visitor safety - hawaii department of...
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Visitor Safety:How Are We Doing?
Dan GalanisInjury Prevention and Control Section,
EMS & Injury Prevention Systems Branch,Hawaii Department of Health
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Overview of presentation
• Part I: Visitor Safety: How are we doing?– Statewide data, 2003-2012
• Injury rates: residents compared to visitors– Fatal and non-fatal injuries
• Part 2: County descriptions– Rate comparisons– County specific trends, data, and maps
• Locations, victim residence, and seasonality (October-March vs. April-September)
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Annual rates of injury-related hospitalizations and deaths, by residence status, 2008-2012
0
10
20
30
40
50
60
2.5
12.6
4.10.6
30.4
18.1
3.1 4.71.7
37.4
0.2
20.5
6.8
1.6
43.9
2.5
8.1 8.5 7.5
50.3
neardrowning
falls mvc-total
poisoning total drowning falls mvc-total
poisoning total
Hospitalizations (/10,000) Deaths (/100,000)
non‐residents Hawaii residents
Non-residents:46%
Non-residents:49%
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Leading causes of fatal injuries in Hawaii, 2008-2012
poisoning
falls
suicide
mvc-occupant
DROWNING
DROWNING
mvc-occupant
poisoning
falls
suicide
15 (5%)
17 (5%)
28 (9%)
36 (11%)
162 (51%)
505 (16%)
541 (17%)
852 (27%)
276 (9%)
170 (5%)
0 250 500 750 1000
Hawaii residents
non-residents
Most (80%) of drownings occur in the ocean (86% for non-residents)
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“Injury Pyramid” for injuries among non-residents in Hawaii
Deaths 68/year
Hospitalizations~550/year
Emergency department visits~7,730/year
Nonfatal injuries
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Leading causes of hospitalizations for non-fatal injuries among non-residents in Hawaii, 2008-2012
assault
suicide
overexertion
water transport
mvc-bicyclist
mvc-motorcyclist
mvc-occupant
near-drowning
struck by/against
falls
12 (2%)
12 (3%)
14 (3%)
15 (3%)
19 (4%)
21 (4%)
25 (5%)
46 (9%)
51 (10%)
227 (46%)
0 50 100 150 200 250
Average annual number (% of total)
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Leading causes of spinal cord injuries in Hawaii, 2009-2012
other injuries sky dive
bicycle crashes (no mvc) water dives, non-ocean
assault other sports (non-aquatic)
striking falls
motor vehicle crashes ocean activities
27 (6%)5 (1%)6 (1%)9 (2%)10 (2%)
15 (3%)25 (6%)
102 (22%)104 (23%)
151 (33%)
0 50 100 150
number (% of total)
Most (77%) are non-residents
body surfing: 42body boarding: 37
“tossed by wave”: 42
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Location (beach) of spinal cord injuries from ocean activities in Hawaii, 2009-2012
un k no w n2 1 b eaches1 3 b eaches
B ellow s H am oa
P o lo B each W aim analo
W aik ik iK aanap ali
W aim eaK ua B a y
L aaloaS and y
H apunaB renn eke
M akena
141
23333
455
78
1113
1416
0 5 10 15
M au i K auai H aw aii O ahu
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Ocean drownings, 2003-2012
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Number and ten-year rate of ocean drownings in Hawaii, by residence of victim, 2003-2012
0
100
200
300
73
209
282 256
179.3 150.1 156.7
19.7
foreign country (14%)
U.S. mainland
(39%)
visitors-total
(52%)
Hawaii residents
(48%)
foreign country
U.S. mainland
visitors-total
Hawaii residents
Number of drownings Rate (/100,000) of drownings
Japan: 39 Canada: 8South Korea: 4 China: 3
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Ocean drownings in Hawaii, by residence and activity of victim, 2003-2012
Unknown activity
Other activity
Surfing/body boarding
Swimming
Snorkeling
Scuba
Free diving
Picking opihi
Fishing shorecasting
Fell in/swept in
Boat accident
23
15
10
92
102
15
3
0
0
21
1
32
22
26
53
13
8
48
9 (2%)
18 (3%)
21
6
55 (10%)
37 (7%)36 (7%)
145 (27%)
115 (21%)
23 (4%)
51 (9%)
42 (8%)
7 (1%)
0 50 100 150
76 (14%) from
unintentional immersions
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County-specific data
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Ten-year rate (/100,000) of ocean drownings in Hawaii, by residence status and county, 2003-2012
0
50
100
150
200
250
300
32.216.9 25.0 20.0
171.0
125.2
269.0
158.7
50.126.2
83.3
54.3
Hawaii Oahu Kauai Maui Hawaii Oahu Kauai Maui Hawaii Oahu Kauai Maui
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Ocean drownings on Kauai, 2003-2012
77
318
10 25
0 10 20 30
unint. immersion
swimming
snorkeling
diving
other activity
unknown
9
4
7
2
5
9
6
4
6
9
3
5
11 1 1
34
2
01
21
98 8
10
6
76
0
4
8
12
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
total (70) non-residents (54, 77%) HI residents (16, 23%)
Number of drownings, by activity
Annual trends,
by residence of victims
• Summary
• 70 total, 2 to 10 per year• Somewhat decreasing trend • Mostly (77%) non-residents • Activity: Swimming (36%) and
snorkeling (26%)
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Napali Coast: 4 drownings:-3 non-residents
-all during Oct-March-3 swimmers
Kee-Princeville: 19 drownings:-17 non-residents (all US)
-no seasonality-5 at Queen's Bath, none since 2008
Poipu area: 15 drownings:-13 non-residents (all US)
-no seasonality-8 snorkelers, 5 swimmers
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North Shore (Polihale-Lighthouse): 29-20 (69%) from Oct-March
East Shore (Larsens - Lihue): 21-13 (62%) from April-Sept.
