Scuba diving and snorkeling safety on Australia's Great Barrier Reef

Fatal diving accidents in Genoa (North-West Italy) from 1968 to 2021: Forensic approach and literature review

Scuba diving is one of the most common and practised water sport activities in Genoa, especially in the more recent years. Although scuba diving is generally considered a safe activity, this does not exclude the possibility of serious or fatal accidents from happening. This retrospective study investigates the case history of deaths resulting from diving accidents recorded by the Municipal Morgue of Genoa over a period of 53 years, specifically from 1968 to 2021. Of the total 52 deaths covered by the study, 48 were male with an age range of 16-71 years. In 25 of these subjects, pre-existing pathological conditions of a cardiovascular nature, not recognised at the time of death, were reported. Out of the total deaths studied, 9 subjects died following a diving accident related to free diving, while 43 subjects died from scuba or rebreather diving. Among the latter subjects, the cause of death was attributed to drowning in 17 cases, arterial gas embolism (AGE) from pulmonary over-distension in 11 cases, cardio-circulatory arrest (CA) favoured by pre-existing and non-existing heart disease known prior to the death in 10 cases, decompression sickness (DCS) in 2 cases, a combination of DCS and AGE in 2 cases and oxygen intoxication in 1 case. Twelve of the fatal accidents occurred in the marine area near the village of Arenzano, where the shipwreck of the oil tanker, the "Haven", sank in 1991 and is today the largest shipwreck explored by divers in the Mediterranean Sea. In all cases of diving deaths, a multi-disciplinary approach is important: in particular, the role of the forensic pathologist is essential in order to accurately reconstruct the dynamics of the accident, thus identifying the predisposing or triggering factors that led to death, and defining the cause of it.

Travel-weary to travel-worry: the epidemiology of injury-related traveller deaths in Australia, 2006-2017

OBJECTIVE

To explore injury deaths in international and domestic interstate travellers, together with those newly arrived to Australia.

METHODS

A population-based cohort study of all injury-related deaths between 1January 2006 and 31 December 2017 registered with Births Death and Marriages in Australia was conducted using Australian Bureau of Statistics' (ABS) Cause of Death information. Population data on travellers were obtained from Tourism Research Australia.

RESULTS

There were 4,503 injury-related traveller deaths (domestic interstate:3,055; international:934; new arrivals:514). The average annual age-standardised mortality rates in domestic interstate travellers was 0.75 per 100,000, compared with 2.22 per 100,000 in international travellers. Leading causes of injury-related death were land transport incidents (n=1495, 33.2%), self-harm (n=786, 17.5%) and falls (n=513, 11.4%), with differences in mechanism by state/territory, traveller type and age group. Intentional self-harm was common amongst all visitor types, however, it was the primary cause of death in new arrivals Conclusion: Age-standardised mortality rates were almost three-fold higher in international than domestic travellers. New arrivals, international and domestic travellers have different injury profiles, and each require specific prevention strategies.

IMPLICATIONS FOR PUBLIC HEALTH

While COVID has restricted travel to and within Australia, this has provided an opportunity for exploration, reflection, and consideration of risk factors for travellers, and to develop targeted injury prevention strategies for visitor types, so travel experience can be optimised and the magnitude of harm can be reduced.

Overseas visitor deaths in Australia, 2001 to 2003

BACKGROUND

The health and safety of international visitors remain an important issue for Australia and other tourist destinations. The death of visitors remains an important indicator of safety. The aim of this study was to provide updated figures on deaths of overseas travelers in Australia.

METHODS

Data were sourced from the Australian Bureau of Statistics concerning deaths of overseas visitors for the years 2001 to 2003.

RESULTS

There were 1,068 overseas visitor deaths (701 males, 66%) during the study period 2001 to 2003. Death by natural causes increased with age, while deaths associated with accidents were more frequent among younger age groups. The majority of deaths were from natural causes (782, 73%), particularly ischemic heart diseases (26%). There were a total of 247 accidental deaths (23% of all deaths) with the main causes being transportation accidents (14% of all deaths) and accidental drowning/submersion (5% of all deaths). The countries contributing the most deaths were the UK (247, 23%), New Zealand (108, 10%) Melanesia/Micronesia (95, 9%), and the United States (57, 5%).

CONCLUSIONS

Australia remains a relatively safe destination for international travelers, at least in terms of fatalities, which appear to be declining. Most deaths of overseas tourists in Australia are due to natural causes with cardiovascular disease being the predominant cause of death in this group. Accidents remain the most common preventable cause of death of travelers, with road and water safety being the major issues. It is important that tourism and travel medicine groups continue to advocate for improved health and safety of international travelers visiting Australia.

