Nitrox refers to any gas mixture composed (excepting trace gases) of nitrogen and oxygen. This includes atmospheric air, which is approximately 78% nitrogen, 21% oxygen, and 1% other gases, primarily argon. In the usual application, underwater diving, nitrox is normally distinguished from air and handled differently. The most common use of nitrox mixtures containing oxygen in higher proportions than atmospheric air is in scuba diving, where the reduced partial pressure of nitrogen is advantageous in reducing nitrogen uptake in the body's tissues, thereby extending the practicable underwater dive time by reducing the decompression requirement, or reducing the risk of decompression sickness (also known as the bends).
Nitrox is used to a lesser extent in surface-supplied diving, as these advantages are reduced by the more complex logistical requirements for nitrox compared to the use of simple low-pressure compressors for breathing gas supply. Nitrox can also be used in hyperbaric treatment of decompression illness, usually at pressures where pure oxygen would be hazardous. Nitrox is not a safer gas than compressed air in all respects; although its use can reduce the risk of decompression sickness, it increases the risk of oxygen toxicity and fire.
Though not generally referred to as nitrox, an oxygen-enriched air mixture is routinely provided at normal surface ambient pressure as oxygen therapy to patients with compromised respiration and circulation.
- 1 Use
- 2 Terminology
- 3 Choice of mixture
- 4 Production
- 5 Cylinder markings to identify contents
- 6 Regional standards and conventions
- 7 Dangers
- 8 History
- 9 In nature
- 10 See also
- 11 References
- 12 Footnotes
- 13 External links
Enriched Air Nitrox, nitrox with an oxygen content above 21%, is mainly used in scuba diving to reduce the proportion of nitrogen in the breathing gas mixture. Reducing the proportion of nitrogen by increasing the proportion of oxygen reduces the risk of decompression sickness for the same dive profile, or allows extended dive times without increasing the need for decompression stops for the same risk. The significant aspect of extended no-stop time when using nitrox mixtures is reduced risk in a situation where breathing gas supply is compromised, as the diver can make a direct ascent to the surface with an acceptably low risk of decompression sickness. The exact values of the extended no-stop times vary depending on the decompression model used to derive the tables, but as an approximation, it is based on the partial pressure of nitrogen at the dive depth. This principle can be used to calculate an equivalent air depth (EAD) with the same partial pressure of nitrogen as the mix to be used, and this depth is less than the actual dive depth for oxygen enriched mixtures. The equivalent air depth is used with air decompression tables to calculate decompression obligation and no-stop times. The Goldman decompression model predicts a significant risk reduction by using nitrox (more so than the PADI tables suggest).
Controlled tests have not shown breathing nitrox to reduce the effects of nitrogen narcosis, as oxygen seems to have similarly narcotic properties under pressure to nitrogen; thus one should not expect a reduction in narcotic effects due only to the use of nitrox.[note 1] Nonetheless, there are people in the diving community who insist that they feel reduced narcotic effects at depths breathing nitrox. This may be due to a dissociation of the subjective and behavioural effects of narcosis. Although oxygen appears chemically more narcotic at the surface, relative narcotic effects at depth have never been studied in detail, but it is known that different gases produce different narcotic effects as depth increases. Helium has no narcotic effect, but results in HPNS when breathed at high pressures, which does not happen with gases that have greater narcotic potency. However, because of risks associated with oxygen toxicity, divers do not usually use nitrox at greater depths where more pronounced narcosis symptoms are more likely to occur. For deep diving, trimix or heliox gases are typically used; these gases contain helium to reduce the amount of narcotic gases in the mixture.
There is anecdotal evidence that the use of nitrox reduces post-dive fatigue, particularly in older and or obese divers; however a double-blind study to test this found no statistically significant reduction in reported fatigue. There was, however, some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i.e. micro bubbles in the blood insufficient to cause symptoms of DCS); the fact that the study mentioned was conducted in a dry chamber with an ideal decompression profile may have been sufficient to reduce sub-clinical DCS and prevent fatigue in both nitrox and air divers. In 2008, a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen.
