Salt water aspiration syndrome or saltwater aspiration syndrome is a medical condition caused by the inhalation or aspiration (entry of materials into lungs from mouth) of small amounts of salt water during an underwater dive, leading to lung irritation and inflammation. Unlike drowning or near-drowning, it does not involve ingestion of large volumes of water. It often results from faulty diving equipment or improper breathing techniques, allowing fine water droplets to reach the lower respiratory tract.
The condition begins with a cough, followed by shortness of breath, chest discomfort or pain, shivering, fever and other systemic symptoms. It can resemble a viral infection but improves within hours, especially with supplemental oxygen. While most cases resolve on their own, severe instances may require critical care. Diagnosis is based on clinical history and symptom progression. Salt water aspiration syndrome was first described in 1970.
Mechanism
Salt water aspiration syndrome occurs when small amounts of salt water are inhaled or aspirated, unlike drowning and near-drowning which involve intake of large volumes of water. This condition can develop subtly over the course of an underwater dive Marine microorganisms and particulates can further exacerbate inflammatory processes, which may cause or contribute towards systemic symptoms seen with this condition.
Presentation
Other diving conditions like pulmonary barotrauma, immersion pulmonary edema and low body temperatures can produce similar symptoms or occur alongside this syndrome; these can be distinguished through the clinical course and imaging results. Critical care may be necessary for severe cases or cases complicated with underlying respiratory disorders. A 1989 study estimated that 37 percent of deaths that occurred during recreational scuba diving in Australia and New Zealand in the 1980s involved salt water aspiration syndrome. The study hypothesized—based on reports of the victim's symptoms and an analysis of their equipment—that the syndrome acted as an intermediate factor, exacerbating panic and exhaustion, which subsequently led to loss of consciousness and death by drowning. In 2019, a case study reported severe salt water aspiration syndrome that occurred during a beluga whale encounter; an audience member at Georgia Aquarium aspirated salt water that a beluga whale splashed, which led to severe inflammation of lungs and low oxygen levels in blood requiring intensive care.