Safer in the Water

Tools & Best Practices for Drowning Prevention

According to the National Drowning Prevention Alliance (NDPA), between 3,500 and 4,000 people die from drowning annually, an average of 10 per day. And, the NDPA says that another 9,000 people a year require emergency room care from drowning.

No doubt there are other dangers in a natatorium, waterpark or resort—slips and falls on decks and in locker rooms require their own rules and policies, and water and air quality issues can sicken swimmers, staff and spectators. Handling chlorine and other pool chemicals also comes with dangers. And this year COVID-19 has added the risk of contracting a virus that has killed more than 300,000 Americans.

But drowning is the best known, most lethal and most common aquatic facility hazard; it gets the headlines and draws the focus of organizations like the NDPA and the lifeguard industry.

The main weapons against drowning have always been the acquisition of swimming skills, the attention and skills of lifeguards, and medical care. The NDPA says that learning to swim can reduce the risk of drowning by 88% for 1- to 4-year-olds who take formal swim lessons.

"We need more of the world's population to learn to swim, understand water safety and have training for what to do in a water emergency," said Adam Katchmarchi, executive director for the NDPA and an assistant professor of Sport Management at Indiana University of Pennsylvania.

"Learning to swim is one of the key ways to prevent drowning and make people safer around water. We know there is still a significant portion of the population in the United States and across the world that do not have basic swimming skills or water competency."

It seems, then, that we know all there is to know about aquatic facility safety and how to maintain it: Keep people from running on wet surfaces, maintain proper water and air quality, teach people to swim, employ a well-trained lifeguard staff, and in 2020 and 2021, follow federal, state and local guidelines to prevent the spread of COVID-19.

Katchmarchi describes the basic approach to facility safety, beginning with the fact that there is no one-size-fits-all approach. "Every aquatic facility is different," he said. "Every event at an aquatic facility is different. Because of this, aquatic facility managers must have a comprehensive and well-practiced safety plan unique to their facility and operations."

According to Katchmarchi, aquatic facilities must:

» Focus on preventing accidents from happening.
» Have a well-trained staff who are familiar with the facility's safety plans and emergency response plans, and who regularly participate in in-service trainings.
» Additionally, facilities should have a robust safety program that involves daily inspections of the facility, proper water quality management, posted and enforced facility rules, a preventive maintenance plan and a risk management plan.

Technology & Innovation

Indeed, continuing best practices is the major part of maximizing safety in and around pools, but experts like Katchmarchi say there is still always research and innovation to bolster what has been done for decades. Residential pools already have aids like alarms to prevent unauthorized water entry, and distress monitoring systems attached to swimmers and lifeguards are available for swimmers at home or in public.

"I see the aquatic safety technology as a major future evolution," he said. "There are a number of technology companies entering the aquatic safety and drowning prevention space. While we are a way off from each aquatic facility having a major safety technology component, this is an exciting time to see the innovation happening in this space."

One of the newest additions to water safety technology is a mobile app developed for lifeguards through the joint effort of aquatic facility management consultant and design firm Counsilman-Hunsaker, forensic consulting and litigation support service firm DJS Associates and the Aquatic Safety Research Group.

The latter was founded by Tom Griffiths, who has also served as the director of aquatics and safety officer for athletics at Penn State University for a quarter century.

Griffiths said the app, set for rollout in early 2021, is designed for recognition and detection of drowning victims in swimming pool settings. He got the idea for the app when he realized that while there was a wealth of good information provided by lifeguard training agencies for rescues and resuscitation, little actual training, if any, was provided to lifeguards as to how they could improve their detection and recognition of distress skills.

Griffiths' sports psychology background had made him familiar with the mental and visual training athletes have used for decades to improve performance.

"We thought this type of virtual training would be excellent for lifeguards who have a difficult time not only detecting drowning distress in the water, but differentiating distress from water play," said Griffiths.

The team spent several years working with computer gaming engineers and software technicians to come up with a visual Lifeguard Simulator that would challenge lifeguards to spot drowning victims on their phones in a timeline fashion.

Griffiths said some of the simulator's assets include:

» While most lifeguard training concentrates on rescue and resuscitation, the app's training concentrates exclusively on visual detection and recognition of victim distress in the water.
» The training app can be used anywhere, ensuring privacy of the user.
» The visual detection and recognition skills will support and supplement pool and classroom work.
» The app supports the growing trend in virtual learning.

