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SCUBA A PRIMER FOR

TECH
TECHNICAL DIVING
DECOMPRESSION
PHILIPPINES THEORY

1|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


Sidemount, Technical & Wreck Guide | Andy Davis
First Published 2016

All documents compiled in this publication


are open-source and freely available on
the internet.

Copyright Is applicable to the named


authors stated within the document.

Cover and logo images are copyright to


ScubaTechPhilippines/Andy Davis.

Not for resale.

This publication is not intended to be used


as a substitute for appropriate dive
training. Diving is a dangerous sport and
proper training should only be conducted
under the safe supervision of an
appropriate, active, diving instructor until
you are fully qualified, and then, only in
conditions and circumstances which are as
good or better than the conditions in
which you were trained.

Technical scuba diving should be taught


by a specialized instructor with training
credentials and experience at that level of
diving. Careful risk assessment,
continuing education and skill practice
may reduce your likelihood of an accident,
but are in no means a guarantee of
complete safety.

This publication assumes a basic


understanding of diving skills and
knowledge. It should be used to
complement the undertaking of
prerequisite training on the route to
enrolling upon technical diving training.

2|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


This primer on decompression theory is designed as a
supplement to your technical diving training. Becoming
familiar with the concepts and terms outlined in this
document will enable you to get the most out of your theory
training with me; and subsequently enjoy safer, more
refined dive planning and management in your technical
diving activities.

I have collated several highly-regarded articles which explain


key concepts behind the design and use of the Bühlmann ZH-
L16 B/C GF algorithm. This algorithm is generally the
preferred decompression model in technical diving
computers and planning software.

If you need any help whilst self-studying this topic, please


don’t hesitate to contact me:

andy@scubatechphilippines.com

3|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


Contents
Gradient Factors - A Simplified Primer ................................................................................................................ 5

Flexible Control of Decompression ...................................................................................................................... 11

Gradient Factors .................................................................................................................................................... 15

History .............................................................................................................................................................. 15

Decompression Basics ..................................................................................................................................... 16

Tissue Saturation and Ascent Ceiling ............................................................................................................. 17

M-Values .......................................................................................................................................................... 19

Gradient Factors .............................................................................................................................................. 21

Practical Applications and Safe Diving Habits ............................................................................................... 24

Understanding M-Values ...................................................................................................................................... 28

What are M-Values? ....................................................................................................................................... 28

Historical Background ..................................................................................................................................... 29

The Workman M-Values ................................................................................................................................. 31

The Bühlmann M-Values................................................................................................................................. 32

DCAP And DSAT M-Values .............................................................................................................................. 34

Comparison of M-Values ................................................................................................................................ 34

Consistency of M-Values................................................................................................................................. 37

Format for M-Values ....................................................................................................................................... 37

M-Value Characteristics .................................................................................................................................. 37

The Ambient Pressure Line ............................................................................................................................. 38

The Decompression Zone ............................................................................................................................... 39

Multiple Inert Gases ........................................................................................................................................ 39

What Do M-Values Represent? ...................................................................................................................... 40

M-Values and Conservatism ........................................................................................................................... 42

M-Value Relationships .................................................................................................................................... 43

Analysis of Profiles .......................................................................................................................................... 44

Universal Reference Values ............................................................................................................................ 44

Margin of Safety .............................................................................................................................................. 46

4|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


Gradient Factors - A Simplified Primer
By Steve Lewis

This short article is based on a series of presentations made in various


locations during the late winter and spring of 2015, and is a shortened
version of a more detailed treatment to be included in an upcoming book.

Let’s start off with a disclaimer and an outline of some assumptions made
while working on this blog post.

First off, I did not start out intending to write a definitive piece on
decompression theory or on the stellar work of Professor Albert Bühlmann.
Also, this contains no detailed explanation of the internal workings of the
maths behind a decompression algorithm and the challenges it meets while
trying to model human physiology. Simply put, this was written to help the
average punter better understand what gradient factors describe; and the
potential impact of playing around with the GF settings on your personal dive
computer (for example, a Shearwater Petrel).

Secondly, I’ve made several assumptions… not the least of which is that
readers have a basic understanding what happens to an individual after
spending more than a couple of minutes sub-surface breathing compressed
gas. (That’s just another way of saying that I’m writing for certified and
reasonably experienced divers who understand that diving can result in
decompression stress of one flavor or another.)

OK, that settled, here we go.

All dives are decompression dives, ergo all divers are decompression divers.
Our acknowledgement of this and the depth of that acknowledgement can
greatly influence our behavior when we dive: most specifically, our ascent
behavior. How deep we dive, what gases we breathe, and how long we spend
at depth vary considerably from dive to dive; but all dives share one common
threat for individual divers: the risk of getting bent.
5|P ag e ©Andy Davis 2015 www.scubatechphilippines.com
Smart divers consider many factors when planning dives, many of which help
to alleviate that risk. One is choosing to dive a “conservative profile.” I guess
there are many interpretations of what that means… but for our purposes
here, it means choosing a decompression algorithm that’s proven, and
choosing a setting for that algorithm that will generate stress-tolerant dive
tables.

Many PDC (personal dive computers) use a Bühlmann ZHL-8 or ZHL-16


algorithm to model decompression stress in divers and their decompression
obligation on ascent. In a way this is odd because both deco models are not
only dated (Herr Doktor Professor Bühlmann died of heart failure in early
1994), but are based on the faulty premise that we can prevent bubbles from
forming in our bodies during our ascent if we follow the schedules the
algorithm kicks out.

The data set on all recreational diving, but in particular staged


decompression diving, has grown considerably since the Professor’s
unfortunate and untimely death, and we now have considerable evidence
that in fact bubbles do form even after the most benign sport dives
conducted well inside the boundaries suggested by Bühlmann’s tables. Some
newer decompression models make the assumption that bubbles do form in
a diver’s body during ascent and make adjustments to the maths which are
intended to control their growth and propagation. Many divers believe
bubble models better predict what goes on in a diver’s body and are
therefore, safer. VPM and RGBM are examples of “bubble models.” Versions
of both are available for use in PDCs.

Yet Bühlmann tables remain popular. They are in fact perfectly functional,
and are helping to keep tens of thousands of divers safe from the bends
every week. The secret is that with very simple tweaking, a Bühlmann
schedule can be made to follow a time-and-place curve very similar to those
produced by bubble models slowing ascent and beginning staged stops
deeper in the water column.