Recreational travel fatalities in US national parks

BACKGROUND

Injuries are a public health problem affecting traveling populations such as tourists visiting National Parks. This study investigates the distribution of visitor fatalities in US National Park Service (NPS) units and identifies the predeath activities and contributing factors associated with them.

METHODS

A retrospective study was conducted of visitor fatalities from all NPS units during 2003 and 2004.

RESULTS

There were 356 reported fatalities during 2003 and 2004. Fatalities were most common during the summer months and on weekends. Males accounted for 75% of the reported fatalities, and visitors aged 20 to 29 and 50 to 59 years accounted for 51% of all deaths. Only 99 of 388 (26%) NPS units reported at least 1 fatality, and only 10 units reported 10 or more fatalities. However, these 10 units were responsible for 36% of all fatalities. Lake Mead National Recreation Area, Blue Ridge Parkway, Grand Canyon National Park, Great Smoky Mountains National Park, and Yosemite National Park reported the highest number of fatalities. Domestic visitors accounted for 73% of the fatalities, and European visitors accounted for 13%. Transportation and water-based activities recorded the highest number of fatalities. Motor vehicle crashes accounted for 20% of fatalities and was followed by suicide (17%), swimming (11%), hiking (10%), plane crashes (9%), climbing (6%), and boating (5%) incidents.

CONCLUSIONS

Fatalities in NPS units are not widespread and are related to more common events such as motor vehicle crashes, suicide, swimming, and hiking rather than exotic causes such as bears or other wildlife. It is recommended that preventive techniques first be developed in the 10 NPS units responsible for 36% of the total NPS-wide fatalities.

Epilepsy and law

Epilepsy can define who one is rather than the diagnosis one has. It may be considered under the rubric of disability with legislative protection against discrimination. Those seeking remedy should investigate alternative dispute resolution in preference to litigation. Many areas of the life of a person with epilepsy deserve examination when considering epilepsy and law. Just some of these include: duty of care; informed consent; driving; research; social interactions; insurance; recreational pursuits; employment; and privacy. This article examines the legal implications and ramifications of these selected topics, acknowledging that the limited scope of the article has only exposed the tip of the iceberg to encourage further exploration.

Scuba-diving related deaths in Okinawa, Japan, from 1982 to 2007

We reviewed the autopsies of scuba-diving related deaths (SDRDs) that were collected from April 1982 until March 2007. In the period under consideration, a total of 40 SDRDs were registered, out of which 34 were males and 6 females. Ages ranged from 19 to 65 years, with the average of 41.5 years (SD=12.9). Divers over the age of 40 accounted for 60% of all fatalities. The major cause of death was drowning (62.5%), followed by disease (28.5%). The average age for drowning and disease-related deaths was 38.6 (SD=12.8) and 48.7 years (SD=10.1), respectively. Of the 40 fatalities, 24 were beginners who had little or no experience. In this study, we compared SDRDs in the first term, from April 1982 to March 1995, and in the second term, from April 1995 to March 2007. The average age in the first and second terms was 35.4 and 45.2 years, respectively; the average age for the second term was 10 years older than the first. Of those in the first term, 13.3%, and of those in the second term, 40.0%, died from complications arising from already existing conditions. This study revealed that the onset of diseases during diving frequently causes fatal accidents, especially for older divers.

Overseas visitors admitted to Queensland hospitals for water-related injuries

OBJECTIVE

To determine the number of overseas visitors admitted to Queensland hospitals for water-related injuries over three years, the causes of their injuries, the resulting conditions treated, and the type of hospitals to which they were admitted.

DESIGN

Retrospective analysis of admissions of overseas visitors to Queensland hospitals over the three financial years 1995/96, 1996/97 and 1997/98.

PATIENTS

296 overseas visitors admitted for water-related injuries, identified from hospital records by their usual place of residence.

MAIN OUTCOME MEASURES

Number of admissions, causes of injuries, conditions treated, and bed days occupied by these patients at different types of hospitals (metropolitan, regional and rural public hospitals, and private hospitals).

RESULTS

The 296 overseas visitors accounted for a total of 596 separate admissions, many of these the result of patients with decompression illness being admitted several times to a regional hospital hyperbaric chamber for treatment as day patients. The largest number of injuries involved the use of diving equipment. The main conditions treated were decompression illness (54.7%), fractures and dislocations (15.5%), and drowning and non-fatal submersion (14.9%). Overall, overseas visitors admitted to hospital following a water-related incident occupied 1215 bed days; 90% of these admissions were to regional hospitals.

CONCLUSIONS

The main reason for admission of overseas visitors is for decompression illness, suggesting that the prevention of injuries among scuba divers requires further coordinated efforts by health and tourism authorities.