1. Perspectives on Recreational Boating Safety
Dr. L. Daniel Maxim
NASBLA 2017 Annual Conference

2. The views presented here are those of the author and do not necessarily reflect those of the United States Coast Guard (USCG), United States Coast Guard Auxiliary (USCGAUX), the National Boating Safety Advisory Council (NBSAC), or the National Association of State Boating Law Administrators (NASBLA)

3. Presentation outline Background What we can learn from statistics
Key issues: Lifejackets and BUI
Closing thoughts

4. Photo credit U. S. Coast Guard.
background
Background

5. Boating is very popular according to 2012 NRBS estimates
27.3% or 32.3 million of the estimated million U.S. households had at least one member who boated
73.4 million persons representing almost a quarter (23.8%) of the U.S. population participated in recreational boating--this includes 57.9 million adults and 15.6 million children
3.6 billion person-hours were spent on board recreational boats taken out on the water
The full copy of the National Recreational Boating Survey is available at

6. Boating is relatively safe and getting safer
Between 1960 and 2016 fatality rates per 100,000 registered boats fell from 33.4 to 5.9—an 82% decrease
The boating fatality rate per exposure hour is comparable to that for automobiles and substantially lower than comparable rates for many other recreational activities (e.g., hang gliding, scuba diving, general aviation, snowmobiles)

7. Nonetheless
The rate of improvement in fatality rates has slowed in recent years
In 2016, there were:
4,463 accidents,
701 deaths,
2,903 injuries and
~ $49 million dollars of damage to property as a result of recreational boating accidents (accident and injury counts likely to be substantially understated)
Most accidents are preventable
Photo Source: 7

8. The challenges
Broadly—what are the opportunities to make boating yet more safe?
What are the major causes/contributing factors to boating fatalities?
What intervention strategies are likely to prove successful?
We know some of the answers

9. What can we learn from statistics?

10. Some core concepts Stress on evidence-based decision making (PHA)
We have a good understanding of the first two steps
We are struggling with the third and fourth steps
Surveillance: Problem definition
Identification of risk factors: What are the causes?
Intervention Evaluation: What works?
Implementation: Who does what? 10

11. Progress over the years
Can we
sustain
progress?
Compared to 1960 rates, we have saved over 120,000 lives, equivalent to the population of a mid-sized city. Nonetheless, the rate of improvement has slowed in recent years and is below the long term trend.

12. Boating fatalities by cause of death 2016
Drowning continues to account for the majority of fatalities

13. Drowning accounts for ~ 70% of boating fatalities in a typical year
~85% of victims were
not wearing life jackets, QED

14. Open motorboats account for the largest share of drownings (2016)

15. Fatalities by boat length (2016)
Fatalities and
Drownings greatest
on small boats
Proportion of
drownings greatest
on boats < 16 ft.

16. Drownings as % of total fatalities by boat type (2016)
Reason(s) why
drowning % is
lower for PWC?

17. Fatalities by accident type (2016)
How many of these
accident types can
be predicted in
advance?

18. Fatalities by education (where known) 2016
The ‘scale’ problem,
gradually reduced
over time as more
boaters become
subject to
mandatory
requirements

19. Non-powered craft accident trends 2005-2015
Is it just
demographics?

20. Data 2010-2014 % fatal accidents by month
Boating activity
peaks in summer
months, but % of
fatal accidents
higher in colder
months—this is the
basis for seasonal
wear requirements
in some states

21. Other relevant boating accident statistics
Although most accidents occur during afternoon hours, the fraction of accidents with fatalities is greatest in late evening or early morning hours
Most accidents occur during relatively benign weather conditions and on lakes ponds, reservoirs, rivers, and gravel pits
Only 8% occur on the gulf, Great Lakes, or oceans

22. Illustrative fact
Photo courtesy of U.S. Coast Guard.
75% of drownings occurred on waters with wave heights < 2 feet;
50% with wave heights < 6 inches 22

23. Implications
Night boating presents greater risks (in part because reported alcohol prevalence is higher in these times)
While boating in bad weather or offshore waters may present greater risks, boating in “benign” environmental conditions offers no guarantee of safety

24. Importance of human factors (2014 data)
Proportions have
not changed
materially over
the years

25. “Top ten” individual contributing factors 2014
Substance impairment
is the leading factor in
boating fatalities

26. “Take home” facts
We have made good progress, but more remains to be done
Drowning is the major cause of fatalities; 85% of victims not wearing life jackets
Small boats account for the majority of fatalities
Capsizing and falls overboard are major causes of fatalities
Non-powered craft account for an increasing share of fatalities
Most fatalities occur in relatively benign environmental conditions
Human error accounts for about 2/3rds of fatalities
BUI is the largest single contributing factor to fatalities

27. Key issues at a glance: 2016 data
All Fatalities
701
Alcohol
Related 133
Drownings
509
Drowning and
alcohol-involved
fatalities account
for about 80% of
total boating
fatalities!
These are the latest data available in Boating Statistics. However, percentages have remained relatively constant in the past several years.