6|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


OK, a little very simple nuts and bolts discussion.

Traditional decompression algorithms – Bühlmann’s included – attempt to


model what happens in a diver’s body using a number of different
calculations each representing a different “theoretical tissue group:” and
each filling up with and emptying inert-gas at different speeds. Important to
note that these tissue groups are mathematical constructs and are not
directly related to any actual body tissue such as blood, bone, muscle or
brain. Those tissues – in fact all the tissues in a human body – are far too
complex in their architecture, component makeup and construction to fit into
any of the algorithm’s simplified tissue categories. The human body is a mass
of variables that defy the constraints of pure maths. So, individual “tissue
groups” don’t relate to a specific body part, but are a series of mathematical
calculations which as a whole attempt to track inert gas uptake and
elimination in vivo.

In Bühlmann’s ZHL-16 algorithm the fastest group has a four-minute halftime,


the slowest (the 16th in this particular series) has a 635-minute halftime.
Since we can regard a tissue group as saturated after six halftimes (standard
science stuff), the fastest group will be “full” in 24 minutes, while the slowest
takes 63 hours and 30 minutes to reach the same state! For the record, the
halftimes or the 14 other groups in the ZHL-16 algorithm are: 8, 12.5, 18.5,
27, 38.3, 54.3, 77, 109, 146, 187, 239, 305, 390, and 498 minutes.)

Clearly, Now that we have some concept of the relationship between variable
times and various group saturations, let’s look at M-values.

In the Bühlmann algorithm, each theoretical tissue group has a maximum


internal pressure it can withstand. This pressure is exerted by dissolved inert
gas and as long as the maximum is not exceeded, the gas stays in solution,
and no bubbles form… well, in theory.

7|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


Like Robert Workman before him, Bühlmann termed this maximum internal
pressure, its M-Value. Workman had coined the phrase while researching
decompression for the U.S. Navy in the 1960s.

His M-Value calculations were based on dives done at sea-level… perfectly


predictable for Navy work. Bühlmann’s modifications took into account
attitude and are slightly more conservative.

Like a tissue group, an M-Value is mathematics and not physiology, and it is


used to track how close a particular tissue group has become to super-
saturation (critical bubbling). When a tissue group reaches 100 percent of its
M-Value, the likelihood of decompression stress is statistically high.

And finally, gradient factors.

One can think of gradient factors (GF) as a way of adjusting the


decompression algorithm to suit our needs, and GF can range between 0 and
100 percent.

One hundred percent is the point where M-Value is on the verge of critical
bubbling (1), and zero percent is the same as ambient pressure (M-Value of 0
where there is no force driving gas out of solution at all). Therefore, effective
decompression can be found somewhere between those two points.

When one uses GFs to set the “conservatism” for one’s decompression, one
uses two numbers: these represent the Low Gradient Factor and the High
Gradient Factor.

In simply terms, the Low Gradient Factor (LGF) defines how deeply in the
water column one takes one’s first decompression stop. The High Gradient
Factor (HGF) defines how close to the 100 percent M-Value one surfaces with
at the end of the dive.

8|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


Obviously we need to set up some gradient to begin the process of off-
gassing (decompression). The slope of that gradient – how much pressure we
allow – is a matter of personal faith, comfort and willingness to act as a
guinea pig. This is the LGF and one option that seems to have been adopted
by many divers – and incidentally recommended by Dr. Neal Pollock from
DAN – is 30%.

This setting promotes off-gassing but stops one’s ascent deep in the water
column but above the gas transition point (the theoretical spot on the water
column at which more gas is eliminated than is taken up according to the
algorithm).

9|P ag e ©Andy Davis 2015 www.scubatechphilippines.com


Setting the HGF is a question of how close to the 100 percent M-Value limit
we are willing to venture. Many divers recommend and use 80 percent.
Again, Dr. Pollock’s suggestion is lower: 70 percent.

Therefore a 30/70 setting is considered by some, including me, to be an


acceptable default GF setting.

However, before forming a rigid interpretation of GFs: just as different speed


limits are applied to different road conditions, different GFs may be more
appropriate for different dives. A 30/70 may work for trimix dives to 60
metres but may be unnecessary conservative for a short warm-water dive to
18-metres… and not sufficiently conservative for deeper dives.

The message then is to experiment with Variable Gradient Factors when


planning your dives. Run what-if scenarios… Take notes… Alternatively, read
what people are doing and what organizations such as DAN suggest

Most of all, be aware, nobody and no organization can predict precisely the
outcome of any dive!

10 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Flexible Control of Decompression
By Dr Neal Pollock

Divers should know that while the decompression algorithms in dive


computers are great at measuring pressure-time profiles, they are blind to a
wide range of variables that affect decompression risk. The approximation of
decompression status predicted by current deterministic algorithms should
not be confused with 'truth,' even though they can provide reasonable
guidance under normal circumstances of relatively conservative exposures.
The next problem is determining what is really 'conservative.' The complex
interplay of exposure, individual status, and individual response makes it
difficult.

Divers who understand the inherent uncertainty in decompression modeling


and want to take a more active role in their own dive planning can use
available tools to tailor the limits to their needs or preferences. This is a good
choice for dynamic conditions or complex dives, when the goal of simply
staying away from limits gets hard to track. Gradient factors represent a good
tool to actively manage risk. This article complements a more complete
review of the topic.1

Decompression stress is largely determined by inert gas uptake and


elimination. The dive profile is clearly the chief determinant of this, but
thermal status and exercise intensity at various phases of a dive can have
major influence. Individual characteristics, which can increase or decrease
susceptibility to insult, play a complex wild card role. Since people rarely
know their sensitivity, on either a chronic or an acute basis, there is an
element of chance in the safety of any exposure.

Half-times, tissue compartments, and M-values are described in more detail


in the article mentioned previously.1 Briefly, half-times mathematically
describe the rate of inert gas equilibrium during exposure to elevated or
reduced pressure. Each half-time represents a theoretical tissue

11 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


compartment construct, not an actual tissue. A range of half-times, covering
fast through slow equilibration, is used to predict uptake and elimination of
gases throughout the body. Supersaturation is the state in which the gas
concentration (tension) in a tissue is higher than the surrounding pressure.
Supersaturation exists when a diver ascends and the ambient pressure falls.

