Article Text

Children and personal watercraft: injury characteristics and potential countermeasures
1. Chester S Jones
1. Health Sciences, University of Arkansas, 308 HPER Building, Fayetteville, AR 72701, USA
1. Correspondence to: Dr Jones.

## Statistics from Altmetric.com

Every summer, families and children travel to the waterways to participate in recreational activities. One increasingly popular water activity for children is riding on, or operating, personal watercraft (PWC). When these were first produced in the 1970s, they were one seat water vessels with a maximum of 40 horsepower engines. Today, many manufacturers are producing vessels with three seats, horsepowers over 120–135, able to reach top speeds of 65–70 miles per hour. Although there are many variations, the most popular is known in America as a Sea-Doo.

These PWCs generally cost $4000 to$8000. As one PWC dealer stated, “You would have to spend at least $35 000 to$40 000 for a boat to go that fast. Personal watercraft is a cheap way to go fast”.1 Clearly, PWCs are getting bigger and faster and manufacturers appear to be targeting younger populations through sophisticated media advertisements, splashy designs, and appealing to the inherent “fun” of PWC use.

In response to the possible dangers from their use by people 18 years and under, many states in the US have passed regulations governing their operation. But questions remain: how safe are PWCs? Are these countermeasures enough? Are those under 19 at greater risk for injury as operators or passengers than older users? Another concern is for the safety of other users of the waterways.

Indications are that injuries, disabilities, and fatalities are increasing as the popularity of these boats grows. Injuries from PWC related crashes in the US have more than doubled from 1990–94.2 Those to operators under 20 years of age have increased by 50% during the same time (these percentages do not include passengers). The magnitude of this public health problem, and research to prevent PWC related injuries, has not been adequately addressed.3–,6 This may be due to the relatively recent emergence of the PWC as a popular watercraft or to the lack of detailed information or surveillance of incidents involving PWCs.

This paper describes childhood use and injury risk associated with PWCs in Arkansas, the availability and accuracy of injury data, and suggests areas for improved surveillance and countermeasures.

## Methods

To document the use and describe injuries associated with PWCs, boating accident reports provided by the Arkansas State Game and Fish Commission from 1994 through July 1996 were collected. By state law, all boating accidents involving a fatality or \$100 or more in personal property damage must be reported to the commission. These reports are collected by boating accident investigators certified through the US Coast Guard. Before 1994, the reporting of such accidents was the sole responsibility of the individuals involved and it was likely the data were inconsistent and unreliable. Therefore, researchers did not compile reports collected before this date.

## Results

Over a 30 month period, Arkansas waterways recorded 82 wrecks, 57 injuries, and four deaths involving PWC. In most cases the operator was responsible for the event. Operators under the age of 18 were involved in 43% (35) (mean age 14 years), less than 20 hours of experience (69%), and most had no prior boating education class (98%). Most passengers were also under the age of 18 (70%). About half of all reported injuries occurred to those under the age of 19 (48%). The youngest fatality was an 18 year old who drowned after being thrown from a PWC.

Of the 27 injuries to those under 19, four included the head and neck, four involved a lower extremity, and one an upper extremity; the body part was not specified in the remaining 18. Specific types of injury included fractures (19%), lacerations (11%) , abrasions (4%), sprain (4%), drowning (4%). Of the injured, 19 (70%) were operators.

The most frequently cited causes for incidents involving operators under 19 were inexperience (50%), inattention (28%), and negligent operation (10%). Alcohol was not noted as a factor in any report. Most events involved collisions between two vessels (77%), with one out of five between two PWC. A majority occurred between June and July (75%), on weekends (65%), and between 2 pm and 6 pm (57%).

Less than half of the victims under 19 reported they were swimmers (44%), but most stated they were wearing a personal flotation device (94%).

## Discussion

This study has several limitations. The reliability of the data is uncertain due to the dependence on the accident investigator to record accurate, detailed information. Information to determine injury type, severity, and etiology is not required on the investigation form and therefore is minimal and inconsistent. Additionally, no data now exist that could provide information on the number of registered PWC in Arkansas. This would assist in determining mortality, incidence, prevalence, and risks.

However, even the limited results indicate clearly that PWC are involved in injury related crashes, and that children and young adults are a priority for prevention. Unfortunately, due to the PWC image as a toy, and the marketing tactics of manufacturers, children may be at higher risk for riding, operating, and therefore, for injury. As PWCs increase in use, size, speed, and there are more children operators, several strategies for prevention of injuries should be considered. Priority areas for possible countermeasures based on the findings of the study, are education, legislation or policy, and manufacturing, engineering, or design modifications.

### EDUCATION

A large percentage of events arose from inexperience or inattention. Only one child had received any boating education. In the US, only 16 states require boating education and only 10 require special training for the operation of a PWC.7 The PWC is much different in handling, maneuvering, and other characteristics, than other boats. Mandatory PWC education and training programs for beginning operators could increase these skills and an appreciation for the responsibilities included in operating these boats.

### LEGISLATION

At present, 43 states have age restrictions limiting PWC operators, but these vary from 10 to 16 years of age.7 Another six states require licensure for operation. Other regulations target speeding, restrictions on areas of PWC use, and boating environment policies. With regard to personal protection devices, most states require their use, but no state currently has laws pertaining to helmets. Due to the risk for head injury, helmets during PWC use should be considered.

### MANUFACTURING AND DESIGN

As with any injury intervention, all this may not be enough. Just as with other products that have potential for injury, PWC manufacturers must take responsibility for developing safer vessels. In general, PWC are considered more safe than other outboard motorboats because their inboard propeller driven design decreases the risk for limb injury. But this is only one example of engineering design changes or modifications that could increase safety. Even though a majority of the wrecks on Arkansas waterways were attributed to human error, designing safer PWCs could limit those errors.

Enacting policies that limit age of PWC operation, mandating education and possibly licensure, and manufacturing design changes, are important countermeasures to consider.

These results are a call for injury professionals and researchers to (1) become more aware of PWC injuries in their communities; (2) enact better surveillance systems for characterizing the etiology of these events; (3) advocate for passage of age restrictions, education, and safe boating environment legislation; and, (4) require manufacturers to produce safer vessels by investing in the design of PWC that ensure safety as well as fun. Any interventions that have as their goal reducing injuries from PWC use should be evaluated for their effectiveness to determine the most appropriate strategies.

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