Further studies with a number of different dive profiles, and also different levels of exertion, would be necessary to fully investigate this issue. For example, there is much better scientific evidence that breathing high-oxygen gases increases exercise tolerance, during aerobic exertion. Though even moderate exertion while breathing from the regulator is a relatively uncommon occurrence in scuba, as divers usually try to minimize it in order to conserve gas, episodes of exertion while regulator-breathing do occasionally occur in sport diving. Examples are surface-swimming a distance to a boat or beach after surfacing, where residual "safety" cylinder gas is often used freely, since the remainder will be wasted anyway when the dive is completed. It is possible that these so-far un-studied situations have contributed to some of the positive reputation of nitrox.
Nitrox50 is used as one of the options in the first stages of therapeutic recompression using the Comex CX 30 table for treatment of vestibular or general decompression sickness. Nitrox is breathed at 30 msw and 24 msw and the ascents from these depths to the next stop. At 18m the gas is switched to oxygen for the rest of the treatment.
Nitrox is known by many names: Enriched Air Nitrox, Oxygen Enriched Air, Nitrox, EANx or Safe Air. Since the word is a compound contraction or coined word and not an acronym, it should not be written in all upper case characters as "NITROX", but may be initially capitalized when referring to specific mixtures such as Nitrox32, which contains 68% nitrogen and 32% oxygen. When one figure is stated, it refers to the oxygen percentage, not the nitrogen percentage. The original convention, Nitrox68/32 became shortened as the first figure is redundant.
The term "nitrox" was originally used to refer to the breathing gas in a seafloor habitat where the oxygen has to be kept to a lower fraction than in air to avoid long term oxygen toxicity problems. It was later used by Dr Morgan Wells of NOAA for mixtures with an oxygen fraction higher than air, and has become a generic term for binary mixtures of nitrogen and oxygen with any oxygen fraction, and in the context of recreational and technical diving, now usually refers to a mixture of nitrogen and oxygen with more than 21% oxygen. "Enriched Air Nitrox" or "EAN", and "Oxygen Enriched Air" are used to emphasize richer than air mixtures. In "EANx", the "x" was originally the x of nitrox, but has come to indicate the percentage of oxygen in the mix and is replaced by a number when the percentage is known; for example a 40% oxygen mix is called EAN40. The two most popular blends are EAN32 and EAN36, developed by NOAA for scientific diving, and also named Nitrox I and Nitrox II, respectively, or Nitrox68/32 and Nitrox64/36. These two mixtures were first utilized to the depth and oxygen limits for scientific diving designated by NOAA at the time.
The term Oxygen Enriched Air (OEN) was accepted by the (American) scientific diving community, but although it is probably the most unambiguous and simply descriptive term yet proposed, it was resisted by the recreational diving community, sometimes in favour of less appropriate terminology.
In its early days of introduction to non-technical divers, nitrox has occasionally also been known by detractors by less complimentary terms, such as "devil gas" or "voodoo gas" (a term now sometimes used with pride).
American Nitrox Divers International (ANDI) uses the term "SafeAir", which they define as any oxygen-enriched air mixture with O2 concentrations between 22% and 50% that meet their gas quality and handling specifications, and specifically claim that these mixtures are safer than normally produced breathing air. Considering the complexities and hazards of mixing, handling, analyzing, and using oxygen-enriched air, this name is considered inappropriate by those who consider that it is not inherently "safe", but merely has decompression advantages.
The constituent gas percentages are what the gas blender aims for, but the final actual mix may vary from the specification, and so a small flow of gas from the cylinder must be measured with an oxygen analyzer, before the cylinder is used underwater.
Maximum Operating Depth (MOD) is the maximum safe depth at which a given nitrox mixture can be used. MOD depends on the allowed partial pressure of oxygen, which is related to exposure time and the acceptable risk assumed for central nervous system oxygen toxicity. Acceptable maximum ppO2 varies depending on the application:
- 1.2 is often used in closed circuit rebreathers.
- 1.4 is recommended by several recreational training agencies for ordinary scuba diving.
- 1.5 is allowed for commercial diving in some jurisdictions.
