title: Survival of immersions during recreational boating events in Alaska, 1999-2004.
abstract: OBJECTIVE
  This retrospective study analyzed records of boating or other watercraft-related events in Alaska from 1999-2004, where at least one drowning occurred, to identify factors associated with survivors of these same events.
  
  
  METHODS
  Records of recreational boating events involving at least one fatality were obtained through the U.S. Coast Guard. Group rescue responses and rescue assistance responses by others outside the parties were categorized and analyzed. We conducted t tests and odds ratios to analyze inter-group differences.
  
  
  RESULTS
  There were 32 immersion events involving 36 fatalities (F-group members) and 72 immersed survivors (S-group.) Analysis of behaviors during and after immersion events showed that two-thirds of the S-group avoided submersion. Most survivors (59%) demonstrated effective exit strategies. Rescue attempts by members of a traveling party resulted in the greatest number of survivors, followed by self rescue attempts.
  
  
  CONCLUSIONS
  This study helps build a case for the need for more detailed surveillance systems to identify factors that contribute to submersion avoidance. This study also points out the need for enforcement, education, and engineering controls to help improve survival of cold water immersions.
authors.affiliation: Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Norrbacka, Stockholm SE-171, Sweden. diana_hudson@hotmail.com <diana_hudson@hotmail.com>
authors.forename: Diana
authors.initials: D
authors.lastname: Hudson
authors.forename: Robert
authors.initials: R
authors.lastname: Ekman
authors.forename: Leif
authors.initials: L
authors.lastname: Svanström
mesh_terms: D000059:Accidents / Q000401:mortality* / Q000706:statistics & numerical data; D000328:Adult; D000413:Alaska / Q000453:epidemiology; D004332:Drowning / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006801:Humans; D007101:Immersion; D015994:Incidence; D008297:Male; D015701:Near Drowning; D011998:Recreation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012767:Ships; D013534:Survival