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9780849323706

Diving Injuries

by ; ;
  • ISBN13:

    9780849323706

  • ISBN10:

    0849323703

  • Format: Hardcover
  • Copyright: 2000-08-30
  • Publisher: CRC
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Summary

Diving Injuries: Research Findings and Recommendations for Reducing Catastrophic Injuries is the most comprehensive study of diving injuries ever compiled in the United States. It addresses swimming pool injuries, injuries from lakes, rivers, and oceans; laws, standards, and regulations for swimming pool design; and the cost of medical and attendant care for spinal cord injury victims. Diving Injuries provides readers with a greater understanding of diving safety from all perspectives.

Author Biography

M. Alexander Gabrielsen, Ph.D. is Professor Emeritus of New York University (NYU) where he served from 1946 to 1970 James H. McElhaney, Ph.D. is the Hudson Distinguished Professor of Biomechanics in the Departments of Biomedical Engineering and Orthopaedic Surgery, Duke University. Ron O'Brien, Ph.D. conducts clinics throughout the country and serves as a consultant

Table of Contents

The Problem in Swimming Pools and at Beaches
Where are They Swimming Now?
1(1)
Definition of Diving
1(1)
Incidence of Diving Injuries
1(1)
Growing Popularity of Swimming Pools
2(1)
Why Do People Get Hurt From Diving?
3(1)
Who is Responsible?
3(1)
Costs of Quadriplegia
4(1)
Early Studies of the Problem
4(2)
Summary
6(1)
References
7(2)
Laws, Regulations, and Professional Standards for Swimming Pools and Beaches
Introduction
9(1)
Pool Standards, Laws, and Regulations
9(2)
Federal Government
9(1)
U.S. Consumer Product Safety Commission
9(1)
Federal Housing Administration
9(1)
U.S. Department of Housing and Urban Development
10(1)
Department of Health and Human Services
10(1)
State and Local Governments
10(1)
Swimming Pool Industry
10(1)
Professional Organizations and Voluntary Agencies
11(1)
Governing Bodies for Competitive Swimming and Diving
11(1)
Council for National Cooperation in Aquatics
11(1)
American Public Health Association
12(1)
National Sanitation Foundation
12(1)
American Red Cross
12(1)
Other Voluntary Groups
12(1)
Inland and Ocean Beach Standards
12(1)
References
13(2)
Research Methodology
Introduction
15(1)
Typical Data Collection Scenario
15(10)
Summary of Data Sources
25(1)
References
26(1)
Swimming Pool Diving Accidents
Introduction
27(1)
Victims
27(2)
Age and Sex
27(1)
Height and Weight
28(1)
Level of Injury
28(1)
Swimming and Diving Instruction
28(1)
Pool Facilities
29(3)
Pool Ownership
29(1)
Location by State
30(1)
Pool Shapes
30(1)
Basin Composition
31(1)
Pool Markings
31(1)
Depth of Water at Impact
32(1)
Environmental Factors
32(1)
Clarity of Water
32(1)
Lighting and Weather
33(1)
Pre- and Postaccident Events
33(3)
Victim: Guest or Owner
33(1)
Time and Day of Accident
33(1)
Month of Accident
33(1)
Year of Accident
33(1)
Victim's Visits to the Pool
33(2)
Dives Made on Prior Visits
35(1)
Dives Made on Day of Accident
35(1)
Type of Social Setting
35(1)
Substance Abuse
35(1)
Safety and Supervision
36(1)
Posted Rules and Warning Signs
36(1)
Lifeguard on Duty
36(1)
Rescue Procedures
36(1)
Person Making Rescue
36(1)
Use of Spineboard and Cardiopulmonary Resuscitation
36(1)
Summary
37(2)
Aboveground Pool Diving Accidents
Introduction
39(1)
Some Background on Aboveground Pools
39(2)
Victims
41(1)
Age and Sex
41(1)
Height and Weight
41(1)
Level of Injury
41(1)
Swimming and Diving Instruction
41(1)
Diving Skill
42(1)
Pool Facilities
42(2)
Pool Ownership
42(1)
Location by State
