Biomechanics and Medicine in Swimming XI

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competency might accurately reflect their ability to cope with risk of drowning. Not withstanding these limitations, the lesser estimations of risk among males in the study does suggest that education aimed at enhancing male youth assessment of drowning risk might help address the over-representation of males in youth drowning and rescue statistics. conclusIon This paper reports on the first part of an international study that attempts to identify the relationship between real and perceived swimming competency, and perceptions of risk of drowning. The results suggest that participants in this study were realistic in self-estimates of their swimming competency and no significant differences were evident in perceived or actual competency by gender or ethnicity. Males were more likely to underestimate the risk associated with aquatic activity reinforcing previous research findings. Further investigation using similar methodology is required to determine whether these findings are replicated in other populations (without a background in physical education) to ascertain whether others can accurately assess their swimming competency or whether they are likely to overestimate their ability to cope with the dangers inherent in any water-based activity thereby placing themselves at greater risk of drowning. reFerences Baker, S.P., O’Neil, B., Ginsburg, M.J. & Li, G. (1992). The injury fact book. New York: Oxford University Press. Brenner, R.A., Moran, K., Stallman, R., Gilchrist, J. & McVan, J.T. (2005). Swimming ability, water safety education and drowning prevention. In: J.J.L.M. Bierens (Ed.). Handbook of drowning (pp.112- 116). Heidelberg: Springer. Child and Youth Mortality Review Committee. (2005). Circumstances surrounding drowning in those under 25 in New Zealand (1980-2002). Wellington: WSNZ. McCool, J.P., Ameratunga, S., Moran, K. & Robinson, E. (2009). Taking a risk perceptions approach to improving beach swimming safety. International Journal of Behavioural Medicine 16(4), 360-66. McCool, J.P., Moran, K., Ameratunga, S. & Robinson, E. (2008). New Zealand beachgoers’ swimming behaviours, swimming abilities and perception of drowning risk. International Journal of Aquatic Research & Education, 2(1), 7-15. Moran, K. (2008). Will they sink or swim? New Zealand youth water safety knowledge and skills. International Journal of Aquatic Research & Education, 2(2), 114-127. Quan L. & Cummings, P. (2003). Characteristics of drowning by different age groups. Injury Prevention, 9(2), 163-6. Stallman, R.S., Junge, M. & Blixt, T. (2008). The teaching of swimming based on a model derived from the causes of drowning. International Journal of Aquatic Research & Education, 2(4), 372-382. chaPter6.medicineandwatersafety Keeping the Safety Messages Simple: The International Task Force on Open-Water Recreational Drowning Prevention Quan, l. 1 , Bennett, e. 2 , Moran, K. 3 (co-chairs) 1 Seattle Children’s Hospital/University of Washington, USA 2 Seattle Children’s Hospital, USA 3 The University of Auckland, New Zealand International task Force Members: Beerman S (Canada), Bennett E (USA), Bierens J (Netherlands), Brewster BC (USA), Connelly J (Ireland), Farmer N (Australia), Franklin R (Australia), George P (Australia), Kania J (Kenya), Matthews B (Australia), Moran K (New Zealand), Quan L (USA), Rahman A (Bangladesh), Stallman R (Norway), Stanley T (New Zealand), Szpilman D (Brazil), Tan RMK (Singapore), Tipton M (UK). Secretariat: Tansik M (USA). Globally, many organizations addressed the risk of drowning associated with aquatic recreation by promoting a plethora of drowning prevention messages. Preliminary discussion among drowning prevention advocates suggested that messages could be contained within simplified generic messages applicable to all settings. Using a modified Delphi technique to harness expert opinion, the Task Force finally agreed on 16 key messages that would foster open water drowning prevention. Messages were categorized into Care of self and on the Care of others. Learning swimming and water safety survival skills was the dominant message in both categories. It is hoped that by providing simple and consistent prioritised safety messages that are applicable to a range of communities and settings, the ultimate goal of saving lives will be achieved. Key words: water safety, drowning prevention, recreational drowning, open water IntroductIon Drowning as a consequence of aquatic recreation is a significant cause of unintentional death worldwide. In many developed countries, aquatic recreation is an integral part of the lifestyle, especially where there is easy access to a wide range of water environments such as beaches, rivers, lakes, and other waterways. While participation in aquatic recreation is generally viewed as indicative of a healthy lifestyle, there are attendant risks of drowning and other water-related injuries (Moran, 2008). In many countries, the highest proportion of drowning deaths occurs in open waters. For example, in Australia, a country renowned for its aquatic leisure pursuits, one third (33%) of the 370 fatalities from 1999- 2004 occurred in natural bodies of water, more than half (55%) had been engaged in leisure activity, and swimming had been the activity prior to drowning in one third (33%) of cases (Australian Institute of Health and Welfare, 2008). Globally, many organizations have attempted to address the risk of drowning associated with aquatic recreation in open water by promoting a diverse plethora of drowning prevention messages. This diversity reflects the multifaceted nature of the drowning problem and has invariably resulted in specific water safety advice relative to particular environments (such as surf beaches or rivers) or specific activities (such as swimming or surfing). Some organizations (such as the International Lifesaving Federation [ILS] at an international level, or the Royal Life Saving Society [RLSS] at a national level) have disseminated information and advice on a wide range of water safety issues. Other organisations have developed expertise in, and engaged in the promotion of, specific aspects of water safety (such as Surf Life Saving Australia [SLSA] for surf safety or New Zealand Coastguard [NZC] for boat 371
