Safe swimming: how to develop a site-specific drowning prevention program in your aquatic facility.

It is crucial for aquatic facility and pool operators to understand the risks associated with aquatics. This is relevant to all pools including residential pools, lodging industry pools, public and private pools. It is essential that owners/operators identify, anticipate and evaluate the risks relevant to their facilities and circumstances so they can effectively manage for these risks.

Risk management is not just the duty of management staff, but should include all personnel and be incorporated into all facets of pool operations in order to be effective. For staffed pools this includes any person that has a responsibility to the pool, and for residential and unstaffed pools this may include family members or responsible users. Aquatic facilities can not survive without risk management planning that includes developing a specific drowning prevention program.

Following motor vehicle accidents, drowning is the second leading cause of accidental death in children between the ages of 0-14 in the United States, according to the U.S. Centers for Disease Control and Prevention. Additionally, for every drowning, there are four hospitalized near-drownings and 11 treated near-drownings. A study by the Consumer Product Safety Commission in 1980 estimated that 69 percent of children younger than 5 years of age were under the supervision of one or both parents at the time of drowning. Furthermore, 77 percent of these children had been unsupervised for less than five minutes prior to the drowning incident. Since a child may be completely submerged and unconscious in 30 seconds or less, aquatic professionals stress constant supervision. However, supervision alone is not a satisfactory prevention strategy, as lapses in supervision occur.

One approach to addressing this problem is the implementation of programs that effectively manage for risks by reducing the number of submersion 

incidents and preventing deaths by drowning. Many experts and organizations dedicated to aquatic safety, believe that drowning is preventable by applying targeted prevention strategies. Since one of the responsibilities of a pool owner/operator is to minimize and prevent submersion injuries and drowning, an accident prevention strategy or a site-specific drowning prevention program can be one part of a multifaceted approach in aquatic risk management planning.

By successfully managing risks and developing a site-specific drowning prevention program, managers or pool owners can reduce fatal accidents at any aquatic facility. Ultimately, these strategies require a comprehensive and cooperative effort from all staff, family members and pool users. Furthermore, experts recommend many layers of protection because one single strategy is not likely to prevent all submersion deaths and injuries. Hence a site-specific drowning prevention program would incorporate essential elements of risk management planning and provide layers of protection.

Though it is generally believed that lifeguards are responsible for aquatic safety and reducing risks and the likelihood of a favorable outcome from a drowning incident is increased with the presence of lifeguards, many swimming facilities exist that do not employ staff or lifeguards. It should also be noted that 90 to 95 percent of drowning incidents occur in unstaffed or residential pools, according to the Foundation for Aquatic Injury Prevention.

Although the critical components of a drowning prevention program listed below are for residential swimming pools, these components can be transferred to and utilized by any swimming facility. Respondents placed importance on a consistent set of criteria throughout the study and continually identified constant supervision, water safety and swimming lessons, fences with self latching and locking gates, rescue equipment, and CPR certification as critical components. By combining these components according to the needs of a swimming facility, a site-specific drowning prevention program will be designed that minimizes risk and provides layers of protection against risk.

It is commonly advocated that children must be constantly supervised by parents and lifeguard personnel near water, and studies have found that constant adult supervision is an effective drowning prevention strategy. Yet, approximately 81 percent of respondents identified "lack of supervision" as the primary cause of drowning.

As swimming facilities integrate constant supervision into a drowning prevention, program they should define constant supervision and alert caregivers and aquatic staff to the signs of a distressed and drowning swimmer. Facility signage and prevention information should stress that the supervising adult should be within an arms length of the child with attention and focus on the child. Parents and caregivers should be especially vigilant when supervising children engaged in aquatic activities, particularly at unguarded facilities, as children can move quickly and escape the caretakers notice and drown within 30 seconds.

