Injuries and Health Issues Occurring During Offshore Transoceanic Sailing: A Survey of Recreational Sailors and Cruisers.

INTRODUCTION: Most of the literature on sailing injuries is centered on competitive sailing, often involving a single regatta. The aims of this study were to provide a description of the types of injuries and illnesses sustained during amateur offshore cruising events, estimate their incidence, and investigate potential risk factors for injuries. METHODS: We conducted a cross-sectional survey of self-reported sailing-related injuries and health issues during 4 different events organized by the World Cruising Club between 2014 and 2015. Prior to departure, sailors received an injury or health issue report form to complete during their sailing event. Questionnaires were then collected at the end of each event. Bivariable (Student's t tests and χ2 tests) and mutilvariable logistic regression were used to study the associations among injuries, health issues, and the characteristics of sailors or sailboats. RESULTS: The incidence of injuries and health issues among the respondents was 1.08 and 1.01 per 10,000 nautical miles, respectively. Smaller boats (P<0.001) and crews with less experience with the current boat (P<0.001) were associated with reporting of more injuries. Most of the injuries were reported during favorable weather conditions. Health issues were more frequent on smaller boats and with women (P=0.008), who reported significantly more seasickness (P<0.001), anxiety (P=0.037), and skin rash/fungal infection (P=0.021). CONCLUSIONS: Injuries and health issues are relatively common among amateur offshore recreational sailors, but severe injuries are rare. Smaller boats and having less experience in sailing with the current boat were associated with more injuries. Preventive strategies should include a sailing experience requirement on the boat being sailed for all crew members, increasing the minimum boat size requirement for sailing events, and mandatory first-aid training prior to a cruising event for all crew members.

Injuries and Fatalities on Sailboats in the United States 2000-2011: An Analysis of US Coast Guard Data.

BACKGROUND: Prior sailing injury studies have been small, focused investigations. This large, population-based study examined the mechanisms and factors contributing to sailboat-related injuries and deaths. METHODS: A retrospective data analysis of the Boating Accident Report Database compiled by the US Coast Guard between 2000 and 2011 was performed. The database was analyzed looking at frequency of events. For each subgroup, proportions were determined and 95% CIs were calculated. These data, used in conjunction with the 2011 US Coast Guard National Recreational Boating Survey, were used to estimate a fatality rate. RESULTS: Two hundred seventy-one sailing-related fatalities and 841 injuries were reported. A fatality rate was calculated at 1.19 deaths per million sailing person-days. Weather or hazardous waters were listed as primary contributing factors in 28.0% (95% CI, 22.7-33.4) of deaths; 70.1% (95% CI, 64.7-75.6) of deaths occurred after falling overboard or capsizing. Drowning was the most common cause of death (73.1%; 95% CI, 67.8-78.4), and 81.6% of victims were not wearing a life jacket. Alcohol intoxication contributed to 12.2% (95% CI, 8.3-16.1) of deaths. Operator- or passenger-preventable factors contributed to 52.7% (95% CI, 49.3-56.1) of all injuries; 51.6% (95% CI, 46.1-57.1) of injuries on nonmotorized sailboats were the result of capsizing, and 46.4% (95% CI, 42.1-50.7) of all injuries on motorized sailboats were the result of collisions or grounding. CONCLUSIONS: The calculated fatality rate is similar to that of alpine skiing. Falls overboard and capsizing were the most common fatal accidents. Operator inattention, inexperience, and alcohol use were common preventable factors contributing to fatal and nonfatal injury.

Pre-Participation Medical Evaluation for Adventure and Wilderness Watersports.

A request for a preparticipation medical evaluation for wilderness watersports may be made by guiding agencies, instructional camps, or by patients presenting for an annual visit. Although guidelines have been published regarding preparticipation physical evaluation for traditional competitive high school and collegiate sports, little has been written about medical evaluations for those wishing to engage in wilderness and adventure watersports. In this article, we offer guidance based on literature review and expert opinion. Watersports are among the most common recreational activities in the United States and are generally safe. Drowning, however, is a significant risk, particularly in small, self-propelled craft, and among children. Medical counseling before participation in watersports should include screening for medical conditions which may impair swimming ability, including a history of seizures, heart disease, and lung disease. Physicians should also promote preventive health measures such as use of lifejackets and sun protection, as well as alcohol avoidance. Swim testing tailored to specific activities should be strongly considered for children and those with questionable swimming ability.

Pre-Participation Medical Evaluation for Adventure and Wilderness Watersports.

