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June 2007    Download the Entire Issue (PDF) Available to the Public Vol. 22, No. 6   RSS Feed for Undercurrent Issues
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Part II: How Many Divers Are There?

injury and fatality rates

from the June, 2007 issue of Undercurrent   Subscribe Now

In last months issue, we used various statistics and information sources to come up with a reasonable number of active divers in the United States (1.2 million, plus or minus 15 percent). Based on the lack of information gathered by dive organizations and their unwillingness to share what they have, calculating more than just an estimate is not easy. The same goes for figuring out dive-related injuries and fatality rates numbers are just not solid.

So because dive counts range all over the place, how do the organizations that need to know diver counts come up with their figures? Take the dive insurance and life insurance agencies. They assess diving risk and must track general injury and death rates, so where do they come up with the numbers to calculate their actuarial tables?

Actually, its a crapshoot, says Ed Budd, executive director for the Society of Insurance Research. You give our industry too much credit for our logic and science. He says because there is no database of how many divers there are, every life insurer has its own way for coming up with numbers, but theyre all probably based on guesstimates. I suspect that originally someone had the judgment that diving was less hazardous than, say, parachuting and more hazardous than rock climbing, and put a factor on it. They kept track over the years of their own policyholders experiences to see whether the numbers were better or worse than the estimates, then adjusted the figures.

However, insurance firms dont make a general mortality rate table because of the lack of universal data. Its easy to see how many people are living and dying in the U.S. because of the census, but for diving, parachuting and most other sports, an insurer just has to make an educated guess, says Budd.

The President of SSI says there’s no way
to track fatalities or injuries. “How
would you, when you don’t know how
much activity there actually is?”

As senior vice president of Willis Insurance, which provides coverage for divers worldwide, Peter Meyer agrees that training agencies dont make it easy for diver-specific insurance firms. They dont release their information to anyone, plus they often make them up. Therefore their certification numbers mean nothing to us, so we dont use them at all.

Fear of liability is another issue. Everyone is afraid to distribute information for fear it will be used against them. The standard behavior is, if you think youre going to be sued, dont talk to anyone, Meyer says. He co-hosts a risk-management seminar, along with Bret Gilliam, at the annual DEMA conference that is open to everyone in the industry, and he speaks frankly. But when he went to a recent SRI/SRT risk-management session at DEMA, he was asked to leave because it was privileged information for members only. This industry doesnt play well with each other.

Meyer says the only legitimate figures are the number of dive instructors (Willis insures 3,500 of them) and thats because they need dive insurance to teach students. But there is no centralized area for gathering student information because divers can buy insurance from several agencies, which dont share with each other. Dive insurance figures arent that great, either. Though its incredibly cheap, most U.S. divers dont buy it, so those numbers dont do that much good either.

Is Diving a Safe Sport?

The industry promotes diving as a relatively safe sport, based on fatalities per 100,000 participants compared to other recreational activities. DANs Annual Diving Report listed 88 U.S. and Canadian fatalities for 2004, the most recent year reported, and says that figure has been stable since 2002. Based on our estimate of 1.2 million active divers, thats one fatality for every 13,636 divers.

Besides DAN, the only organization that calculates dive-related injuries on a regular basis is the National Safety Council, which puts out an annual report of sports injuries based on trips to the emergency room. For 2005, it estimated 1,401 dive-related injuries. Based on our estimated diver population, thats one injury for every 856 divers. That was the smallest number of injuries listed for a sport -- cycling and football had the highest injury rates at 486,000 and 418,260 respectively but the Council had no data for the number of U.S. divers, nor did it have listings for injured divers taken to hyperbaric chambers, so those figures are on the low side of the truth.

Based on his 30-year career as a dive instructor, liveaboard owner and now dive-insurance executive, Meyer believes there are a lot more diving accidents than reported. If we multiplied our numbers by three, I think that would be a fair figure of the true accident rate. I believe there are 200 fatalities every year in North America, and thats too much, especially since the typical diver is in the water maybe six times a year for an hour at a time. And while divers like to bandy about the notion that diving is safer than driving, when you factor in the number of hours spent doing either, the argument becomes nonsensical.

