COA S TAL SAFE T Y BRIE F DIVING & S NORKE LLING S U R F L I FE S AV I N G AU S T R A L I A
ND ATI VI O I NNGA LS N OAVPE SRH VO I ETW 20 0 4 -20
ANALYSIS
135
people have died on our coast while diving (SCUBA & SSBA*), an average of eight people each year. Together with snorkelling, diving is number seven in the top 10 National Safety Agenda Issues.
1|1 13|17
15|13 4|7
AVERAGE DROWNING AVERAGE FATALITIES PER YEAR DEATHS PER YEAR
3
5
21|10 DROWNING|FATALITY
14|10
#NCSS2020 PARTICIPATION • 0.4 million scuba divers in 2020
• Occasional divers average 5 hours per year
• 0.1 million frequent scuba divers
• Frequent divers average 70 hours per year
DROWNING DEATHS
OTHER FATALITIES
KEY DEMOGRAPHICS
30–54
MALES AGED
6|3 KEY DEMOGRAPHICS MALES AGED
45–59
61 80% 51 54% 0.02
74 78% 45 65% 0.02
Australian residents, Australian born
Australian residents, Australian born
AVERAGE AGE
AVERAGE AGE
MALE
MALE
AVERAGE MORTALITY RATE
AVERAGE MORTALITY RATE
WERE DIVING OFFSHORE (MORE THAN 500M)
WERE DIVING OFFSHORE (MORE THAN 500M)
PER 100,000 POPULATION
PER 100,000 POPULATION
DIVING (SCUBA & SSBA*) DROWNING DEATHS & OTHER FATALITIES 18
Deaths
0.04 6 0.02
SURF LIFE SAVING AUSTR ALIA
9 2019-20
8 2018-19
1 2017-18
2
10 2016-17
12 2015-16
6 2014-15
12 2013-14
6 2012-13
16 2011-12
11 2010-11
7 2009-10
8 2008-09
7 2007-08
4 2006-07
9 2005-06
2004-05
9
Rate per 100,000 pop.
0.06 12
0
Rate per 100,000 pop. Total drowning deaths Total other fatalaties
0.08
0.00
* Surface Supply Breathing Apparatus
# National Coastal Safety Survey COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
SNORKELLING SNAPSHOT 20 0 4 -20
0|1 ANALYSIS
206
people have died on our coast while snorkelling, an average of thirteen people each year. Together with diving, snorkelling is number seven in the top 10 National Safety Agenda Issues.
1|1 65|44
26|16 5|1
AVERAGE DROWNING AVERAGE FATALITIES DEATHS PER YEAR PER YEAR
9
4
27|3 DROWNING|FATALITY
13|2
#NCSS2020 PARTICIPATION • 2.0 million snorkellers in 2020
• Occasional snorkellers average 5 hours per year
• 0.4 million frequent snorkellers
• Frequent snorkellers average 70 hours per year
DROWNING DEATHS
OTHER FATALITIES
KEY DEMOGRAPHICS MALES AGED
1|0
20–44
KEY DEMOGRAPHICS MALES AGED
55–69
68 84% 55 35% 0.02
138 89% 46 46% 0.04
International tourists, European-born
Australian Residents
AVERAGE AGE
AVERAGE AGE
MALE
MALE
AVERAGE MORTALITY RATE
AVERAGE MORTALITY RATE
WERE SNORKELLING OFF A BEACH
WERE SNORKELLING OFF A BEACH
PER 100,000 POPULATION
PER 100,000 POPULATION
SNORKELLING DROWNING DEATHS & OTHER FATALITIES TREND 0.10
15
0.08 0.06 0.04
5 13
8
8
8
15
10
8
17
16
5
19
18
20
16
15
10
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
2017-18
2018-19
2019-20
0
0.02
2004-05
Deaths
10
0.00
Rate per 100,000 pop. Total drowning deaths Total other fatalaties
Rate per 100,000 pop.
20
DIVING & S NORKE LLING IN AUS TR ALIA
Diving and snorkelling have become priority activities for Surf Life Saving Australia (SLSA) to monitor, due to the increasing prevalence of drowning deaths in coastal waters. Since 2004, SLSA has recorded 135 diving and 206 snorkelling deaths, of which 74 diving and 138 snorkelling deaths were due to drowning. However, in recent years the annual numbers of deaths recorded have been above the 16-year average. ABOUT THE BRIEF The 2020 Diving and Snorkelling coastal safety brief presents the trends in Australian drowning deaths and fatalities of divers and snorkellers. The snorkelling data explores drowning deaths and other fatalities (i.e. those due to other causal factors such as medical issues), including recreational sightseeing snorkellers, freedivers, spearfishers and abalone harvesters, where snorkelling was the primary activity. Similarly, the diving data explores drowning deaths and deaths from other causes in divers. Divers include those using scuba (i.e. wearing cylinders contained compressed gas – usually air), and those breathing from a compressed gas supply delivered via a hose from the surface (surface-supplied breathing apparatus – SSBA). Scuba diving is far more common than diving using SSBA, which is usually the realm of occupational divers as well as some keen recreational seafood harvesters. A brief feature on SSBA is presented here, adapted from recent published research1. This brief highlights the participation trends of Australian adults (16 years and older) in scuba diving and snorkelling activities, using data collected in SLSA’s annual National Coastal Safety Survey (NCSS). According to the NCSS2020, survey respondents reported snorkelling participation to be above that of surfing and watercraft activities and similar to those who participate in boating or land-based fishing. In comparison, scuba diving participation is lower, however, one quarter of all scuba diving participants go frequently (at least once per month) and half consider themselves to have advanced expertise.
SURF LIFE SAVING AUSTR ALIA
2
MOVING FORWARD Diving and snorkelling are common activities used to explore and enjoy the remarkable Australian coastline. Diving and snorkelling are some of the best ways to experience Australia’s spectacular underwater views and interact with our extraordinary marine life. Unfortunately, being situated in and under the water means that when tragic incidents occur, assistance may be some distance away and lives can be lost. To this end, SLSA continues to monitor and record fatal diving and snorkelling incidents for these activities and has extended this research to investigate causality and other contributing factors. Scuba diving and snorkelling are very popular activities in Australia. Twelve per cent of 1,600 survey respondents (NCSS2020) reported that they scuba dive and/or snorkel at least once a year. Extrapolation of this data equates to approximately 2.4 million participants annually (although this number must be considered with caution due to relatively small numbers2). In addition, many international tourists scuba dive and snorkel on Australian beaches (albeit recent changes with impacts of COVID-19) and offshore reefs to experience internationally renowned destinations such as the Great Barrier Reef, which alone has received an average of 2.2 million visitors annually since 20133. While most snorkellers say they take basic safety precautions, like avoiding alcohol and drugs and staying within their skill level, only one quarter (28%) always check coastal conditions before snorkelling. Just over half (57%) reported that they always snorkel with a buddy, although in reality they often separate in the water. Similarly, around one-third (39%) of scuba divers, who are required to be qualified, say they don’t always follow the safety practices and regulations applicable to scuba diving. These simple safety practices can make a big difference if a diver gets into difficulties and have saved many lives.
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
SLSA has recorded 212 diving and snorkelling drowning deaths and 129 other fatalities over the 16-year period from July 2004 to June 2020, equating to an average of 21 deaths each year. The number of deaths fluctuates from year to year, but as a trend the number of snorkelling deaths around Australia has generally increased over time, consistent with other research4. Historically, diving deaths increased steadily until the early 1990s after which it generally plateaued with some annual fluctuations5.
Spearfishing and freediving deaths are emergent associated in almost one-third of snorkelling deaths (36%). Freediving has become increasingly popular in recent years despite the high levels of associated risk7,8. Another issue occurs during the short, highly regulated fishing seasons, like the abalone or crayfishing season, that receive large influxes of divers, freedivers and snorkellers in dangerous locations at the same time9,10. With the increasing popularity of snorkelling, ‘breath-hold blackouts’ (sometimes called ‘shallow water blackouts’) are implicated in many snorkelling-related deaths and are receiving more and more media attention. This brief finishes with a feature that explores what these are, the mechanisms behind their occurrence, and how they can be avoided while participating in these popular and rewarding activities.
Almost all diving decedents (93%) were diving with other people and many were experienced or even highly experienced divers. This suggests that diving incidents are not necessarily an effect of inexperience or negligence, but rather happen in unexpected moments of inattention or panic. Being underwater, diving does not leave much room for error or the inability to cope with this potentially hostile environment due to physical or precipitating factors6. A small mistake or pushing your physical limits too far may have severe consequences. Medical conditions and injuries combined played a notable role in a large proportion of diving (56%) and snorkelling incidents (49%). Cardiac issues were the most common cause of medical-related death, implicated in 21% of diving and 36% of snorkelling deaths, respectively, consistent with earlier reports.4,6 Diving and snorkelling can exacerbate existing medical conditions, highlighting the importance of regular health checks, especially prior to going on holidays. Most diving and snorkelling deaths have occurred in Queensland, Western Australia, and New South Wales. In Queensland, over half of all snorkelling deaths occurred on the Great Barrier Reef (59%), generally during organised snorkelling tours or private snorkelling trips. Similarly, more than half of all diving deaths (60%) were recorded at offshore locations. As such, it is not surprising that 88% and 90% of diving and snorkelling deaths respectively happened greater than one kilometre from a surf lifesaving service. This emphasises the importance of skills maintenance and highlevel water safety training of individuals and tour operators, as it can prevent fatal mistakes and ultimately save lives.