- 1.6 is allowed for technical diving decompression stops, and is the recommended maximum according to NOAA
Higher values are used by commercial and military divers in special circumstances, often when the diver uses surface supplied breathing apparatus, or for treatment in a chamber, where the airway is relatively secure.
Choice of mixture
The two most common recreational diving nitrox mixes contain 32% and 36% oxygen, which have maximum operating depths (MODs) of 34 metres (112 ft) and 29 metres (95 ft) respectively when limited to a maximum partial pressure of oxygen of 1.4 bar (140 kPa). Divers may calculate an equivalent air depth to determine their decompression requirements or may use nitrox tables or a nitrox-capable dive computer.
Nitrox with more than 40% oxygen is uncommon within recreational diving. There are two main reasons for this: the first is that all pieces of diving equipment that come into contact with mixes containing higher proportions of oxygen, particularly at high pressure, need special cleaning and servicing to reduce the risk of fire. The second reason is that richer mixes extend the time the diver can stay underwater without needing decompression stops far further than the duration permitted by the capacity of typical diving cylinders. For example, based on the PADI nitrox recommendations, the maximum operating depth for EAN45 would be 21 metres (69 ft) and the maximum dive time available at this depth even with EAN36 is nearly 1 hour 15 minutes: a diver with a breathing rate of 20 litres per minute using twin 10-litre, 230-bar (about double 85 cu. ft.) cylinders would have completely emptied the cylinders after 1 hour 14 minutes at this depth.
Use of nitrox mixtures containing 50% to 80% oxygen is common in technical diving as decompression gas, which by virtue of its lower partial pressure of inert gases such as nitrogen and helium, allows for more efficient (faster) elimination of these gases from the tissues than leaner oxygen mixtures.
In deep open circuit technical diving, where hypoxic gases are breathed during the bottom portion of the dive, a Nitrox mix with 50% or less oxygen called a "travel mix" is sometimes breathed during the beginning of the descent in order to avoid hypoxia. Normally, however, the most oxygen-lean of the diver's decompression gases would be used for this purpose, since descent time spent reaching a depth where bottom mix is no longer hypoxic is normally small, and the distance between this depth and the MOD of any nitrox decompression gas is likely to be very short, if it occurs at all.
The composition of a nitrox mix can be optimized for a given planned dive profile. This is termed "Best mix", for the dive, and provides the maximum no-decompression time compatible with acceptable oxygen exposure. An acceptable maximum partial pressure of oxygen is selected based on depth and planned bottom time, and this value is used to calculate the oxygen content of the best mix for the dive:
- Mixing by partial pressure: a measured pressure of oxygen is decanted into the cylinder and cylinder is "topped up" with air from the diving air compressor. This method is very versatile and requires relatively little additional equipment if a suitable compressor is available, but it is labour-intensive, and high partial pressures of oxygen are relatively hazardous.
- Pre-mix decanting: the gas supplier provides large cylinders with popular mixes such as 32% and 36%. These may be further diluted with air to provide a larger range of mixtures.
- Mixing by continuous blending: measured quantities of oxygen are introduced to air and mixed with it before it reaches the compressor inlet. The compressor and particularly the compressor oil, must be suitable for this service. If the resulting oxygen fraction is less than 40%, the cylinder and valve may not be required to be cleaned for oxygen service. Relatively efficient and quick compared to partial pressure blending, but requires a suitable compressor, and the range of mixes may be limited by the compressor specification.
- Mixing by mass fraction: oxygen and air or nitrogen are added to a cylinder that is accurately weighed until the required mix is achieved. This method requires fairly large and highly accurate scales, otherwise it is similar to partial pressure blending, but insensitive to temperature variations.
- Mixing by gas separation: a nitrogen permeable membrane is used to remove some of the smaller nitrogen molecules from low pressure air until the required mix is achieved. The resulting low pressure nitrox is then pumped into cylinders by a compressor. Limited range of mixes are possible, but the equipment is quick and easy to operate and relatively safe, as there is never high partial pressure oxygen involved.
- Pressure swing adsorption requires relatively complex equipment, otherwise the advantages are similar to membrane separation.
