title: Snorkelling deaths in Australia, 1987-1996.
abstract: OBJECTIVE
  To examine the causes and circumstances of snorkelling deaths in Australia from 1987 to 1996.
  
  
  METHODS
  Retrospective case extraction. CASES AND DATA SOURCES: 60 snorkelling deaths extracted from an ongoing diving fatality survey and from coroners' reports. Further details were obtained from police reports, diving industry (incorporating commercial operators, relevant government departments and instructors' organisations) inquiries and coronal inquests.
  
  
  METHODS
  Cause of death (determined by the authors from information obtained and from detailed autopsy findings) and the circumstances surrounding death.
  
  
  RESULTS
  15 of the 60 snorkellers who died were female. The three major causes of death were drowning (27 cases), cardiac events (18) and hypoxia with breath-holding after hyperventilation and/or during ascent producing unconsciousness then drowning (12). Overseas tourists were notable among those who drowned, while middle-aged men dominated the group who died of cardiac events (mostly on the surface). Those who died of breath-holding hypoxia were all young, Australian and male. The use of "buddy" diving was infrequent overall, and many of those who drowned or suffered cardiac events were not wearing flippers to aid propulsion. Adverse environmental conditions were implicated in 14 deaths.
  
  
  CONCLUSIONS
  Hyperventilation to increase breath-hold time is a dangerous practice which should be discouraged. Safety measures, such as the use of flippers for propulsion and employment of the "buddy" system, should be encouraged, and made mandatory in commercial diving operations.
authors.affiliation: Diving Medial Centre, St Leonards, NSW. divmed@ozemail.com.au
authors.forename: C W
authors.initials: CW
authors.lastname: Edmonds
authors.forename: D G
authors.initials: DG
authors.lastname: Walker
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D004242:Diving / Q000293:injuries / Q000706:statistics & numerical data*; D004332:Drowning / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged