visitor safety...• specific beaches on each island • county data – hawaii county highest...
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1
Visitor Safety:How Are We Doing?
Dan GalanisInjury Prevention and Control Section,
EMS & Injury Prevention Systems Branch,Hawaii Department of Health
2
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)
3
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%
4
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)
5
“Injury Pyramid” for injuries among non-residents in Hawaii
Deaths 68/year
Hospitalizations~550/year
Emergency department visits~7,730/year
Nonfatal injuries
6
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)
7
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
8
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
9
Ocean drownings, 2003-2012
10
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
11
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
12
County-specific data
13
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
14
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%)
15
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
16
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
17
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
18Leeward coast: 42 drownings:52% residents; not much seasonality
North Shore: 26 drownings:
eastern Oahu (Honolulu-Kailua): 154 drownings (59%)
19
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
20
South Shore: 104 drownings:-71 (68%) from April-September
Seasonality
21
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%)
22
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
23
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
24
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
25
west coast (Mauna Kea-Milolii):
-33 of 51 (65%) victims non-residents
south and windward coasts:-35 of 41 (85%) victims non-residents
Residence
26
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
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