Where do insurers come up with the
number of divers to calculate actuarial
tables? “Actually, it’s a crapshoot.”

Jed Livingston, NAUIs vice president, says he is surprised by Meyers numbers. If that was actually true, insurance companies longevity would suffer. When loss ratios become untenable, they leave the market. It would be like property insurance in Florida. How would they make a profit? They would run from the market. He says NAUIs numbers are a fraction of Meyers estimates, but does admit that not all their members file incident reports. Sustainable programs are in place because loss reviews at the end of the day show theyre sustainable. He cites a 2001 National Sports Association survey calculating two fatalities per 100 divers, and he believes those figures are still correct.

Gary Clark, president of Scuba Schools International, says there is no way to track fatalities or injuries. How would you know if its under- or over-reported activity when you dont know how much activity there actually is? When it comes to injuries, Clark says defining one is as hard as defining an active diver. If I twist my ankle or get a cramp, is that a dive-related accident? What if I cut myself with my knife? Those are different than getting an embolism. He says SSI tracks its trainers and files injury reports from stubbed toes upwards but the vast majority of reports is nothing major.

Tracking Systems

NAUI, SSI and PADI all agreed that DAN has the most relevant data. Ironically, DAN says its efforts to collect better information for its annual fatality reports are often stymied by the training agencies. We used to get some data from them, but theyre quite proprietary now and no longer share, says spokesperson Renee Duncan. Thats why for collecting accident fatalities, we get a skewed number. Even if theres fewer than 1,000 accidents every year, we still dont know what kind of percentage that is.

DAN recently issued its 2006 report on decompression sickness and dive fatalities. According to data collected between 1998 and 2004, the DCS rate among warm-water divers fluctuated from zero to 5 cases per 100,000 dives. The annual fatality rate between 1997 and 2004 ranged from 11 to 18 deaths per 100,000 DAN members per year. But because DAN can only realistically track fatality rates for its own members, it cant extrapolate those figures to the entire diver population. It also follows media reports of U.S. and Canadian divers deaths but only for those happening in North American waters. Accounts of North American divers dying in Caribbean, South Pacific and other foreign bodies of water often fall through the cracks.

The good news is now that DAN has partnered with PADI and NAUI as their exclusive dive insurer, more names can be put into one central database. But even though DAN tried to do a service with its fatality rates report, even dive insurers are close-mouthed about their data. We dont report our claims to DAN because it is privileged, confidential information, so its up to the individual to decide whether he or she wants to share it, says Meyer.

Canada found a good way to measure safety statistics through its Abacus Project, the results of which were released a couple of years ago. Abacus was a field survey conducted during a 14-month period starting in October 1999 in British Columbia. The goal was to establish the risk of death and nonfatal decompression illness in recreational scuba diving. Every dive shop and charter operator in BC was asked to count the number of tanks that were filled for recreational diving. For the same time period, hyperbaric chambers reported the number of BC divers treated for nonfatal DCI, and the provincial coroners records were reviewed for scuba fatalities. There were 146,291 fills, three fatalities and 14 cases of nonfatal DCI. The incidence of recreational scuba death was 0.00002 percent (2.05/100,000 dives). The incidence of nonfatal DCI was 0.010 percent (9.57/100,000 dives).

SSIs Clark notes that in other countries, like Australia, diving is more closely regulated by the government so it has to track data, but the U.S. dive industry does not have to. He adds that it will never happen if the dive industries dont share their numbers. Thats what bugs me about this industry there is very little information about anyone.

However, if the industry still wants to tout diving as a safe sport compared to cycling or tennis, it better open its doors to share and compare numbers. Otherwise, the number of dive-related fatalities will continue to be anyones guess, which doesnt help divers or the industry learn how to reduce those numbers.

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