The importance of documenting swimming-pool accidents.

Though drownings or near drownings receive significant attention in the news media, "other" swimming pool-related accidents usually do not. Though this is related to the "life-threatening" nature of drowning, other accidents more frequently occur. Pool managers should be greatly concerned with these accidents for several reasons:

1. Swimming continues to rank as one of the five most popular recreation activities in the United States (NPS Statistical Abstract, 1988; Stone, 1991; Cordes & Ibrahim, 1996) and, therefore, bather safety should be paramount.

2. An accident, no matter how minor, has the potential to (a) detract from your customers' recreation experiences, (b) damage your facility's reputation, and (c) result in legal action.

3. There exists no comprehensive data on swimming-pool accidents (Hayes, 1996).

4. Swimming pools vary significantly in terms of size, shape, depth, accessory equipment, physical layout, hours of operation, circulation and sanitation systems, and customers.

5. By having accident data specific to their pool, pool managers can more effectively address those accidents and have hard data documenting their need for additional staff, supplies, equipment, or repairs.

6. Maintaining accident records provides baseline data by which safety measures can be implemented and success evaluated.

With these six points in mind, a descriptive analysis was conducted on accident data collected at 18 public swimming pools during the summer of 1995. All pools were operated under the direction of an aquatic-facility management company that was responsible for all programming (lifeguarding, swim lessons, swim-team coaching, pool parties, water exercise, scuba lessons) and operation (maintenance, repairs, chemicals, spring opening, winterization). All were seasonal-use facilities, supervised by certified lifeguards. They included pools owned by country clubs, racquet and swim clubs, homeowner associations, and recreation clubs located in eastern North Carolina. Data collected included (1) types of accidents, (2) bodily locations of injuries, (3) locations of accidents, (4) a comparison of accidents occurring at pools with and without diving boards, (5) causes of accidents, (6) times of accidents, (7) dates of accidents, and (8) ages of those injured.

Table 1 (Types of Accidents) showed that 71 percent of all onsite, pool-related accidents occurring in 1995 were classified as either abrasions or cuts. Bruises followed with 11 percent, and insect stings/bites were fourth with nine percent. Thus, abrasions, cuts, bruises, and insect stings/bites were the major types of accidents, accounting for 91 percent of accidents reported.

TABLE 1. TYPES OF ACCIDENTS

Accident               Frequency      Percentage

Cuts                      24             37%
Abrasions                 22             34%
Bruises                    7             11%
Insect Stings/Bites        6              9%
Punctures                  3              5%
Dislocations               1              2%
Breathing                  1              2%
Sprains                    0              0%
Other                      1              2%
Information Not
  Available                0              0%
TOTAL                      65           100%

Table 2 (Bodily Location of Injuries) revealed that pool-related injuries predominately occurred to the lower extremities (41 percent to the feet and legs). Injuries to the head and face followed with 25 percent. This is alarming because of the potential for more serious (neck and eye) injuries.

TABLE 2. BODILY LOCATIONS OF INJURIES

Bodily Location         Frequency       Percentage
Foot                    19              29%
Face                    9               14%
Leg                     8               12%
Head                    7               11%
Hand                    5               8%
Back                    3               5%
Arm                     2               3%
Inside Mouth            2               3%
Hip                     1               2%
Rear End                1               2%
Shoulder                1               2%
Combination of
  Locations             4               6%
Other                   2               3%
Information Not
  Available             1               2%
TOTAL                   65              100%

Table 3 (Locations of Accidents) revealed that accidents occurred at an equal rate both in and out of the water/pool. It should be noted that 84 percent of all accidents occurred in four locations: (1) on the deck (29 percent), (2) in the shallow end (29 percent), (3) on the diving board (14 percent), and (4) in the deep end (12 percent). Wading pools accounted for only two percent of all accidents.

