Principles for the Design, Validation, and Acceptance of Decompression Procedures.

Introduction: The 1987 UHMS Workshop on the Validation of Decompression Tables provided standards for the design, testing, and acceptance of decompression tables. Forty years later, research funding has become scarce, and diving companies no longer receive support from universities and Navy research centers. Companies build on their experience and safety culture to improve existing decompression procedures. We list principles and propose guidelines for these internal developments. Principles: Editing decompression tables is a technical activity that aims to provide a practical solution to an immediate operational problem. It relies heavily on current scientific knowledge and experience and on recognized design principles, validation protocols, and acceptance criteria. Validation: Validating decompression procedures fits into the company's Health and Safety management system. Today, decompression tables result from a risk assessment and are presented as a mitigation measure against decompression risks. Management of Change offers a step-by-step approach compatible with the UHMS recommendation for improving existing procedures. Acceptance: Accepting decompression procedures is based on the definition and measurements of relevant endpoints used as acceptance criteria. Endpoints have evolved from DCS incidence to the larger concept of decompression stress. We highlight the importance of dive monitoring in documenting procedure performances and supporting the acceptance decision. Discussion: We conclude that Management of Change can be used by diving companies to develop new or revised decompression procedures, as a complement to the 1987 UHMS recommendations. We recommend that the process be detailed in the company documentation to keep the lessons learned and inform operational personnel.