3000 Lives, 6 Billion Dollars Lost, 18 Years of Surveillance - What Have We Learned About Safe Boating in Canada?

Transcription

1 3000 Lives, 6 Billion Dollars Lost, 18 Years of Surveillance - What Have We Learned About Safe Boating in Canada? *Peter Barss, **Shelley Dalke, **Jane Hamilton, ***Myke Dwyer * Interior Health Authority of British Columbia, Canada; School of Population and Public Health, University of British Columbia **Canadian Red Cross ***Transport Canada, Office of Boating Safety Canadian Red Cross 1

2 Background Boating accounts for about 40% of all immersion deaths in Canada Boating is under-researched because: most victims do not survive long enough to reach a hospital incidents have not been tabulated with other drownings by WHO 2

3 Methods A national surveillance system for boating and other water-related injury deaths was developed as a basis for prevention in Canada in 1991 Multisectorial collaboration: Red Cross, Transport Canada, Lifesaving, Coast Guard, National Association of Coroners, and Public Health Methods Activity, purpose, risk factors for about 3000 boating deaths abstracted for from coroners reports by structured questionnaire 16 years presented today Each death file reviewed and corrected, doubly entered with compare, and final database analysed using statistical software 3

4 All Boating Fatalities: Trends by Type of Boat & Activity Results Immersions accounted for 95% of deaths, trauma the remainder 90% of victims adult males all ages; children rare Alcohol associated with 50% Many victims weak or non-swimmers Two thirds involved powerboats, mainly small open aluminum, remainder unpowered, mainly canoes Personal watercraft accounted for 2% of powerboat immersion deaths, 29% of collision deaths 4

5 Results Only 12% of victims properly wearing a flotation device Many non-swimmers not wearing flotation Cold water, mainly below 10 C, played a role in 36% of deaths 27% (95% confidence intervals 17, 31) decline from 0.71 per 100,000 person years to 0.54 between first and second 5-year periods Trends in boating fatalities* by type of boat Canada (n=2,765) * Includes death from all causes: drowning, immersion hypothermia, and trauma 5

6 Trends in boating fatalities* by purpose of activity Canada (n=2,765) * Includes death from all causes: drowning, immersion hypothermia, and trauma Includes boating during recreation and daily life Recreational Boating Fatalities by Activity & Type of Incident 6

7 Recreational boating* immersion deaths by activity Canada (n=2,232) * Includes boating during recreation and daily life ; Includes drownings and immersion hypothermia deaths Recreational boating* fatalities by type of incident Canada * Includes boating during recreation and daily life; Includes death from all causes: drowning, immersion hypothermia, and trauma 7

8 Recreational boating* immersion deaths by type of boat and type of incident, Canada (n=2,232) * Includes boating during recreation and daily life; Includes drownings and immersion hypothermia deaths Excludes 120 cases where unknown if the boat was powered or unpowered Recreational Boating Fatalities by Personal Risk Factors 8

9 Blood alcohol levels* for immersion deaths during recreational boating, Canada (victims 15 years of age; n=2,165) * Legal limit is 80 mg% Includes drownings and immersion hypothermia deaths Includes boating during recreation and daily life This figure excludes 39 victims; decomposition rendered blood alcohol unreliable 106 at 1-49 mg %, 80 at mg %, 98 unspecified Blood alcohol levels* for immersion deaths during recreational boating by type of boat, Canada (victims 15 years of age; n=2,165) * Legal limit is 80 mg% Includes drownings and immersion hypothermia deaths Includes boating during recreation and daily life; excludes occupational boating This figure excludes 114 cases where it was unknown if the boat was powered or unpowered 70 at 1-49 mg %, 41 at mg %, 55 unspecified ** 32 at 1-49 mg %, 35 at mg %, 35 unspecified Charts exclude 33 victims (19, 14); decomposition rendered blood alcohol unreliable 9