The term 'maximum value,' or 'M-value,' was coined to describe the


theoretical level of supersaturation a tissue can tolerate before an orderly
elimination of inert gas is replaced with a disordered outcome. Individual
tissues may have different M-values and, in the fundamental sense, the
disordered outcome in any tissue can be thought of as a decompression
insult.

Experience has shown that bubbles can form and decompression sickness can
develop when supersaturation is within established M-value limits. This
indicates the imperfection of simple limits. In response, many dive computers
offer some degree of user-selectable conservatism. Conservatism can be
important for both physical safety and psychological comfort. The person
who believes himself or herself to be bends-resistant may be happy with
settings that would not be comfortable for a person less confident about
being bulletproof or one simply wanting additional peace of mind.

The actual effects of conservatism schemes are often poorly described by


manufacturers or marketers. Some even include poorly thought out
descriptions of conservatism levels that play on the vanity of divers, with
potentially adverse effects on decision-making. One conservatism construct,
gradient factors, stands as a method that is fairly easy to understand, easy to
quantify, and relatively free of descriptive bias.

Gradient factors, in the simplest sense, allow exposure limits to be adjusted


to become a fraction of other limits. The mathematical power of dive
computers allows numerous half-times to be tracked simultaneously, letting
any that reach the assigned limit become the leading, and effectively the
controlling compartment. Gradient factors are commonly applied to the

12 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Buhlmann algorithm, a well-researched set of decompression procedures
that were openly released to the community. The open release allowed for
all aspects of the algorithm to be studied carefully by many who ultimately
contributed to corrections in subsequently revised versions.

Gradient factors are typically applied in two steps. The first number (GFlow)
represents that percentage of the M-value used to determine the first stop
during ascent. The second number (GFhigh) is the percentage of the M-value
that cannot be exceeded at any point during surfacing. The dive computer
effectively draws a straight line between the two, creating the ascent slope.
The alteration of limits is applicable to both technical and non-technical
exposures.

Gradient factors adjust the limits displayed on the computer screen. Low
GFlow values (e.g., ≤20) are for those who believe in deep stops. Higher
GFlow values (e.g., ≥30) get divers off the bottom to reduce inert gas uptake
in tissues that are not saturated. Low GFhigh values (e.g., ≤70) limit the
maximal decompression stress experienced on the dive. High GFhigh values
(e.g., ≥80) get divers out of the water quickly.

13 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Fully adjustable gradient factors, which includes the ability to change GFhigh
during a dive, provide a great deal of control. If an unexpected amount of
work or excessive warmth was experienced during the descent or bottom
phase of a dive, GFhigh could be reduced to prolong the ascent. If part of a
critical gas supply was lost during the dive, GFhigh could be increased to
expedite the return to the surface.

One practical note is that adding extra shallow stop time is not the same as
reducing GFhigh. Extra shallow stop time will reduce the effective GF at the
point of surfacing, but higher effective GF values could have been reached
earlier during ascent. The impact of reducing GFhigh is greatest near the
surface, but it will moderate the ascent profile throughout. Extra shallow
stop time provides additional protection and is well worthwhile if time, gas,
and conditions allow.

The thoughtful and well-informed diver knows that conditions during a dive
affect real-time risk. Having a dive computer that can help manage exposures
to keep them within zones of comfort can also help ensure good outcomes
on every dive.

14 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Gradient Factors
By Matti Anttila, Ph.D.

Remember your first diving classes and the lesson about bubbling soda bottle
and too rapid ascents? No matter how deeply you study the decompression
theory, this soda bubble analogy is still valid. However, it’s time to introduce
some more fundamentals of the issue. But let’s start from the history:

History
Decompression theory is a relatively old science. Already in late 1800’s,
French physiologist Paul Bert (1833-1886) discovered decompression sickness
and the need for decompression stops and slow ascend speed. Bert also
studied the effects of oxygen to the humans, as he was more interested in
the physiological effects of mountaineering and hot air ballooning. He also
extended his studies to cover high pressure environments, and found out
later about oxygen toxicity.

Bert made a conclusion that high oxygen partial pressures affect humans
chemically, not mechanically, as he described the causes of Central Nervous
System (CNS) oxygen toxicity. When Bert studied air and nitrogen, he
correctly determined the cause of the Decompression Sickness (DCS) to be
caused by the nitrogen bubbles in the blood and other tissues (mechanical
effects). Bert also did experiments on recompression therapy and oxygen
administration in DCS cases. The most famous of Bert’s books is “La Pression
barometrique” 1 , published in 1878, which dealt with the human physiology
in low and high air-pressures.

While Bert laid the fundamentals to the decompression studies, it was John
Scott Haldane (1860-1936), a Scottish physiologist who approached the
problem of decompression theory with more scientific approach. In 1905,
Haldane was appointed by the Royal Navy to perform research about Navy’s
diving operations.

15 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


His focus was to study the decompression sickness and how it could be
avoided. Haldane performed several tests and studied the effects of
compressed air at depth, and in 1908 he published the results of his tests in
the Journal of Medicine 2. This article also contained his diving tables.

Haldane is considered to be the father of modern decompression theory. In


his research, he made an important conclusion that a diver could surface
from an indefinitely long 10m/33ft dive without DCS. From this result, he
determined that human body could tolerate pressure change with a factor of
2:1 (the pressure in 10m/33ft is 2 ATA, while on surface it is 1 ATA).

Later this number was refined to be 1.58:1 by Robert Workman. Workman


was an M.D. and decompression researcher in U.S. Navy during 1960’s. He
studied systematically the decompression model that was used in the U.S.
Navy and which was then based on Haldane’s research. In addition to refining
the tissue pressure ratio, Workman found out that the ratio varied by tissue
type (hence the term “tissue compartment” or TC, representing different
half-times, e.g. speed of gas dissolving) and depth.

Dr. Albert A. Bühlmann (1923-1994) from Zürich developed decompression


theory further. During his long research career, he extended the number of
tissue compartments to 16, which was the basis of his ZH-L16 decompression
model (“ZH” as Zürich, “L” as Linear and “16” for the number of TCs). The first
set of ZH-L16 tables was published in 1990 (previous tables 3, published
earlier, contained smaller amount of TCs).

Decompression Basics
Let’s start from basics: A diver goes down and breathes compressed air from
his/her cylinder. Air contains nitrogen, which, as an inert gas, dissolves into
the diver’s tissues. When the diver starts ascending, the ambient pressure
decreases and dissolved nitrogen transfers from other tissues to the blood,
from there to the lungs and finally leaves the body with each exhale cycle.
Simple as that, is it?