"We truly believe (the app) will significantly assist lifeguards in anticipating, recognizing and detecting drowning behaviors before it is too late," said Griffiths.

The Basics & Beyond

Because all this technology is relatively new and not in common use yet, most facility operators have to adhere to traditional ways of keeping everyone safe. Emily Wujcik has been the aquatics and safety coordinator at Saint Louis University's 120,000-square-foot Simon Recreation Center since 2017, the culmination of a career centered on the pool.

Though the facility is many more things than a place to swim, and Wujcik's background includes early childhood and special education and sports management, her history with both swimming and aquatic safety go back to the start of her lifeguarding career at 16 years old. She added swimming instructor certification shortly after and continued both guarding and teaching throughout her college career.

"Throughout my education, I've learned a lot, and the main thing is to respect the water," she said. "Water can be calming, relaxing and fun. It can also be unforgivable, and on a greater scale can be life-threatening and life-taking. Drowning is a preventable cause of death, and I continue to share that message, particularly with my staff, our patrons when applicable and those in the greater St. Louis area."

The rec center includes a 40-yard indoor pool with six 25-yard lanes, a diving well, a whirlpool and an outdoor recreation area with two leisure pools. To those areas Wujcik brings a foundation of safety that begins with prevention. "My definition of risk management is preventing what can go wrong while being ready to act appropriately when something does go wrong," she said.

Wujcik focuses on constant training of staff, covering a wide range of topics to be best prepared for any situation that may arise. Her staff is comfortable asking for training as well, whether it be volume or type. "Listening to staff and focusing on areas to strengthen their confidence has helped us develop trainings that are both fun and engaging," she said.

She said she relies on regulars, swimmers and patrons, to know the facility's rules as well as their own swimming abilities. On the infrequent occasions when the facility hosts events, spectators watch from a designated observation deck that overlooks the pool. "Too many people on deck makes it very hard for a lifeguard to maintain control and even see what is going on," Wujcik said. "Here, spectators can still feel the electric atmosphere but are far enough away from the pool to not be a direct distraction."

Despite the basics of safety being well known, Wujcik said there are some challenges. Each semester brings more swimmers, which not only increases the chances of danger through volume, but also boosts the chances of there being inexperienced swimmers.

"I love to see people in the water—whether they're doing a workout, having some leisure time, rehabbing an injury or being in the water for the first time," said Wujcik. "When we get more people in the water, we can sometimes find overcrowding, but my main concern with any new person in the water is not knowing what their comfort is in the water and what is their swimming ability."

As a teenaged lifeguard, Wujcik learned the importance of knowing a patron's comfort and ability in the water, along with always remaining alert and attentive when on duty.

"I like to replace the word 'scanning' with 'searching,'" said Wujcik. "This implies that there is something to be found. What we want to find on each search is where the swimmers are, what they are doing and what they look like—and no, not only what kind of swimsuit they have, or what new pair of goggles they have, but are they continuing to make forward progress?"

Wujcik explained that in mere moments any swimmer can go from being a swimmer to a distressed swimmer to an active drowning victim to a passive drowning victim to a passive submerged victim. All that can happen silently, which is why she emphasizes "searching" for lifeguards.

"The job is in the name—we are guarding people's lives, and it is important to remain focused and alert when on duty," she said.

The facility hosts a number of water-related clubs, and these too must be monitored by staff. A swim team, swim club, water polo club and kayak club keep lifeguards on their toes, and Wujcik said while most lifeguards are familiar with swimming and water polo, kayaking tends to throw them for a loop because many have never guarded a pool while someone was practicing kayaking before.

"I make sure that during in-service training, we all get a chance to practice how to properly get someone out of an upside-down kayak," said Wujcik. "Our staff really likes practicing this, and we get to have a lot of fun while they also learn something new or are brushing up on this skill.

"Overall, there are things that may be new to people. All that means is that we get to have more material to pull from for training and practice doing while still having fun along the way. Learning more about how the kayaks work and being more comfortable with them in the water has also even led to some guards joining the team!"

The Pandemic Impact

Of course, the main new challenge all operators are dealing with is COVID-19. Affecting everything from the number of patrons allowed to extra sanitizing, the management of virus spread has added layers to facility safety that were unknown before 2020. Wujcik said one obstacle rises above the others.

