A review of snorkelling and scuba diving fatalities in Queensland, Australia, 2000 to 2019.

Introduction: This study examined all known diving-related fatalities in Queensland, Australia, from 2000 to 2019 to determine likely causes and potential countermeasures.

Methods: Data were extracted from the Australasian Diving Safety Foundation fatality database, including previously published reports. The National Coronial Information System was searched to identify diving-related deaths in Queensland for 2014-2019 and data were extracted, analysed, and combined with previously published data covering the period 2000-2013. Descriptive statistics and parametric and non-parametric tests were used to analyse these data.

Results: There were 166 snorkelling and 41 scuba victims identified with median ages of 59 and 49 years respectively, and 83% of snorkel and 64% of scuba victims were males. One quarter of snorkel and 40% of scuba victims were obese. Two-thirds of the snorkellers and three quarters of scuba divers were overseas tourists. Contributory predisposing health conditions were identified in 61% of snorkel and 50% of scuba victims. Nine scuba victims died on their first dive.

Conclusions: The increase in snorkelling deaths likely reflects increased participation, higher age, and poorer health. The main disabling condition in both cohorts was cardiac-related. Pre-existing health conditions, poor skills, inexperience, poor planning, supervision shortcomings and lack of effective buddy systems featured in both cohorts, and apnoeic hypoxia in breath-hold divers. Suggested countermeasures include improved education on the importance of health and fitness for safe diving and snorkelling, increased emphasis on an honest and accurate pre-activity health declaration and subsequent implementation of appropriate risk mitigation strategies, improved supervision, better buddy pairing, and on-going education on the hazards of extended apnoea.