10 Recreational Boating Fatalities by Equipment Factors Trends in recreational boating* immersion deaths by type of boat, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths 10

11 Recreational boating* immersion deaths by use of a flotation device, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths Personal flotation device (PFD) or lifejacket Not fastened or inappropriate size Recreational boating* immersion deaths by type of boat and use of a flotation device, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths Personal flotation device (PFD) or lifejacket This figure excludes 120 cases where it was unknown if the boat was powered or unpowered Not fastened or inappropriate size 11

12 Trends in recreational boating* immersion deaths by use of a flotation device, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths Personal flotation device (PFD) or lifejacket Not fastened or inappropriate size Recreational Boating Fatalities by Environment Factors 12

13 Recreational boating* immersion deaths by body of water and by type of boat, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths Lake includes pond & reservoir Recreational boating* immersion deaths in rivers by current, Canada (n=522) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths 13

14 Recreational boating* immersion deaths by environmental risk factors, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths Recreational boating* immersion deaths by depth of water and distance from shore, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths 14

15 Recreational boating* immersion deaths by accompaniment and by type of boat, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths; Adult indicates that victim was accompanied by adult(s); does not exclude presence of minor(s) (<18 years); Minor indicates presence of minors only Recreational boating* immersion deaths by various contributing risk factors and by type of boat, Canada (n=2,232) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths; There may be more than one contributing risk factor per incident 15

16 Recreational Boating Trauma Deaths Recreational boating* trauma deaths by type of incident and type of collision, Canada (n=123) * Includes boating during recreation and daily life; Includes all injury fatalities other than immersion deaths 16

17 Blood alcohol levels* for trauma deaths during recreational boating, Canada (victims 15 years of age; n=107) * Legal limit is 80 mg% Includes all injury fatalities other than immersion deaths Includes boating during recreation and daily life 11 at 1-49 mg %, 3 at mg %, 1 unspecified Personal Watercraft Deaths 17

18 Recreational* personal watercraft fatalities by type of incident and type of collision, Canada (n=61) * Includes boating during recreation and daily life Recreational boating* trauma deaths by type of boat Canada (n=123) * Includes boating during recreation and daily life Includes all injury fatalities other than immersion deaths 18

19 Recreational* personal watercraft fatalities by nature of injury and type of incident, Canada (n=61) * Includes boating during recreation and daily life Includes drownings and immersion hypothermia deaths Includes all other injury fatalities Blood alcohol levels* for personal watercraft fatalities during recreational boating by nature of injury, Canada (victims 15 years of age; n=54) * Legal limit is 80 mg% Includes boating during recreation and daily life 3 at 1-49 mg %, 2 at mg %, 1 unspecified 1 at 1-49 mg %, 1 unspecified Includes drownings and immersion hypothermia deaths ** Includes all other injury fatalities 19

20 Recreational* personal watercraft fatalities by nature of injury and use of a flotation device, Canada (n=61) * Includes boating during recreation and daily life Personal flotation device (PFD) or lifejacket Not fastened or inappropriate size Includes drownings and immersion hypothermia deaths Includes all other injury fatalities Conclusions While some improvement in boating immersion death rates observed, proportion of boaters who died wearing a flotation device unchanged for 16 years at 1 in 10. Most effective intervention would be mandatory wearing of appropriate flotation by all boaters at all times, with operators accountable for wearing by all passengers. 20

21 Conclusions Mandatory wearing and effective enforcement could prevent up to 90% of boating deaths in Canada, with annual cost savings of at least $330 million Shops should stock flotation devices for active and inactive boating and cold and warm water conditions Conclusions Small open powerboats and motors require mandatory improved safety features to increase survival after capsizing, swamping and falling overboard Helmets and safety design features are essential to improve automatic/passive protection for users of personal and other high speed watercraft 21

22 Publications available for download at Canadian Red Cross website under drowning research won Canadian Marine Safety Award for 2009 Available at Transport Canada website 22