UHM 2018, Vol. 45, No.
1 – LETTERS: REGULATOR PERFORMANCE IN POLAR DIVING
Re: Evaluation of regulator performance in polar diving [1]
The authors describe an effort to evaluate regulator
performance during Antarctic diving [1]. This is an
important topic given the hazards associated with
breathing system compromise in extreme– particularly
extreme overhead – environments. There are several
issues, however, that must be addressed. The first is
a frank misstatement of our previously published
work [2]. The authors supported their finding of no
difference in failure rates with Sherwood regulators
with and without brass blocks by stating that we
reported no differences in second-stage temperature
with and without heat retention plates during a
previous polar regulator study. This is not true.
We reported significantly higher second-stage
temperatures when heat retention plates were present.
Significant differences were seen overall and, when
dives were separated by depth, in all but the shallowest
of four 30-foot ranges [2].
A second misstatement was that their report was
the first to find statistically significant groupings of
regulator performance. In fact, we documented
significantly better performance for the Sherwood
Maximus and Poseidon Thor against 17 other regulators
that had seen some use in the US Antarctic Program [3].
The shortcomings of the manuscript are not limited to
misstatement. There are additional foundational issues
that make some of the conclusions difficult to accept.
The paper claimed a secondary goal “to determine
whether body habitus contributes to regulatory
reliability in the extreme polar environment.” While
this is a laudable aspiration, it was not achieved
through this work. The effort reported relied on body
mass index (BMI) and body surface area (BSA) as key
indices. BMI is simply a height-to-weight ratio for an
individual (BMI = weight in kg/[height in m]2). BMI
is not a measure of body composition, and BMI values
can be heavily influenced by differences in both lean
and fat mass. Similarly, the prediction of body surface
Copyright © 2018 Undersea & Hyperbaric Medical Society, Inc.
Letters ✒
area is an old prediction with little practical utility. In
addition to BMI and BSA, the authors listed lean body
mass, percent body fat, basal oxygen consumption, and
predicted vital capacity (Table 1), but did not describe
how any of these values were determined. Ultimately,
BMI and BSA are extremely coarse measures unlikely to
have relevance, and if the other values were predicted
instead of being measured, they have virtually no value.
In any case, the methods used to generate all numbers
must be provided for the benefit of readers.
The authors stated that “all regulators experienced
the same diving conditions,” but then they focus on a
limited number of pre- and post-dive factors. It is far
more likely that diving conditions varied substantially,
for example, due to differences in dive depth, duration,
diver size, workload, individual ventilatory patterns,
and possibly outside temperatures and time on the sur-
face prior to water entry if any of the dives were
conducted from outside holes instead of from inside
huts. The information provided is insufficient to
address several critical questions, but it is certain that
the dives were not controlled. The potential impact
of variables not adequately captured should be
enumerated in a limitations section.
A critical problem with the interpretation seen in the
work is the arbitrary description of “acceptable” for
regulators with a substantial failure rate (<11%).
This does not make sense for critical life support
equipment. The reason that the Sherwood Maximus
served as a workhorse in the US Antarctic Program
for 20 years was its extremely low failure rate (<2%)
[2,3]. It performed badly in bench tests conducted
by the U.S. Navy Experimental Diving Unit, as can
be confirmed by the second author, but this really
highlights the need for both bench and field trials.
The Sherwood Maximus was not an easy-breathing
regulator, but a regulator that breathes reliably in polar
conditions is gold. ➠
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 UHM 2018, Vol. 45, No. 1 – LETTERS: REGULATOR PERFORMANCE IN POLAR DIVING
The need for ongoing testing is clear, and an awareness
that manufacturing changes can have unexpected
consequences is important. There is a fundamental
conflict between engineers trying to build extremely
easy breathing regulators and an environment in which
too much ease of breathing can promote earlier entry
into a cold-water failure cascade. The issues are
complex, and assessment requires proper research
design, capture of critical information, objective inter-
pretation of findings, and a clear acknowledgment of
the limitations of any effort.
The current report has value in identifying four
regulators associated with less than one free-flow in
60 dives. Further attention should be directed at
regulators with similarly high performance to refine
what should be the next workhorse regulators for polar
diving. New work is required to allow meaningful
comment on the contribution of the user to regulator
performance. Efforts that effectively combine bench
with properly designed field evaluations are strongly
encouraged.
___________________________________________________________________________________________________________________________________________
Re: Evaluation of regulator performance in polar diving – authors’ response
LETTER to the EDITOR/LTE Para. 1. In his first
paragraph, the writer claims that we misrepresented his
1995 non-peer-reviewed article. We could not disagree
more. In truth, we have long recognized a discrepancy
between what the 1995 paper reports, in terms of its
data, and what the authors claim. The authors claim
a highly significant (P<0.0001) difference between
internal temperatures in one regulator model with heat
retention blocks internal to the second stage, compared
to the same regulator without internal heat retention
blocks.
We commend the 1995 authors for attempting
measurement of second stage temperatures in the field.
That measurement is so fraught with difficulty that
NEDU only attempts it in the laboratory. However, even
casual inspection of Pollock’s Figures 1 through 3 reveal
the problem with his conclusion. In fact, the
present authors (Lang/Clarke) have had other
professionals attempt to understand the source of the
112
Neal W. Pollock, PhD
Université Laval
Québec, QC, Canada G1V 0A6
and
Service de médecine hyperbare
Centre de médecine de plongée du Québec
Hôtel-Dieu de Lévis
Lévis, QC, G6B 3Z1
Neal.Pollock@kin.ulaval.ca
References
1. Lang MA, Clarke JR. Performance of life support
breathing apparatus for under-ice diving operations.
Undersea Hyperb Med. 2017; 44(4): 299-308.
2. Mastro JG, Pollock NW. Sherwood Maximus
regulator temperature and performance during
Antarctic diving. In: Harper DE Jr, ed. Proceedings
of the 15th annual scientific diving symposium:
Diving for Science...1995. Nahant, MA: American
Academy of Underwater Sciences, 1995: 51-62.
3. Pollock NW, Mastro JG. A five-year review of
regulator performance in the US Antarctic Program.
Antc J US. 1996; 31(1): 24-26. ✦
P-value of <0.0001 based on the presented data,
without success. It seems highly implausible, as
described below.
If we perform an unpaired T-test on the overall data
shown by Pollock in the bottom line of his Table 7,
given only the mean temperatures and standard
deviation from Table 7, and assuming a sample size of
18 based on a pool of six divers, there is no statistical
difference between the two regulator treatments
(P > 0.11). Our statistical exercise assumes the measured
data was normally distributed. It may not have been,
but the authors say nothing about normality, so we are
left to wonder: 1) why they used a non-parametric test;
and 2) how a non-parametric rank order test could have
delivered such a significant P-value (P<0.0001) when a
parametric test showed no significance (P>0.05).
Using Monte Carlo methods, NEDU generated with
SigmaPlot (Systat Software) eight randomly sampled
Pollock NW vs. Lang MA, Clarke JR