Drownings in Hawaii, 1993-1997
A Review of Death Certificates
by the
State of Hawaii
Department of Health
Injury Prevention and Control Program
Daniel J. Galanis, Ph.D.
Epidemiologist
There were 306 drownings in the state over the 5-year
period, with no apparent trend over time in any of the individual
counties (Figure 1). Nearly half (139) occurred on the island of
Oahu.
Figure 1. Annual number of drownings in
Hawaii, by county, 1993-1997.
*Four of the deaths in Maui County occurred on the
island of Lanai (3 in 1995, 1 in 1996), 6 on Molokai (2 in 1994,
1 in 1995, 3 in 1996). The remaining 50 occurred on the island of
Maui.
More than 80% (250) of the victims were males. Figure
2 below shows that the age of the victims was very broadly
distributed, for both genders.
Figure 2. Age distribution of drowning
victims in Hawaii, 1993-1997.
(Proportion of females indicated by shading.)
Age and gender differed somewhat by the type of
drowning, however, as shown in the following two figures. Figure
3 shows that there were a significant proportion of females only
for drownings occurring in bathtubs (56% of those drownings) and
swimming pools (39%). In contrast, there were relatively few
females among victims who drowned in the ocean (14%) or rivers
and streams (19%).
The figure also shows that more than three-quarters
(238) of all drownings in Hawaii occurred in the ocean or other
saltwater environments. Of this total, 147 were noted to occur
near the shore (128 near beaches, 13 in harbors, and 6 in
canals), and 39 occurred offshore. (This information was not
specified for the remaining 52 cases.) Of the 23 drownings in
swimming pools, only one was noted to have occurred in a public
pool.
Figure 3. Place of drowning in Hawaii,
by gender, 1993-1997.
A higher proportion of the drownings on Oahu occurred
in swimming pools, compared to Neighbor Islands (13% vs. 3%).
Conversely, there were proportionally fewer ocean drownings on
Oahu than Neighbor Islands (73% vs. 81%).
Bathtub and swimming pool drownings included
proportionally more young and old victims (Figure 4). Twenty-nine
percent (12) of these victims were aged 5 years or younger, and
41% (17) were over age 60. Age was more evenly distributed among
victims who drowned in rivers or saltwater enviornments, and only
2% (6) were younger than 14 years of age.
Figure 4. Age distribution of drowning
victims, by place of drowning, 1993-1997.
Figure 5 summarizes the activity for the remaining 188
incidents. (Note: all of the 23 victims who drowned in swimming
pools were assumed to be swimming. This assumption was not made
for those who drowned in the ocean, so most of the incidents
classified under "unknown activity" (102/118) include ocean
drownings for which no activity was listed.)
Not surprisingly, swimming was the most common
activity associated with drowning (18% of all incidents). Thirty
six of the victims were fishing at the time of drowning,
including at least 9 of whom were fishing from the shore and were
swept out to sea. Another 9 victims were gathering
`opihi [i.e., limpet snails - Cellana exarata
(makaiauli), C. sandwicensis (`alinalina), C. talcosa (ko`ele),
C. melanastoma, or Siphonaria normalis (`opihi awa)] at the
time of drowning. Other common activities were scuba diving (23
victims), snorkeling (20) and surfing or body boarding
(17).
Figure 5. Drownings in Hawaii, by
activity and resident status, 1993-1997.
(White bars indicate drowning totals among state residents, black
among non-residents.)
Forty-one percent (127) of the drowning victims were
not residents of Hawaii. Figure 5 shows that residence status
differed somewhat by the type of activity the victims were
engaged in at the time of drowning. All of the victims who were
fishing or picking `opihi [i.e., limpet snails -
Cellana exarata (makaiauli), C. sandwicensis (`alinalina), C.
talcosa (ko`ele), C. melanastoma, or Siphonaria normalis (`opihi
awa)] were residents, and only one of the 11 who were free
diving was a non-resident. Residence status was equally divided
among the victims who were swimming or scuba diving, while
non-residents constituted the majority (80%) of victims who
drowned while snorkeling.