Cylinder markings to identify contents
Any diving cylinder containing a blend of gasses other than standard air is required by most diver training organizations, and some national governments, to be clearly marked to indicate the current gas mixture. In practice it is common to use a printed adhesive label to indicate the type of gas (in this case nitrox), and to add a temporary label to specify the analysis of the current mix.
Training standards for nitrox certification suggest the composition must be verified by the diver by using an oxygen analyzer before use.
Regional standards and conventions
Within the EU, valves with M26x2 outlet thread are recommended for cylinders with increased oxygen content. Regulators for use with these cylinders require compatible connectors, and are not directly connectable with cylinders for compressed air.
A German standard specifies that any mixture with an oxygen content greater than atmospheric air must be treated as pure oxygen. A nitrox cylinder is specially cleaned and identified. The cylinder colour is overall white with the letter N on opposite sides of the cylinder. The fraction of oxygen in the bottle is checked after filling and marked on the cylinder.
South African National Standard 10019:2008 specifies the colour of all scuba cylinders as Golden yellow with French gray shoulder. This applies to all underwater breathing gases except medical oxygen, which must be carried in cylinders that are Black with a White shoulder. Nitrox cylinders must be identified by a transparent, self-adhesive label with green lettering, fitted below the shoulder. In effect this is green lettering on a yellow cylinder, with a gray shoulder. The composition of the gas must also be specified on the label. In practice this is done by a small additional self-adhesive label with the oxygen fraction, which is changed when a new mix is filled.
Every nitrox cylinder should also have a sticker stating whether or not the cylinder is oxygen clean and suitable for partial pressure blending. Any oxygen-clean cylinder may have any mix up to 100% oxygen inside. If by some accident an oxygen-clean cylinder is filled at a station that does not supply gas to oxygen-clean standards it is then considered contaminated and must be re-cleaned before a gas containing more than 40% oxygen may again be added. Cylinders marked as 'not oxygen clean' may only be filled with oxygen-enriched air mixtures from membrane or stick blending systems where the gas is mixed before being added to the cylinder, and to an oxygen fraction not exceeding 40% by volume.
Diving with and handling nitrox raise a number of potentially fatal dangers due to the high partial pressure of oxygen (ppO2). Nitrox is not a deep-diving gas mixture owing to the increased proportion of oxygen, which becomes toxic when breathed at high pressure. For example, the maximum operating depth of nitrox with 36% oxygen, a popular recreational diving mix, is 29 metres (95 ft) to ensure a maximum ppO2 of no more than 1.4 bar (140 kPa). The exact value of the maximum allowed ppO2 and maximum operating depth varies depending on factors such as the training agency, the type of dive, the breathing equipment and the level of surface support, with professional divers sometimes being allowed to breathe higher ppO2 than those recommended to recreational divers.
To dive safely with nitrox, the diver must learn good buoyancy control, a vital part of scuba diving in its own right, and a disciplined approach to preparing, planning and executing a dive to ensure that the ppO2 is known, and the maximum operating depth is not exceeded. Many dive shops, dive operators, and gas blenders require the diver to present a nitrox certification card before selling nitrox to divers.
Some training agencies, such as PADI and Technical Diving International, teach the use of two depth limits to protect against oxygen toxicity. The shallower depth is called the "maximum operating depth" and is reached when the partial pressure of oxygen in the breathing gas reaches 1.4 bar (140 kPa). The deeper depth, called the "contingency depth", is reached when the partial pressure reaches 1.6 bar (160 kPa). Diving at or beyond this level exposes the diver to a greater risk of central nervous system (CNS) oxygen toxicity. This can be extremely dangerous since its onset is often without warning and can lead to drowning, as the regulator may be spat out during convulsions, which occur in conjunction with sudden unconsciousness (general seizure induced by oxygen toxicity).
Divers trained to use nitrox may memorise the acronym VENTID-C or sometimes ConVENTID, (which stands for Vision (blurriness), Ears (ringing sound), Nausea, Twitching, Irritability, Dizziness, and Convulsions). However, evidence from non-fatal oxygen convulsions indicates that most convulsions are not preceded by any warning symptoms at all. Further, many of the suggested warning signs are also symptoms of nitrogen narcosis, and so may lead to misdiagnosis by a diver. A solution to either is to ascend to a shallower depth.