42(1)
Pool Shapes and Dimensions
43(1)
Basin Finish
43(1)
Pool Markings
43(1)
Slides and Jumpboards
43(1)
Decks and Ladders
44(1)
Environmental Factors
44(1)
Clarity of Water
44(1)
Lighting and Weather
44(1)
Pre- and Postaccident Events
45(3)
Victim: Guest or Owner
45(1)
Time and Day of Accident
45(1)
Month and Year of Accident
45(1)
Victim's Visits to the Pool
46(1)
Dives Made on Prior Visits
46(1)
Dives Made on Day of Accident
46(1)
Activity Resulting in Injury
47(1)
Type of Social Setting
47(1)
Substance Abuse
48(1)
Safety and Supervision
48(1)
Posted Rules and Warning Signs
48(1)
Lifeguard on Duty
48(1)
Rescue Procedures
48(1)
Person Making Rescue
48(1)
Use of Spineboard and Cardiopulmonary Resuscitation
48(1)
Conclusions
49(2)
Inground Pool Diving Accidents
Introduction
51(1)
Victims
51(3)
Age and Sex
51(1)
Height and Weight
51(2)
Level of Injury
53(1)
Source of Initial Swimming and Diving Instruction
53(1)
Pool Facilities
54(3)
Pool Ownership
54(1)
Location by State
54(1)
Pool Shapes
54(1)
Basin Finish
54(1)
Pool Markings
54(1)
Depth of Water at Impact
55(2)
Environmental Factors
57(1)
Clarity of Water
57(1)
Lighting and Weather
57(1)
Pre- and Postaccident Events
58(3)
Victim: Guest or Owner
58(1)
Time and Day of the Accident
58(1)
Year and Month of Accident
58(1)
Victim's Visits to the Pool
58(1)
Dives Made on Prior Visits
59(1)
Dives Made on Day of Accident
59(1)
Position of Arms/Hands at Entry
60(1)
Location of Dive
60(1)
Type of Social Setting
61(1)
Substance Abuse
61(1)
Safety and Supervision
61(1)
Posted Rules and Warning Signs
61(1)
Lifeguard on Duty
61(1)
Rescue Procedures
61(1)
Person Making Rescue
61(1)
Use of Spineboard and Cardiopulmonary Resuscitation
62(1)
Conclusions
62(5)
Springboard/Jumpboard Diving Accidents
Introduction
67(1)
Background
67(5)
Human Factors
67(1)
Environmental Factors
67(1)
Mechanics of Diving
68(1)
Evolution of Diving Boards
68(1)
Competitive Diving Boards
68(1)
Recreational Diving Boards
68(4)
Victims
72(2)
Age and Sex
72(1)
Height and Weight
73(1)
Level of Injury
73(1)
Source of Initial Swimming and Diving Instruction
73(1)
Pool Facilities and Boards
74(4)
Pool Ownership
74(1)
Location by State
74(1)
Pool Shapes
74(1)
Basin Finish
75(1)
Board Type
75(1)
Bottom Profile of Pool
76(1)
Site of Dive
76(1)
Pool Markings
76(1)
Depth of Water
76(2)
Environmental Factors
78(1)
Clarity of Water
78(1)
Lighting and Weather
78(1)
Pre- and Postaccident Events
78(3)
Victim: Guest or Owner
78(1)
Time and Day of Accident
78(1)
Month of Accident
79(1)
Year of Accident
79(1)
Victim's Visits to the Pool
80(1)
Dives Made on Previous Visits
80(1)
Dives Made on Day of Accident
80(1)
Type of Social Setting
80(1)
Substance Abuse
80(1)
Safety and Supervision
81(1)
Posted Rules and Warning Signs
81(1)
Lifeguard on Duty
81(1)
Rescue Procedures
81(1)
Person Making Rescue
82(1)
Use of Spineboard and Cardiopulmonary Resuscitation
82(1)
Paramedic Involvement
82(1)
Conclusions
82(1)
Pools Where the Accident Occured
83(1)
Bottom Configuration
83(1)
Depth of Water Where Victim Struck Bottom
83(1)
Type of Diving Equipment
83(1)
Lack of Depth Markers
83(1)
Lack of Posted Rules
83(1)
Industry Standards and Government Regulations
83(1)
Industry Standards are in Error
83(1)
NSPI Water Depth Unsafe
84(1)
Adults Should Not Dive into Residential Pools
84(1)
Excessive Variety of Boards and Stands
84(1)
Transition Upslope Too Close to the End of the Springboard
84(1)
Hopper- and Spoon-Type Pools Unsafe for Diving
84(1)
The Victims
84(1)
Age and Sex
84(1)
Use of Alcoholic Beverages and Drugs
84(1)
Diving Training
84(1)
Appearance of Safety
