Background Boating is the most frequent activity for water-related immersion deaths in Canada. Central in immersion/drowning is non-wearing of personal flotation devices (PFDs). Anecdotal observation of frequent non-wearing among victims led to quantitive assessment using negative binomial and Poisson regression models.

Methods Annual Red Cross collection of 1991–2010 Canadian coroner data was by structured questionnaire. Analysis included ten variables in the final model.

Results There were 2678 recreational and daily living boating immersion deaths during 1991–2010. Certain variables significantly increased the odds of properly wearing a PFD and others decreased them. Controlling for all other variables, victims with average swimming ability had 1.93 times the odds of wearing compared with non and weak swimmers combined (95% CI: 1.29–2.87). Strong swimmers had 1.90 times the odds of wearing compared with non/weak swimmers (95% CI: 1.06–3.40).

Conclusion It was surprising that boating victims with low swimming ability were less likely than swimmers to have worn a flotation device. It is possible, but remains to be established, that poor swimmers were less likely to have participated in a swimming course, which included the main elements of water safety for boating and other activities.