Drowning by Numbers

It was very sad to see the death of a young man in a life-saving competition in Australia last week. He drowned.

It is one of those modern shibboleths that learning to swim is in the interests of safety. Not actually true; it is thus one of a suite of similar now-institutionalised half-baked myths:

1.            That using sun screen prevents melanoma.  In fact, the evidence is now pretty clear that your risk of developing a dangerous skin cancer is more likely to be caused, not prevented, by the use of sun screens. For a recent review of the evidence; see http://www.second-opinions.co.uk/sunlight.html.  Even Wikipedia (usually pretty taken in by fatuous consensus-driven drivel) is pretty clear on the point:

Increased risk of malignant melanoma in sunscreen users has been the subject of many epidemiological studies.[3][4][14][15][16][17][18]

2.            That low speed limits on roads makes driving safer. In fact, the posting of lower speed limits on the roads – and enforcing them – has repeatedly been shown to increase the rate both of accidents and fatalities;

3.            That governments can fix economic woes by spending money that they do not have.  In fact, all past attempts in this regard, whether they be labelled Keynesian solutions, butter mountains, economic stimulus, or whatever,  have caused long term damage (not to the politicians, of course, who do quite well out of them in electoral terms, but to the economy, and hence the well-being of the people themselves);

4.            That the oil reserves in the ground are the finite product of decomposed prehistoric animals. In fact, the majority of the oil results from chemical reactions deep within the earth (and evidently many other bodies within our solar system, most palpably Titan) which continue to produce both hydrocarbons and water which gradually migrate towards the surface;

5.            The mankind is causing damage to the environment by way of run-away global warming.  In fact, the evidence that the world stopped significant warming about a decade ago, that the theoretical models linking temperature to CO2 concentrations lie in tatters, and anyway, a bit of global warming – were it to resume – would be a good thing, not a bad thing, for humanity.

I have noted the  first, second, third and fourth before, and as readers of this blog will know, the fifth many times. Unhappily, there are now huge vested interests in perpetrating the myths – all the things such as sunscreens, speeding tickets and carbon taxes are huge earners, and governments are hardly keen to turn off the cash tap.

The reason for the swimming myth is less obvious. I am not against people learning to swim, but it is likely to increase the chances of drowning, at any rate in Westernised countries. Curiously, many drowning deaths in Africa, India and China appear to take place in open ditches and streams of one sort or another, often as a result of people doing their washing in such places. These statistics as to such deaths in the third world are notoriously unreliable, and so I restrict these remarks to countries where people normally wash their clothes in a washing machine.

There is surprisingly little research into the relationship between swimming ability and drowning.  The people who run swimming courses say (unsurprisingly) something along the lines of “Be safe; learn to swim” but without any evidence at all to back this up.  The sceptics say (unsurprisingly): “Hold on here. People who don’t know how to swim are not going to go swimming, so they are less likely to drown”.  And the evidence is…

Thin, and oddly, from places you might not associate most closely with swimming.

The Canadian Red Cross has done a fair of research.  Males drown far more frequently than females, and a disproportionate number of deaths are young men (“76% of all water-related fatalities were male.  Of them, 55% were between the ages of 15 and 34”), either during recreational swimming or boating. But interestingly, their figures show that

60% of the recreational swimmers who drowned had an “average to strong” swimming ability.

Which strongly suggests that the sceptics are likely to be right: it is dangerous to learn to swim, and the better you are, the more likely you are to drown.  Because the better swimmer you are, the more likely you are (especially if you are a young man) to go swimming somewhere dangerous.

Similarly, from Holland, the Handbook on drowning: prevention, rescue treatment by Joost J. L. M. Bierens, Maatschappij tot Redding van Drenkelingen includes this:

Few would argue that under identical circumstances, a proficient swimmer is more likely to possess the skills to assure his survival than is a non-swimmer.

However, examination of the relationship between swimming ability and drowning risk is complicated by the need to account for differential exposures to water between swimmers and non-swimmers and other compounding factors that may be related to both drowning risk and swimming ability, such as age.

Additionally, varying water conditions, such as the presence of currents, cold water temperatures, and wave splash can also alter the relationship between swimming ability and drowning risk [2]. More proficient swimmers are likely to swim more often and in higher risk situations as in unguarded or remote sites, providing this group with more opportunities to drown. Overconfidence in abilities may lead to underestimation of conditions and failure to take reasonable precautions. For example, a proficient swimmer may be less likely to wear a life vest when boating than a non-swimmer. Should the boat capsize the non—swimmer with the life vest would probably be less likely to drown than the proficient swimmer without the vest. Failure to account for these differences in use of protective equipment, risk taking, exposure to water and other confounding factors can lead to erroneous conclusions regarding the relationship between swimming ability and drowning risk.

The Irish Lifesaving Foundation says that

Being able to swim is not enough to save you from drowning.

Research indicates that the majority of those who drown can swim and that most accidental drowning deaths take place within the length of a standard swimming pool from safety, so why don’t swimmers just swim to safety and climb out of the water?

The answer, according to the Irish Lifesaving Foundation, is that they can’t (swim to safety) and   ‘being able to swim’, as the public understands being able to swim, is not enough to protect you from drowning. The Foundation also states that in some circumstances non-swimmers are safer than swimmers around water.

The Norwegian Life Saving Society says something similar. In a paper called Good swimmers drown more often than non-swimmers: How open water swimming could feature in beginner swimming, Torill Hindmarch and Mats Melbye note that:

It is commonly said, “The best insurance against drowning is learning to swim”. But the figures tell us something else… One might assume that good swimmers to a greater degree engage in water related activities, equally, the figures say nothing about how many survive due to good aquatic skills. Figures from a Survey made by Norwegian Swimming Federation indicate that only a half of the Norwegian population can be classed as ‘competent’ swimmers. Combining these figures one can conclude that learning to swim in fact doubles the risk of drowning.

These authors go on the make the compelling point – on the evidence – that the skills learnt in a nice warm and calm swimming pool are of remarkably little use in the situations in which people tend to drown.

So there is the bottom line advice for safety-conscious mums and dads: making little Johnny learn to swim will roughly double the change of little Johnny drowning by his mid-thirties.  Making little Jane learn to swim is rather less likely to kill her.

Personally, I quite like swimming in some circumstances, and it would be annoying not to be able to swim.  It is worth the risk. I like flopping into the pool on a hot day, I adore flopping into the pool if I wake up restless in the middle of on a really hot night, and I like snorkelling or scuba diving in a nice warm sea.  Like, I suspect, many others who grew up in London in the 1950’s, I am not a very elegant swimmer: we learned to hate the swimming baths because they were cold, smelly, veruca-infested pits of chemical muck, and the wise thing was to keep your head fully above water as much as possible.

Ironically, that may not have been such unhelpful training, from a safety point of view.





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