title: How much did cold shock and swimming failure contribute to drowning deaths in the fishing industry in British Columbia 1976-2002?
abstract: BACKGROUND
  The Workers' Compensation Board of British Columbia requested a retrospective analysis of all fishermen's deaths from immersion in water in British Columbia.
  
  
  OBJECTIVE
  To identify the underlying cause of drowning and make recommendations to improve safety in the fishing industry.
  
  
  METHODS
  Eighty-nine inshore and offshore fishing accidents were analysed. Where possible, deaths were classified into the four stages of cold-water immersion: cold shock, swimming failure, hypothermia and post-rescue collapse. Other factors that led up to the drowning were also identified.
  
  
  RESULTS
  One hundred and thirty fishermen died from immersion between 1976 and 2002. One hundred and twenty-eight drownings were certified by the coroner as drowning or drowning/hypothermia and two were certified as cardiac event after immersion. The underlying causes of drownings were reclassified as: cold shock (5.4%), swimming failure (5.4%), hypothermia (5.4%), post-rescue collapse (0.8%), cardiac event (0.8%) and drowning/other (10%). In the remaining 72.2% of deaths, there was insufficient information to determine an underlying cause. All deaths occurred in water below 17.5 degrees C but 95% were in water less than 15 degrees C.
  
  
  CONCLUSIONS
  Immersion in water below 15 degrees C is dangerous and this should be emphasized on marine survival courses. Accident investigators, coroners and pathologists need a common checklist to record vital data. A recommended format is included as Supplementary data available at Occupational Medicine Online. Fishermen should be educated about the dangers of sudden, unexpected immersion in cold water. Consideration should be given to making marine survival courses mandatory for fishermen.
authors.affiliation: Survival Systems Limited, 40 Mount Hope Avenue, Dartmouth, Nova Scotia, B2Y 4K9 Canada. chrisb@sstl.com
authors.forename: C J
authors.initials: CJ
authors.lastname: Brooks
authors.forename: K A
authors.initials: KA
authors.lastname: Howard
authors.forename: S K
authors.initials: SK
authors.lastname: Neifer
mesh_terms: D000062:Accidents, Occupational / Q000401:mortality*; D000328:Adult; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D003080:Cold Temperature / Q000009:adverse effects*; D004332:Drowning / Q000401:mortality*; D005260:Female; D005398:Fisheries / Q000706:statistics & numerical data*; D006801:Humans; D007035:Hypothermia / Q000401:mortality*; D007101:Immersion / Q000009:adverse effects; D008875:Middle Aged; D012769:Shock / Q000401:mortality; D013550:Swimming / Q000706:statistics & numerical data*