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  1. Article ; Online: Impact of a surfer rescue training program in Australia and New Zealand: a mixed methods evaluation.

    Koon, William / Peden, Amy E / Brander, Robert W

    BMC public health

    2023  Volume 23, Issue 1, Page(s) 2193

    Abstract: Background: Surfers play a critical role in coastal drowning prevention, conservatively estimated to make as many rescues as beach lifeguards. The Surfer Rescue 24/7 (SR24/7) program is a coastal safety intervention in Australia and New Zealand that ... ...

    Abstract Background: Surfers play a critical role in coastal drowning prevention, conservatively estimated to make as many rescues as beach lifeguards. The Surfer Rescue 24/7 (SR24/7) program is a coastal safety intervention in Australia and New Zealand that teaches surfers safe rescue skills and promotes prevention activities. This multi-part, mixed-methods study aimed to evaluate the impact of the SR24/7 program.
    Methods: The study consisted of three parts employing quantitative and qualitative methods: a retrospective survey of course participants, in-depth interviews with course participants who had conducted rescues, and an analysis of self-reported skills confidence ratings before and after the program.
    Results: Triangulated results from the three study components indicated that after the course, participants exhibited high levels of satisfaction with their experience in the program and would encourage others to attend, were more observant and aware of safety concerns while surfing, had a better understanding of ocean conditions and hazards, learned new rescue techniques and skills, grasped important course concepts related to their own personal safety, and improved their confidence in responding to an emergency situation. Several participants had conducted rescues in real life and indicated that the course was effective in providing them with the baseline knowledge and skills to keep safe while helping others in the ocean. This study also provides new insight on the role of surfers in coastal safety, specifically that surfers are engaged in a range of prevention activities before rescue is required.
    Conclusions: Despite persistent challenges in combating coastal drowning rates, the SR24/7 program is an effective intervention that helps save lives. Importantly, this study provides evidence that the course successfully equips surfers with techniques to act responsibly and safely. Expanding coastal safety focus and resources towards surfers, an often-overlooked demographic in beach safety strategies, could substantially enhance community-level capacity to prevent and respond to ocean emergencies.
    MeSH term(s) Humans ; Drowning/prevention & control ; New Zealand ; Retrospective Studies ; Sports ; Australia
    Language English
    Publishing date 2023-11-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041338-5
    ISSN 1471-2458 ; 1471-2458
    ISSN (online) 1471-2458
    ISSN 1471-2458
    DOI 10.1186/s12889-023-17057-w
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  2. Article ; Online: Mortality trends and the impact of exposure on Australian coastal drowning deaths, 2004-2021.

    Koon, William A / Peden, Amy E / Lawes, Jasmin C / Brander, Robert W

    Australian and New Zealand journal of public health

    2023  Volume 47, Issue 2, Page(s) 100034

    Abstract: Objective: The aim of this study is to characterise Australian coastal drowning trends and evaluate impact of exposure on drowning risk.: Methods: Descriptive epidemiological analysis of unintentional fatal drowning occurring July 2004-June 2021 at ... ...

    Abstract Objective: The aim of this study is to characterise Australian coastal drowning trends and evaluate impact of exposure on drowning risk.
    Methods: Descriptive epidemiological analysis of unintentional fatal drowning occurring July 2004-June 2021 at Australian coastal sites (beaches, rock platforms, bays, harbours, offshore locations etc.). Total population, exposed-person and exposed-person-time rates per 100,000 population were calculated by age, sex, socio-economic status, remoteness category and pre-submersion activity. Annual trends were assessed using joinpoint regression. Exposure-based rates used estimates from Surf Life Saving Australia's National Coastal Safety Survey.
    Results: The cumulative unintentional coastal fatal drowning rate was 0.43 per 100,000 Australian residents (95%CI: 0.41-0.45) and did not change throughout the study period (p=0.289). The exposed-person rate was 0.67 per 100,000 coastal visitors (95%CI: 0.62-0.72), and there were 0.55 coastal drowning deaths per 10 million coastal visitor hours (95%CI: 0.51-0.59). Men, older people and residents of lower socio-economic and remote areas had higher drowning rates; rock fishing and scuba diving had the highest activity exposure-based rates.
    Conclusions: Education- and policy-based coastal safety interventions should focus on identified risk factors to reduce annual coastal drowning rates.
    Implications for public health: Exposure-based risk measurements are important for developing and prioritising interventions; assessments based on counts or total population measures alone may misinform prevention efforts.
    MeSH term(s) Male ; Humans ; Aged ; Australia/epidemiology ; Drowning ; Risk Factors ; Educational Status ; Incidence
    Language English
    Publishing date 2023-03-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1323548-5
    ISSN 1753-6405 ; 1326-0200
    ISSN (online) 1753-6405
    ISSN 1326-0200
    DOI 10.1016/j.anzjph.2023.100034
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  3. Article ; Online: Corrigendum to "Mortality trends and the impact of exposure on Australian coastal drowning deaths, 2004-2021" [Australian and New Zealand Journal of Public Health 47 (2023) 100034].