Precautionary procedures at the fill station
Many training agencies such as PADI, CMAS, SSI and NAUI train their divers to personally check the oxygen percentage content of each nitrox cylinder before every dive. If the oxygen percentage deviates by more than 1% from the value written on the cylinder by the gas blender, the scuba diver must either recalculate his or her bottom times with the actual mix, or else abort the dive to avoid increased risk of oxygen toxicity or decompression sickness. Under IANTD and ANDI rules for use of nitrox, which are followed by most dive resorts around the world, filled nitrox cylinders are signed out personally in a gas blender log book, which contains, for each cylinder and fill, the cylinder number, the measured oxygen percent composition, the signature of the receiving diver (who should have personally measured the oxygen partial pressure before taking delivery), and finally a calculation of the maximum operating depth for that fill/cylinder. All of these steps minimize danger but increase complexity of operations (for example, personalized cylinders for each diver must generally be kept track of on dive boats with nitrox, which is not the case with generic compressed air cylinders). In South Africa, the national standard for handling and filling portable cylinders with pressurised gases (SANS 10019) requires that the cylinder be labelled with a sticker identifying the contents as nitrox, and specifying the oxygen fraction. Similar requirements may apply in other countries.
Fire and toxic cylinder contamination from oxygen reactions
Partial pressure blending using pure oxygen decanted into the cylinder before topping up with air may involve very high oxygen fractions and oxygen partial pressures during the decanting process, which constitute a relatively high fire hazard. This procedure requires care and precautions by the operator, and decanting equipment and cylinders which are clean for oxygen service, but the equipment is relatively simple and inexpensive. Partial pressure blending using pure oxygen is often used to provide nitrox on live-aboard dive boats, but it is also used in some dive shops and clubs.
Any gas which contains a significantly larger percentage of oxygen than air is a fire hazard, and such gases can react with hydrocarbons or lubricants and sealing materials inside the filling system to produce toxic gases, even if a fire is not apparent. Some organisations exempt equipment from oxygen-clean standards if the oxygen fraction is limited to 40% or less.
Among training agencies, only ANDI subscribes to the guideline of requiring oxygen cleaning for equipment used with more than 23% oxygen fraction. The USCG, NOAA, U.S. Navy, OSHA, and the other nitrox training agencies accept the limit as 40% as no accident or incident has been known to occur when this guideline has been properly applied. Tens of thousands of recreational divers are trained each year and the overwhelming majority of these divers are taught the "over 40% rule". Most nitrox fill stations which supply pre-mixed nitrox will fill cylinders with mixtures below 40% without certification of cleanliness for oxygen service. For a history of this controversy see Luxfer cylinders.
The following references for oxygen cleaning specifically cite the "over 40%" guideline that has been in widespread use since the 1960s, and consensus at the 1992 Enriched Air Workshop was to accept that guideline and continue the status quo.
- Code of Federal Regulations, Part 1910.430 (i) - Commercial Diving Operations
- OSHA Oxygen Specifications 1910.420 (1)
- NOAA Oxygen Specifications (appendix D)
- U.S. Navy Oxygen Specifications U.S. MIL-STD-777E (SH) Note K-6-4, Cat. K.6
- U.S. Coast Guard Oxygen Specifications Title 46: Shipping, revisions through 10-1-92. 197.452 Oxygen Cleaning 46 CFR 197.451
Much of the confusion appears to be a result of misapplying PVHO (pressure vessel for human occupancy) guidelines which prescribe a maximum ambient oxygen content of 25% when a human is sealed into a pressure vessel (chamber). The concern here is for a fire hazard to a living person who could be trapped in an oxygen-rich burning environment.
Of the three commonly applied methods of producing enriched air mixes - continuous blending, partial pressure blending, and membrane separation systems - only partial pressure blending would require the valve and cylinder components to be oxygen cleaned for mixtures with less than 40% oxygen. The other two methods ensure that the equipment is never subjected to greater than 40% oxygen content.
