Water Sanitation Health

Guidelines for safe recreational water environments
Volume 1 : Coastal and fresh waters

Executive summary

Drowning and injury prevention

Drowning, which has been defined as death arising from impairment of respiratory function as a result of immersion in liquid, is a major cause of death worldwide, particularly for male children. Near drowning is also a serious problem as it may have life-long effects. The recovery rate from near drowning may be lower among young children than among teenagers and adults. Studies show that the prognosis for survival depends more on the effectiveness of the initial rescue and resuscitation than on the quality of subsequent hospital care.

Drowning may be associated with swimming as well as with recreational water uses involving minimal water contact, such as recreational use of watercraft (yachts, boats, canoes) and fishing. Alcohol consumption is one of the most frequently reported contributory factors associated with drownings for adults, whereas lapses in parental supervision are most frequently cited among children. In cold weather, immersion cooling may be a significant contributory factor.

Of sports-related spinal cord injuries, the majority appear to be associated with diving. Injuries in diving incidents are almost exclusively located in the cervical vertebrae, resulting in quadriplegia or paraplegia. Data suggest that body surfing and striking the bottom is the most common cause of spinal injury. Alcohol consumption may contribute significantly to the frequency of injury. Other injuries associated with recreational water use activities include brain and head injuries, fractures, dislocations and other minor impact injuries, and cuts, lesions and punctures.

Prevention is the best way to reduce the incidence of injury and death related to the aquatic environment, and the majority of injuries can be prevented by appropriate measures at a local level. Physical hazards should first be removed or reduced if possible, or measures should be taken to prevent or reduce human exposure. Physical hazards that cannot be completely dealt with in this way should be the subject of additional preventive or remedial measures. These include drowning prevention programmes, public information and warnings (such as signs, flags and general education and awareness raising), the provision of effective lifeguard supervision and rescue services, and the establishment of different recreation zones for different recreational activities using lines, buoys and markers.

Monitoring of a site for existing and new hazards should be undertaken on a regular basis. The frequency and timing of inspections will vary with the location.