|Title||A practical approach to identifying and counting cold-water immersion deaths, and assessing associated activities and risks|
|Publication Type||Conference Paper|
|Year of Publication||2007|
|Authors||Barss, P, Mercier, M|
|Conference Name||World Conference on Drowning Prevention|
|Publisher||International Life Saving Federation|
|Conference Location||Porto, Portugal|
Introduction: Most cold immersion deaths are difficult to identify due to lack of a specific test and inexperience of many investigating police and coroners. In order to assess the circumstances of such incidents, it was necessary to develop a practical epidemiologic approach to identification of cases.
Methods: Selection criteria developed for review of cases in the Canadian Surveillance System for Water-Related Injury Fatalities included:
Selection is done in a descending manner, not counting or reselecting cases twice. Bath and hot tub and pool incidents are excluded, unless outdoors during winter.
Results: During 1991-2000, 2007 cold immersion deaths were identified; these deaths comprised 40% of 5006 immersion deaths; 758 tub and pool cases were excluded. 38% of cold immersions resulted from boating, 22% activities on ice, 15% land transport, 14% falls into water, 7% aquatic activities, air transport 1%, and other/unknown 3%. The purpose of these activities included recreation 55%, daily life/subsistence 27%, occupational 11%, rescue 1%, other/unknown 6%.
Conclusions: Pool vendors and owners have low levels of knowledge about evidence-based prevention of pool drowning and spinal cord injury, particularly automatic gates and safe depths and lengths for diving. Pool vendors have a more realistic perception of the risk of spinal cord injury from diving into home pools, but do not provide written information about this hazard. Mandatory safety training of pool vendors and owners together with strict regulations for childproof automatic gates are needed to protect the public from death and permanent injury.
Discussion: Cold immersions have been divided into four phases, including gasping and cold shock, swimming failure, hypothermia, and post-rescue collapse. At present, few death records provide this level of detail so one must rely on other criteria to provide an epidemiologic assessment of the incidence and risk factors for cold immersion deaths.
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