In a fire, the pressure in a gas cylinder rises in direct proportion to its absolute temperature. If the internal pressure exceeds the mechanical limitations of the cylinder and there are no means to safely vent the pressurized gas to the atmosphere, the vessel will fail mechanically. If the vessel contents are ignitable or a contaminant is present this event may result in a "fireball".
In 1911 Draeger of Germany tested an injector operated rebreather backpack for a standard diving suit. This concept was produced and marketed as the DM20 oxygen rebreather system and the DM40 nitrox rebreather system, in which air from one cylinder and oxygen from a second cylinder were mixed during injection through a nozzle which circulated the breathing gas through the scrubber and the rest of the loop. The DM40 was rated for depths up to 40m.
In World War II or soon after, British commando frogmen and work divers started sometimes diving with oxygen rebreathers adapted for semi-closed-circuit nitrox (which they called "mixture") diving by fitting larger cylinders and carefully setting the gas flow rate using a flow meter. These developments were kept secret until independently duplicated by civilians in the 1960s.
In 1970, Morgan Wells, who was the first director of the National Oceanographic and Atmospheric Administration (NOAA) Diving Center, began instituting diving procedures for oxygen-enriched air. He introduced the concept of Equivalent Air Depth (EAD). He also developed a process for mixing oxygen and air which he called a continuous blending system. For many years Wells' invention was the only practical alternative to partial pressure blending. In 1979 NOAA published Wells' procedures for the scientific use of nitrox in the NOAA Diving Manual.
In 1985 Dick Rutkowski, a former NOAA diving safety officer, formed IAND (International Association of Nitrox Divers) and began teaching nitrox use for recreational diving. This was considered dangerous by some, and met with heavy skepticism by the diving community.
In 1991, in a watershed moment, the annual DEMA show (held in Houston, Texas that year) banned nitrox training providers from the show. This caused a backlash, and when DEMA relented, a number of organizations took the opportunity to present nitrox workshops outside the show.
In 1992 IAND's name was changed to the International Association of Nitrox and Technical Divers (IANTD), the T being added when the European Association of Technical Divers (EATD) merged with IAND. In the early 1990s, these agencies were teaching nitrox, but the main scuba agencies were not. Additional new organizations, including the American Nitrox Divers International (ANDI) - which invented the term "Safe Air" for marketing purposes - and Technical Diving International (TDI) were begun.
Meanwhile, diving stores were finding a purely economic reason to offer nitrox: not only was an entire new course and certification needed to use it, but instead of cheap or free tank fills with compressed air, dive shops found they could charge premium amounts of money for custom-gas blending of nitrox to their ordinary, moderately experienced divers. With the new dive computers which could be programmed to allow for the longer bottom-times and shorter residual nitrogen times that nitrox gave, the incentive for the sport diver to use the gas increased.
In 1993 Skin Diver magazine, the leading recreational diving publication at the time, published a three-part series arguing that nitrox was unsafe for sport divers.[note 2] Against this trend, in 1992 NAUI became the first existing major recreational diver training agency to sanction nitrox.
In 1994 BSAC reversed its policy on Nitrox and announced BSAC nitrox training to start in 1995
In 1996, the Professional Association of Diving Instructors (PADI) announced full educational support for nitrox. While other mainline scuba organizations had announced their support of nitrox earlier, it was PADI's endorsement that established nitrox as a standard recreational diving option.[unreliable source?]
At times in the geological past the Earth's atmosphere contained much more than 20% oxygen: e.g. up to 35% in the Upper Carboniferous period. This let animals absorb oxygen more easily and influenced their evolutionary patterns.
- Other breathing gases:
- Methods of Gas blending:
- Diving cylinders
- Equivalent air depth
- Partial pressure
- Maximum operating depth
- Nitrogen narcosis
- Oxygen toxicity
- Brubakk, A. O.; T. S. Neuman (2003). Bennett and Elliott's physiology and medicine of diving (5th Rev ed.). United States: Saunders Ltd. p. 800. ISBN 0-7020-2571-2.
- Joiner, J. T. (2001). NOAA Diving Manual: Diving for Science and Technology (Fourth ed.). United States: Best Publishing. p. 660. ISBN 0-941332-70-5.
