This study aimed to clarify the actual conditions of occupational health and safety among commercial divers in Japan and identify the factors associated with decompression sickness （DCS）. A web-based nationwide survey was conducted targeting 544 commercial diving companies listed in a national business directory. A total of 210 valid responses were obtained and analyzed using descriptive statistics, chi-square tests, and multiple logistic regression.
The results revealed that both age and annual diving work duration were significantly associated with self-reported DCS, while educational background, diving method （scuba vs. hookah）, and level of information access showed no significant association. There were notable individual differences in the frequency of dive computer use and comprehension of decompression tables. While many divers reported sufficient understanding of decompression theory, over half indicated they were not adequately prepared to handle DCS emergencies.
Furthermore, knowledge gaps were found in key areas such as “M-values” and emergency procedures, and access to recompression treatment varied widely by region. Although this study indicated improvements in regulatory awareness and safety behavior compared to a prior survey conducted before the 2015 amendment to Japan’s High Pressure Work Safety Regulation, disparities in education, information access, and emergency response systems remain.
Recommendations include implementing a mandatory license renewal system with continuing education （e.g., e-learning）, promoting standardized decompression tables, improving emergency training, and addressing regional disparities in medical care access. As the first comprehensive survey after t regulatory revision, this study provides crucial baseline data to inform future occupational health policies for commercial divers.
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