    Koon, William A / Peden, Amy E / Lawes, Jasmin C / Brander, Robert W

    Australian and New Zealand journal of public health

    2023  Volume 47, Issue 6, Page(s) 100125

    Language English
    Publishing date 2023-11-22
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 1323548-5
    ISSN 1753-6405 ; 1326-0200
    ISSN (online) 1753-6405
    ISSN 1326-0200
    DOI 10.1016/j.anzjph.2023.100125
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  4. Article ; Online: Identifying risk factors and implications for beach drowning prevention amongst an Australian multicultural community.

    Woods, Mark / Koon, William / Brander, Robert W

    PloS one

    2022  Volume 17, Issue 1, Page(s) e0262175

    Abstract: Multicultural communities in Australia are recognised as a priority area for drowning prevention, but no evidence-based study has addressed their knowledge of beach safety. This study used an online survey tool to identify and examine risk factors ... ...

    Abstract Multicultural communities in Australia are recognised as a priority area for drowning prevention, but no evidence-based study has addressed their knowledge of beach safety. This study used an online survey tool to identify and examine risk factors relating to swimming ability, beach visitation characteristics and behaviour, and beach safety knowledge of the Australian Southern Asian community to assist in the development of future beach safety interventions. Data was obtained through 249 online and in-person surveys of people aged > 18 years. Most respondents reported poor swimming ability (80%), often swam in in the absence of lifeguards (77%), did not understand the rip current hazard (58%), but reported that they entered the water (76%) when visiting beaches. Close to one-quarter (28%) had not heard, or didn't know the purpose, of the red and yellow beach flags, which identify lifeguard supervised areas on Australian beaches. Length of time living in Australia is an important beach safety consideration for this community, with minimal differences in terms of gender and age. Those who have lived < 10 years in Australia visit beaches more frequently and are less likely to have participated in swimming lessons, be able to swim, heard of the flags or swim between them, understand rip currents, or have participated in a beach safety program. Very few (3%) respondents received beach safety information from within their own community. The importance of beach safety education and swimming lessons within the Southern Asian community should be prioritised for new and recent migrants to Australia.
    MeSH term(s) Adolescent ; Adult ; Australia ; Cultural Diversity ; Drowning/prevention & control ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Safety ; Surveys and Questionnaires ; Swimming/statistics & numerical data ; Young Adult
    Language English
    Publishing date 2022-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0262175
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  5. Article ; Online: The epidemiology, risk factors and impact of exposure on unintentional surfer and bodyboarder deaths.

    Lawes, Jasmin C / Koon, William / Berg, Ingvar / van de Schoot, Dion / Peden, Amy E

    PloS one

    2023  Volume 18, Issue 5, Page(s) e0285928

    Abstract: Surfing and bodyboarding (SAB) are popular activities, but not without risk. Limited SAB mortality and exposure risk explorations exist, so this cross-sectional study explores epidemiology and risk factors for SAB deaths (1 July, 2004-30 June,2020) in ... ...