Proportionally fewer of the Oahu (29%) and Hawaii
(26%) victims were non-residents, compared to those who drowned
on Maui (65%) and Kauai (74%).
Comparison of ocean/saltwater drowning
rates among Hawaiian islands, 1993-1997.
Although Oahu had the greatest number of ocean or
saltwater drownings over the 5-year period, the rates were by far
the lowest on Oahu, when calculated by any of three methods
(described below).
Rates were calculated using two sources for the
denominator: estimated attendance at lifeguarded beaches, and
1995 de facto population estimates. Each of these methods has
pros and cons. Population estimates include all parts of each
island and are relatively accurate. The obvious problem, however,
is that not all those who are included in the denominator are
really "at risk" of drowning, since not everyone goes to or swims
in the ocean.
This problem is somewhat alleviated by using lifeguard
estimations of both the number of beachgoers and (with the
exception of Kauai) the number of people either swimming or
surfing in the water. Lifeguards estimated the number of
sunbathers, swimmers and surfers at 5 different times during the
day. Estimates were available for 7 lifeguarded beaches on Kauai
in 1995, 7 on Maui in 1997, 10 on Hawaii in 1997, and 19 on Oahu
in 1998. The problems with this source as a rate denominator are
that not all beaches on each island are lifeguarded, and the
attendance estimations may not be accurate or completely
consistent among all lifeguards. Therefore, although this
drowning rate estimation may be conceptually better than one
based on population alone, the following comparisons should be
interpreted with caution.
The number and rate of ocean drownings
in Hawaii, by island, 1993-1997.
1. Number of drownings (leftmost graph): There were
238 drownings that occurred in the ocean or saltwater
environments. Not included in the above chart are 6 that happened
on Molokai and 4 others on Lanai. Of the remaining 228 drownings,
44% occurred on Oahu.
2. Rate of drownings/5,000,000 beachgoers: The
denominators for these calculations comes from lifeguard
logsheets (1995 for Kauai, 1997 for Maui and Hawaii, and 1998 for
Oahu). The graph above (second from left) shows that Oahu had by
far the lowest estimated rate, less than ¼ that computed
for Neighbor Islands. Also, the rates for Hawaii, Kauai and Maui
are remarkably similar.
3. Rate of drownings/5,000,000 swimmers and surfers:
The denominators here are the same as those used for #2 above,
minus the number of sunbathers. (This breakdown was not available
from Kauai lifeguard reports, so no rate was calculated.) Again,
the rate for Oahu is much lower than that for Hawaii or Maui,
which had the highest rate.
4. Rate of drownings/100,000 de facto population
(rightmost graph): Rates on Oahu are 3- to 4-times lower than
those for Neighbor Islands. Kauai had the highest
rate.
Statistics on victims who drowned while fishing or
harvesting in Hawaii, 1993-1997.
*All 25 of these victims were male, and all were Hawaii
residents.
Age distribution, by type of
fishing.
*The ages of those fishing from shore were broadly
distributed over the 20-69 year range.
*Among the 9 victims who were picking `opihi [i.e.,
limpet snails - Cellana exarata (makaiauli), C. sandwicensis
(`alinalina), C. talcosa (ko`ele), C. melanastoma, or Siphonaria
normalis (`opihi awa)], all but 1 were between 32 and 45
years of age.
Island of drowning
*Eight of the nine victims who were fishing from shore
drowned on Hawaii or Oahu.
*Six of the nine victims who were picking `opihi [i.e.,
limpet snails - Cellana exarata (makaiauli), C. sandwicensis
(`alinalina), C. talcosa (ko`ele), C. melanastoma, or Siphonaria
normalis (`opihi awa)] drowned on Hawaii, 4 in the Puna
district.
Statistics on victims who drowned while
diving or snorkeling in Hawaii, 1993-1997.
*Eleven of the 54 victims were females. Only 1 of the
11 victims who were free diving was a female, and 4 of the 23
victims who were scuba diving. The gender distribution of the
snorkeling victims was more equal (6 female, 8
male).