28. Implications
We need to identify ways (outreach, regulation) to convince boaters to wear life jackets—at least on smaller boats
We need to reduce the prevalence of alcohol consumption on the water
We need a better understanding of human factors and paddlecraft accidents

29. First Key Issue: Life Jackets
Photo credits: U. S. Coast Guard.
First Key Issue: Life Jackets

30. Life jacket basics
Life jackets do not prevent accidents, but substantially increase the likelihood of survival in the event of capsizing or falls overboard
It is difficult to predict the circumstances where life jackets will be required beforehand, and therefore,
Life jackets need to be worn, not just carried—particularly for small boats

31. Studies show that increased wear rates
could reduce boating fatalities dramatically 31

32. Efficacy of life jacket wear supported by studies
Cummings et al. (2010) matched cohort design U.S.: authors estimated that wearing a life jacket reduced the risk of drowning by 49% (95% CI 26% to 65%)
Maxim (2010) U. S.: For open motorboats, canoes, kayaks, and rowboats the incremental lives saved if wear rates could be increased to 70% were estimated to be approximately 125 annually, a 34% reduction
Cummings, P., Mueller, B.A., and Quan, L., (2011). Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Inj Prev, 17:156–9.
Maxim, L. D., (2010). Drownings Avoided by Increased Lifejacket Wear: Suggested Models and Illustrative Calculations (Unpublished, but peer-reviewed Working Paper).

33. Efficacy of life jacket wear supported by studies
Gungor and Viauroux (2014) U. S.: the expected number of drownings per vessel would decrease by about 80% if the operator wears a life jacket
O’Connor and O’Connor (2005) Australia: probability of surviving was 34/50 = 0.68 (95% CI ) if the person was wearing a life jacket compared to 128/257 = 0.50 (95% CI ) if not
Bugeja et al., (2014) Victoria Australia: 67% decrease in drownings after regulation requiring life jacket wear went into effect
Gungor and Viaroux later published as: Viauroux, C. and Gungor, A., (2015). An Empirical Analysis of Life Jacket Effectiveness in Recreational Boating. Risk Analysis. doi: /risa
O’Connor, P., and O’Connor, N., (2005). Causes and prevention of boating fatalities. Accident Analysis and Prevention, 37, 4:
Bugeja, L., Cassell, E., Brodie, L. R., and Walter, S. J., (2014). Effectiveness of the 2005 compulsory personal flotation device (PFD) wearing regulations in reducing drowning deaths among recreational boaters in Victoria, Australia. Inj Prev, 0:1-6.

34. Let’s see now… Drowning accounts for the majority of fatalities
Most drownings occur in benign environmental conditions, not offshore or on the great lakes
Most drownings occur as a result of unpredictable circumstances (capsizing, falls overboard, flooding/swamping)
Wearing (not merely carrying) a life jacket can reduce fatalities substantially

35. Therefore…
Wearing a life jacket, particularly on small craft ought to be a “no-brainer” and so
Life jacket wear rates should be high
But, Lets look at data on actual wear rates
Photo credit: U. S. Coast Guard

36. JSI Research and Training Institute studies
Wear rate studies under CG grant from 1999 forward
Based on actual observations, not interviews
Data collected include wear rates by age and gender of boater, type, and length of boat

37. Life jacket wear rates: all boats excluding PWCs
What will it
take to move
the needle
for adults?
The latest JSI wear rate study is available at

38. Adult wear rates by boat type 2015
Regulation and
risk perception?
But what about
powerboats?

39. Wear rates by age 2015 (excluding PWCs)
Children subject to mandatory wear requirements
Do teen-agers view freedom from legal wear requirements a “rite of passage?”
Adults: the primary behavioral target group

40. Several studies on attitudes towards life jacket wear

41. CliffsNotes summary: why don’t adults wear life jackets?
Boating is safe enough
Life jackets are not comfortable
Life jackets are un-attractive
Wearing a life jacket is a sign of fear
I’m a good swimmer
I can anticipate situations where life jackets might be needed—or don one in the water if I fall overboard
Life jackets won’t save my life
Many of these are factually incorrect!
Several studies point to these attitudes, see e.g.,
Groff, P. and Ghadiali, J., (2003). Will it Float? Mandatory PFD Wear Legislation: A Background Research Paper prepared for the Canadian Safe Boating Council. SMARTRISK Toronto, Ontario, Canada, 286 pp.
Isaacs, J. C., and Lavergne, D. R., (2010). The Louisiana Department of Wildlife and Fisheries Survey of Louisiana Recreational Boaters, Louisiana Department of Wildlife and Fisheries Socioeconomic Research and Development Section, 99pp. Available electronically at
Turner, S., Wylde, J., Langham, M., Sharpe, S., and Jackson, K., (2009). MCA Lifejacket Wear-Behavioural Change. Report prepared for the Maritime Coastguard Agency and the Royal National Lifeboat Institution, 101pp.
University of South Florida, Center for Social Marketing, (2009). Social Marketing and Boating Safety: A Project to Increase Personal Floatation Device Use – Literature Review. USF Center for Social Marketing, 13pp.