    Abstract Surfing and bodyboarding (SAB) are popular activities, but not without risk. Limited SAB mortality and exposure risk explorations exist, so this cross-sectional study explores epidemiology and risk factors for SAB deaths (1 July, 2004-30 June,2020) in Australia: including decedent and incident profiles, causes of death, differences between fatalities during SAB and other coastal activities; and the impact of exposure on SAB mortality risk. Fatality data were sourced from the National Coronial Information System, incident and media reports. Tide-state data, population data and participation data were sourced from relevant authorities. Analyses included chi-square testing and simple logistic regression with odds ratios. There were 155 SAB deaths (80.6% surfing; 96.1% male; 36.8% aged 55+years; 0.04/100,000 residents; 0.63/100,000 surfers). Drowning was the most common cause of death (58.1%; n = 90), but higher in bodyboarding, with bodyboarders 4.62 times more likely to drown than surfers (95%CI: 1.66-12.82; p = 0.003). Almost half (44.5%; n = 69; χ22 = 9.802; p = 0.007) were with friends/family, and the largest proportion occurred during a rising tide (41.3%; n = 64; χ23 = 180.627; p<0.001) followed by a low tide (36.8%;n = 57). Australians surf 45.7 times each year, for 1.88 hours each visit equalling 86.1 'exposed' hours. With exposure-time considered, exposure-adjusted surfer mortality rate (0.06/1 million hours) is lower than other in-water activities (0.11/1 million hours). Younger surfers (14-34 years) surfed more yet had the lowest mortality rate (114.5 hours/year; 0.02/1 million hours). Older surfers (55+ years) had a lower SAB mortality rate (0.052) than the all-cause crude mortality rate of their average population counterparts (1.36). Cardiac conditions were identified in 32.9% (n = 69) of SAB deaths. SAB are relatively safe, with lower exposure mortality rates than other activities. Prevention should target older surfers, inland residents, and identification of surfers with risk factors for cardiac events.
    MeSH term(s) Humans ; Male ; Female ; Cross-Sectional Studies ; Australia/epidemiology ; Sports ; Water ; Drowning/epidemiology ; Risk Factors
    Chemical Substances Water (059QF0KO0R)
    Language English
    Publishing date 2023-05-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0285928
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  6. Article ; Online: Burden of fatal drowning in California, 2005-2019.

    Koon, William / Stewart, Orion / Brander, Robert / Quan, Linda / Peden, Amy E

    Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention

    2023  Volume 29, Issue 5, Page(s) 371–377

    Abstract: Objective: To characterise risk factors for fatal drowning in California, USA to inform priorities for prevention, policy and research.: Methods: This retrospective population-based epidemiological review of death certificate data evaluated fatal ... ...

    Abstract Objective: To characterise risk factors for fatal drowning in California, USA to inform priorities for prevention, policy and research.
    Methods: This retrospective population-based epidemiological review of death certificate data evaluated fatal drowning events in California from 2005 to 2019. Unintentional, intentional, and undetermined drowning deaths and rates were described by person (age, sex, race) and context-based variables (region and body of water).
    Results: California's fatal drowning rate was 1.48 per 100 000 population (n=9237). Highest total fatal drowning rates occurred in the lower population density northern regions, among older adults (75-84 years: 2.54 per 100 000 population; 85+: 3.47 per 100 000 population) and non-Hispanic American Indian or Alaska Native persons (2.84 per 100 000 population). Male drowning deaths occurred at 2.7 times the rate of females; drowning deaths occurred mainly in swimming pools (27%), rivers/canals (22.4%) and coastal waters (20.2%). The intentional fatal drowning rate increased 89% during the study period.
    Conclusions: California's overall fatal drowning rate was similar to the rest of the USA but differed among subpopulations. These divergences from national data, along with regional differences in drowning population and context-related characteristics, underscore the need for state and regional level analyses to inform drowning prevention policy, programmes and research.
    MeSH term(s) Female ; Humans ; Male ; Infant ; Aged ; Drowning/epidemiology ; Drowning/prevention & control ; Retrospective Studies ; Risk Factors ; California/epidemiology ; Rivers
    Language English
    Publishing date 2023-05-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 1433667-4
    ISSN 1475-5785 ; 1353-8047
    ISSN (online) 1475-5785
    ISSN 1353-8047
    DOI 10.1136/ip-2023-044862
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4910: Show issues Location:
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  7. Article: 'I actually thought that I was going to die': Lessons on the rip current hazard from survivor experiences.

    Cornell, Samuel / Brander, Robert W / Roberts, Amelia / Koon, William / Peden, Amy E / Lawes, Jasmin C

    Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals

    2023  Volume 35, Issue 2, Page(s) 551–564

    Abstract: Background: Rip currents are strong, narrow, fast-flowing currents of water that occur on many beaches and in Australia contributing to 26 drowning deaths and several thousand lifeguard/lifesaver rescues each year. Educating the public about the rip ... ...