16 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


In recreational diving, no decompression dives are being conducted. Divers
are told to stay within their no-decompression limits (NDL) of bottom time.
This NDL is shown in diving tables, and besides that, divers must stay within
certain ascent speed. This information is generally enough for most divers,
but what is the case when we exceed the NDL and start accumulating
decompression time?

Tissue Saturation and Ascent Ceiling


When we dive, we always have an invisible ceiling above us. This ceiling is a
depth, which we can ascend to without getting DCS symptoms (generally
speaking). The ceiling is based on the amount of dissolved inert gas in our
tissues.

Figure 1 represents a typical decompression dive profile with multiple


decompression stops. Before the dive, your “ceiling” is in fact negative depth
(above surface), meaning that your tissues could tolerate certain
overpressure gradient.

Figure 1: A typical decompression dive profile with ceiling line visible.


Numbers represent different phases (see phases also in Figure 2).

17 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


As the run time increases and diver spends time at the bottom, the ceiling
depth goes down and starts limiting the ascent possibilities, generating the
need for decompression. In fact, some decompression software indicates the
ceiling depth when user types in the desired dive levels. Diving computers
indicate the ceiling as the deepest required decompression depth.

When the ascent starts, the diver cannot ascend above the ceiling without
risking the possibility of decompression sickness. The decompression stops
are clearly visible in the dive profile when the line goes below the ceiling
depth. The closer one goes to the ceiling, the less margin of safety remains.

The ceiling depth does not yet indicate on-gassing or off-gassing. Bühlmann
used 16 tissue compartments to model inert gas dissolving in our body. These
compartments either take more dissolved gas in (on-gassing) or expel
dissolved gas out (off-gassing).

The ceiling depth indicates the pressure change from current depth, in which
the leading compartment off-gasses so fast, that further increased pressure
drop would risk the possibility of DCS.

Figure 2 (below) illustrates these 16 tissue compartments during the dive,


presented in Figure 1. A tissue compartment (TC) has reached its saturation
point when it is 100% full.

During the ascent phase, a TC can go supersaturated (exceed 100%). The key
of the decompression is to be supersaturated, but not so much that the
dissolved gas would form excess bubbles to our tissues and blood.

As shown, the amount of dissolved gas, or specifically the partial pressure of


the dissolved inert gas in our tissues, tends to follow the ambient pressure in
which we are during the dive.

The bigger the pressure difference (i.e. pressure gradient), the faster the gas
dissolves, in both directions. This leads to an obvious question: Why not just
come up? What are the limits of supersaturation, and how are they defined?

18 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Figure 2: An example of inert gas loading in tissues. Pressure in tissue
compartment is indicated as percents, 100% being ambient pressure.

M-Values
Back to the history: Robert Workman introduced the term M-value, which
means Maximum inert gas pressure in a hypothetical tissue compartment
which it can tolerate without DCS. As mentioned, Haldane found out in his
research that M-value is 2, and Workman refined it to be 1.58 (this number
comes from pressure change from 2 ATA to 1 ATA, and taking into account
that air has 79% inert gases, mainly nitrogen).

19 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Workman determined the M-values using depths (pressure values) instead of
ratios of pressure, which he then used to form a linear projection as a
function of depth. The slope of the M-value line is called ΔM (delta-M) and it
represents the change of M-value with a change in depth (depth pressure).

Bühlmann used the same method than Workman to express the M-values,
but instead of using the depth pressure (relative pressure), he used absolute
pressure, which is 1 ATA higher at depth. This difference is shown in Figure 3,
where Workman’s M-value line goes above Bühlmann’s M-value line.

Figure 3: Comparison of different M-value lines.

20 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Figure 3 shows a comparison between Workman and Bühlmann M-value
lines. A more detailed explanation can be found in literature 4, but it is easy
to spot the greatest differences: while Workman M-value line is steeper than
Bühlmann M-value line, there is also less margin for safety. Workman M-
values also allow higher supersaturation than Bühlmann’s.

To make things a bit more complex, it should be noted that while the M-
values vary by tissue compartment, also two sets of M-values are used for
each TC; M0-values (of depth pressure, indicating surfacing pressure. M0 is
pronounced “M naught”) and M-values of pressure ratio (ΔM, “delta-
M” values).

Workman defined the relationship of these different M-values as:

These sets of values are listed in literature 4. However, they concern the
same thing: maximum allowed overpressure of the tissue compartments. It is
also important to know, that decompression illness does not exactly follow
the M-values. More sickness occurs at and above the pressures represented
by the M-values, and less sickness occurs when divers stay well below the M-
values.

Gradient Factors
Gradient Factors are meant to offer conservatism settings for Bühlmann’s
decompression model.

As mentioned in the previous chapter, M-value line sets a limit which is not
supposed to be exceeded during ascent and decompression. However, as no
decompression model can positively prevent all DCS cases, and because both
dives and divers are individual, additional safety margin should be applied.

21 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


As shown in Figure 3, ascent and decompression occurs between the M-value
line and Ambient Pressure line. Inert gas pressure in tissue compartments
must exceed the ambient pressure to enable off-gassing.

On the other hand, we do not want to go too close to the M-value line for
safety reasons. Gradient Factors define the conservatism here.

The Gradient Factor defines the amount of inert gas supersaturation in


leading tissue compartment.

Thus, GF 0% means that there is no supersaturation occurring and inert gas


partial pressure equals ambient pressure in leading compartment

(Note: The leading TC is not necessarily the fastest TC!).

GF 100% means that decompression is being done in a situation where the


leading TC is at its Bühlmann’s M-value line and risk for DCS is far greater
than using lower GF.

(Note: Sometimes, especially in equations and calculations, GF’s may be


numbered as 0.00 … 1.00 instead of percentage. However, these are
effectively the same thing as 100% = 1)

Some diver’s did not like the idea of using the same conservatism factor
throughout the ascent. Instead of having one GF, there was need to change
the safety margin during the ascent. This led to two GF values; “GF Low” and
“GF High”.

Low Gradient Factor defines the first decompression stop, while High
Gradient Factor defines the surfacing value. Using this method, the GF
actually changes throughout the ascent.