42. About user perceptions
Can’t simply claim “you are misinformed:” To the consumer, perception = reality; understanding barriers is a key to success
Some obviously flawed (e.g., good swimmer, don’t go far offshore, won’t save lives, will wear when in potentially “dangerous” conditions)
Need to reinforce correct perceptions and counter incorrect perceptions (well researched FAQs)

43. Strategies to increase life jacket wear
Outreach
Options
Design
Regulation 43

44. Outreach efforts
Materials, pamphlets, print articles, and campaigns (e.g., NSBW)
Vessel Safety Checks and other one-on-one educational opportunities
Life jacket loaner stations
PSAs including PSAs on social media
Cell phone Apps

45. Outreach materials 45

46. Additional comments on outreach efforts
Clearly well intentioned and successful to various degrees (e.g., awareness), but thus far have had only a limited impact on behavior, despite having spent $ millions in past 20 years
Need to determine messages that resonate, identify target audience(s), and choose the right PSAs and media mix to optimize likelihood of success

47. Life jacket design
Designs have evolved over time, but is there still room for further improvement?
Style
Function
Reliability
Comfort
Design competitions (e.g., BoatUS, NMMA, LJA) potentially valuable

48. Regulation Mandatory life jacket wear policies
In Australia and Ireland
In certain seasons in seven US states (CT, MA, MD, ME, NY, PA, and WV)
In certain bodies of water (e.g., USACE)
For certain types of craft (PWC)
For people of certain ages (youth)
Typically successful where implemented

49. Second Key Issue: alcohol use
Photo credit: U. S. Coast Guard.
Second Key Issue: alcohol use

50. BUI basics
Alcohol consumption impairs balance and judgement and slows reaction time
Alcohol consumption increases the likelihood of an accident and lowers the chance of survival after an accident
Alcohol consumption increases the risk ratio for fatalities at levels well below present BUI legal limits (Smith et al., 2001)

51. Risk ratios (Smith et al., 2001)
Some points on this graph
BAC 0.03; RR = 2.2
BAC 0.05; RR = 3.7
BAC 0.08; RR = 7.1
BAC 0.10; RR = 10.4

52. Impairments as function of BAC for auto drivers
.01
.02
.03
.04
.05
.06
.07
.08
.09
.10
Driving Simulator Lane Deviations, Divided Attention
Drowsiness
Vigilance
Perception, Visual Functions
Tracking
The complete reference is Moskowitz, H. and Fiorentino, D., (2000). A review of the scientific literature regarding the effects of alcohol on driving-related behavior at blood alcohol concentrations of 0.08 grams per deciliter and lower. DOT HS U. S. Dept. of Transportation, NHTSA, Washington, DC: 62 pp.
Cognitive Tasks, Psychomotor Skills, Choice Reaction Time
Simple Reaction Time, Critical Flicker Fusion
(From Moskowitz and Fiorentino, 2000; cited by NTSB)

53. What’s been done to date?
Increased enforcement
More publicity of enforcement efforts
Prohibition of alcohol use on certain waters
Outreach efforts
Research
NTSB recommendation for automobiles
The NTSB report is available at

54. Limited progress to date
Whether measured as a % of total fatalities or to numbered boats, there has been little progress
ERAC looking at ways to improve data
Data from Boating Statistics

55. Why is it a hard problem? Social acceptability of drinking and boating
Lack of success of certain strategies (e.g., utility of “designated driver”)
Difficulty of enforcement efforts—you can’t have enforcement 24/7 on all bodies of water
Emerging issue—drug use
Prevalence of drinking when boating is reportedly quite high. For example, according to one reference: ““Surveys conducted over the last two decades have consistently shown that 30% to 40% of boaters drink while on their vessels.” See Howland, J., Smith, G.S., Mangione, T., Hingson, R., DeJong, W., and Bell, N., (1993). Missing the boat on drinking and boating. JAMA 270(1): Estimates are even higher for some populations.

56. Closing thoughts

57. Challenges: Life Jacket wear
Regulatory options may be difficult to implement on national level
USACE efforts noteworthy, possible opportunities with other government agencies or individual states
Outreach efforts; limited success for adults—time for a coordinated effort to create an impactful campaign

58. Challenges: BUI
Difficult to measure accurately—how can role of alcohol consumption as contributing factor be assessed?
Role of alcohol probably understated—efforts to develop improved measurements valuable
Need for authoritative “backgrounder” to provide a common understanding
Search for effective intervention strategies from other transportation modes potentially worthwhile

59. Other challenges
Can we increase the extent and effectiveness of boater education?
The scale problem:
Not all boaters required to take boating courses (solved over time)
The scope problem:
Presently no requirements for on-the-water skills training or testing
Should content of boating courses be changed to include or focus on human factors and risk management?

60. Time to modify the scope of boating instruction?
FAA Aviation Instructor’s Handbook and Risk Management Handbook have large discussion of human factors, errors, error management
Could these be a model for boating instruction?
Here is a convenient web site for the Aviation Instructor’s Handbook.
Here is the web site for the Risk Management Handbook:

61. Use this meeting to develop your own ideas61