84(1)
Victim: Guest or Owner
85(1)
Summary
85(2)
Starting Block Diving Accidents
Introduction
87(1)
Some Background on the Problem
87(5)
Evolution of the Racing Start in Swimming
88(1)
Period between 1920s and 1930s
88(1)
Starting Blocks Approved in 1940
88(1)
Increased Angle of Entry
89(2)
Introduction of the ``Pike Dive''
91(1)
Grab Start
91(1)
Dangers Associated with the Pike Dive
92(2)
Need for Greater Precision
92(1)
Need for Immediate Planing
92(2)
Victims
94(2)
Age and Sex
94(1)
Height and Weight
94(1)
Level of Injury
94(1)
Source of Initial Swimming and Diving Instruction
94(2)
Pool Facilities
96(1)
Pool Ownership
96(1)
Location by State
96(1)
Pool Shapes
96(1)
Basin Composition
96(1)
Pool Markings
97(1)
Environmental Factors
97(1)
Clarity of Water
97(1)
Lighting and Weather
97(1)
Pre- and Postaccident Events
97(4)
When Accident Occurred
97(1)
Description of Type of Dive
97(1)
Instructions to Swimmers Relative to Pike Dive
98(1)
Depth of Water where Victim Struck Bottom
98(1)
Member of Swim Team
99(1)
Swim Coach Present
99(1)
Victim: Guest or Pool Owner
99(1)
Time and Day of Accident
99(1)
Month of Accident
99(1)
Year of Accident
100(1)
Victim's Visits to the Pool
100(1)
Dives Made on Prior Visits
100(1)
Dives Made on Day of Accident
100(1)
Type of Social Setting
101(1)
Substance Abuse
101(1)
Warnings and Supervision
101(1)
Posted Rules and Warning Signs
101(1)
Lifeguard on Duty
101(1)
Rescue Procedures
102(1)
Person Making Rescue
102(1)
Use of Spineboard and Cardiopulmonary Resuscitation
102(1)
Conclusions
102(1)
References
103(2)
Diving Accidents Occurring in the Natural Environment
Introduction
105(1)
Background
105(1)
Ownership of Water and Shoreline Properties
106(1)
Federal Government
106(1)
State Governments
106(1)
County Governments
106(1)
City Governments
106(1)
Private Organizations
106(1)
Lack of Public Awareness
107(1)
Victims
108(1)
Age and Sex
108(1)
Height and Weight
108(1)
Formal Diving Instruction
109(1)
Level of Injury
109(1)
Facilities
109(2)
Ownership
109(1)
Site of Dive
110(1)
Location by State
110(1)
Designated Swimming Area
110(1)
Depth of Water at Impact
111(1)
Environmental Factors
111(1)
Clarity of Water
111(1)
Lighting and Weather
111(1)
Pre- and Postaccident Events
112(4)
Time and Day of Accident
112(1)
Month of Accident
112(1)
Year of Accident
112(1)
Victim's Visits to the Site
113(1)
Dives Made on Day of Accident
113(1)
Position of Arms/Hands at Entry
113(1)
Location and Activity
114(1)
Substance Abuse
115(1)
Type of Social Setting
115(1)
Safety and Supervision
116(1)
Posted Rules and Warning Signs
116(1)
Lifeguard on Duty
116(1)
Rescue Procedures
116(1)
Person Making Rescue
116(1)
Use of Spineboard and Cardiopulmonary Resuscitation
116(1)
Paramedic Involvement
117(1)
Summary of Facts
117(1)
Conclusions
118(2)
Major Factors Contributing to Diving Accidents
118(1)
Shallow Water
118(1)
Turbid Water Conditions
118(1)
Inexperienced Diver
118(1)
Diver Misjudgment
118(1)
Failure of Property Owners
119(1)
Unsupervised Recreation Areas
119(1)
Failure to Inform and Warn
119(1)
Lack of Lifeguards in Designated Swimming Areas
119(1)
Lack of Risk Analysis
119(1)
Failure to Remove Trees and Branches
119(1)
Misplaced Structures
120(1)
Lack of Public Education
120(1)
Running Dives from Beaches
120(1)
Most Dangerous Activities
120(1)
Deficiencies Noted in the Design, Operation, and Use of Aquatic Facilities
120(6)
Failure of Owners and Operators to Follow Known Principles of Aquatic Safety
121(1)
Failure of Patrons to Act Safely in the Use of Designated Swimming Facilities
122(2)
Failure of Commercial Builders and/or Contractors
