submarine medicine


Summary: The field of medicine concerned with conditions affecting the health of people in submarines or sealabs.

Top Publications

  1. Kehat I, Shupak A, Goldenberg I, Shoshani O. Long-term hematological effects in Special Forces trainees. Mil Med. 2003;168:116-9 pubmed
    ..Because these lower values were not seen in an otherwise identical group of submarine trainees, they could be attributed to the endurance training. ..
  2. Castellani J, O BRIEN C, Stulz D, Blanchard L, DeGroot D, Bovill M, et al. Physiological responses to cold exposure in men: a disabled submarine study. Undersea Hyperb Med. 2002;29:189-203 pubmed
    ..These thermoregulatory effector changes do not increase the risk for hypothermia in DISSUB survivors who are adequately clothed. ..
  3. Qiu X, Zhong J, Wan N, Shang W, Han L. [Effect of submarine training on antioxidant ability in submarine men]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2010;28:430-2 pubmed
    ..05). Submarine training, especially sea training, may decrease the antioxidant ability. ..
  4. Haidegger T, Sandor J, Benyo Z. Surgery in space: the future of robotic telesurgery. Surg Endosc. 2011;25:681-90 pubmed publisher
    ..With the proposed three-layered concept-relying only on currently available technology-effective support of long-distance telesurgery and human space missions are both feasible. ..
  5. Curley M, Ferrigno M, Lovrincevic M, Wylegala J, Lundgren C. Extending submarine crew survival by reducing CO2 production with quickly reversible sedation. Aviat Space Environ Med. 2010;81:537-44 pubmed
    ..Reversible sedation to lower crew metabolism in a disabled submarine may be effective, safe, and practical. ..
  6. Baker A, Wood C, Wood A, Timms P, Allsopp A. Changes in vitamin D and matrix metalloproteinase-9 in submariners during a submerged patrol. Occup Environ Med. 2014;71:104-8 pubmed publisher
    ..Circulating vitamin D concentrations on board were insufficient to prevent a rise in MMP. This has potential for adverse health effects and requires further study. ..
  7. Lepper P, D Spain G. Measurement and modeling of the acoustic field near an underwater vehicle and implications for acoustic source localization. J Acoust Soc Am. 2007;122:892-905 pubmed
    ..Matched field processing techniques quantify the source localization capabilities for both measurements and numerical modeling output. ..
  8. O Shea M, Scutt M. Morbidity rates on Vanguard Class submarines during nuclear deterrent patrol: a retrospective review over 13 years. J R Nav Med Serv. 2009;95:127-35 pubmed
    ..Despite the limitations placed on the doctor on board these submarines they have proven to be effective in reducing the rate of medical evacuation. ..
  9. Jackman R, Willette P, White D, Krizek S. Minimizing exposure to passive smoke in the enclosed environment of U.S. submarines. Aviat Space Environ Med. 2004;75:60-4 pubmed
    ..Using cotinine as a marker, passive smoke exposure appears to be minimum. The location of the designated smoking area aboard U. S. Navy submarines does not appear to have any effect on urinary cotinine levels. ..

More Information


  1. Sims J, Tibbles P, Jackman R. A descriptive analysis of asthma in the U.S. Navy Submarine Force. Aviat Space Environ Med. 1999;70:1214-8 pubmed
    ..Although the period prevalence of asthma is low in the U.S. Navy Submarine Force, submariners disqualified for asthma have similar historical and ethnic risk factors as the civilian population. ..
  2. Myznikov I. [Express-assessment of body functional state conducted in submariners]. Voen Med Zh. 2004;325:35-7 pubmed
  3. Barchukov V, Salenko I, Kalutskiń≠ V, Krylov S, Babich M, Butakov S. [Metabolic and functional changes in a submariner body during long-term exposure to the factors of a controlled environment]. Voen Med Zh. 2004;325:45-51 pubmed
  4. Persson O, Ostberg C, Pagels J, Sebastian A. Air contaminants in a submarine equipped with air independent propulsion. J Environ Monit. 2006;8:1111-21 pubmed
    ..It is reasonable to assume that a substantial build-up of the investigated contaminants is not likely if the submersion period is prolonged several times, which is the case for modern submarines equipped with air independent propulsion. ..
