Most fatal drownings worldwide occur in open water. Flotation devices may protect swimmers. Their use by those recreating in water has not been described.
Methods Observational survey of swimmers and waders at designated swim sites at lakes and rivers evaluated them by age group, sex, type of flotation used (life jacket vs substandard flotation, eg, water wings, noodles, inflatables) and, for children <6 years, being within arm's reach of an adult.
Results Of 1967 swimmers/waders observed, 37% used some type of flotation device. Use rates, especially of life jackets, decreased with increasing age. Children <6 years had the highest use of some type of flotation (140/212, 66%) and the highest use of life jackets (50.5%). Children <13 years were more likely to use flotation devices and life jackets than teens (RR 6.78, 3.62 to 12.71); boys were more likely than girls to wear life jackets (RR 1.47, 1.18 to 1.83). While teenagers and adults used flotation (29.5% and 23.5%), they rarely used life jackets (2–3%). Boys <6 years who were further than arm's length of an adult were more likely to wear life jackets than girls. Substandard flotation use did not differ among age groups (15.5–26.5%) but their use was greater among females in most age groups.
Conclusions Flotation devices were frequently used for recreational wading and swimming in open water by all age groups. Life jacket use was limited to children. Promoting use of flotation devices with safety standards that provide protection as well as fun could potentially decrease open water drowning rates.
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Contributors EB, TM and LQ conceived the question and study design. TM, WC and EB were involved with data collection. WC provided statistical analysis. TM, EB and LQ were involved with data analysis and writing the document. All authors reviewed the final document.
Funding Study was partially funded by the WA State Department of Health, Emergency Medical Services for Children State Partnership Demonstration Grant.
Competing interests TM and WC conduct life jacket observational studies for the USCG.
Ethics approval Seattle Children's Hospital IRB.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Unpublished data from the study are available to all the coauthors. They reside with Tom Mangione who would share them and/or analyse them.