TABLE 3. PHYSICAL LOCATION OF ACCIDENTS

                                Categorical     Total
Location           Frequency    Percentage      Percentage

In the pool           31                          48%
  Shallow End         19           61%            29%
  Deep End            18           26%            12%
  Around Ladders       3           10%             5%
  Wading Pool          1            3%             2%
Out of the pool       31                           48%
  On the Deck         19           61%             29%
  On Diving Boards     9           29%             14%
  In Concessions       3           10%              5%
  In Restrooms         0            0%              0%
Lifeguard Accidents    1                            2%
Other                  2                            3%
Information Not
  Available            0                            0%
TOTAL                  65                          100%%

Table 4 presented a comparison of accidents at pools with and without diving boards. Using a non-parametric test (Wilcoxan Rank Sum), the number of accidents at pools with diving boards was significantly higher (t=-1.87) than at pools without diving boards; accidents occurred three times more frequently at the former.

TABLE 4. COMPARISON OF ACCIDENTS OCCURRING AT POOLS WITH AND WITHOUT
DIVING BOARD

t-Test for Independent Samples

Item                            Group 1       Group 2

Sample Size                      10             8
Mean                             5.30           1.50
Standard Deviation               5.60           1.50
t-Value                         -1.8749
Probability One-Tailed           0.0396
Point-Biserial Correlation      -0.4244

Table 5 (Causes of Accidents) indicated that the most frequent accident (22 percent) was hitting the pool bottom or wall; this was followed by falling on the deck or diving board (14 percent) and stepping on an object (14 percent). These three accounted for nearly half (48 percent) of all causes. An additional 28 percent was caused by a cut from another object (11%), insect stings and bites (nine percent), and being hit by another swimmer (eight percent). Because of the potentially higher degree of severity, it should be noted that six percent of the reported accidents were caused by hitting the diving board while diving. When these seven situations combined, 84 percent of causes explaining pool-related accidents are explained.

TABLE 5. CAUSES OF ACCIDENTS

Cause of Accident                      Frequency        Percentage

Hit pool wall and/or bottom             14                 22%
Fell (On deck or on diving               9                 14%
  board)
Stepped on object                        9                  4%
Cut from other object                    7                 11%
Insect stings/bites                      6                  9%
Hit by another swimmer                   5                  8%
Hit by another object                    4                  6%
Hit diving board while diving            4                  6%
Other                                    4                  6%
Information Not Available                3                  4%
TOTAL                                   65                100%

Table 6 (Times of Accidents) showed that two-thirds (66 percent) of reported pool accidents occurred between 1-6 p.m.- generally the hottest part of the day and the heaviest bather load. It should be noted, however, that this data represents pools with opening times ranging from 10 a.m.-2 p.m. and closing times from 7-10 p.m.

TABLE 6. TIME OF ACCIDENTS

Time Period             No. of Accidents    Percentage

8-9 a.m.                               1            2%
9-10 a.m.                              0            0%
10-11 a.m.                             2            3%
11 a.m.-Noon                           4            6%
Noon-1 p.m.                            3            5%
1-2 p.m.                              11           17%
2-3 p.m.                               8           12%
3-4 p.m.                              10           15%
4-5 p.m.                               7           11%
5-6 p.m.                               7           11%
6-7 p.m.                               6            9%
7-8 p.m.                               3            0%
After 8 p.m.                           0            0%
Time Not Available                     3            5%
TOTAL                                 65          100%

Table 7 (Dates of Accidents) is representative of seasonal outdoor pools. Though some pools opened as early as May 1, the majority (15) opened on Memorial Day and closed on Labor Day. Forty-one percent of reported accidents occurred in the five-week period between Memorial weekend (May 24-26) and June 30. Seventy percent occurred in the eight-week period between June 1 and July 31, and 80 percent of all pool-related accidents occurred before August, when bather load declines because of school openings.