  5. Myznikov I, Solov ev V. [Change of functional form of organism of submariner during the organized rest in conditions of European North]. Voen Med Zh. 2007;328:36-9, 96 pubmed
    ..It's confirmed that good exponents of health condition could be attained by overpressure of functional systems. Authors propose to examine the submariner's organism functions by different diagnostics axis. ..
  6. Luria T, Matsliah Y, Adir Y, Josephy N, Moran D, Evans R, et al. Effects of a prolonged submersion on bone strength and metabolism in young healthy submariners. Calcif Tissue Int. 2010;86:8-13 pubmed publisher
    ..Prevention and/or rehabilitation programs should be developed following periods of relative disuse even for young submariners. The effects of repeated prolonged submersions on bone health are yet to be determined. ..
  7. Gennser M, Blogg S. Venous gas emboli in goats after simulated submarine escape from 290 msw breathing air or hyperoxic gas. Aviat Space Environ Med. 2009;80:927-32 pubmed
    ..Breathing hyperoxic gas during escape from 3000 kPa reduces the overall time with circulating VGE and, despite exposure to a maximum inspired partial pressure of oxygen of 1.8 MPa, symptoms of oxygen toxicity were not observed. ..
  8. Reini S, Fothergill D, Horn W. Assessment of cognitive function while on low-dose propranolol: implications for usage by survivors in a disabled submarine. Mil Med. 2012;177:451-5 pubmed
    ..These results suggest that 40 mg of propranolol taken twice daily does not significantly impair cognitive function and may be a viable option for use in a DISSUB scenario. ..
  9. Flagg S, Regis D, Petersen K, Mahon R. Interrupted oxygen pre-breathing and decompression outcomes in swine. Aviat Space Environ Med. 2013;84:12-6 pubmed
    ..Based on these findings we concluded that the protective effects of OPB against severe DCS are reduced with increasing periods of air interruption. ..
  10. Aktas S, Toklu A, Yildiz S, Uzun G. Development of underwater and hyperbaric medicine as a medical specialty in Turkey. Undersea Hyperb Med. 2013;40:63-7 pubmed
    ..The history of underwater and hyperbaric medicine as a medical specialty is dated back to the 1960s. In this paper, we review standards and the development of underwater and hyperbaric medicine as a medical specialty in Turkey. ..
  11. Reid M, Fock A, Doolette D. Decompressing rescue personnel during Australian submarine rescue operations. Diving Hyperb Med. 2017;47:159-167 pubmed
    ..Adopting these tables may negate the requirement for saturation decompression of rescue personnel exceeding DCIEM limits. ..
  12. Reid M, Fock A, Doolette D. Decompressing recompression chamber attendants during Australian submarine rescue operations. Diving Hyperb Med. 2017;47:168-172 pubmed
    ..The introduction of 90 minutes of oxygen breathing greatly reduces the probability of this interruption to rescue operations. ..
  13. Reynolds R, Styer D, Schlichting C. Decreased vitamin B-6 status of submariners during prolonged patrol. Am J Clin Nutr. 1988;47:463-9 pubmed
    ..These depression measures did not correlate with the vitamin B-6 status indices, indicating that the mood depressions during a patrol do not appear to be related to the vitamin B-6 status of the submariners. ..
  14. Zong Z, Lam K. Biodynamic response of shipboard sitting subject to ship shock motion. J Biomech. 2002;35:35-43 pubmed
    ..Both damping and stiffness have important influences on the pelvis, but have much less influences on other parts. Injury criteria in the literature are also summarized to facilitate injury assessment. ..
  15. House C, Grist D, Denison D. Will prior hyperventilation reduce cerebral blood flow during escape from a submarine?. Undersea Hyperb Med. 2001;28:201-5 pubmed
    ..It is concluded that, although hyperventilation effectively reduces CBV, the reduction is neither sustained during the escape procedure nor sufficiently consistent to recommend that it should be used before escape from a submarine. ..
