Kids, Teens More Likely to Wear Life Jackets If Adults Wear Them, Yet Use Remains Low Among Adults, New Studies Show

Researchers at Seattle Children’s and UW Medicine encourage more adults to be role models for kids and wear water safety gear this Memorial Day weekend

New studies from researchers at Seattle Children’s Hospital and the Harborview Injury Prevention & Research Center have found that the use of life jackets among adults can significantly influence whether kids wear them, too, and help prevent half of boating-related deaths. Yet use of life jackets by adults on boats remains low, researchers say.

About 85 percent of recreational boating-related drowning victims in the United States in 2012 did not wear a life jacket. This fact is especially timely with Memorial Day weekend fast approaching, as open-water drowning remains an important public health problem in the U.S., and impacts many adults as well as children.

New science on boating risks and safety are appearing in three articles in the journal Injury Prevention and another in the journal Accident Analysis and Prevention. Study authors found that boaters were more likely to wear life jackets (also known as personal flotation devices or PFDs) if laws required their use; that even the most experienced boaters may not be prepared for a mishap if they are not wearing a life jacket; and that life jackets must be worn to work correctly. UW Medicine lead author Dr. Alex Quistberg reports that alcohol use, perceived greater level of swimming ability and larger boat sizes were all found to be associated with low or no life jacket use. Conversely, life jacket use was more likely when an inflatable life jacket was onboard or if the person had taken a boating safety class.

“Inflatable life jackets were the clear winners,” said Quistberg, a UW Medicine researcher at Harborview Injury Prevention & Research Center. “This is probably because people like inflatable lifejackets: they’re less cumbersome and they’re more comfortable. Boaters who have them on board were more likely to report high use.”

“Wearing a life jacket may prevent one in two drowning deaths, but as we have seen, life jackets are rarely used by most adults,” said Dr. Linda Quan, study co-author, and researcher at Seattle Children’s Hospital. “The reasons for this are typically discomfort and the belief that life jacket use indicates inexperience or poor swimming skills.”

An observational study of life jacket use, which was conducted between August and September of 2010, followed 5,157 boaters in Washington and made note of life jacket use. Despite the advent of new, more comfortable inflatable life jackets and an increased push for boater education and awareness, researchers found that only 31 percent wore life jackets. Life jacket use was highest among groups who are required to wear them by state law: personal watercraft users (97 percent), people like water-skiers that are being towed (95 percent) and children 0-12 years old (82 percent).

Researchers also found children were much more likely to use a life jacket if any adult in the boat was wearing one: 100 percent versus 87 percent for ages 0-5 years and 93 percent versus 77 percent for ages 6-12 years. Adult role modeling appeared to be particularly beneficial for teenagers ages 13-17, who were not covered by a life jacket law.

”We found that teens were 20 times more likely to wear a life jacket if at least one adult was wearing a life jacket,” said Celeste Chung, MSW, MPH, of Seattle Children’s.

A fourth study looked at fatal and non-fatal boating accident report data. Key risk factors were lack of life jacket use, lack of safety features, and being in non-motorized craft (paddle craft) and using alcohol. “The data show that fatalities are more than two-times more likely to not be wearing a life jacket than those who were injured, but survived,” said Sarah Stempski, MPH, MCHES, Seattle Children’s Hospital.

U.S. federal law requires all recreational boats to carry a life jacket that fits for each passenger, but this research shows that life jackets are rarely used by most adults.

Researchers recommend proper adult role modeling, the design of more comfortable life jackets and boater education classes as effective strategies for increasing life jacket use among adults and children. As has been done with seat belts and bicycle helmets, they also advise that the passage and enforcement of life jacket legislation for teens and adults on high risk waterways is likely the most promising approach for prompting this behavior change.

Quistberg D, Quan L, Ebel B, Bennett E, Mueller B. Barriers to life jacket use among adult recreational boaters. Injury Prevention2014 Mar 31. doi: 10.1136/injuryprev-2013-040973. [Epub ahead of print]

Chung C, Quan L, Bennett E, Kernic M, Ebel, B.
Informing policy on open water drowning prevention: an observational survey of life jacket use in Washington state. Injury Prevention 2014 Feb 10. doi: 10.1136/injuryprev-2013-041005. [Epub ahead of print]

Stempski S, Schiff M, Bennett E, Quan L.
A case control study of boat-related injuries and fatalities in Washington state. Injury Prevention 2014 31 Mar. doi:10.1136/injuryprev-2013-041022. [Epub ahead of print]

Quistberg A, Bennett E, Quan L, Ebel B. Low personal flotation device use among adult recreational boaters: A qualitative study of risk perception and behavior factors. Accident Analysis and Prevention. 2014, 62: 276-284. doi: 10.1016/j.aap.2013.10.015.

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