Supervision from caregivers, parents and aquatic staff must be continuous with no lapses in order to be an effective strategy. Consequently, aquatic staff and in-service training should include scanning, patron surveillance and victim recognition techniques. Most bystanders and professional lifeguards fail to recognize distress and believe the actively drowning victim to be playing. Contrary to popular belief, most drownings are not loud thrashing victims and children usually do not splash and yell when they are having difficulty. Hence, an important element of a drowning prevention program is to change this stereotyped misconception of drowning through educating private and residential pool owners and continued training of aquatic staff and lifeguards.

As swimming facilities integrate water safety and swimming lessons into their drowning prevention programs, they need to consider the age and the physical and cognitive development of the children because they vary on when they are ready for formal swimming lessons. A facility may want to offer "water adjustment" or "general pool safety" classes as well as learn to swim programs, to provide an opportunity for parents to work with their children to be safe in the facility. This class could be offered to the public to educate residential pool owners to encourage site-specific drowning prevention. It is important to remember that an increased swimming ability does not guarantee that one will behave safely around water. Therefore, it is vital to include water safety information in all swimming lessons. Even the best swimmers are not drown-proof.

Research shows that most drowning and near-drowning incidents for young children occurred by entering the pool directly from their home, with no intervening fence. Swimming pool drownings can be prevented through the use of a four-sided fence with a self-latching and locking gate that opens outward and away from the pool. These gates distinctly restrict access and provide a barrier to the pool and should isolate the pool from other buildings, structures and facility amenities.

Because 70 percent of drowning incidents occurred in the victim's home pool, and about 20-25 percent occurred in a friend or relative's pool, all or nearly all, of these drownings could have been prevented through adequate fencing. Research has shown that the ornamental iron fence was the most difficult to climb and also offered excellent vision through the fence which could improve supervision of children. All aquatic facilities should require that all doors with access to the pool have spring locks and have gates that are self-closing, self-latching and self locking. This will help prevent children from wandering into the pool area when no one is there to provide proper supervision. This also assists aquatic staff and lifeguards with monitoring pool entrances to aid in effective patron surveillance and supervision; which is a critical component of a site-specific drowning prevention program.

Rescue equipment is also an integral component of a site-specific drowning prevention program and should be located on all sides of a swimming pool regardless of the type of aquatic facility. All pools should use buoy lines to indicate where deep water begins so that swimmers do not accidentally wander or drift into water that is over their heads. Additionally, all water depths should be well marked on pool decks and walls and easy to read. Reaching and throwing aids should be strategically placed on all sides of the pool and may vary for various pool sizes and shapes. Throwing aids with longer tow lines should be placed in areas of deeper water to meet rescuer needs. First aid supplies should be centrally located, easily accessible, and relevant to site-specific injuries that may occur (i.e., bee sting supplies or sunscreen for outdoor pools).

Pool lighting needs to provide enough light for the entire facility. Aquatic staff, lifeguards, caregivers, parents and swimmers must clearly see the bottom to prevent accidents and unintentional submersions.

It is recommended that all youth care providers, including parents, should learn basic first aid and CPR. This is especially important if care is provided to children with special needs and/or if children are engaging in aquatic activities, Immediate resuscitation is an important means of secondary prevention as children who still require CPR when they arrive at the emergency department have a poor prognosis, and caregivers who know CPR can greatly improve a drowning victim's survival rate.

Since mothers and lifeguards are the primary rescuers in the majority of drowning incidents, it is imperative that they, along with parents, lifeguards and care providers, learn and administer first aid and CPR as part of a drowning prevention program. It is the pool owner's/operator's responsibility to ensure that all staff, supervising adults and care givers are currently certified in CPR.

These five identified critical components assist a pool owner/operator in developing a site-specific drowning prevention program. Constant supervision, water safety and swimming lessons, and fences with self latching and locking gates are drowning prevention strategies that are implemented prior to the opening of a swimming facility. Poolside rescue equipment and CPR certification are drowning prevention strategies that are designed to assist in an emergency to prevent further injury. The tailored combination of the five components creates a site-specific drowning prevention program that not only meets the facility needs but reduces the risk of a submersion injury or death while providing layers of protection against aquatic risks or losses.