  16. Van Wijk C, Waters A. Personality characteristics of South African Navy submarine personnel. Mil Med. 2000;165:656-8 pubmed
    ..They were adventurousness, confidence, group orientation, and self-sentiment. These factors appeared appropriate when discussed from an environmental demand perspective. ..
  17. Lundgren C, Eckhardt L, Senf C, Bowdwin M, Pendergast D. Negative pressure breathing increases cardiac output and nitrogen elimination in seated subjects. Undersea Hyperb Med. 2013;40:403-10 pubmed
    ..Negative pressure breathing during denitrogenation may facilitate decompression in divers and in crew members being rescued from a DISSUB. ..
  18. Velez de la Calle J, Rachou E, Le Martelot M, Ducot B, Multigner L, Thonneau P. Male infertility risk factors in a French military population. Hum Reprod. 2001;16:481-6 pubmed
    ..In conclusion, this study suggests that in this military population, having worked as a submariner in a nuclear-powered submarine, and having worked in very hot conditions, should be considered as risk factors for infertility. ..
  19. Alexander W, Briggs G, Still K, Jederberg W, MacMahon K, Baker W, et al. Toxicity of 2,6-Di-tert-butyl-4-Nitrophenol (DBNP). Appl Occup Environ Hyg. 2001;16:487-95 pubmed
    ..No adverse effects from DBNP exposures have been reported to date. ..
  20. Brasher K, Sparshott K, Weir A, Day A, Bridger R. Two year follow-up study of stressors and occupational stress in submariners. Occup Med (Lond). 2012;62:563-5 pubmed publisher
    ..However, the psychosocial predictors of stress were significantly different for this RN specialist group, demonstrating the importance of developing individual models of stress for different occupational groups. ..
  21. Holy X, Collombet J, Labarthe F, Granger Veyron N, Begot L. Effects of seasonal vitamin D deficiency and respiratory acidosis on bone metabolism markers in submarine crewmembers during prolonged patrols. J Appl Physiol (1985). 2012;112:587-96 pubmed publisher
    ..On patrol day 58, the discrepancy observed in terms of CRA compensation between SP and WP may result from the seasonal influence on vitamin D status. ..
  22. Shah A, Arnold M. The clinical implications of a smoking ban on submarines in the U.S. Navy. Mil Med. 2011;176:222-7 pubmed
    ..Recommendations for a successful implementation program are included. ..
  23. Mazurek W. Current submarine atmosphere control technology. Life Support Biosph Sci. 1998;5:279-85 pubmed
    ..Some progress has been made in the development of new technology and the adoption of air purification equipment used in the nuclear-powered submarines for this application. ..
  24. Okamoto M, Yamagichi H. Development of prototype full-automatic environmental control system for nitrox saturation diving. Life Support Biosph Sci. 1998;5:295-307 pubmed
    ..Also, by using solid-state conductor circuit, an AC 100 V type blower to use under hyperbaric conditions could be developed. A prototype HECS was manufactured and settled in JAMSTEC diving simulator for further evaluation. ..
  25. Jankosky C. Mass casualty in an isolated environment: medical response to a submarine collision. Mil Med. 2008;173:734-7 pubmed
    ..Subsequent emergency medical response is described as well as the 3-month physical and psychological morbidity. Recommendations for medical training, equipment, and policy for workers in isolated environments are discussed. ..
  26. Gennser M, Blogg S. Oxygen or carbogen breathing before simulated submarine escape. J Appl Physiol (1985). 2008;104:50-6 pubmed
    ..001). Oxygen breathing before submarine escape reduces initial bubble scores, although its significance in reducing central nervous system DCS needs to be investigated further. ..
  27. Cymerman A, Young A, Francis T, Wray D, Ditzler D, Stulz D, et al. Subjective symptoms and postural control during a disabled submarine simulation. Undersea Hyperb Med. 2002;29:204-15 pubmed
    ..These observations may be of practical importance when tasks aboard a disabled submarine involve balance and mobility. ..
  28. Dean M. An overview of the Institute of Naval Medicine. J R Nav Med Serv. 2005;91:164-6 pubmed
    ..However, I hope I have been able to demonstrate that INM is indeed living up to its Mission Statement and motto 'e mari ad salutum'. ..