    Abstract Background: Rip currents are strong, narrow, fast-flowing currents of water that occur on many beaches and in Australia contributing to 26 drowning deaths and several thousand lifeguard/lifesaver rescues each year. Educating the public about the rip current hazard is a primary focus of beach safety practitioners, but there has been a lack of qualitative research exploring the firsthand experiences of being caught in a rip current to assist in this regard. The aim of this study was to analyse interviews of rip current survivors to understand more about how people react when unintentionally caught in a rip current in order to help guide future public education to mitigate rip current drowning.
    Methods: Semi-structured interviews were conducted with 56 individuals (primarily Australian-born) about their experience of being caught in a rip current. Interviewees were recruited via an online survey and varied in age and self-reported swimming ability.
    Results: Thematic analysis revealed three key temporal elements to the rip current experience: Before the Rip in which lack of awareness and knowledge, complacency, over-confidence, and attitude were prevalent themes; During the Rip which identified panic and temporary inhibition of decision-making, physical response, prior experience, and relationships with other beach users as themes; and After the Rip where post-rip effects and rip safety messaging and education were key themes. The importance of experiential immersion was a prevalent thread throughout all phases of the thematic analysis.
    Discussion: Our research shows that being caught in a rip current can be an intense and traumatic experience and that lessons learned from survivors have significant implications for improving existing and future rip current education efforts. In this regard, we provide several recommendations based on evidence-based insights gained from our interviews including the development of immersive rip current experience using virtual reality.
    So what: Despite the prevalence of rip currents causing drowning deaths and rescues, there has been a lack of qualitative research on firsthand experiences to aid in public education. These interviews emphasise the intense and traumatic nature of being caught in a rip current, underscoring the need for improved rip current education to aid in prevention of this, often harrowing, experience.
    MeSH term(s) Humans ; Drowning/prevention & control ; Australia ; Swimming ; Surveys and Questionnaires ; Rescue Work
    Language English
    Publishing date 2023-08-07
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2250864-8
    ISSN 2201-1617 ; 1036-1073
    ISSN (online) 2201-1617
    ISSN 1036-1073
    DOI 10.1002/hpja.785
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  8. Article: Lessons learned from co-designing a high school beach safety education program with lifeguards and students.

    Koon, William / Brander, Robert W / Alonzo, Dennis / Peden, Amy E

    Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals

    2022  Volume 34, Issue 1, Page(s) 222–231

    Abstract: Issue addressed: School-based beach safety education programs are common, but best practice guidance and information on their design and development is limited.: Methods: Researchers, professional ocean lifeguards and students participated in a co- ... ...

    Abstract Issue addressed: School-based beach safety education programs are common, but best practice guidance and information on their design and development is limited.
    Methods: Researchers, professional ocean lifeguards and students participated in a co-design process to inform a lifeguard-delivered, school-based beach safety education program for a coastal community in New South Wales, Australia. Lifeguards and researchers (experts) provided structured feedback about the program in a survey and facilitated workshop; students (n = 26) aged 11 to 13 years participated in focus group sessions intended to garner in-depth understanding of their experiences at the beach and knowledge of, and attitudes towards, beach safety.
    Results and discussion: The co-design process provided a novel and inclusive model for beach safety education program development, and valuable lessons for future efforts. Specifically, student focus groups identified several facets of pre-teens and younger teenagers' beach experience that prompted revision of the education program, primarily framing of program content and safety messages. Peers are a primary motivator for this age group and students' burgeoning independence emerged as an important theme. While knowledgeable about beach hazards and risks, students conveyed mixed safety attitudes and self-reported safety practices, highlighting the importance of designing programs to motivate behaviour and promote safe decision-making vs raising awareness alone. Findings illustrate the value of adopting co-design processes for all beach safety programs, school or otherwise. SO WHAT?: Beach safety programs may not be delivering information that is needed, wanted or useful. Structured consultation with the priority population must become standard practice in beach safety and drowning prevention education program development.
    MeSH term(s) Child ; Adolescent ; Humans ; Drowning/prevention & control ; Students ; Australia ; Program Development ; Schools
    Language English
    Publishing date 2022-09-25
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2250864-8
    ISSN 2201-1617 ; 1036-1073
    ISSN (online) 2201-1617
    ISSN 1036-1073
    DOI 10.1002/hpja.664
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  9. Article ; Online: Studying outcome predictors of drowning at the scene: Why do we have so few answers?