"In my opinion, the biggest challenge with COVID-19 is the fact that when you are swimming, you cannot wear a mask," she said. "We all know that wearing a mask helps to prevent the spread of COVID-19, but this environment makes it impossible to do so. Because of this, we must take into consideration other recommendations, like social distancing."

Currently, Wujcik's facility is permitting one person per 7-foot-wide lane. The campus health care center has shared N95 masks, gowns and safety glasses for use when responding to an emergency situation. While the personal protective equipment (PPE) is helpful, it can only be used out of the water, said Wujcik.

"We still are practicing rescues in the water, but have switched to mainly focusing on rear rescues by having the rescuer and victim face the same way to help reduce the amount of face-to-face time while in the water since neither are wearing masks while in the water," said Wujcik.

"Once out of the water, our staff can put on their PPE including the N95 mask and the one they had on before they entered the water. In having additional PPE, our staff has shared that they feel more comfortable in responding to emergencies. I think that even when we go back to normal, we will continue to have these items available. Whatever we can do to keep our staff and our patrons safer is worth having."

Griffiths said the COVID-19 precautions taken by aquatic facilities around the country make aquatic venues cleaner and safer, and he thinks they will continue when the health crisis is over.

"Following the recommendations of the (Centers for Disease Control) and the (World Health Organization) made our swimming pool and ancillary amenities look and smell better through constant cleaning, as well as safer by disinfecting surfaces," he said.

The masks and social distancing may become tactics of the past, but Griffiths said the new hygiene practices may become the "new normal." He said he has been impressed with the response of the aquatics community to the challenges of the virus. "Aquatic professionals went to work making their facilities cleaner and safer for their communities," he said. "We experienced very little complaining, even with the increased workload. That's good news."

He has identified some negative consequences, however:

» Participation in swim lessons, swim teams and aquatic classes declined because of physical distancing requirements.
» Because most group swimming classes were cancelled and replaced with private or semi-private lessons, fewer children probably learned how to swim during this pandemic.
» Because fewer learned to swim this year, drownings may see an increase.

"We think the data may also reveal an increase in open-water drowning deaths because many swimming pools were either closed or reduced their operations," Griffiths said. "Therefore, many individuals probably sought to swim in unguarded open-water areas rather than guarded swimming pools."

Wujcik said locker room policies also have been affected by COVID-19, adding an element to maintaining a space that is often overlooked when aquatic facility safety is discussed. This past year Wujcik's policy changed to ask patrons to refrain from being in the locker rooms as much as possible, asking them to come to the facility dressed and ready to go, to shower at home.

"We still are allowing patrons to use the showers but have added clean rags and disinfectant bottles that patrons can and do use to wipe down the shower both before and after each use," she said.

Without COVID-19 considerations, locker rooms are dangerous for the same reason pool decks are—slips and falls. "One of the biggest safety concerns I always have with locker rooms is what the flooring is made of," Wujcik said. "Flooring in this space needs to not get too slippery when the floor gets wet."

Operators overseeing construction or remodeling should be sure that lockers and benches are secured appropriately to the walls and floors. Benches in particular need to be stable, she added. "Ideally, they are up against a wall or at the bottom of a wall of half lockers so that there is a back rest for patrons to use," said Wujcik.

Overall, a great way to ensure that locker rooms are remaining clean is to have staff walk through them on a regular basis, Wujcik said. They may find that a toilet isn't working, or that there is a pair of shoes that needs to go into lost and found, but they are also looking to make sure that area remains as safe as possible.

Griffiths said that while safety has evolved to using psychology and video simulation and mobile apps to help lifeguards train to detect and prevent rather than rescue, some safety basics will never change. You cannot be too safe, he said.

He cites monthly in-service training along with pre-job orientations as being the industry standard of care. Operators and instructors do a much better job of educating parents and patrons so that the lifeguard on duty is not solely responsible for the safety of the children in the pools. Griffiths said with the support of the medical field, particularly the American Academy of Pediatricians (AAP), he recommends swimming lessons begin much earlier than age 4, which used to be the recommended age for initial instruction.

"Pool safety has grown tremendously in the last half century," said Griffiths. "We have evolved from simply having a teenager with a heartbeat and a lifeguard certification card to layers of protection through facility safety teams and technologies, as well as policies, programs and practices to make our facilities safer." RM