A request for a preparticipation medical evaluation for wilderness watersports may be made by guiding agencies, instructional camps, or by patients presenting for an annual visit. Although guidelines have been published regarding preparticipation physical evaluation for traditional competitive high school and collegiate sports, little has been written about medical evaluations for those wishing to engage in wilderness and adventure watersports. in this article, we offer guidance based on literature review and expert opinion. Watersports are among the most common recreational activities in the United states and are generally safe. Drowning, however, is a significant risk, particularly in small, self-propelled craft, and among children. Medical counseling before participation in watersports should include screening for medical conditions which may impair swimming ability, including a history of seizures, heart disease, and lung disease. Physicians should also promote preventive health measures such as use of lifejackets and sun protection, as well as alcohol avoidance. Swim testing tailored to specific activities should be strongly considered for children and those with questionable swimming ability.

Analysis of lifeguard-recorded data at Hanauma Bay, Hawaii.

OBJECTIVE: To describe rescue events at Hanauma Bay using data collected by lifeguards stationed at the bay. METHODS: Lifeguard collected data documenting estimates of daily beach attendance, and characteristics of rescue victims and events were analyzed for the period 2000 to 2007. RESULTS: A total of 4888 Logsheets spanning 2000 to 2007 and 1567 Incident Reports spanning 2000 to 2002 and 2006 to 2007 documenting 1249 rescues were available for analyses. Lifeguard estimates of attendance summing tallies made at 12, 2, and 4 pm overestimated actual attendance by a factor of 1.78 (SD = 0.08) while estimates summing 12 and 4 pm tallies underestimated actual attendance by a factor of 0.91 (SD = 0.04). Both estimates were strongly correlated with actual attendance values (R = 0.98 and R = 0.98, respectively). The average rescue rate for the study period was 7 rescues per 10,000 bathers. Nonresidents accounted for 88% of all visitors to the bay and accounted for a disproportionate percentage of the rescue population (96%, p-value = 0.04). A majority of rescues (63.2%) occurred at a single location called "The Slot." Following rescues, 91.4% of rescue victims were released to the beach, 5.9% were released to their parents or guardians, and 1.4% required transfer to a hospital via ambulance. CONCLUSION: Lifeguard estimates of attendance at Hanauma were precise, and summing 12 and 4 pm attendance tallies provided the most accurate estimate of actual attendance. Rescues at Hanauma Bay occurred predominantly among nonresidents and were concentrated to a single location called "The Slot."

Sailing injury and illness: results of an online survey.

OBJECTIVE: The purpose of this study was to describe the relative frequency, patterns, and mechanisms of sailing-related injuries in dinghies and keelboats. Data were also collected on risky and risk-averse behaviors of sailors, as well as on sailing-related illnesses. METHODS: A web-based, logic-driven, multiple-choice survey was developed and links were posted on sailing-related websites. Data were collected from March through November 2006 on any injuries or illnesses sailors sustained over the prior 12 months. RESULTS: From 1188 respondents, a total of 1715 injuries and 559 illnesses was reported. The top 3 injuries for keel boats were leg contusions (11%), hand lacerations (8%), and arm contusions (6%), and in dinghies they were leg contusions (13%), knee contusions (6%), and leg lacerations (6%). The most common mechanisms of injury were "trip/fall," "hit by object," and "caught in lines." Tacking, heavy weather, and jibing were the most common factors contributing to injury. The rates of injury and severe injury in this internet-based survey were 4.6 and 0.57 per 1000 days of sailing, respectively. Of the 70 severe injuries, 25% were fractures, 16% were torn tendons or cartilage, 14% were concussions, and 8% were dislocations. The median rate of lifejacket use was 30%, and median rate of sunscreen use was 80%. Sixteen percent of sailors reported sunburn over the prior 12 months. Seven percent of sailors reported use of alcohol within the 2 hours preceding injury. CONCLUSIONS: The most common injuries in both keel boats and dinghies are soft-tissue injuries to the extremities. Severe injuries and illnesses in sailing are uncommon in this study population.

Injury and illness at the Newport-Bermuda race 1998- 2006.

OBJECTIVE: To describe the relative frequency and types of injury and illness in the Newport-Bermuda off-shore yachting race. METHODS: At the end of each race held in even numbered years from 1998-2006, the captain of each boat was asked to complete a survey detailing any injury or illness among his/her crew. RESULTS: There was an overall 87% response rate to the survey. During the study period, 38 injuries and 57 illnesses were reported for an estimated 8105 sailors, yielding rate of injury or illness of 12 per 1000 races per sailor. Most common were injuries to the upper extremity (47%), and lacerations were the most common type of injury (45%). Sea sickness was the most common illness, and the rate of illness and injury increased in races that took place in heavy weather. Radio consultations were used 4 times, and 3 sailors required transport to a hospital. CONCLUSIONS: The rate of injury and illness was relatively low in the Newport-Bermuda race. Injuries to the upper extremities and lacerations were most common, and sea sickness was the most common illness. The majority of illness and injury can be initially managed onboard.