater domain awareness
* Underwater vehicle

| Deep-submergence
vehicle|

* Aluminaut
* DSV Alvin
* American submarine NR-1
* Bathyscaphe
* Archimède
* FNRS-2
* FNRS-3
* Harmony class bathyscaphe
* Sea Pole-class bathyscaphe
* Trieste II
* Deepsea Challenger
* Ictineu 3
* JAGO
* Jiaolong
* Konsul-class submersible
* Limiting Factor
* Russian submarine Losharik
* Mir
* Nautile
* Pisces-class deep submergence vehicle
* DSV Sea Cliff
* DSV Shinkai
* DSV Shinkai 2000
* DSV Shinkai 6500
* DSV Turtle
* DSV-5 Nemo

|

Submarine rescue|

* International Submarine Escape and Rescue Liaison Office
* Submarine Escape and Rescue system (Royal Swedish Navy)
* McCann Rescue Chamber
* Submarine rescue ship

| Deep-submergence
rescue vehicle|

* LR5
* LR7
* MSM-1
* Mystic-class deep-submergence rescue vehicle
* DSRV-1 Mystic
* DSRV-2 Avalon
* NATO Submarine Rescue System
* Priz-class deep-submergence rescue vehicle
* Russian deep submergence rescue vehicle AS-28
* Russian submarine AS-34
* ASRV Remora
* SRV-300
* Submarine Rescue Diving Recompression System
* Type 7103 DSRV
* URF (Swedish Navy)

|

Submarine escape|

* Escape trunk
* Submarine escape training facility
* Submarine Escape Training Facility (Australia)

| Escape set|

* Davis Submerged Escape Apparatus
* Momsen lung
* Steinke hood
* Submarine Escape Immersion Equipment

|

Special
interest
groups|

* Artificial Reef Society of British Columbia
* CMAS Europe
* Coral Reef Alliance
* Divers Alert Network
* Green Fins
* Finger Lakes Underwater Preserve Association
* Karst Underwater Research
* Nautical Archaeology Program
* Nautical Archaeology Society
* Naval Air Command Sub Aqua Club
* PADI AWARE
* Reef Check
* Reef Life Survey
* Rubicon Foundation
* Save Ontario Shipwrecks
* SeaKeys
* Sea Research Society
* Society for Underwater Historical Research
* Society for Underwater Technology
* Underwater Archaeology Branch, Naval History & Heritage Command

Neutral buoyancy
facilities for
Astronaut training|

* Neutral Buoyancy Laboratory
* Neutral buoyancy pool
* Neutral buoyancy simulation as a training aid
* Neutral Buoyancy Simulator
* Space Systems Laboratory
* Yuri Gagarin Cosmonaut Training Center

Other|

* Nautilus Productions
* Helicopter Aircrew Breathing Device
* Scuba diving therapy
* Seabed mining

* Category
* Commons
* Glossary
* Indexes: Dive sites
* Divers
* Diving
* Outline
* Portal

Authority control databases

National|

* Germany
* United States
* Czech Republic
* Israel

Other|

* Encyclopedia of Modern Ukraine

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