  29. Berg J, Grieger T, Spira J. Psychiatric symptoms and cognitive appraisal following the near sinking of a research submarine. Mil Med. 2005;170:44-7 pubmed
    ..Previous and subsequent life events may play a more significant role in the level of postdisaster symptoms. ..
  30. Yildiz S, Ay H, Gunay A, Yaygili S, Aktas S. Submarine escape from depths of 30 and 60 feet: 41,183 training ascents without serious injury. Aviat Space Environ Med. 2004;75:269-71 pubmed
    ..1%), with rupture of the tympanic membrane in 35 cases. Submarine escape ascents can be safely performed provided that subjects are medically screened and well trained. ..
  31. Shang W, Qiu X, Zhong J. [Nutrition protective research on oxidative damage to submarine men]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2009;27:480-2 pubmed
    ..96% +/- 0.10%)] were lower than the control group [(2.44 +/- 0.32) nmol/ml and (23.12% +/- 0.77%)]. The difference was significant (P<0.05). To add antioxidant nutrients can improve the submarine men's antioxidant capacity. ..
  32. Blogg S, Gennser M, Loveman G, Seddon F, Thacker J, White M. The effect of breathing hyperoxic gas during simulated submarine escape on venous gas emboli and decompression illness. Undersea Hyperb Med. 2003;30:163-74 pubmed
    ..The rate of disappearance of VGE was significantly faster (p < 0.01) in the hyperoxic group. O2 toxicity was not discernible in any of the animals. ..
  33. Kohshi K, Wong R, Abe H, Katoh T, Okudera T, Mano Y. Neurological manifestations in Japanese Ama divers. Undersea Hyperb Med. 2005;32:11-20 pubmed
    ..Although the mechanisms of brain damage in BH diving are unclear, N2 bubbles passing through the lungs or the heart so as to become arterialized are most likely to be the etiological factor. ..
  34. Bourn S, Evans G, O Shea M. Panton-Valentine Leukocidin Staphylococcus aureus (PVL-SA) - an uninvited stowaway aboard a Royal Navy submarine. J R Nav Med Serv. 2013;99:3-8 pubmed
    ..The case highlights many important issues pertinent to military populations including clinical and public health considerations. ..
  35. Still K, Jung A, Ritchie G, Jederberg W, Wilfong E, Briggs G, et al. Disposition of 2,6-di-tert-butyl-4-nitrophenol (DBNP), a submarine atmosphere contaminant, in male Sprague-Dawley rats. Environ Res. 2005;98:363-7 pubmed
    ..These findings suggest that DBNP may accumulate in the body as a result of continuous or repeat exposures of short interval to DBNP. ..
  36. Campbell M, Johnston S, Marshburn T, Kane J, Lugg D. Nonoperative treatment of suspected appendicitis in remote medical care environments: implications for future spaceflight medical care. J Am Coll Surg. 2004;198:822-30 pubmed
  37. Loveman G, Seddon F, Thacker J, White M, Jurd K. Physiological effects of rapid reduction in carbon dioxide partial pressure in submarine tower escape. Diving Hyperb Med. 2014;44:86-90 pubmed
    ..This study shows that the risk of fainting, sudden collapse or vomiting on switching to 100% O? following acute exposures to hypercapnia at a PiCO? of up to 5.0 kPa is less than 8%. ..
  38. Lance R, Moon R, Crisafulli M, Bass C. Did the crew of the submarine H.L. Hunley suffocate?. Forensic Sci Int. 2016;260:59-65 pubmed publisher
    ..Based on this result and the location of the crew when discovered, hypoxia and hypercapnia do not explain the sinking of the world's first successful combat submarine. ..
  39. Vaernes R, Sandal G. Human reactions to deep-water conditions. Lancet. 2003;362 Suppl:s10-1 pubmed
  40. Ferrari M, Lodola L, Ghittori S, Zadra P, Ricciardi L, Imbriani M. [Indoor air quality in an Italian military submarine]. G Ital Med Lav Ergon. 2005;27:308-11 pubmed
    ..Moreover, we could find that pollutants sometimes reach notable peak concentrations being potentially able to induce adverse health effects in crewmembers. Our data highlight the need to promote further investigations. ..