SURF LIFE SAVING AUSTR ALIA
3
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
DIVING
0.4M
70HRS
26%
SCUBA DIVERS IN AUSTRALIA IN 2019/20
PER YEAR BY FREQUENT SCUBA DIVERS
ARE ADVANCED SCUBA DIVERS
SURF LIFE SAVING AUSTR ALIA
4
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S DIVING 20 0 4 -20
DROWNING DEATHS
FATALITIES
WHY
5%
7%
ILLICIT DRUGS WERE DETECTED
ILLICIT DRUGS WERE DETECTED
41%
14%
DUE TO INJURY
DUE TO INJURY
WHERE
54%
65%
WERE DIVING OFFSHORE (MORE THAN 500M)
WERE DIVING OFFSHORE (MORE THAN 500M)
WHEN
50%
58%
DIVING BETWEEN 6AM–12PM*
DIVING BETWEEN 6AM–12PM*
45%
39%
DURING THE SUMMER MONTHS
WHO
DURING THE SUMMER MONTHS
51% 35%
44% 31%
WERE AUSTRALIAN BORN*
WERE AUSTRALIAN BORN*
WERE INTRASTATE VISITORS
WERE INTRASTATE VISITORS
*These percentages do not include ‘unknown’ data
SURF LIFE SAVING AUSTR ALIA
5
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
L O C AT I O N DIVING 20 0 4 -20
2004 – 20
DIVING DROWNING DEATHS & FATALITIES BY STATE (n=135) Key to Activity Diving Drowning Death Other Diving Fatality Multiple instances per activity at the same location
4
Capital City
15 | 13
2 2 2
2
PERTH
2
2
2
2
2004 – 20 DIVING DROWNING DEATHS (n=74) AND FATALITIES (n=61) BY STATE AND WATER TYPE
[
DROWNING FATALITY
[
DROWNING FATALITY
[
DROWNING FATALITY
[
DROWNING FATALITY
[
DROWNING FATALITY
[
DROWNING FATALITY
[
DROWNING FATALITY
NSW QLD WA
VIC TAS SA
NT
Coastal Ocean Sovereign Water 0
5
10
SURF LIFE SAVING AUSTR ALIA
15
6
20
25
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
0
5 5
2
3
DARWIN 2
2 2
22
1|1 2
13 | 17 2
4|7
3 6 2 17
BRISBANE 2
4 2
5 2 13 2
21 | 10
3
Lord Howe Island
SYDNEY
ADELAIDE
2
CANBERRA
MELBOURNE
4
3 2 5 2
3 3 2 2
14 | 10 2
1,000km
HOBART
6|3
SCALE
SURF LIFE SAVING AUSTR ALIA
7
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S DIVING 20 0 4 -20
FATALITIES
DROWNING DEATHS
80% MALE
78% MALE
2004 – 20 DIVING: INCIDENT LOCATION 1% 7%
OCCURRED OFFSHORE
3%
11%
65% 54%
3%
7%
16% 54%
16%
DROWNING DEATHS
65%
FATALITIES
Offshore Bay Beach Rock/Cliff Jetty Port/Marina
16%
DROWNING DEATHS
FATALITIES
2004 – 20 DIVING: CONTINENT OF BIRTH
51% 43%
2%
3%
AUSTRALIAN BORN
7%
7% 17% 15% 43%
51%
DROWING DEATHS
FATALITIES
2%
2%
Australia Europe Asia North America Africa Oceania Latin America
20%
DROWNING DEATHS
28% FATALITIES
NB: analyses include known cases only
SURF LIFE SAVING AUSTR ALIA
8
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S DIVING 20 0 4 -20
DROWNING DEATHS Average age of deceased
45 YEARS
FATALITIES
39% 27%
38% 30%
Average age of deceased
51
AGED 30-44 YEARS
AGED 45-54 YEARS
AGED 45-54 YEARS
AGED 55-64 YEARS
YEARS
2004 – 20 DIVING: TOXICOLOGY
ILLICIT DRUGS DETECTED
7% 5%
18%
3% 1%
7%
13%
5% 8%
3%
DROWING DEATHS
FATALITIES
Illicit Drugs Legal Drugs Alcohol & Legal Drugs None Not Performed Unknown
69%
74%
DROWNING DEATHS
FATALITIES
2004 – 20 DIVING: MEDICAL AND INJURY-RELATED
INJURY
14% 41%
17%
14% 21% 11% 2%
41%
DROWNING DEATHS 14% Injury Medical Cardiac None Unknown
44%
FATALITIES
DROWNING DEATHS
SURF LIFE SAVING AUSTR ALIA
9
31% 5% FATALITIES
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S D R O W N I N G D E AT H S DIVING 20 0 4 -20
AGE & GENDER 10 9
39% 27%
45
10
9 7 5
4
AGED 30-44 YEARS
YEARS
Male Female
11
DROWNING DEATHS BY AGE & GENDER (n=74)
3
3
2 1 0-4
AGED 45-54 YEARS
5-9
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84
85+
TIME DROWNING DEATHS BY TIME (n=72*) Shading denotes daylight hours
16
50% 49%
12
6
6AM-12PM
7
6
0
0
0
9 - 10pm
6 - 7pm
5 - 6pm
4 - 5pm
3 - 4pm
2 - 3pm
1 - 2pm
1
8 - 9pm
2
4
12 - 1pm
11 - 12pm
10 - 11am
9 - 10am
8 - 9am
7 - 8am
6 - 7am
12-6PM
5
7 - 8pm
4 5
2
2
*This number does not include ‘unknown’ time of death, this is due to under reporting of night-time deaths which are usually not recorded until the morning and have occurred without witnesses. 2.7% (n=2) of cases occurred at unknown times.
