Asthma Research Online Survey

All Data presented here is Medical - in - Confidence and will be used solely for research purposes only

Name:

Country: ———Age:

Email:

Gender: Male Female

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Diving Profile

1. No. of previous dives (if '0' = New to sport)

2. No. of dives per year

3. Depth of Dives

• Max Depth

• Min Depth

• Ave Depth

4. No.of years of diving experience

5. Age of starting to learn to dive

6. Year started to learn to dive

7. Grade of dive & year obtained Open Water Advanced Open water Rescue Dive Master Instructor Others:

Year obtained

8. Training Agency PADI SSI NAUI BSAC Others :

Diving practices

9. Have you ever performed Free Ascent Air Share Free Ascent + Air Share

Asthma Profile

10. Asthma in childhood Adolescence Age of onset :

11. Trigger factors (Please tick all that apply)

Exercise

Pollen

Cold air

Cold infections

Cold air and exercise

Emotions

Animals

Dust mites

Alcohol

Others (Please Specify)

12. Pre-dive Managment ( Plseas tick all that apply)

Preventer only

Reliever only

Preventer & reliever

13. Problems Underwater

Wheezing

Chest tightening

DCI

AGE

Blackout

Panic

14. Problems Above water

Snorkelling

Wheezing

Chest tightening

All above

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