22 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Figure 4: One-tissue model of decompression. Graph starts from top right and
goes left down, staying between the ambient pressure line and Gradient
Factor (GF) line. GF line stays below the M-value line and forms the safety
margin for the decompression. Pure Bühlmann decompression would follow
the M-value line (GF 100/100).

This is illustrated in Figure 4, where GF Low and GF High forms start and end
points to a Gradient Factor line. In that graph, decompression starts when
the inert gas partial pressure in diver’s TC’s reaches 30% of the of the way
between Ambient Pressure line and M-value line.

Then the diver spends time in that stop until partial pressure drops in the
TC’s enough for enabling ascent to next stop, which again has a bit higher GF.

23 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


These two GF values are often written as “GF Low-% / High-%”, e.g. GF 30/80,
where 30% is GF Low value and 80% GF High value.

Practical Applications and Safe Diving Habits


No decompression model can positively prevent divers getting hit. M-values
do not represent any hard line between “no DCS symptoms” and “getting
hit”.

In fact, modern decompression science has proven that there are bubbles
present in our tissues even when there are no DCS symptoms after a dive.
Therefore, M-values neither represent a bubble-free situation,
but tolerable amount of “silent” bubbles in tissues.

Figure 5: Silent bubbles are present in our tissues even when no DCS
symptoms are present. It is important to know personal safety margin and
individual susceptibility to DCS.

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It is important to understand that certain dives and different people may
need different safety margins. Therefore it is good to know the practical
differences between dive plans where different Gradient Factors are used.
Let’s take another example:

A diver goes to 50m/165ft for 20 minutes bottom time, using Trimix 18/45
(18% oxygen, 45% helium) as back gas, and oxygen for decompression from
6m (20ft) on. Descent rate is 15m/min (50ft/min) and ascent rate is 10m/min
(33ft/min). Decompression algorithm is based on Bühlmann ZH-L16B and the
different decompression tables, based on five different GFs, are shown in
Table 1.

Table 1: Decompression tables for 50m (165ft) / 20min using different


Gradient Factors

These GF parameters are commonly used for different types of dives (e.g.
rebreather, deep/cold dives, default values in some decompression SW) and
GF 100/100 is shown here as a reference, since it is pure Bühlmann table
(containing no margin, so it is also not very safe!).

As clearly shown in Table 1, low GF Low numbers generate deeper stops. In


fact, some divers use GF Low value of 10% to generate “deep stops” 5. Deep
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stops, also called “Pyle stops”, are a means to reduce micro bubbles during
deeper phase of ascent. However, during deep stops, many slower tissues are
still on-gassing and thus total decompression time will increase (but again,
safety is worth for some added hang-time!).

It is easy to modify the dive plan even drastically by using different gradient
factors.

Most modern decompression software provides either conservatism settings


(in verbal terms or numbers) or gradient factors. A diver can modify the total
dive time easily by even tens of minutes with these settings, not to mention
also the decompression gas needed.

But this is also a pitfall; consider a situation where decompression software


indicates that you need an intermediate decompression mix fill pressure
which is just above your cylinder capacity (including margins).

Now, an easy but dangerous choice would be altering the gradient factors so
that the decompression time decreases, leading to lower decompression gas
need.

Divers using computers, which have user-configurable gradient factors,


should understand how modifying their GF’s will affect to their
decompression profiles.

Too many divers simply use the default settings or copy their GF parameters
from other divers or even from the Internet, no matter what kind of a dive
they are doing.

Some divers have higher susceptibility to DCS and some dives are physically
more demanding than others. Although the gradient factor method provides
substantial flexibility in controlling the decompression profiles and thus the
dive plan and gas logistics, it just might be worth to hang there a bit longer
sometimes.

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As always in diving, it remains YOUR responsibility to choose the gradient
factors and conservatism appropriate for you!

REFERENCES

 Bert, Paul: La Pression barométrique, recherches de physiologie expérimentale, 1878


 Boycott, A.E., Damant, G.C.C., and Haldane, J.S: The Prevention of Compressed Air
Illness, The Journal of Medicine (Journal of Hygiene, Volume 8, (1908), pp. 342-443.)
 Bühlmann, Albert A.: Decompression – Decompression Sickness. Berlin: Springer-
Verlag, 1984.
 Baker, Erik C.: Understanding M-values
 Baker, Erik C.: Clearing Up The Confusion About "Deep Stops"

27 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Understanding M-Values
By Erik C. Baker

In conjunction with an array of hypothetical "tissue" compartments, gas


loading calculations and M-values compose the major elements of the
dissolved gas or "Haldanian" decompression model.

Through the use of widely-available desktop computer programs, technical


divers rely on this model for their decompression safety.

A good understanding of M-values can help divers to determine appropriate


conservatism factors and evaluate the adequacy of various decompression
profiles for a particular dive.

What are M-Values?


The term "M-value" was coined by Robert D. Workman in the mid-1960's
when he was doing decompression research for the U.S. Navy Experimental
Diving Unit (NEDU). Workman was a medical doctor with the rank of Captain
in the Medical Corps of the U.S. Navy.

The "M" in M-Value stands for "Maximum."

For a given ambient pressure, an M-value is defined as the maximum value of


inert gas pressure (absolute) that a hypothetical "tissue" compartment can
"tolerate" without presenting overt symptoms of decompression sickness
(DCS).

M-values are representative limits for the tolerated gradient between inert
gas pressure and ambient pressure in each compartment.

Other terms used for M-values are "limits for tolerated overpressure,"
"critical tensions," and "supersaturation limits." The term M-value is
commonly used by decompression modelers.
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Historical Background
In the dissolved gas or "Haldanian" decompression model, gas loading
calculations for each hypothetical "tissue" compartment are compared
against "ascent limiting criteria" to determine the safe profile for ascent.

In the early years of the model, including the method developed by John S.
Haldane in 1908, the ascent limiting criteria was in the form of
"supersaturation ratios."

For example, Haldane found that a diver whose "tissues" were saturated by
breathing air at a depth of 33 fsw could ascend directly to the surface (sea
level) without experiencing symptoms of DCS.

Because the ambient pressure at 33 fsw depth is twice that at sea level,
Haldane concluded that a ratio of 2:1 for tolerated overpressure above
ambient could be used as the ascent limiting criteria.

This approximate ratio was used by Haldane to develop the first


decompression tables. In later years, and up until the 1960's, other ratios
were used by various modelers for the different halftime compartments.

Most of the U.S. Navy decompression tables were calculated using this
supersaturation ratio method.