South Shore (Kekaha-Poipu): 22-13 (59%) from April-Sept.
Seasonality
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Ocean drownings on Oahu, 2003-2013
2846
4150
3167
0 20 40 60 80
unint. immersion
swimming
snorkeling
diving
other activity
unknown
19
2630
22
812 10 8 10 9 10
1712
9
1621
12
29
22 19
31
22
43
10
14 1714
26
17
11
0
10
20
30
40
50
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
total (263) non-residents (108, 41%) HI residents (155, 59%)
Number of drownings, by activity
Annual trends,
by residence of victims
• Summary• 263 total, 19 to 43 per year• No consistent trend
• Slightly more residents (59%)•• Activity: wide distribution
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18Leeward coast: 42 drownings:52% residents; not much seasonality
North Shore: 26 drownings:
eastern Oahu (Honolulu-Kailua): 154 drownings (59%)
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Point Panic-Ala Wai marina: 25:-21 residents
Hilton Hawaiian-Kapahulu: 35:-26 non-residents (10 US, 16 foreigners)
Kahala-Portlock: 23:-17 residents
Hanauma: 20:-19 non-residents
-7 US, 12 foreigners
Residence
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South Shore: 104 drownings:-71 (68%) from April-September
Seasonality
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Ocean drownings on Maui County, 2003-2013
87
1030
1436
-15 5 25 45
unint. immersion
swimming
snorkeling
diving
other activity
unknown
11
14 13
75
11
16
7
13 3 3
6
19
6 7
12
86
9
5
8755 54
11 20
4
8
12
16
20
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
total (105) non-residents (76, 72%) HI residents (29, 28%)
Number of drownings, by activity
Annual trends,
by residence of victims
• Summary• 105 total, 6 to 19 per year
– (95 on Maui, 8 Molokai, 2 on Lanai)• Increasing trend
• Mostly (72%) non-residents •• Activity: Swimming (34%),
snorkeling (29%), and unintentional immersions (13%)
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Kaanapali: 21 drownings:-13 in Black Rock area
-20 non-residents (18 US)-17 from 2008-2012
-14 from October-March
Kamaole-Oneloa (Big Beach) 26:-10 at Big (5) or Little (5) Beach
-24 non-residents (21 US)-16 from 2008-2012
-little seasonalityMolokini: 6
-5 from 2011-2012
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Ocean drownings on Hawaii County, 2003-2012
1213
2017
2117
-5 5 15 25
unint. immersion
swimming
snorkeling
diving
other activity
unknown
13
4
9
16
3 4 4
0
4
75 4 5
9
4 5
9
15
99
97
9
2
11
4
65
4
0
4
8
12
16
20
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
total (100) non-residents (44, 44%) HI residents (56, 56%)
Number of drownings, by activity
Annual trends,
by residence of victims
• Summary• 100 total, 4 to 16 per year• No consistent trend
• Slightly more residents (56%)
• Activity: wide distribution
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Waikoloa Beach-Mauna Kea: 13:-11 non-residents (8 US)
-8 snorkelers
Kailua Bay-Keauhou: 17-12 from April-September
Kumukahi Lighthouse-Pohoiki: 11:-10 residents
-10 from 2006-2012
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west coast (Mauna Kea-Milolii):
-33 of 51 (65%) victims non-residents
south and windward coasts:-35 of 41 (85%) victims non-residents
Residence
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Summary
• Visitors have low risks (rates) of injury, with the exception of drowning, near-drowning and spinal cord injury– Comprise nearly half the drowning victims/patients
• Mortality rates ~7 times higher, morbidity ~10 times higher– Comprise 77% of ocean-related SCI
• Specific beaches on each island
• County data– Hawaii County highest drowning rate among residents– Kauai highest rate among non-residents and total– Descriptions (victim residence, activity, seasonality,
trends) available for each county