Snorkelling and breath-hold diving fatalities in Australian waters, 2014 to 2018.

Introduction: This study investigated snorkelling and breath-hold diving deaths in Australia from 2014-2018 and compared these to those from 2001-2013 to identify ongoing problems and assess the effectiveness of countermeasures. Methods: Media reports and the National Coronial Information System were searched to identify snorkelling/breath-hold diving deaths for 2014-2018, inclusive. Data were extracted from witness and police reports, medical histories, and autopsies. An Excel® database was created and a chain of events analysis conducted. Comparisons were made with the earlier report. Results: Ninety-one fatalities (78 males, 13 females, median age 48 years [range 16-80]) were identified with one third likely doing some breath-hold diving. Fifty-two of 77 with known body mass index were overweight or obese. Approximately two thirds were inexperienced snorkellers and 64 were alone. Fifty-one were tourists. Planning shortcomings, such as solo diving and diving in adverse conditions, as well as pre-existing health conditions and inexperience predisposed to many incidents. Primary drowning was the likely disabling condition in 39% of cases with drowning recorded as the cause of death (COD) in two thirds. Cardiac events were the likely disabling conditions in 31% although recorded as the COD in 21% of cases. Conclusions: Increasing age, obesity and associated cardiac disease have become increasingly prevalent in snorkelling deaths and there is a need for improved health surveillance and risk management. Closer supervision of inexperienced snorkellers is indicated. Apnoeic hypoxia from extended breath-holding and poor supervision remain a problem. The increased risk of harvesting seafood in areas frequented by large marine predators needs to be appreciated and managed appropriately.