- Lang, M.A. (2001). DAN Nitrox Workshop Proceedings. Durham, NC: Divers Alert Network. p. 197. Retrieved 2008-05-02.
- Lambertsen, CJ (1994). "Safety Analysis of NOAA Nitrox I and NOAA Nitrox II Decompression Tables. Final Report, Related to NOAA Contract NA36 RU 4022". Environmental Biomedical Stress Data Center Technical Report. Retrieved 2015-12-31.
- Goldman, Saul (23 September 2013). "How SAUL relates to the PADI dive tables". Modern decompression. Retrieved 10 September 2014.
- Hesser, CM; Fagraeus, L; Adolfson, J (1978). "Roles of nitrogen, oxygen, and carbon dioxide in compressed-air narcosis". Undersea Biomedical Research. Bethesda, Md: Undersea and Hyperbaric Medical Society. 5 (4): 391–400. ISSN 0093-5387. OCLC 2068005. PMID 734806. Retrieved 2008-04-08.
- Brubakk, Alf O; Neuman, Tom S (2003). Bennett and Elliott's physiology and medicine of diving (5th Rev ed.). United States: Saunders Ltd. p. 304. ISBN 0-7020-2571-2.
- Hamilton K, Laliberté MF, Fowler B (March 1995). "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation". Undersea and Hyperbaric Medicine. Undersea and Hyperbaric Medical Society. 22 (1): 41–9. PMID 7742709. Retrieved 2009-01-27.
- "How does nitrox make you feel?". ScubaBoard. 2007. Retrieved 2009-05-21.
- Harris RJ, Doolette DJ, Wilkinson DC, Williams DJ (2003). "Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox". Undersea and Hyperbaric Medicine. Undersea and Hyperbaric Medical Society. 30 (4): 285–91. PMID 14756231. Retrieved 2008-05-02.
- Chapman SD, Plato PA. Brueggeman P, Pollock NW, eds. "Measurement of Fatigue following 18 msw Open Water Dives Breathing Air or EAN36". In: Diving for Science 2008. Proceedings of the American Academy of Underwater Sciences 27th Symposium. Retrieved 2009-05-21.
- Owen Anderson, Ergogenic Aids: can increasing oxygen levels improve sports performance? Sports Performance Bulletin, "Archived copy". Archived from the original on 2007-09-28. Retrieved 2008-01-04. accessed 27 July 2015
- Berghage, T.E.; Vorosmarti, J.; Barnard, E.E.P. (July 25, 1978). Miner, W.F, ed. Recompression treatment tables used throughout the world by government and industry (PDF). Bethesda, Maryland: Naval Medical Research Institute. Retrieved 2015-07-31.
- Elliott, D (1996). "Nitrox". South Pacific Underwater Medicine Society Journal. 26 (3). ISSN 0813-1988. OCLC 16986801. Retrieved 2008-05-02.
- Mastro, SJ (1989). "Use of two primary breathing mixtures for enriched air diving operations". In: Lang, MA; Jaap, WC (ed). Diving for Science…1989. Proceedings of the American Academy of Underwater Sciences annual scientific diving symposium 28 September - 1 October 1989 Wood Hole Oceanographic Institution, Woods Hole, Massachusetts, USA. Retrieved 2013-05-16.
- Harlow, Vance (2002). Oxygen Hacker's Companion (fourth ed.). Warner, NH: Airspeed Press. ISBN 0-9678873-2-1.
- Staff (2015). "What is SafeAir". ANDI. Retrieved 28 July 2016.
- Lippmann, John; Mitchell, Simon J (October 2005). "28". Deeper into Diving (2nd ed.). Victoria, Australia: J.L. Publications. pp. 403–4. ISBN 0-9752290-1-X. OCLC 66524750.
- Logan, JA (1961). "An evaluation of the equivalent air depth theory". United States Navy Experimental Diving Unit Technical Report. NEDU-RR-01-61. Retrieved 2008-05-01.
- Berghage Thomas E, McCraken TM (December 1979). "Equivalent air depth: fact or fiction". Undersea Biomedical Research. 6 (4): 379–84. PMID 538866. Retrieved 2008-05-01.