124(1)
Failure to Educate the Public in the Selection of Safe Swimming Area
124(2)
Failure of Owners of Vacation Homes and Cottages
126(1)
Failure of Sponsors and Organizers of Groups that Use Aquatic Areas
126(1)
Recommendations
126(1)
Public Education
126(1)
Responsible Design, Ownership, and Operation
127(1)
Professional Standards
127(1)
Boat Dock Standards
127(1)
A Plea from Victims
127(2)
Mathematics and Mechanics of Diving
Introduction
129(1)
Springboard and Platform Diving
129(2)
External Factors
129(1)
Type of Springboard
129(1)
Condition of the Board
129(1)
Installation of the Board
130(1)
Board Response
130(1)
Environmental Conditions
130(1)
Human Factors
131(1)
Physiological Characteristics and Condition of the Diver
131(1)
Ability and Agility of the Diver
131(1)
Psychological Factors
131(1)
Components Involved in Executing a Dive
131(3)
Starting Position
131(1)
Approach
131(1)
Hurdle and Board Depression
131(1)
Takeoff
132(1)
Flight of the Body
133(1)
Body Entry
133(1)
Course of the Body in Water
133(1)
Diving from Low Stationary Structures
134(1)
Sliding Headfirst Down a Water Slide
135(2)
Height of Slide Exit Ramp Above Water
136(1)
Exit Angle of Slide
136(1)
Angle of Water Entry
136(1)
In-Water Speeds
136(1)
Hydrodynamic Drag
136(1)
Depth of Penetration
136(1)
Mechanical Considerations
137(4)
Center of Mass
137(1)
Air Resistance and Wind
137(1)
Energy Source
137(1)
Direction and Trajectory in Air
137(1)
Maximum Height of Diver's Trajectory Above Water
137(1)
Water Entry Point
138(1)
Water Entry Speeds
138(1)
Angle of Entry
138(1)
In-Water Trajectory
139(1)
In-Water Speeds
140(1)
Impact Forces
140(1)
Mathematical Modeling of Diving Injuries
141(2)
Horizontal Equations
141(1)
Vertical Equations
142(1)
Water-Entry Angle and Head Speed
142(1)
In-Water Head Speed
142(1)
Introduction to the Work-Energy Theorem
143(2)
Simulation Analyses
145(1)
Dives from 6-in. Deck
145(1)
Dives from 1/2 m
146(1)
Dives from 1 m
146(1)
Conclusions
146(1)
Acknowledgment
146(1)
References
146(3)
Biomechanical Aspects of Cervical Trauma from Diving
Introduction
149(1)
Incidence
149(3)
Anatomy
152(3)
Injury Mechanisms and Classifications
155(1)
Compression Fractures
156(6)
Compression
156(1)
Compression-Flexion
157(4)
Compression-Extension
161(1)
Diving
162(3)
Experimental Studies
165(1)
Simulated Injuries with Cadavers
165(1)
Flexion-Extension
165(1)
Compression
165(1)
Mechanical Factors of Experimental Cervical Spinal Injury
166(4)
Loading Rate
166(1)
Load Position and Combined Loading
167(1)
Buckling and Buckled Deformation
168(1)
End Condition
168(1)
Impact Surface Stiffness and Padding Characteristics
169(1)
Impact Attitude and Head Inertia
170(1)
Tolerance of the Cervical Spine
170(2)
Compression
171(1)
Summary
172(1)
Acknowledgments
172(1)
References
172(5)
Recommendations for Reducing the Number of Pool Diving Injuries
What the Data Revealed
177(2)
Major Pool Design Changes Needed for Reducing Pool Diving Accidents
179(3)
Specifications of the Diving Well
179(1)
Pool Bottom Markings
179(1)
Starting Blocks
179(1)
Pool Water Slides
179(1)
Depth Markers
180(1)
Location of Pools
180(1)
Warning Signs
180(1)
Lighting
181(1)
Pool Barriers
181(1)
Recommendations for Improving the Management and Operation of Pools
182(1)
Supervision of Pool Patrons
182(1)
Industry Standards
182(1)
State and Local Laws and Regulations
182(1)
Other Specific Recommendations
183(8)
Correcting Pool Design Defects
184(1)
Water Depth of Pools
185(1)
Shallow Portion of Pool
185(1)
Diving Envelope
186(1)
Bottom Markings
187(1)
Depth Markings
187(1)
Color of Pool Basin
188(1)
