Feature Article - January 2005
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Potentially Dangerous When Wet

Aquatic risk management red flags

By Stacy St. Clair


Perhaps it's no surprise that drinking and diving don't mix.

A recent study, however, shows how dangerous it really is. Research done by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) shows a diver's ability to perform shallow-entry dives is impaired at a blood-alcohol concentration of only 0.04 percent.

That's half the legal limit in most states and the equivalent of a 160-pound man drinking two beers in an hour.

"It increases the risk to the point that the alcohol is a contributor to serious injury," says Dr. Bud Perrine, the scientist who led the study. "We now know what happens even with these fairly low amounts of alcohol."

As part of the study, 13 male subjects were asked to dive into a pool as if it held 3.5 feet of water. The performances were videotaped and rated on the relative risk of injury due to contact with the hypothetical pool bottom. None of the men realized his abilities deteriorated in lock step with his drinking, researchers found.

"As important as impaired performance, the divers show impaired perception of performances," says Enoch Gordis, NIAAA director.

The men were allowed to perform the maneuver sober, and all completed the task like a racing dive in which they hit the water and sprung to the surface. As they consumed alcohol, the dives became deeper, and in some cases, the subjects made little effort to stop their plunge. Roughly 11 percent of the 207 dives probably would have resulted in injury if the pool actually had been 3.5 feet deep.

The subjects also misbehaved on the pool deck, increasing the chances of a water-related injury in an uncontrolled environment.

"Their diving just really deteriorated—just as their behavior did," says Perrine, who also is the director of the Vermont Alcohol Research Center. "They started clowning around on the side of the pool and dancing. It wasn't very safe behavior."

The study is extremely important given the serious nature of diving-related injuries. Nearly 95 percent of diving accidents result in paralysis from the neck down, studies show.

"When we talk about shallow-entry injuries, we aren't talking about minor injuries," Perrine says. "We're talking about injuries that leave them quadriplegic, with no neurological function below the neck."

The data sends a critical risk management message for hotels, country clubs and other aquatic centers that have alcohol served in close proximity to the water.

Perrine has testified as an expert witness in several lawsuits between hotels and patrons who went swimming after drinking alcohol. In some cases, he says, the injuries resulted in upwards of $15 million judgments against the pool operators.

Many times, the hotel placed low priority on the pool after it closed. They wrongly believed the pool only required attention during hours of operation, Perrine says.

"That's a fallacious assumption," he says. "They have to secure the pool at night. Having a night watchman check every half-half hour is not enough. The control point has to be the pool itself."

Perrine recommends operators install motion censors that turn on lights and alert security personnel if the pool area is entered after hours. Other security measures such as higher fencing and constant security checks are additional ways of combating the problem.

"It cannot be a low priority," Perrine says.


Ever have a patron who nearly drowned? Turns out there's no such thing.

The CDC's National Center for Injury Prevention and Control is advocating that the term "near drowning" be stricken from our vocabulary.

The new definition of drowning, which will be published in Springer-Verlag's "Handbook on Drowning," describes drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid." It also has three classifications: death, morbidity and no morbidity.

However it's classified, drowning is—and always has been—the top safety concern for waterpark managers.

The latest CDC statistics show just how deadly it can be.

  • In 2001, 3,281 people drowned in the United States. The numbers, which do not include boating accidents, reflect an average of nine people per day.
  • For every child who drowns, three children receive emergency department care for nonfatal submersion injuries. Forty percent of these children require hospitalization.
  • Nonfatal incidents can cause brain damage ranging from memory loss and learning disabilities to a permanent vegetative state.
  • Males accounted for 78 percent of all drowning incidents in 2001.
  • Despite drowning rates, more women than men report a limited swimming ability.
  • In 2001, 859 children between the ages of 0 and 18 died from drowning. While drowning rates have declined in recent years, it is still the second-leading cause of injury-related death for children ages 1 to 14.
  • The drowning rate for all African-Americans is 1.4 times higher than for whites. The drowning rate for African-Americans between the ages of 5 and 19 is 2.6 times higher than white children.