    Koon, William / Clemens, Tessa / Bierens, Joost / Quan, Linda

    The American journal of emergency medicine

    2020  Volume 46, Page(s) 361–366

    Abstract: Background: Identification of predictors of outcome at the scene of drowning events could guide prevention, care and resource utilization. This review aimed to describe where, what and how scene predictive factors have been evaluated in drowning outcome ...

    Abstract Background: Identification of predictors of outcome at the scene of drowning events could guide prevention, care and resource utilization. This review aimed to describe where, what and how scene predictive factors have been evaluated in drowning outcome studies.
    Methods: We reviewed studies reporting scene drowning predictors published between 2003 and 2019. Data extraction included study populations, data sources, predictor factors (victim, incident, rescue, resuscitation and hospital-related), outcome measures and type of analyses.
    Results: Of 49 studies, 87.6% were from high-income countries, 57.1% used data from only one source (92.9% of these from either hospital or EMS), 73.5% included cases who received medical care and 53.1% defined outcomes as survival or death. A total of 78 different factors were studied; the most commonly studied group of factors described victim demographics, included in 42 studies (85.7%), followed by resuscitation factors, included in 30 studies (61.2%). Few studies described rescue (6.1%). The most frequent statistically significant single predictors of outcome known at the scene were submersion duration (evaluated in 19, predictor in 14) and age (evaluated in 31, predictor in 16). Only 38.7% of studies employed multivariable methods.
    Conclusions: Gaps to be addressed in drowning outcomes research include data from low- and middle-income countries, standardized definition of factors to allow evaluation across studies, inclusive study populations that can be generalized beyond those receiving medical care, study rescue and resuscitation factors, use of more meaningful outcomes (survival with good neurologic status) and advanced analyses to identify which factors are true predictors versus confounding variables.
    MeSH term(s) Age Factors ; Drowning/mortality ; Humans ; Near Drowning/therapy ; Prognosis ; Resuscitation ; Risk Factors ; Survival Analysis ; Time Factors
    Language English
    Publishing date 2020-10-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2020.10.011
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  10. Article ; Online: Coastal drowning: A scoping review of burden, risk factors, and prevention strategies.

    Koon, William / Peden, Amy / Lawes, Jasmin C / Brander, Robert W

    PloS one

    2021  Volume 16, Issue 2, Page(s) e0246034

    Abstract: Objective: Coastal drowning is a global public health problem which requires evidence to support safety initiatives. The growing multidisciplinary body of coastal drowning research and associated prevention countermeasures is diverse and has not been ... ...

    Abstract Objective: Coastal drowning is a global public health problem which requires evidence to support safety initiatives. The growing multidisciplinary body of coastal drowning research and associated prevention countermeasures is diverse and has not been characterised as a whole. The objective of this scoping review was to identify key concepts, findings, evidence and research gaps in the coastal drowning literature to guide future research and inform prevention activities.
    Methods: We conducted a scoping review to identify peer reviewed studies published before May 2020 reporting either (i) fatal unintentional coastal drowning statistics from non-boating, -disaster or -occupational aetiologies; (ii) risk factors for unintentional fatal coastal drowning; or (iii) coastal drowning prevention strategies. Systematic searches were conducted in six databases, two authors independently screened studies for inclusion and one author extracted data using a standardised data charting form developed by the study team.
    Results: Of the 146 included studies, the majority (76.7%) were from high income countries, 87 (59.6%) reported coastal drowning deaths, 61 (41.8%) reported risk factors, and 88 (60.3%) reported prevention strategies. Populations, data sources and coastal water site terminology in the studies varied widely; as did reported risk factors, which most frequently related to demographics such as gender and age. Prevention strategies were commonly based on survey data or expert opinion and primarily focused on education, lifeguards and signage. Few studies (n = 10) evaluated coastal drowning prevention strategies.
    Discussion: Coastal drowning is an expansive, multidisciplinary field that demands cross-sector collaborative research. Gaps to be addressed in coastal safety research include the lack of research from lower resourced settings, unclear and inconsistent terminology and reporting, and the lack of evaluation for prevention strategies. Advancing coastal drowning science will result in a stronger evidence base from which to design and implement effective countermeasures that ultimately save lives and keep people safe.
    MeSH term(s) Drowning/epidemiology ; Drowning/prevention & control ; Humans ; Risk Factors
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0246034
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