MONTH DROWNING DEATHS BY MONTH (n=74) Shading denotes seasons
20
18
15
2020 SUMMER
45%
DECEMBER-FEBRUARY
10
10 6
5
4
0
July
6
5
6
6
4
4
4
May
June
1
SURF LIFE SAVING AUSTR ALIA
August
September
10
October
November
December
January
February
March
April
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S F ATA L I T I E S DIVING 20 0 4 -20
AGE & GENDER Male Female
14
FATALITIES DEATHS BY AGE (n=58)
11
51 YEARS
38% 30%
9 7
AGED 45-54 YEARS
AGED 55-64 YEARS
4
4
5-9
2
1
1 0-4
4
4
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84
85+
TIME FATALITIES BY TIME (n=60*)
15
Shading denotes daylight hours
7
1
6 - 7pm
1
5 - 6pm
3 - 4pm
2 - 3pm
1 - 2pm
12 - 1pm
11 - 12pm
10 - 11am
9 - 10am
7 - 8am
1 0
8 - 9am
0
6 - 7am
12-6PM
0
3
0
0
9 - 10pm
3
3
8 - 9pm
6AM-12PM
6
7
7 - 8pm
8 5
4 - 5pm
58% 38%
*This number does not include ‘unknown’ time of death, this is due to under reporting of night-time deaths which are usually not recorded until the morning and have occurred without witnesses. 1.6% (n=1) of cases occurred at unknown times.
MONTH FATALITIES BY MONTH (n=61)
10
Shading denotes seasons
8 8
8
2020 SUMMER
39%
DECEMBER-FEBRUARY
6
6
6 5
4 4
4
2
2 0
6 6
2
1 July
SURF LIFE SAVING AUSTR ALIA
August
September
11
October
November
December
January
February
March
April
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
May
June
P A R T I C I P AT I O N P R O F I L E SCUBA DIVING
The NCSS2020 revealed that coastal participation differs by activity, gender, frequency and state. These pages show the proportion of male and female participants, the number of total and frequent participants, how many hours annually frequent vs. occasional participants spend on an activity, and the percentage of the state population who participate in each activity.
GENDER
NCSS2020 PARTICIPATION BY STATE
1
2%
%
2%
66%
2% FREQUENCY
STATE
5%
2 3%
%
400,000
100,000
NCSS2020
NCSS2020
SCUBA DIVERS
27% USUALLY SCUBA DIVE AT AN OFFSHORE LOCATION
34%
70
5
HOURS
HOURS
FREQUENT
OCCASIONAL
FREQUENT SCUBA DIVERS
66%
69%
CAN SWIM 50M IN THE OCEAN WITHOUT STOPPING OR TOUCHING THE BOTTOM
SURF LIFE SAVING AUSTR ALIA
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12
SEEK COASTAL SAFETY INFORMATION ONLINE
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
NCSS2020 AGE OF SCUBA DIVING PARTICIPANTS
36%
57%
33%
21% 10%
SCUBA DIVERS ARE 16-34 YEARS OF AGE
16 - 24
25 - 34
35 - 49
50+
NCSS2020 SELF-REPORTED SCUBA DIVING EXPERTISE 50%
50%
26%
22%
SCUBA DIVERS ARE ADVANCED DIVERS Beginner
Intermediate
NCSS2020 SWIMMING ABILITY OF SCUBA DIVERS OVERALL 50 COMPARED TO OCEAN
50% SCUBA DIVERS SAY THEY ARE AVERAGE OCEAN SWIMMERS
50% Overall Ocean
42%
40
37%
30
26% 19%
20
13%
11% 10 2% 0
Advanced
Unable to Swim/Weak Swimmer
SURF LIFE SAVING AUSTR ALIA
13
Average
Competent
Highy Competent
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
SAFET Y PR AC TICES SCUBA DIVING
78%
NCSS2020 SAFETY EQUIPMENT USE BY SCUBA DIVERS Q. Please indicate what equipment you carry or use when scuba diving?