Age distribution, by type of
diving.
(Females indicated by open squares.)
*All but 2 of the 11 free divers were between 32 and
43 years of age.
*Eighteen of 23 victims who drowned while scuba diving were
between 20 and 47 years old.
*Victims who drowned while snorkeling tended to be older; 15 of
20 were 49 years or older.
Island of death, by residence
status.
(White bars represent Hawaii residents, black bars
non-residents.)
*Free divers: 10 of 11 victims drowned on Hawaii or
Oahu, on various parts of both islands.
*Scuba divers: About half (12/23) drowned on Oahu: 3 in Waikiki
area, 2 on the Eastside, 3 on North Shore, and 3 along the
Windward coast.
*Snorkelers: 40% drowned on Maui: 3 on the Kihei coast, 2 off
Molokini and 2 near Lahaina.
Statistics on victims who drowned
during miscellaneous ocean sports on Hawaii,
1993-1997.
*Most (17/24) of these victims were surfing or body
boarding at the time of the drowning.
*All but 2 were males.
*The "other water sports" category includes 1
windsurfer and 2 victims who drowned after jumping off rocks into
the ocean.
Age distribution, by type of sport.
(Females indicated by open squares.)
*10 of the 17 surfers/body boarders were between 22
and 37 years of age.
Island of death, by residence
status.
(White bars represent Hawaii residents, black bars
non-residents.)
*Five of the 9 surfers/body boarders who drowned on
Oahu drowned in the North Shore area.
*Among the 5 surfers/body boarders who drowned on Hawaii, 4
drowned in the Hilo area.
Statistics on victims who drowned while
swimming in Hawaii, 1993-1997.
*Included in this grouping are all victims who drowned
in swimming pools and those who were specifically noted to be
"swimming" at the time of drowning. Not included are the 12
victims who drowned in rivers or streams or the 102 victims who
drowned in saltwater environments for whom no activity was
specified. These statistics should therefore be interpreted with
caution until the activity of those 114 victims can be accurately
determined.
*Only 9 of the 53 victims were female, and all of
those drowned in swimming pools.
Age distribution of swimmers, by type
of environment.
(Females indicated by open squares.)
*Again, swimming pool victims included the very young
and the very old: There were five 1 year-olds and one 2 year-old;
all were Hawaii residents and all drowned in home pools. Five of
the 7 victim who were older than 70 were residents; all 7 drowned
in home pools. Eight of the remaining 10 victims drowned in hotel
pools.
*All but 1 of the 6 victims who drowned in rivers were
between 14 and 22 years of age.
*The age range of saltwater drowning victims was
wider, although all but 1 were 18 or older.
Island of death, by residence
status.
(White bars represent Hawaii residents, black bars
non-residents.)
*Hawaii river victims: 3 in Wailuku river, 2 in a
single 1995 incident.
Recommended Citation:
Galanis, D. J. (1999, November). Drownings in Hawaii,
1993-1997: A review of death certificates. State of Hawaii,
Department of Health, Injury Prevention and Control Program.
World Wide Web:
<http://www.aloha.com/~lifeguards/drownings93_97.html>.
-
DROWNING PREVENTION CHECKLIST
ESPECIALLY FOR PARENTS:
![[CHECKMARK]](checkmrk.gif)
Supervise all young children while they are in, on, or
near the water. Drownings and near-drownings occur in familiar
surroundings during very short lapses in
supervision.
- Do
not have older siblings watch younger children in the water. They
are not trained or mature enough to be given such a
responsibility.
-
Take a CPR course. Know what to do in case of an
emergency. And when there's an emergency - Don't Stall, Call
911!
- Do
not rely on floatation devices or swimming lessons to protect a
child. Children are not waterproof.
-
Keep a portable telephone by your pool, hottub,
or spa.
-
Surround your pool, hottub,
or spa with four-sided fencing which does not include your
house as one side. Children should not be able to access home
pools.
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