TABLE 7. DATE OF ACCIDENTS

                May                 June

Week    No. of Accidents     Week       No. of Accidents

1-7               0(0%)      1-77                  (11%)
8-15              1(1%)      8-15                  5(8%)
16-23             1(1%)     16-23                  6(9%)
24-31             5(8%)     24-31                  3(5%)
TOTAL            7(10%)     TOTAL                21(33%)

               July                 August

Week    No. of Accidents        Week    No. of Accidents

1 -7               6(9%)        1-7               3(5%)
8-15              9(14%)        8-15              4(6%)
16-23              5(8%)        16-23             5(8%)
24-31              4(6%)        24-31             1(1%)
TOTAL            24(37%)        TOTAL           13(20%)

Table 8 (Ages of Injuries) revealed that nearly 80 percent of reported accidents were to children and teenagers. Within those ages, the 4-7 year olds and 8-12 year olds accounted for 22 percent and 37 percent of all accidents, respectively.

TABLE 8. AGES OF INJURED

Age (years)              Frequency       Percentage

Birth-3                         5                8%
4-7                             14              22%
8-12                            24              37%
13-16                           8               12%
17-20                           0                0%
21-24                           1                2%
Information Not
  Available                     13              20%
TOTAL                           65             100%

Management Implications

Following are management implications based on analysis of accidents that occurred at 18 swimming pools in 1995. It should be noted, and it is recommended, that pool managers monitor pool-related accidents annually and on an individual pool basis.

1. Pool-related accidents usually occurred to the lower extremities (feet and legs), although a significant number also occurred to the head. Abrasions and cuts were the result of most accidents; however, bruises and insect stings/bites also occurred frequently.

Implications:

a. What policies and procedures could be developed and implemented that would reduce such injuries? b. Is your pool staff qualified to handle these types of injuries? c. Does your first-aid kit contain supplies and equipment necessary to treat these injuries (including universal safety protection equipment such as latex gloves and pocket vent) ?

2. Pool-related accidents occurred at an equal rate both in and out of the pool. The majority of accidents occurred (in decreasing order of frequency) on the deck, in the shallow end of the pool, on the diving board, and in the deep end. The most frequent causes of accidents were hitting the pool bottom or wall, falling on the deck or diving board, and stepping on an object. Other causes that frequently occurred included cuts from other objects, insect stings/bites, and being hit by another swimmer.

Implications:

a. What are the causes and locations of your pool accidents? b. What is the frequency and severity of those accidents? c. What policies and procedures could be developed and implemented that would reduce such accidents?

3. Accidents occurred most frequently between 1-6 pan., and from spring opening through the end of July.

Implications.

a. Are more staff members needed during these times? b. Are bather limits needed? c. Do existing rules need to be more strictly enforced? 4. Pool-related accidents occurred primarily to children and teenagers (16 years old and younger), with 8-12 year olds the most frequently injured group, followed by 4-7 year olds.

Implications:

a. Are staff members focusing their attention on these age groups? b. Do new rules need to be developed or existing rules more strictly enforced? c. How are they dealing with babies (4 years and under) and their parents, children (5-8 years), pre-adolescents (9-12 years), teenagers (13-16years)? d. Do staff members need management strategies specific to these different age groups?

Summary

The state health code of North Carolina requires that accident reports be completed when injuries occur at public swimming pools. This study illustrates the value of such data. Clearly, pool managers have the opportunity to attain this information, analyze it, share it with their pool staff, and act upon it prior to opening their facilities.

References

Cordes, K.A. & H.M. Ibrahim. 1996. Applications In Recreation & Leisure For Today And The Future. Mosby-Year Book Inc., St. Louis, Missouri.

Hayes, James. 1996. Interview on February 12,1996. Public Pool Manager, Division of Environmental Health, North Carolina Department of Health, Environment, & Natural Resources, Raleigh, North Carolina.

Stone, W.J. 1991. "Changing Physical Activity Preferences of American Adults". Journal of Physical Education, Recreation & Dance. April 1991. p.67-71, 76.

USDI National Park Service. 1988. National Park Service Statistical Abstract. Denver Service Center, Denver, Colorado.

Note: The authors wish to acknowledge the assistance in data analysis provided by Frank Nahar and Tim Meyer, graduate teaching assistants in the Exercise and Sport Science Department at East Carolina University