SCUBA DIVERS WEAR FLIPPERS WHEN DIVING
78%
80 70
67%
60
64%
58%
50
54% 47%
40
33%
30
29%
20 10
5%
0 Flippers
Buoyancy aid
Secondary regulator
Dive flag
Whistle
Spare air tank
Shark deterrent device
Lifejacket
Other
37%
NCSS2020 SAFETY PRACTICES OF SCUBA DIVERS Q. How often do you follow each of these practices when you go scuba diving?
SCUBA DIVERS ALWAYS CHECK CONDITIONS BEFORE GOING DIVING Always
100
14%
13%
14%
16%
9%
8%
Most of the time
7%
Sometimes
8% 24%
13% 80
13%
17%
17%
19%
32%
28%
Never
15% 15%
31%
15%
Can’t say
19%
60
33% 40
73%
70%
69%
65%
63%
63%
61%
60%
57% 37%
20
0
Use safety equipment
Dive to appropriate Consistently Use only certified skill/training monitor and functioning level location/conditions scuba equipment
SURF LIFE SAVING AUSTR ALIA
Dive with at least one other person
14
Avoid diving under the influence of alcohol/drugs
Follow laws and Consistently monitor Have a dive plan regulations air levels and an emergency plan
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
Check conditions with authorities
HAZARD PERCEPTION SCUBA DIVING
NCSS2020 COASTAL HAZARD PERCEPTION OF SCUBA DIVERS Q. How hazardous do you believe the coast to be? (Including the ocean, surfzone and adjacent rocky coast)
55%
86% FREQUENT SCUBA DIVERS BELIEVE THE COAST IS SOMEWHAT HAZARDOUS
Frequent Occasional
86%
16% 2%
3%
Extremely hazardous
12%
19% 8%
0%
0%
Very hazardous
Somewhat hazardous
Not very hazardous
Not at all hazardous
NCSS2020 HAZARD PERCEPTION OF SCUBA DIVING
Q. How hazardous do you believe scuba diving to be? 51%
51%
27% 18%
SCUBA DIVERS BELIEVE THAT DIVING IS SOMEWHAT HAZARDOUS
3% Extremely hazardous
Very hazardous
Somewhat hazardous
Not very hazardous
1%
0%
Not at all hazardous
Can't say
NCSS2020 HAZARD PERCEPTION OF FREQUENT VS OCCASIONAL SCUBA DIVERS Q. How hazardous do you believe scuba diving to be?
27% FREQUENT SCUBA DIVERS BELIEVE DIVING IS EXTREMELY /VERY HAZARDOUS
55% 40%
37% 25%
15%
19%
9% 0% Extremely hazardous
Frequent Occassional
SURF LIFE SAVING AUSTR ALIA
0% Very hazardous
15
2%
Somewhat hazardous Not very hazardous Not at all hazardous
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
0%
0%
Can't say
S U R F A C E - S U P P L I E D B R E AT H I N G A P P A R AT U S (S S B A) D I V I N G
Surface-supplied breathing apparatus (SSBA) diving differs from scuba diving as it involves breathing gas (usually air) supplied from a device on the surface. The term “hookah” is commonly used describe the basic equipment which supplies air from a simple, usually petrol-driven, compressor which delivers the air to divers via a long hose with a demand valve.
breathing gas. If exhaust fumes enter the breathing air, there is a high risk of carbon monoxide (CO) poisoning, which can be fatal but may also lead unconsciousness underwater and death by drowning. Carbon monoxide can also be produced from a faulty and/or overheating compressor, so thorough maintenance and checking is important. The diver usually wears a mask, fins, suit, weights, and, ideally, a buoyancy compensator device. An emergency gas supply in the form of a bail-out cylinder should also be worn in case of an air supply failure, although this important safety measure is too often neglected.
