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. 2022 Mar;81(3):71-76.

Factors Contributing to Snorkel Drowning in Hawai'i

Philip R Foti  1 , Carol M Wilcox  1 , Ralph S Goto  1
Affiliations

Factors Contributing to Snorkel Drowning in Hawai'i

Philip R Foti et al. Hawaii J Health Soc Welf. 2022 Mar.

Abstract

Causes of the extraordinarily high and increasing incidence of snorkeler drownings in Hawai'i have remained unexplained for years. Defining the mechanisms and factors predisposing to drowning while snorkeling is needed to provide recommendations to substantially mitigate the incidence of this form of preventable death. The mechanisms of drowning are described and insight into the predisposing factors are explored in this study. Methods included measuring snorkel airway resistance characteristics, case reports from the State of Hawai'i Medical Examiner's office, and collating information by survey, principally from rescued survivors. This study identified 2 modes of drowning while snorkeling that need further investigation: accidental or inadvertent aspiration, and hypoxia resulting from acute negative pressure pulmonary edema. The incidence of drowning from mechanisms of hypoxia due to rapid onset pulmonary edema is an important focus of the study and a number of potentially significant predisposing factors are presented that need further investigation but provide bases that may become part of updated policies and practices for snorkelers to substantially lower the risk of death. This report is meant for both medical and public health information purposes.

Keywords: Aspiration; Hypoxia; Pulmonary Edema; Snorkels.

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Figures

Figure 1.
Figure 1.
Separation of Negative Pressure Results Based on Snorkel Category Type Blue = no dry device, Green = full-face mask, Yellow = dry device. Dotted Red line indicates the median negative pressure value per category: no dry device = 3.00, full facemask = 4.46, dry device = 3.7. There is no statistical significance in the difference of median based on Mann Whitney tests between full facemask and dry device (W = 55, P = .89), full facemask no dry device (W = 42, P = .37), and dry and no dry device (W = 310,p= P = .07).
See this image and copyright information in PMC

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