  41. Rozali A, Sulaiman A, Zin B, Khairuddin H, Abd Halim M, Sherina M. Pulmonary overinflation syndrome in an underwater logger. Med J Malaysia. 2006;61:496-8 pubmed
    ..He was treated in a recompression chamber with hyperbaric oxygen therapy and discharged with residual weakness in his right leg. ..
  42. Risberg J, Ostberg C, Svensson T, Norfleet W, Ornhagen H, Mjaavatten O, et al. Atmospheric changes and physiological responses during a 6-day "disabled submarine" exercise. Aviat Space Environ Med. 2004;75:138-49 pubmed
    ..Atmospheric conditions can be controlled acceptably for 6 d, 18 h within the front compartment of an Ula-class submarine operating according to emergency SUBSUNK procedures. ..
  43. Myznikov I, Sadchenko S, Safronova K, Perminov D, Alanicheva G. [Applied significance of some morphological and functional parameters of health status in submariners]. Voen Med Zh. 2003;324:53-7 pubmed
  44. Suedfeld P, Steel G. The environmental psychology of capsule habitats. Annu Rev Psychol. 2000;51:227-53 pubmed
  45. Blogg S, Gennser M. The need for optimisation of post-dive ultrasound monitoring to properly evaluate the evolution of venous gas emboli. Diving Hyperb Med. 2011;41:139-46 pubmed
    ..Earlier and more prolonged measurement is recommended, while the frequency of measurements should also be increased; in doing so, the accuracy and value of studies dependent on bubble evolution will be improved. ..
  46. Castellani J, Francis J, Stulz D, Delany J, Hoyt R, Bovill M, et al. Body fluid regulation in a simulated disabled submarine: effects of cold, reduced O2, and elevated CO2. Aviat Space Environ Med. 2005;76:753-9 pubmed
    ..These data indicate that the combination of cold, low O2, and high CO2 for 5-7 d did not change total body water and hormone changes and urinary measures across the DISSUB were consistent with fluid retention. ..
  47. Connor C, Ferrigno M. Estimates of N2 narcosis and O2 toxicity during submarine escapes from 600 to 1,000 fsw. Undersea Hyperb Med. 2009;36:237-45 pubmed
    ..When DT in the escape trunk is very short (e.g., 10 s), the risk of either incapacitating N2 narcosis and/or O2-induced convulsions occurring in the trunk is low, even during escapes from 1,000 fsw...
  48. Jackman R, Schlichting C, Carr W, Dubois A. Prevalence of Helicobacter pylori in United States Navy submarine crews. Epidemiol Infect. 2006;134:460-4 pubmed
    ..These data demonstrate that submarine service (and by inference activity requiring isolation and close contact, per se) is not a risk factor for H. pylori infection. ..
  49. Deutsch W. Dental events during periods of isolation in the U.S. submarine force. Mil Med. 2008;173:29-37 pubmed
    ..Of the problems reported, 13.1% had a dental problem during the 101-day submergence, 9.8% had a canker sore, and 4.1% had a gum problem. ..
  50. Sandal G, Endresen I, Vaernes R, Ursin H. Personality and coping strategies during submarine missions. Hum Perf Extrem Environ. 2003;7:29-42 pubmed
    ..The findings suggest that interpersonal characteristics need to be considered in the selection of submariners and personnel for other military settings in which units are exposed to prolonged stress and isolation. ..
  51. Volk B. Evaluating the sex ratio in the offspring of U.S. Navy submariners. Mil Med. 2004;169:890-3 pubmed
    ..5% (p = 0.03). Smokers were noted to have a higher ratio of male offspring compared with non-smokers, although this finding was not statistically significant (p = 0.46). ..
  52. Apuzzo M, Pag√°n V, Faccio R, Liu C. A Bosphorus submarine passage and the reinvention of neurosurgery. World Neurosurg. 2013;79:40-52 pubmed publisher
  53. Devlin J. Evaluation of a contingency blood donor program on U.S. Navy submarines. Mil Med. 2004;169:292-7 pubmed
    ..This protocol provides blood for the reversal of hemorrhagic shock onboard submarines in the event of traumatic injury. ..