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Addressing Confusion And Concerns Created By The Following Study

I sent this to the authors of the study and the editor of Aquatics Magazine and was told he'd get back to me about it. Thus far nothing has happened 1/25/09.

Addressing Confusion And Concerns Created By The Following Study

By

Wayne Oras

 

Pioneering Study Examines Diving Injury Risks. By Kendra Kozen

&

Diving-Related Injuries in Children <20 Years Old

Treated in Emergency Rooms in the United States:

1990-2006     by Coral Day, BS, Uwe Stoltz, PHD,MPH,

Tracy J. Mehan, MA, Gary A. Smith, MD, DrPH and

 Laura B. Mc Kenzie, PHD, MA

Dept.  of Pediatrics

Ohio State U. College of Medicine

Center for Injury Research and Policy, Research Institute, Nationwide Children’s Hospital, Columbus, Ohio.

 

            As a former Diving Coach and diving enthusiast I am concerned about the affect this study may have on the Sport of Competitive Diving. Any person who reads these articles should understand that any activity involves certain risks and sometimes these risks result in serious injury and even death and not just in diving. That was the whole idea behind Informed Consent, “When a body or an object or both are in motion, there is a risk of serious injury or death associated with that movement.”

            I finished my own research that ended in 1990. It was an attempt to justify keeping diving boards in swimming pools. I found similar injuries to the ones discussed in these articles but at the time I was looking for those catastrophic injuries that had risk managers removing diving boards from swimming pools. This study states, “All of the injuries reported in this article are National estimates unless otherwise specified as unweighted cases”. I fail to understand the need for this study to come up with injury estimates when there is a reporting system like the National Electronic Injury Surveillance System and others in place. The concept of NEISS is that it accurately demonstrates the treated diving related injuries not estimated ones.

            The purpose of the study was to examine recreational and competitive diving related injuries…. using a nationally representative sample. The actual study under the Discussion section states, “We were unable to distinguish between competitive and recreational dives because of the lack of detail in case narratives”. I’m not sure how one can distinguish between recreational and competitive diving when the study didn’t even distinguish between residential and public pools. If 80% of the injuries occurred from heights less than 1-meter then none of those injuries was Competitive Diving related or occurred in a public swimming pool (except in shallow water). All of the other injuries stated in the study can occur in any pool.

            The study states that, “many sources cite diving as a high risk athletic activity and neglect to discuss injuries other than catastrophic injuries”. These are the types of injury that risk managers are concerned with and cause them to eliminate diving boards altogether. During this 17-year study period of E.R. reported injuries the study cited only one fatal injury but it was not included in this study for unspecified reasons. This reader can presume that this fatality occurred in the natural environment and not in swimming pools. Furthermore it can be assumed for this 17-year period that no catastrophic injuries were sustained since there was no mention of them in the study.

            Competitive diving injuries from hitting the pool bottom are almost non-existent today because the diving envelope is not only deeper but much larger than that of residential pools. Most public pools when built try to follow the National Governing Body’s suggested pool depth. That is not the case for residential pools where there is a smaller, shallower, diving envelope and a closer slope toward the shallow end. It appears that this is the area where injury occurs because the diver over-shoots the deepest part of the pool and lands on the slope to or even in the shallow end.

            I understand why the “softer pool bottom” was a suggested safety recommendation but it’s really not a good idea. The reason is that if the diver hits the bottom with the head, the soft bottom traps the head, which could lead to a more serious neck injury. This idea was presented for review of residential swimming pools with a depth of 3 to 4 feet. Their recommendation from this statement was to place no diving warning signs around those shallow pools.

            The concern of anyone involved in competitive diving is that one will assume that the sport is unsafe because there has never been a clear distinction between Competitive Diving, recreational diving, diving off the side of the pool into shallow water and diving off a dock in a lake. The term diving lumps all of these together under this one heading. This is how diving boards disappear from facilities that are safe and have this equipment. These are the pools that future divers find an interest in the activity and then join the sport.

            Since this study involved a University hospital and doctors, a valid recommendation should be to develop a code to indicate Competitive, Recreational and shallow water diving injury. That code could be expanded to include the type of pool and the area of the pool where the injury occurred. This would be most helpful if we are looking to reduce injuries. Injury reduction cannot be accomplished if we continually focus on the competitive environment when many injuries are occurring in a non-competitive environment.

            In conclusion, it is difficult to understand why in the opening paragraphs this study mentions competitive diving and the <20 age group if the study couldn’t differentiate detail or data on either. This information should have been stated at the beginning of the study to prevent readers from making false assumptions based on the information presented thereafter.

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