Compressors must be fit-for-purpose, well-maintained, and appropriately configured to provide a steady air supply to all the divers using it. Compressors also need to be positioned securely in a well-ventilated area to prevent overheating and to ensure that exhaust fumes cannot contaminate the
SURF LIFE SAVING AUSTR ALIA
16
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
A recent study of SSBA deaths in Australia1 identified 84 SSBA-related deaths between 1965 and 2019. Unlike in scuba diving incidents, equipment-related issues were the major contributor to SSBA deaths. Incomplete (i.e. when certain components are missing), or faulty equipment predisposed to one third of the deaths. Equipment problems were also identified as the triggers in one-quarter of cases. The main source of these problems were poorly maintained, badly positioned, or inappropriately configured compressors, which led to interruption or contamination of the breathing gas supplied to divers. Most victims were relatively young, healthy males (average age of 33 years). At least half of victims were undertaking work-related diving, and more than one third were recreational diving. Many of the recreational victims were untrained in the use of SSBA and some had no dive training or certification in any form. Unlike scuba diving, where certification should be shown before receiving a cylinder fill, there is no restriction on who can buy and use a “hookah”. One quarter of the deaths were from primary drowning (although 44% resulted in drowning, sometimes subsequent to unconsciousness from another cause). Lung overpressure injury (usually due to a rapid ascent following loss of air supply) accounted for another one quarter of the deaths, gas contamination (usually carbon monoxide [CO]) for 17%, and trauma (from shark, crocodile and boats) led to 12% of deaths. SSBA deaths between 2004-2020 SLSA’s Coastal Fatality database has recorded fourteen deaths of divers using SSBA, half of these being recreational divers collecting seafood. The average age of the casualties was 46 years, and all were males. At least ten were described as experienced divers. There were two deaths in each of the Northern Territory, Queensland, South Australia, Victoria and Western Australia, four in Tasmania, and none in New South Wales. The causes of two incidents were unknown, while others were attributed to cardiac events (3), impact with boat or propeller (2), loss of air supply (2), crocodile attack (1), shark attack (1), and CO contamination of the air supply. Six of the divers died from drowning, three from trauma, two as a result of a lung overpressure injury, and one from CO poisoning. The cause of death for the two remaining cases are yet to be determined. This excerpt has been adapted from Lippmann (2021)1.
SURF LIFE SAVING AUSTR ALIA
17
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
SNORKELLING
2M
70HRS
49%
SNORKELLERS IN AUSTRALIA IN 2019/20
PER YEAR BY FREQUENT SNORKELLERS
AGED BETWEEN 16-34 YEARS OF AGE
SURF LIFE SAVING AUSTR ALIA
18
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S SNORKELLING 20 0 4 -20
FATALITIES
DROWNING DEATHS WHY
1%
3%
ILLICIT DRUGS WERE DETECTED
ILLICIT DRUGS WERE DETECTED
65%
22%
DUE TO CARDIAC CONDITION
DUE TO CARDIAC CONDITION
WHERE
35%
46%
WERE SNORKELLING OFF A BEACH
WERE SNORKELLING OFF A BEACH
WHEN
47%
51%
DIVING BETWEEN 6AM–12PM*
DIVING BETWEEN 6AM–12PM*
33%
39%
DURING THE SUMMER MONTHS*
WHO
DURING THE SUMMER MONTHS*
35% 42%
40% 48%
WERE ASIAN-BORN*
WERE EUROPEN-BORN*
WERE INTERNATIONAL TOURISTS
WERE INTERNATIONAL TOURISTS
*These percentages do not include ‘unknown’ data
SURF LIFE SAVING AUSTR ALIA
19
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
L O C AT I O N SNORKELLING 20 0 4 -20
2004 – 20 SNORKELLING DROWNING DEATHS & FATALITIES BY STATE (n=206) Key to Drowning Activity Snorkelling Drowning Death Other Snorkelling Fatality Multiple instances per activity at the same location
4
Capital City
2
4
3
3
4 6
26 | 16
Activity
wning Death
g Fatality
OCCURRED AT THE GREAT BARRIER REEF
es per activity at the same location
54% 66%
DROWNING DEATHS
