Background Pools with lifeguards are often perceived to represent a safe environment for swimming.
Objectives To examine how often fatalities occurred in pools with lifeguards and what factors were common in these incidents.
Design Case series.
Subjects A case was defined as a death in a swimming pool with at least one lifeguard that occurred in the USA from 2000 to 2008. Potential cases were identified from media accounts using Lexis-Nexis and ProQuest databases. Supplemental information was obtained through internet based searches and review of death certificates.
Results A total of 140 deaths from 37 states were identified. Of decedents, 109 (78%) were children and 93 (66%) were males. African Americans accounted for 44% of deaths among those of known race. 104 (74%) fatalities occurred during May through August; 85 (61%) deaths occurred in outdoor pools. Sites for fatal incidents included 53 (38%) municipal pools, 21 (15%) community organisations, and 20 (14%) schools. The median swimmer to lifeguard ratio was 13:1. Decedents were initially identified in the pool twice as often by non-lifeguards (eg, other swimmers or bystanders) as by lifeguards.
Conclusions Deaths in pools with lifeguards are uncommon, but do occur. Groups most affected include children, males, and African Americans. While lifeguards provide an important layer of protection at swimming pools, they alone cannot prevent all drownings. Additional safety measures are needed.
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Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Funding This work was done by federal employees as part of their normal work activities. There were no external sources of funding for this study. The findings in this report are based, in part, on contributions by Kenneth Ascher, Christy Cechman, Gerald Dworkin and Francesco Pia.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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