However, there was a problem. Many of the tables produced by this method
were deficient when it came to deeper and longer dives.

Robert Workman began a systematic review of the decompression model


including previous research that had been performed by the U.S. Navy. He
arrived at some important conclusions.

First of all, he recognized that Haldane's original ratio of 2:1 (based on air)
was really a ratio of 1.58:1 if you considered only the partial pressure of the
inert gas in air - nitrogen.

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[By that time in decompression research it was known that oxygen was not a
significant factor in DCS; it was the inert gases like nitrogen and helium that
were the culprits.]

In his review of the research data,


Workman found that the "tissue
ratios" for tolerated overpressure
varied by halftime compartment
and by depth.

The data showed that the faster


halftime compartments tolerated a
greater overpressure ratio than the
slower compartments, and that for
all compartments the tolerated
ratios became less with increasing
depth.

Then, instead of using ratios,


Workman described the maximum
tolerated partial pressure of
nitrogen and helium for each
compartment at each depth as the
"M-value."

Next, he made a "linear projection"


of these M-values as a function of
depth and found that it was a
reasonably close match to the
actual data. He made the
observation that "a linear
projection of M-values is useful for
computer programming as well."

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The Workman M-Values
Workman's presentation of M-values in the form of a linear equation was a
significant step in the evolution of the dissolved gas decompression model.

His M-values established the concept of a linear relationship between depth


pressure [or ambient pressure] and the tolerated inert gas pressure in each
"tissue" compartment. This concept is an important element of the
presentday dissolved gas model as applied by a variety of modelers.

Workman expressed his M-values in the slope intercept form of a linear


equation (see Figure 1). His surfacing value was designated MO [pronounced
"M naught"]. This was the intercept value in the linear equation at zero depth
pressure (gauge) at sea level. The slope in the linear equation was designated
DM [pronounced "delta M"] and represented the change in M-value with
change in depth pressure.

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The Bühlmann M-Values
Professor Albert A. Bühlmann, M.D., began doing decompression research in
1959 in the Laboratory of Hyperbaric Physiology at the University Hospital in
Zürich, Switzerland.

Bühlmann continued his research for over thirty years and made a number of
important contributions to decompression science. In 1983 he published the
first edition (in German) of a successful book entitled Decompression _
Decompression Sickness.

An English translation of the book was published in 1984. Bühlmann's book


was the first nearly complete reference on making decompression
calculations that was widely-available to the diving public.

As a result, the "Bühlmann algorithm" became the basis for most of the
world's in-water decompression computers and do-it-yourself desktop
computer programs.

Three more editions of the book were published in German in 1990, 1993,
and 1995 under the name Tauchmedizin or "Diving Medicine." [An English
translation of the 4th Edition of the book (1995) is in preparation for
publication].

Bühlmann's method for decompression calculations was similar to the one


that Workman had prescribed. This included M-values which expressed a
linear relationship between ambient pressure and tolerated inert gas
pressure in the hypothetical "tissue" compartments.

The major difference between the two approaches was that Workman's M-
values were based on depth pressure (i.e. diving from sea level) and
Bühlmann's M-values were based on absolute pressure (i.e. for diving at
altitude).

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This makes sense, of course, since Workman was concerned with the diving
activities of the U.S. Navy (presumably performed at sea level) while
Bühlmann was concerned with diving activities in the high mountain lakes of
Switzerland.

Bühlmann published two sets of M-values which have become well-known in


diving circles; the ZH-L12 set from the 1983 book, and the ZH-L16 set(s) from
the 1990 book (and its later editions). The "ZH" in these designations stands
for "Zürich" (named after his hometown), the "L" stands for "limits," and the
"12" or "16" represents the number of pairs of coefficients (M-values) for the
array of half-time compartments for helium and nitrogen. The ZH-L12 set has
twelve pairs of coefficients for sixteen half-time compartments and these M-
values were determined empirically (i.e. with actual decompression trials).

The ZH-L16A set has sixteen pairs of coefficients for sixteen half-time
compartments and these M-values were mathematically-derived from the
half-times based on the tolerated surplus volumes and solubilities of the inert
gases. The ZH-L16A set of M-values for nitrogen is further divided into
subsets B and C because the mathematically-derived set A was found
empirically not to be conservative enough in the middle compartments.

The modified set B (slightly more conservative) is suggested for table


calculations and the modified set C (somewhat more conservative) is
suggested for use with in-water decompression computers which calculate in
real-time.

Similar to the Workman M-values, the Bühlmann M-values are expressed in


the slope-intercept form of a linear equation (see Figure 1). The Coefficient a
is the intercept at zero ambient pressure (absolute) and the Coefficient b is
the reciprocal of the slope. [Note: the Coefficient a does not imply that
humans can withstand zero absolute pressure! This is simply a mathematical
requirement for the equation. The lower limit for ambient pressure in the
application of the Bühlmann M-values is on the order of 0.5 atm/bar.]

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DCAP And DSAT M-Values
Many technical divers will recognize the 11F6 set of M-values used by
Hamilton Research's Decompression Computation and Analysis Program
(DCAP). This set or "matrix" of M-values was determined by Dr. Bill Hamilton
and colleagues during development of new air decompression tables for the
Swedish Navy.

In addition to air diving, the 11F6 M-values have worked well for trimix diving
and are the basis for many custom decompression tables in use by technical
divers.Many sport divers are familiar with the Recreational Dive Planner
(RDP) distributed by the Professional Association of Diving Instructors (PADI).

The M-values used for the RDP were developed and tested by Dr. Raymond E.
Rogers, Dr. Michael R. Powell, and colleagues with Diving Science and
Technology Corp. (DSAT), a corporate affiliate of PADI. The DSAT M-values
were empirically verified with extensive in-water diver testing and Doppler
monitoring.

Comparison of M-Values
Tables 1 thru 4 (below) present a comparison of M-values for nitrogen and
helium between the various Haldanian decompression algorithms discussed
in this article. All M-values are presented in Workman-style format. An
evolution or refinement in the M-values is evident from Workman (1965) to
Bühlmann (1990).

The general trend has been to become slightly more conservative. This trend
reflects a more intensive validation process (empirical testing) and includes
the use of Doppler ultrasound monitoring for the presence and quantity of
"silent bubbles" (bubbles which are detectable in the circulation but are not
associated with overt symptoms of decompression sickness).