- Lothar Becker: Nitrox Handbuch, 2nd edition, Delius Klasing Verlag, Bielefeld 2007, ISBN 978-3-7688-2420-0
- Millar IL, Mouldey PG (2008). "Compressed breathing air – the potential for evil from within". Diving and Hyperbaric Medicine. South Pacific Underwater Medicine Society. 38: 145–51. Retrieved 2009-02-28.
- South African National Standard 10019:2008, Transportable containers for compressed, dissolved and liquefied gases - Basic design, manufacture, use and maintenance, Standards South Africa, Pretoria
- EN144-3:2003 Respiratory protective devices - Gas cylinder valves - Part 3: Outlet connections for diving gases Nitrox and oxygen
- Butler, Glen L; Mastro, Steven J; Hulbert, Alan W; Hamilton Jr, Robert W (1992). Cahoon, LB, ed. "Oxygen safety in the production of enriched air nitrox breathing mixtures". In: Proceedings of the American Academy of Underwater Sciences Twelfth Annual Scientific Diving Symposium "Diving for Science 1992". Held September 24–27, 1992 at the University of North Carolina at Wilmington, Wilmington, NC. American Academy of Underwater Sciences. Retrieved 2011-01-11.
- Clark, James M; Thom, Stephen R (2003). "Oxygen under pressure". In Brubakk, Alf O; Neuman, Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed.). United States: Saunders. p. 375. ISBN 0-7020-2571-2. OCLC 51607923.
- Richardson, D & Shreeves, K (1996). "The PADI Enriched Air Diver course and DSAT oxygen exposure limits". South Pacific Underwater Medicine Society Journal. 26 (3). ISSN 0813-1988. OCLC 16986801. Retrieved 2008-05-02.
- https://web.archive.org/web/20060426185643/http://www.andihq.com/pages/mainpage.html. Archived from the original on April 26, 2006. Retrieved May 14, 2006. Missing or empty
- Rosales KR, Shoffstall MS, Stoltzfus JM (2007). "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems". NASA Johnson Space Center Technical Report. NASA/TM-2007-213740. Retrieved 2008-06-05.
- "Incident Insights - Trust But Verify". Divers Alert Network.
- Dekker, David L. "1889. Draegerwerk Lübeck". Chronology of Diving in Holland. www.divinghelmet.nl. Retrieved 14 January 2017.
- Lambertsen, CJ (1941). "A diving apparatus for life saving work". JAMA. 116 (13): 1387–1389. doi:10.1001/jama.1941.62820130001015.
- US Navy Diving Manual, 6th revision. United States: US Naval Sea Systems Command. 2006. Retrieved 2008-04-24.
- Lang, Michael (2006). "A The state of oxygen-enriched air (nitrox)". Diving and Hyperbaric Medicine. 36 (2): 87–93. Retrieved 2014-03-21.
- Allen, C (1996). "BSAC gives the OK to nitrox". Diver 1995; 40(5) May: 35-36. reprinted in South Pacific Underwater Medicine Society Journal. 26 (3). ISSN 0813-1988. OCLC 16986801. Retrieved 2008-05-02.
- "NAUI History". National Association of Underwater Instructors. Retrieved 2015-12-31.
- TDI, Nitrox Gas Blending Manual, at pages 9-11
- "Nitrox History". 2002. Archived from the original on 4 July 2009. Retrieved 28 July 2015.
- Berner, R.A.; Canfield, D.E. (1989). "A new model for atmospheric oxygen over Phanerozoic time". American Journal of Science. 289: 333–361. doi:10.2475/ajs.289.4.333. PMID 11539776.
- Dudley, Robert. "Atmospheric oxygen, Giant Paleozoic Insects and the Evolution of Aerial Locomotor Performance" (PDF). Journal of Experimental Biology. 201: 1043–1050.
- Oxygen has the potential to be 1.7 times more narcotic than nitrogen - see relevant narcotic potency of gases
- A position which it would formally maintain until in 1995 magazine editor Bill Gleason was reported to say that nitrox was "all right". Skin Diver would later go into bankruptcy.