Immersion and recreational boating-related injuries in Alaska

Background: Cold water is an ever-present hazard in Alaska, and when water-related injuries occur, they often take place in remote environments, where the nearest trained emergency response teams are several hours away. Alaska’s crude drowning death rate in 2002 was 4.21 per 100,000 population, a rate nearly three times higher than the US average. Immersion and recreational boating-related injuries occur frequently in Alaska, and such events present special challenges to researchers. Boaters and swimmers are subject to the normal risks of land-based activities, including falls, burns, and cuts. They also incur additional risks for asphyxia from submersions, and are exposed to hypothermic water.

Materials and methods: This research analyzed data from the Alaska Occupational Injury Surveillance System (Study One), the Alaska Trauma Registry (Studies Two and Three), and the Boating Accident Report Data System (Study Four) to compare fatalities and injuries occurring in commercial fishermen (Study One), injuries occurring during immersions related to recreational events (Study Two), injuries occurring to passengers while on board recreational vessels (Study Three), and differences in factors associated with fatalities and survivors who had been together during recreational boating-related immersions (Study Four). Descriptive statistics, t- tests, odds ratios, and logistic regression were used to elucidate differences in risk factors and injury outcomes in comparison groups.

Findings: Our research found that permanent flotation device (PFD) use provided strong protection from hypothermia and/or cold water drowning (Study One). The research also found that half of hospitalizations due to immersion involved other traumatic injuries (Study Two). Another research finding demonstrated that injuries on board recreational vessels frequently resulted in fractures, and often occurred to nonresidents who were traveling aboard cruise ships (Study Three). Our research also showed that cold-water immersion events in Alaska are survivable (Study Four).

Conclusion: Immersion and recreational boating-related injuries in Alaska are associated with predictable risk factors, and thus, can be prevented. The prevention of drowning and recreational-immersion related injuries requires a combination of education, enforcement, and engineering approaches to address multiple risk factors.

List of scientific papers

I. Hudson DS, Conway GA (2004). The role of hyperthermia and drowning in commercial fishing deaths in Alaska, 1990-2002. Journal of Circumpolar Health. 63 (S2): 357-60.
https://pubmed.ncbi.nlm.nih.gov/15736684

II. Hudson DS, Nilsen P, Johnson JS, Mode NA, Moore MA, Bensyl DM, Ekman RS (2005). Hospitalizations for immersion-related injuries in Alaska, 1991-2000. Safety Science. [Accepted]
https://doi.org/10.1016/j.ssci.2005.08.013

III. Hudson DS, Nilsen P, Dahl E, Mode NA, Ekman RS (2005). Factors associated with injuries occuring aboard vessels in Alaska: differences between residents and nonresidents. [Accepted]
https://doi.org/10.1111/j.1708-8305.2006.00018.x

IV. Hudson DS, Ekman RS, Svanstrom L (2005). Survival during recreational boating events in Alaska, 1999-2004. Accident Analysis and Prevention. [Accepted]
https://doi.org/10.1016/j.aap.205.10.002