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.