Coefficient of Friction of Bottom
188(1)
Pool Location
189(1)
Variable Depth Bottoms of Aboveground Pools
189(1)
Eliminate Hopper-Bottom Pools
189(1)
Eliminate Spoon-Shaped Pool Bottoms
189(1)
Eliminate Constant Depth in Shallow Portion of Pools
189(1)
Lighting for Night Swimming
189(1)
Eliminate Safety Ledges
189(1)
Mark Edges of Steps and Seats
190(1)
Recess All Steps and Ladders
190(1)
Recess Anchors and Receptacles
190(1)
Separate Spas and Hot Tubs
190(1)
Lifeline
190(1)
Specify Location of Safe Diving Areas
190(1)
Starting Blocks for Competitive Swimming
190(1)
Depth Markers
191(1)
Revising and Strengthening Pool Standards and Laws
191(2)
Swimming Pool Industry
191(1)
Revision of NSPI Standards for Residential and Public Pools
191(1)
Manufacturers of Pools
192(1)
Fabricators of Pool Liners
192(1)
Manufacturers of Springboards/Jumpboards
192(1)
Regulatory Agencies
192(1)
State
192(1)
Counties and Cities
193(1)
Consumer Product Safety Commission
193(1)
Improving the Management and Operation of Semipublic and Residential Pools
193(2)
Owners of Residential Pools
193(1)
Owners and Operators of Motel/Hotel, Apartment/Condominium, and All Public Pools
194(1)
Strengthening the Communication with Pool Patrons
195(1)
Summary
195(2)
Warnings and Supervision: Essential Ingredients for Safety
Introduction
197(1)
Purpose of Warnings
197(1)
Warnings in Place of Safety Design Modifications
197(2)
Effective Warnings
199(1)
Standardization, Pictorials, and Testing
199(2)
Other Studies Relative to Warning Signs
201(1)
Warnings Summary
201(1)
Guidelines for Pool Owners
202(2)
Typical Objections to Signs
204(1)
Responsibility to Post Signs
205(1)
Signage for Use Adjacent to Natural Bodies of Water
206(1)
Guidelines for Owners of Natural Water Areas
207(1)
Is Supervision Necessary? The Answer is Yes!
208(1)
References
208(2)
A Coach Looks at the Data
Observations Concerning Recreational and Competitive Divers
210(4)
Findings and Implications of Data from the 440 Diving Cases
214(3)
Conclusions
217(2)
The Dilemma: The Controversial Issue of No Diving
What are the Implications of the findings?
219(1)
Recommended Actions
220(5)
Educate the Public
220(1)
Video Tapes
221(1)
``Water Safety Week''
222(1)
Revision of Educational Curricula
222(1)
Communicating Directly with the Potential Diver
222(1)
Verbal Messages
222(1)
Posted Pool Rules and Warning Signs
222(1)
Urgent Need to Inform
222(1)
Increasing Responsibility of Pool Builders, Owners, and Operators
223(1)
Regulate Swimming Pools and Beaches
223(1)
Standards for Boat Docks
224(1)
Need for Additional Research
224(1)
Human Performance of Divers
224(1)
Warning Signs and Pool Rules
224(1)
Pool and Its Equipment
225(1)
Effects of Alcohol and Drugs
225(1)
Development of a Data Set and Database System
225(1)
The Dilemma
225(3)
Conclusions
228(2)
Appendix A
Safety Checklist for Owners, managers, and Operators of Swimming Pools
230(2)
Profile of the Diving Accident Victim
232(1)
Profile of the Diving Accident Pool
232(1)
Suggested Rules for Use of Aboveground Pools
233(1)
Activities that Should be Prohibited in Aboveground Pools
233(1)
What Every Operator of Public and Semipublic Pools Should Do to Ensure the Safety of Patrons
234(1)
Instructions for the Use of the Pool to be Given to Tenants and Guests of Apartments/Condominiums
235(1)
What Every Motel/Hotel Owner/Operator Should Do to Maximize the Safety of Their Pool Guests
236(1)
What Every Apartment/Condominium Owner/Operator Should Do to Maximize the Safety of Pool Users
237(2)
Appendix B 239(10)
Index 249

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