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Consistency of M-Values
One observation that can be made about the comparison between the M-
values of the various algorithms is that there is not a great difference
between them.

In other words, there appears to be a certain consistency between the values


determined by various independent researchers around the globe. This is a
good sign as it indicates that the science has determined a relatively
consistent threshold for symptoms of decompression sickness across the
human population.

Format for M-Values


M-values are often expressed in the form of a linear equation as in the
Workman-style or the Bühlmann-style.

This format is ideal for computer programming since it allows the M-values to
be calculated "on-the-fly" as they are needed. The linear format permits the
display of M-value lines on the pressure graph as well.

M-values can also be expressed in the form of a matrix or table. This is simply
where the M-values for each half-time compartment and each stop depth are
pre-calculated and arranged in columns and rows.

This format is useful for detailed comparisons and analysis. Some of the early
dive computers and desktop computer programs used the table format to
"look up" M-values for each stop during the calculation process.

M-Value Characteristics
M-value sets can be classified into two categories, no-decompression sets
and decompression sets. No-decompression M-values are surfacing values
only.

The DSAT RDP M-values are an example. No-stop dive profiles are designed
so that the calculated gas loadings in the compartments do not exceed the
surfacing M-values. This allows for direct ascent to the surface at any time
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during the dive. Some no-decompression algorithms account for ascent and
descent rates in the calculations.

Decompression M-values are characterized by having a slope parameter


which determines the change in M-value with change in ambient pressure.
The value of the slope parameter will vary depending on the half-time of the
hypothetical "tissue" compartment. Generally, faster half-time
compartments will have a greater slope than slower half-time compartments.

This reflects the observation that faster compartments tolerate greater


overpressure than slower compartments. If the slope is greater than 1.0 then
the M-value line "expands" on the pressure graph and that compartment will
tolerate greater overpressure gradients with increasing depth.

A fixed slope of 1.0 means that the compartment will tolerate the same
overpressure gradient regardless of depth. In all cases, the value of the slope
can never be less than 1.0. Otherwise, the M-value line would cross under
the ambient pressure line at some point and this would represent an illogical
situation whereby the compartment could not tolerate even the ambient
pressures.

The Ambient Pressure Line


The ambient pressure line is an all-important reference line on the pressure
graph. Passing through the origin, it has a slope of 1.0 and simply represents
the collection of points where the compartment inert gas loading will be
equal to ambient pressure.

This is important because when the inert gas loading in a compartment goes
above the ambient pressure line, an overpressure gradient is created. An M-
value line represents the established limit for tolerated overpressure gradient
above the ambient pressure line.

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The Decompression Zone
The "decompression zone" is the region on the pressure graph between the
ambient pressure line and the M-value line (see Figure 3). Within the context
of the dissolved gas model, this zone represents the functional area in which
decompression should take place.

In theory, a positive gradient above ambient pressure of some magnitude is


required in order for a compartment to "off-gas" or "decompress" in an
optimum manner. Depending on the fraction of oxygen in the mix, a
compartment may still be able to off-gas even though the total inert gas
partial pressure is less than ambient pressure.

However, an "efficient" decompression profile is characterized by leading


compartment gas loadings which plot within the decompression zone. The
gas loadings for various half-time compartments will cross into and then out
of the decompression zone during the decompression profile depending
upon which compartment is "leading" or "controlling" at the time.

Generally, the faster compartments will cross into the decompression zone
first and be leading (gas loadings closest to M-value lines) and then the rest
of the decompression profile will be controlled by the slower compartments
in sequence.

Multiple Inert Gases


Present-day dissolved gas models employ a concept for multiple inert gases
which states that the total inert gas pressure in a hypothetical "tissue"
compartment is the sum of the partial pressures of the inert gases present in
the compartment, even though the various inert gases each have a different
half-time for that compartment.

Mixed gas decompression algorithms must deal with more than one inert gas
in the breathing mix, such as helium and nitrogen in trimix. M-values for this
situation are handled differently by the various algorithms. Some

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methodologies use the same M-values for both nitrogen and helium; usually
they are based on the M-values for nitrogen.

In the Bühlmann algorithm, an intermediate M-value is calculated which is an


adjustment between the separate M-values for nitrogen and helium based
on the proportion of these inert gases present in the compartment.

In the M-value linear equation, the Coefficient a (He+N2) and the Coefficient
b (He+N2) are computed in accordance with the partial pressures of helium
(PHe) and nitrogen (PN2) as follows:

a (He+N2) = [a (He)×PHe + a (N2)×PN2] / [PHe + PN2];

b (He+N2) = [b (He)×PHe + b (N2)×PN2] / [PHe + PN2].

What Do M-Values Represent?


A misconception among some divers is that M-values represent a hard line
between "getting the bends" and "not getting the bends."

This might explain why some divers routinely push the limits of their tables or
dive computer.

The experience of diving medicine has shown that the established limits (M-
values) are sometimes inadequate. The degree of inadequacy is seen to vary
with the individual and the situation.

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Accordingly, it may be more appropriate to describe an M-value as "a solid
line drawn through a fuzzy, gray area" (see Figure 2). The reasons for this lack
of definitude involve complex human physiology, variations among
individuals, and predisposing factors for decompression sickness.

Overall, the dissolved gas model has worked well for divers and the
knowledge base has continued to grow. For example, it was originally
presumed that all inert gas had to remain dissolved in solution and that any
bubbles were indicative of DCS.

However, we now know that silent bubbles are present even during
symptom-free dives. Thus, the reality is that there is a combination of two
conditions during a dive _ most of the inert gas presumably in solution and
some of the inert gas out of solution as bubbles. An M-value, therefore,

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represents not only a tolerable overpressure gradient, but a tolerable
amount of bubbles as well.

Overall, the M-values are empirically verified, meaning that actual


decompression trials are carried out with human subjects. These tests are
conducted with a relatively small number of subjects intended to represent
the much larger population of divers.

Even though good data is obtained about the approximate threshold for
symptoms of decompression sickness (M-values), this process cannot
accurately predict or guarantee an absolute threshold for everyone.

Also, we know from experience that certain factors are predisposing for DCS:

- Lack of physical conditioning, - Dehydration


- Fattiness - Very cold water
- Fatigue - Patent foramen ovale (PFO)
- Drugs/alcohol Over-exertion

Individual susceptibility can vary on a daily basis as well.