BiomechanicsandmedicineinswimmingXi safety), while others have focused on particular at-risk groups (such as Safe Kids, for children). While site-, activity-, and group-specific water safety messages are valued components of any targeted promotion, their multiplicity has the potential to obfuscate critical messages or confuse intended recipients. Preliminary discussion among drowning prevention advocates at a workshop in the World Water Safety Conference in Oporto, Portugal, in 2007 suggested that essential advice to the public in general and those in care of others around water might be better promoted primarily within simplified generic messages applicable to all open water recreational settings, all swimming-related activities, and all population groups. As a consequence of this initial discussion, a group of like-minded drowning prevention experts established the International Task Force on Open Water Recreational Drowning Prevention in 2008. It was the purpose of this Task Force to establish simplified guidelines for the promotion of key public water safety messages related to open water recreational drowning prevention. Method The process of developing the generic open water drowning prevention messages was evolutionary, the initial session was held with approximately 35 people from the Washington State Drowning Prevention Network. It focused on the need to develop water safety messaging for recreational open water settings for parents and families. In addition, the discussion also focused on in-water, swimming-related activity (such as swimming and playing in water) rather than aquatic sports (such as fishing or diving) or craft-related activity (such as boating or surfing). The brainstorming technique was replicated in a workshop during the World Water Safety Conference 2007 in Oporto, Portugal. In response to interest from the international water safety community who shared a collective concern about the ambiguity and inconsistency of water safety messaging, drowning prevention advocates were invited to take part in a task force that would prioritize and provide coherent and consistent safety messages to reduce the risk of drowning during open water aquatic recreation. From the preliminary workshops and initial rounds of teleconferencing among Task Force members, a list of water safety messages was compiled in a central database. Messages specific to water sites (such as river currents) were separated out of the main list. The messages were then divided into two categories: Care of Self and Care of Others. As a consequence of this process, 65 messages were included in the Care of Self database and 66 in the Care of Others database. Using the Delphi technique to distill the opinions of experts (Brown, 1968), Task Force members were asked to rate the two lists of items by assigning a total of 100 points for messages related to Care of Self and another 100 points for Care of Others. After the first round, points were totaled and only the top 50% of messages were retained. The messages were then reviewed and similar messages were combined. Members were asked for feedback on wording, rationale and any other comments related to the remaining messages prior to the second round of voting. During the second round, messages were ordered by number of points in the first round and all members were able to see the number of points allocated during the first round. After the second round of scoring, the top 50% of messages were chosen. Two subsequent rounds of voting occurred to approve the wording, combining messages, deleting messages due to lack of supporting information and the final list of messages. All final messages received at least 80% approval by Task Force members and two final rounds of draft documents were sent for review and feedback. Finally, a brief reader friendly rationale and a set of critical actions were developed for messages based on content developed during the message generation process. Full details of the rationale and key actions supporting these key messages are contained in a user friendly version of the findings available at: www. drowning-prevention.org 372 results As a consequence of the multiple rounds of distillation of drowning prevention messages previously described, a total of eight messages for each category- Care for self and Care for others-were ultimately approved (see Tables 1 and 2). Table 1: Key messages of open-water Drowning Prevention: Care of self 1. Learn swimming and water safety survival skills 2. Always swim with others 3. Obey all safety signs and warning flags 4. Never go in the water after drinking alcohol 5. Know how and when to use a life jacket 6. Swim in areas with lifeguards 7. Know the weather and water conditions before getting in the water 8. Always enter shallow and unknown water feet first Table 1 shows, in descending order of priority, the eight statements that were identified as the most important messages related to Care of self during swimming-related activities in open water environments. Learning swimming and water safety survival skills was seen as paramount in keeping one’s self safe in open water swimming-related recreation. Behind this dominant message, a cluster of three messages were well supported by Task Force members, they included: always swimming with others, obeying all safety signs and warning flags, and never going in the water after drinking alcohol. Other messages to receive moderate support in the final round of distillation included: knowing how and when to use a life jacket, swimming in areas with lifeguards, knowing the weather and water conditions before going in the water, and always entering shallow and water of unknown depth, feet first. Table 2 shows that, as was the case with Care of self messages, the learning of swimming and water safety survival skills was again the dominant message to prevent drowning when caring for others. Other messages to receive strong support in the Care of Others category all related to safe supervision and included the need to swim under lifeguard supervision, to set and follow rules when caring for others in and around water, and when supervising young children, to always provide close and constant attention without distraction. Knowledge of the use and application of life jackets and the acquisition of first aid and CPR skills were also strongly advocated. Other messages to receive moderate support in the final round of prioritisation included the need to learn safe ways to rescue others without putting yourself in danger and obeying all safety signs and warning flags.
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average VO2 measured during resting
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Figure 2. Repeatability of the LTin
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• Without restriction; • Blinde
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