2
3 2 2
FATALITIES
2
2
2004 – 20 SNORKELLING DROWNING DEATHS (n=138) AND FATALITIES (n=68) BY STATE AND WATER TYPE
[ NSW[ WA[ VIC[ SA[ NT[ TAS[ Torres Strait[ QLD
DROWNING FATALITY DROWNING FATALITY DROWNING FATALITY DROWNING FATALITY
0
DROWNING FATALITY DROWNING FATALITY
Coastal Ocean Sovereign Water
DROWNING FATALITY DROWNING FATALITY
0
PERTH
10
20
SURF LIFE SAVING AUSTR ALIA
30
40
20
50
60
70
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
0|1 5 5
2
DARWIN 2
2 4
4 6
3 6
7
9
2 3
7 3 2
2 2 4 3
1|1
2
4
4 3
65 | 44 2 3 2
4 2 2
5|1
3 6 2
BRISBANE 2
5
27 | 3 2
2 4
SYDNEY
ADELAIDE 2
4 5
CANBERRA
MELBOURNE
2 2
5
4
2
2 4
6 2
13 | 2
3
3
2
1,000km
HOBART
SCALE
SURF LIFE SAVING AUSTR ALIA
21
1|0
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
Lord Howe Island
C A U S A L A N A LY S I S SNORKELLING 20 0 4 -20
DROWNING DEATHS
FATALITIES
84% MALE
89% MALE
2004 – 20 SNORKELLING: INCIDENT LOCATION 1%
1% 9%
OCCURRED AT A BEACH
13%
7% 35%
46% 35%
46%
DROWNING DEATHS 37%
Beach Offshore Bay Rock/Cliff Jetty
FATALITIES
50%
DROWNING DEATHS
FATALITIES
2004 – 20 SNORKELLING: CONTINENT OF BIRTH
35% 14%
DROWING DEATHS
2%
2%
ASIAN BORN
7%
14%
12%
8% 35%
24%
32%
FATALITIES
Asia Australia Europe North America Oceania Africa
25% DROWNING DEATHS
40%
FATALITIES
NB: analyses include known cases only
SURF LIFE SAVING AUSTR ALIA
22
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S SNORKELLING 20 0 4 -20
DROWNING DEATHS Average age of deceased
46
FATALITIES
32% 25%
Average age of deceased
55
AGED 20-34 YEARS
AGED 60-74 YEARS
YEARS
32% 21%
AGED 55-64 YEARS
AGED 65-74 YEARS
YEARS
2004 – 20 SNORKELLING: TOXICOLOGY 2%
ILLICIT DRUGS DETECTED
3% 1%
15%
3%
1%
1% 13%
1%
3%
DROWING DEATHS
FATALITIES
Alcohol Illicit Drugs Legal Drugs Alcohol & Illicit Drugs None Not Performed Unknown
74%
82%
DROWNING DEATHS
FATALITIES
2004 – 20 SNORKELLING: MEDICAL & INJURY-RELATED
CARDIAC CONDITION
22% 65%
13% 23%
22%
19% 7%
DROWNING DEATHS
FATALITIES
1%
46% DROWNING DEATHS
SURF LIFE SAVING AUSTR ALIA
65% Cardiac Medical Injury None Unknown
23
3%
FATALITIES
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
C A U S A L A N A LY S I S D R O W N I N G D E AT H SNORKELLING 20 0 4 -20
AGE & GENDER DROWNING DEATHS BY AGE (n=138)
32% 25%
46
17
12
11
11
11 9 7
AGED 25-34 YEARS
YEARS
AGED 60-74 YEARS
Male Female
17
16
8
7
6
4 2 0 0-4
0
0
5-9
0
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84
85+
TIME DROWNING DEATHS BY TIME (n=135*)
19
19
Shading denotes daylight hours
17
16
8
8
8
7
8 6 4
0
9 - 10pm
1
10 - 11pm
0
8 - 9pm
7 - 8pm
6 - 7pm
5 - 6pm
4 - 5pm
3 - 4pm
2 - 3pm
1 - 2pm
12 - 1pm
11 - 12pm
10 - 11am
9 - 10am
1
8 - 9am
12-6PM
8 5
7 - 8am
6AM-12PM
6 - 7am
47% 47%
*This number does not include ‘unknown’ time of death, this is due to under reporting of night-time deaths which are usually not recorded until the morning and have occurred without witnesses. 3% (n=4) of cases occurred at unknown times.
MONTH DROWNING DEATHS BY MONTH (n=137*) Shading denotes seasons
19 17 15
2020 SUMMER
34%
DECEMBER-FEBRUARY
15
16
15
10
9 8
5
6
2 July
August
September
October
November
December
January
February
March
April
*This number does not include ‘unknown’ month of death. One case occurred in an unknown month.
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COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
May
June
C A U S A L A N A LY S I S F ATA L I T Y SNORKELLING 20 0 4 -20
AGE 11
FATALITIES DEATHS BY AGE (n=68)
32% 21%
55
8 7 6
6
AGED 65-74 YEARS
5
5
AGED 55-64 YEARS
YEARS
Male Female
11
3
3 1
1 0 0-4
0
0 5-9
1 0
0
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84
85+
TIME FATALITIES BY TIME (n=67*) Shading denotes daylight hours
13 11
8
5
6AM-12PM
3 1
7 - 8pm
0
0
10 - 11pm
0
9 - 10pm
0
8 - 9pm
5 - 6pm
0
4 - 5pm
3 - 4pm
2 - 3pm
1 - 2pm
12 - 1pm
11 - 12pm
10 - 11am
7 - 8am
8 - 9am
0
6 - 7pm
1 0
6 - 7am
12-6PM
8
6
9 - 10am
51% 47%
11
*This number does not include ‘unknown’ time of death, this is due to under reporting of night-time deaths which are usually not recorded until the morning and have occurred without witnesses. 3% (n=2) of cases occurred at unknown times.
