title: Compliance with an ordinance requiring the use of personal flotation devices by children in public waterways.
abstract: BACKGROUND
  For children ages 1-14, 21.6% of drowning cases involve swimming, wading, or playing in natural bodies of water, such as rivers and lakes. Personal flotation devices (PFDs) are believed to be an effective prevention measure. We measure compliance with city and county ordinances, publicized but not actively enforced, requiring that PFDs be worn by children accessing public bodies of water in Sacramento County, California.
  
  
  METHODS
  During June-August 2010, volunteers conducted 79 observation sessions at three popular local river beaches where PFDs were available for use at no cost. They recorded personal characteristics and PFD use for 1,727 children in or very near the water and believed to be 0-13 years of age (the age covered by the ordinances). We used logistic regression to quantify differences in use by subject characteristics and study site.
  
  
  RESULTS
  The prevalence of PFD use was 29.9% overall, with large and significant differences by age: < 1, 55.6%; 1-4, 37.6%; 5-10, 29.4%; 10-13, 14.6%; P < 0.0001. Usage did not vary significantly by sex or race/ethnicity, and was somewhat higher at one study site (33.1%) than at the others (25.9% and 27.3%), P = 0.009.
  
  
  CONCLUSIONS
  The combination of a statutory requirement and a cost-elimination strategy was associated with moderate rates of PFD use that were highest among young children.
authors.affiliation: Department of Emergency Medicine, University of California Davis, California.
authors.forename: Garen J
authors.initials: GJ
authors.lastname: Wintemute
authors.forename: Amy
authors.initials: A
authors.lastname: Anton
authors.forename: Emily
authors.initials: E
authors.lastname: Andrada
authors.forename: Ryan
authors.initials: R
authors.lastname: Ribeira