Factors associated with open-circuit recreational diving fatalities

TitleFactors associated with open-circuit recreational diving fatalities
Publication TypeConference Paper
Year of Publication2007
AuthorsdeL. Dear, G, Denoble, PJ, Caruso, J, Pieper, CF, Vann, RD
Conference NameWorld Conference on Drowning Prevention
Date Published09/2007
PublisherInternational Life Saving Federation
Conference LocationPorto, Portugal
Other Numbers02-51
Abstract

Divers Alert Network (DAN) collected data from 1992-2003 concerning 965 recreational scuba diving deaths involving open-circuit scuba. Events for each case were classified in a four-step sequence that included: trigger, harmful action, disabling condition, and cause of death (COD). Drowning was the most common COD but was usually secondary to a disabling condition that caused incapacitation. The data were combined and explored for associations among cause of death, disabling injury, and 51 possible risk factors using Pareto analysis and multivariate logistic regression. This was to improve statistical power and risk estimation for diving fatality investigation. The cause of death as provided by the medical examiner was less informative than the disabling injury reported by others. Drowning, arterial gas embolism (AGE), and cardiac injury were the three most common disabling injuries, associated with 87% of the 862 deaths for which a disabling injury could be assigned. Disabling injuries ascribed to trauma, decompression sickness, loss of consciousness, or inappropriate gases were rare. Drowning was associated predominantly with entrapment (Odds Ratio, OR≥30) and insufficient gas (OR=16). Insufficient gas and emergency ascent (OR≥30) were the principal factors associated with injuries ascribed to AGE. For cardiac injury, external adverse events were rarely identified, and the principal associations were a history of cardiovascular disease (OR≥30) and increasing age (OR=2 per 10 years of age). While diving deaths will never be completely eliminated, emphasis on avoiding and managing factors associated with the common disabling injuries – drowning, AGE, and cardiac injury – offers a reasonable opportunity to reduce their occurrence.

Learning Outcomes
  1. The majority of drownings were found to be associated with evidence of an incapacitating event that may have rendered the decedent incapable of self-rescue
  2. Drowning was predominantly associated with the triggers entrapment and insufficient gas and, to a lesser extent, with equipment trouble and rough water.
  3. Death is not an inevitable consequence and the above analysis suggests that some reduction in crude death rate might be achieved.