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Occupational Health and Safety Act, 1993 (Act No. 85 of 1993)

Code of Practice

Diving Regulations, 2009

Code of Practice for Inshore Diving

9. Medical

9.3 Medical certification


9.3.1        Fitness to dive certification


A diver shall not be permitted to dive unless a he has a valid diving medical certificate signed by a Designated Medical Practitioner, and the certificate includes all the aspects listed in the Regulations. This examination should be performed every 12 months, or more frequently as determined by the examining Designated Medical Practitioner.


If the medical examination is carried out during the last 30 days of the validity of the preceding medical then the start date of the new certificate will be the expiry date of the old certificate.


9.3.2        Additional fitness to dive requirements


Additional risks (as determined by the HIRA) may necessitate additional medical examinations, The level 2 Designated Medical Practitioner should scrutinize all medical examinations of the company divers to ensure all the relevant examinations were performed. If such Designated Medical Practitioner did not perform the examinations himself, this may require consultation with the other Designated Medical Practitioner who has performed the initial fitness evaluation. These additional tests will then be performed when needed. Such additional requirements (if any) and the specific fitness requirements should be listed in a specific medical section in the operations manual.


9.3.3        Occupational Health requirements


Exposure to specific occupational health risks may require even further examinations in terms of other regulations. Many of these examinations must be performed by an occupational health practitioner or an occupational medicine practitioner and a Designated Medical Practitioner who does not have this qualification is not legally allowed to perform the examinations himself. An additional certificate (issued by the occupational health practitioner or occupational medicine practitioner) should then be provided.


9.3.4        Medical certificates from international diving doctors


Some diver may have completed a diving medical examination internationally before diving in South Africa. The level 2 Designated Medical Practitioner must scrutinize all these medical examinations and perform any additional examinations that are required in terms of local conditions, regulations and specific workplace risks.


Not all of these investigations need to be repeated, provided that the level 2 Designated Medical Practitioner has ascertained that:

the examinations pertains to that specific diver (verified by a signature of the examiner AND the diver on all examinations)
the examinations were performed by an appropriate medical practitioner
the examinations comply with appropriate quality and validity requirements
Any X-ray examinations must be accompanied by the original X-ray plates OR a report issued by a specialist radiologist.
The physical examination shall always be repeated.


The level 2 DMP may then issue a valid medical certificate based on these examinations and those additional examinations that may be needed. Clear procedures in the operations manual will provide transparency.


9.3.5        Extensions of fitness


The fitness of a diver for diving work is certified for a maximum of 12 months. This period may however be shortened for specific reasons (e.g. 3-monthly follow-up of blood pressure) at the discretion of the examining Designated Medical Practitioner. The Designated Medical Practitioner that has provided this restriction in the duration of fitness may extend this fitness if based on good medical principles and the initial concerns were adequately addressed. This may, for instance, happen after discussions between the level 2 Designated Medical Practitioner and the Designated Medical Practitioner initially performing the examination and issuing the restriction.


No medical certificate may be extended beyond the maximum period of 12 months. Divers that are planning to work in the period close to expiry of their medical certification, should ensure that they submit for a medical examination prior to leaving on such diving p or alternatively ensure that they can obtain a diving medical examination prior to the expiry thereof.


9.3.6        Appeal against fitness decisions


All persons found unfit for diving, or fit with a restriction1 may appeal such a decision if he or she feels there is a reason providing sufficient grounds for such an appeal. The appeal procedures are dearly explained in the Regulations.


Before appealing against the decision, it is advisable to discuss the decision with the Designated Medical Practitioner especially the level 2 Designated Medical Practitioner. The reason for the unfitness or restricted fitness should be explained in plain language to the person concerned, including the explanation of results of investigations that the decision is based on. This requires designated medical practitioners to ensure that appropriate investigations are performed before a decision is made.


The appeal procedure should NOT be used to cover the costs of non -routine or expensive specialist investigations and examinations. When these are indicated, it should be performed BEFORE the diver is certified unfit or fit with restrictions. Discussion with other medical colleagues may be indicated. All Designated Medical Practitioners are advised to confirm all cases of unfitness with a colleague prior to declaring a person unfit.


An appeal should be accompanied by the medical certificate issued in terms of the examination, as well as the grounds for the appeal.