Risk Management Strategies in Recreational Scuba Diving and Dive Tourism: A Narrative Review

Abstract

Recreational scuba diving is both a sport activity and a tourism product conducted in an environment that exposes participants to interacting environmental, equipment-related, physiological, behavioral, and organizational hazards. This narrative review critically integrates evidence relevant to recreational scuba diving, dive centers, and dive-tourism operations. A non-systematic, purposive review approach was used, with evidence organized across hazard identification, risk assessment, prevention, human factors, governance, emergency preparedness, environmental sustainability, and technology. Peer-reviewed empirical studies and authoritative guidance were given greater interpretive weight than theses, conference papers, and technology prototypes. The literature suggests that effective risk management is a continuous cycle of hazard identification, context-sensitive assessment, layered control, dynamic monitoring, emergency readiness, and organizational learning. Accidents usually emerge through interactions among environmental conditions, equipment and breathing-gas systems, participant health and behavior, team performance, and organizational decisions. Pre-dive screening, structured equipment checks, competence-based activity matching, gas and ascent planning, buddy-team communication, explicit stop criteria, emergency oxygen delivered by trained personnel, rescue rehearsal, incident and near-miss learning, and ecologically responsible site controls together provide a defensible safety architecture. However, the strength of evidence varies across these interventions, and several operational recommendations remain based on expert guidance or practice-oriented literature rather than controlled studies. Dive safety should therefore be managed as an adaptive organizational system while recognizing uncertainty, professional boundaries in medical decision-making, and the ecological conditions on which dive tourism depends.