>In recent years, an increasing number of divers have reported stinging injuries as a result of grasping permanent mooring lines with ungloved hands. While rope fibers alone can cause injury, from the reports DAN receives the majority of mooring line injuries appear consistent with marine life envenomation. Colonies of organisms eventually inhabit man-made objects in the ocean, including permanent mooring lines. Colonizing organisms may vary depending on environment and geographical location. Many authorities maintain that the most likely suspect is a member of the hydroid family, a class of coelenterates, which also includes jellyfish; therefore the initial treatment for this injury is the same as for jellyfish and related creatures.
>Flush the injury with white household vinegar (a mild acetic acid solution between 5-8% in distilled water) for at least 30 seconds to neutralize any unfired nematocysts. Repeat this process every 30 minutes in the 2-hour period following the injury
>Following the vinegar application, immerse the wound in hot water for 30-90 minutes or for as long as the pain persists. The water should be as hot as the diver can tolerate (approximately 113°F/45°C). If hot water is not available, use dry hot packs. As a third choice, dry cold packs may be helpful in decreasing pain although they are not as effective. The heat or cold application can be repeated as necessary to help relieve initial symptoms. Some individuals experience continued itching and irritation. Physicians generally recommend applying over-the-counter topical hydrocortisone cream. It is always important to monitor for any signs of infection.
>The DAN medical team frequently receives calls from individuals who experienced itching, burning and redness of the skin after a marine encounter of unknown origin. Usually the symptoms disappear after one to two days, but sometimes they abruptly return. This can occur anytime from two to five days after the initial encounter, and the recurring symptoms may be worse than they were initially. According to DAN consultant Dr. Bruce Miller, a board-certified dermatologist, dive medicine physician and diver, this is a "delayed hypersensitivity reaction," or reaction to a toxin or antigens. Unlike a systemic (whole body) allergic reaction, which may affect larger skin areas or other organs, the delayed reaction tends to remain confined to the injury site.
>"Once this delayed reaction occurs," Miller said, "topical hydrocortisone cream may have little or no benefit. The recommendation is to be evaluated by a physician, because oral steroids may be required to treat the reaction." Mill compared this delayed reaction to a very bad case of poison oak. "Without proper treatment, the symptoms can persist for weeks or longer. It's important to seek evaluation by a physician to ensure no secondary infection exists from the skin breaks that can occur when the skin is scratched too vigorously."
>Mastering proper buoyancy skills can help eliminate the need to grasp a mooring line during a safety stop. If you have to grasp the mooring line for any reason, try to limit the amount of skin actually making contact with line, such as using only your thumb and index finger. If you experience an injury, call the DAN Emergency Hotline at +1-919-684-9111. The possibility of stings or irritation should not be sufficient cause to discontinue accepted safety practices nor to abandon efforts to preserve the marine environment.