M-Values and Conservatism


Limited symptoms, if any, and a reasonably low level of risk are associated
with M-values. This criteria, however, may not be entirely acceptable to all
divers.

Many divers would like to be in the range of "no symptoms" and "very low
level of risk" when it comes to their decompression profiles. Fortunately, it is
well understood among decompression modelers and programmers that
calculations based on the established M-values alone cannot produce
sufficiently reliable decompression tables for all individuals and all scenarios.

This is why decompression programs provide for a means of introducing


conservatism into the calculations.

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Some of the methodologies include increasing the inert gas fractions used in
the calculations, applying a depth safety factor which calculates for a deeper-
than-actual dive depth, calculating for a longer-than-actual bottom time, and
adjusting the half-times to be asymmetrical during off-gassing (slower). Some
programs use more than one of these methods combined.

These methodologies for conservatism are effective when properly applied.


The degree of "effectiveness" is usually gauged by divers in terms of how
much longer and deeper the decompression profiles become, and through
individual experience with the outcome of the profiles.

M-Value Relationships
Some fundamental relationships involving M-values and decompression
calculations are indicated on the pressure graph in Figure 3

.
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The Percent M-value calculation has been used by various decompression
modelers over the years. Professor Bühlmann, for example, evaluated many
of his decompression trials on a Percent M-value basis and reported the data
as such in his book(s).

The Percent M-value Gradient calculation is a measure of how far a


decompression profile has entered into the decompression zone. 0% M-value
Gradient is at the ambient pressure line and represents the bottom of the
decompression zone. 100% M-value Gradient is at the M-value line and
represents the top of the decompression zone.

Analysis of Profiles
Many divers would like to know precisely what the effect is of the
conservatism factors in their desktop decompression program(s). They realize
that longer and deeper profiles are generated with increasing conservatism
factors, but more fundamental information is desired.

Both the Percent M-value and Percent M-value Gradient relationships are
useful for the analysis and evaluation of decompression profiles. Using a
standard set of reference M-values, different profiles can be evaluated on a
consistent basis. This includes comparison of profiles generated by entirely
different programs, algorithms, and decompression models.

Universal Reference Values


The Bühlmann ZH-L16 M-values are employed in most, if not all, of the
desktop decompression programs in use by technical divers. These M-values
were developed and tested for a broad range of ambient pressure exposures;
from high altitude diving to deep sea diving.

When used with appropriate conservatism, they have proven to be "reliable"


for technical diving (to the extent that something can be reliable in an inexact
science). They have become the de facto world-wide standard that can serve
as universal reference values for the comparison and evaluation of
decompression profiles.

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It is a relatively easy task for programmers to include Percent M-value and
Percent M-value Gradient calculations in summary form with the
decompression profiles.

Table 5 is an example of this and shows the effect of conservatism factors


used in a commercially-available desktop decompression program. At 0%
Conservatism Factor, the decompression profile is in the 90% M-value range
and has entered approximately 70% into the decompression zone (70% M-
value Gradient).

It is evident that this program employs a level of baseline conservatism since


none of the values reaches 100%. At 50% Conservatism Factor (which is
recommended in the user's manual), the profile is in the 85% M-value range
and has entered approximately 40-50% into the decompression zone.

At 100% Conservatism Factor, the profile is in the 77% M-value range and has
entered approximately 20-35% into the decompression zone. Note that the
values given in Table 5 are upon arrival the respective stops which is the
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worst-case condition. This correlates with the edges of the "stair-steps" in the
gas loading profile on the pressure graph (see example in Figure 3).

The highest values across all profiles are calculated upon arrival at the
surface which illustrates why a very slow final ascent from the last
decompression stop to the surface is always prudent.

Margin of Safety
Using the M-value relationships and a standard set of reference M-values,
divers can determine personal decompression limits which are both well-
defined and transportable. The margin of safety selected will depend on
individual disposition and prior experience with profiles.

An honest assessment of one's fitness for decompression diving is always in


order. For example, this author/diver (an office worker) has chosen a
personal limit of 85% M-value and 50-60% M-value Gradient for typical trimix
dives.

To ensure a fixed margin of safety, a decompression profile can be calculated


directly to a predetermined percentage of the M-value Gradient. The
advantage of this approach is complete consistency across the entire ambient
pressure range and precise control over the resultant profile.

About the Author

Erik C. Baker is an electrical engineer with an architecture/engineering firm in


Pennsylvania. He pursues research into decompression and diving physiology
as a hobby, and has developed several FORTRAN computer programs for
decompression calculation and analysis. Erik is a certified cave diver and
trimix diver.

46 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com


Decompression References:

- Bennett PB, Elliott DH, eds. 1993. The physiology and medicine of diving. London: WB
Saunders.
- Boycott AE, Damant GCC, Haldane JS. 1908. The prevention of compressed air illness. J
Hyg (London) 8:342-443.
- Bühlmann, AA. 1984. Decompression_ Decompression sickness. Berlin: Springer-
Verlag.Bühlmann, AA. 1995. Tauchmedizin. Berlin: Springer-Verlag.
- Hamilton RW, Muren A, Röckert H, Örnhagen H. 1988. Proposed new Swedish air
decompression tables. In: Shields TG, ed. XIVth Annual Meeting of the EUBS. European
Undersea Biomedical Society. Aberdeen: National Hyperbaric Center.
- Hamilton RW, Rogers RE, Powell MR, Vann RD. 1994. Development and validation of no-
stop decompression procedures for recreational diving: The DSAT Recreational Dive
Planner. Santa Ana, CA: Diving Science and Technology Corp.
- Schreiner HR, Kelley PL. 1971. A pragmatic view of decompression. In: Lambertsen CJ, ed.
Underwater Physiology IV. New York: Academic Press.
- Wienke BR. 1991. Basic decompression theory and application. Flagstaff, AZ: Best
Publishing Co.
- Wienke BR. 1994. Basic diving physics and applications. Flagstaff, AZ: Best Publishing Co.
- Workman RD. 1965. Calculation of decompression schedules for nitrogen-oxygen and
helium-oxygen dives. Research Report 6-65. Washington: Navy Experimental Diving Unit.
- Workman RD. 1969. American decompression theory and practice. In: Bennett PB, Elliott
DH, eds. The physiology and medicine of diving and compressed air work. London:
Baillière, Tindall & Cassell.

Good luck, safe diving


….and see you soon!

Andy
47 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com

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