MONTH FATALITIES BY MONTH (n=68) Shading denotes seasons
11 9
9 8
2020 SUMMER
40%
7 6 5 4 3
DECEMBER-FEBRUARY
2
July
SURF LIFE SAVING AUSTR ALIA
August
September
25
October
November
December
January
February
March
April
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
2
2
May
June
P A R T I C I P AT I O N P R O F I L E SNORKELLING
The NCSS2020 revealed that coastal participation differs by activity, gender, frequency and state. These pages show the proportion of male and female participants, the number of total and frequent participants, how many hours annually frequent vs. occasional participants spend on an activity, and the percentage of the state population who participate in each activity.
12% 11% 8%
55%
11% FREQUENCY
14
%
STATE
GENDER
NCSS2020 PARTICIPATION BY STATE
10 12%
%
2,000,000
400,000
NCSS2020
NCSS2020
SNORKELLERS
31%
70
5
HOURS
HOURS
FREQUENT
OCCASIONAL
70%
CAN SWIM 50M IN THE OCEAN WITHOUT STOPPING OR TOUCHING THE BOTTOM
SURF LIFE SAVING AUSTR ALIA
45%
FREQUENT SNORKELLERS
61%
SNORKEL AT A PATROLLED BEACH DURING PATROL HOURS
|
26
SEEK COASTAL SAFETY INFORMATION ONLINE
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
NCSS2020 AGE OF SNORKELLING PARTICIPANTS
33%
49%
25%
24%
18%
SNORKELLERS ARE 16-34 YEARS OF AGE
16 - 24
25 - 34
35 - 49
50+
NCSS2020 SELF-REPORTED SNORKELLING EXPERTISE 51%
51%
32% 17%
SNORKELLERS ARE INTERMEDIATE Beginner
Intermediate
NCSS2020 SWIMMING ABILITY OF SNORKELLERS OVERALL COMPARED TO OCEAN
Overall Ocean
35%
22% 16% 10%
10%
Unable to Swim/Weak Swimmer
37%
30%
22% SNORKELLERS SAY THEY ARE WEAK OCEAN SWIMMERS
38%
Advanced
SURF LIFE SAVING AUSTR ALIA
Average
27
Competent
Highy Competent
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
SAFET Y PR AC TICES SNORKELLING
88%
NCSS2020 SAFETY EQUIPMENT USE BY SNORKELLERS Q. Please indicate what equipment you carry or use when snorkelling?
SNORKELLERS WEAR FLIPPERS WHEN SNORKELLING
88%
37%
34%
28%
19%
18% 6%
Flippers
Lifejacket
Buoyancy aid
Whistle
Shark deterrent device
Dive flag
Other
76%
NCSS2020 SAFETY PRACTICES OF SNORKELLER Q. How often do you follow each of these practices when you go snorkelling?
AVOID SNORKELLING UNDER THE INFLUENCE OF ALCOHOL AND DRUGS Most of the time
Always 1% 12%
6%
12%
24%
1% 1%
2% 3% 6%
17%
1% 2%
4% 10%
13%
Sometimes
Never
Can’t say 2%
4%
11%
19%
16%
17%
25%
31%
28%
27%
21%
28%
22%
25%
76% 68%
69%
64% 57%
58%
Avoid snorkelling under the influence of alcohol/drugs
Snorkel to appropriate skill/training level
Follow laws and regulations
Consistently monitor location/conditions
SURF LIFE SAVING AUSTR ALIA
28
Snorkel with at least one other person
26%
60% 50%
Use safety equipment
31%
28%
Have a dive plan and an emergency plan
Check conditions with authorities
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
HAZARD PERCEPTION SNORKELLING
NCSS2020 COASTAL HAZARD PERCEPTION OF SNORKELLERS 54%
Q. How hazardous do you believe the coast to be? (Including the ocean, surfzone and adjacent rocky coast)
Frequent Occasional
41%
54% OCCASIONAL SNORKELLERS BELIEVE THE COAST IS SOMEWHAT HAZARDOUS
22% 16%
14%
12%
19%
13% 5%
4% Extremely hazardous
Very hazardous
Somewhat hazardous
Not very hazardous
Not at all hazardous
NCSS2020 HAZARD PERCEPTION OF SNORKELLING Q. How hazardous do you believe snorkelling to be?
41%
40%
46% BELIEVE THAT SNORKELLING IS SOMEWHAT/VERY HAZARDOUS
12% 5%
2%
0% Extremely hazardous
Very hazardous
Somewhat hazardous
Not very hazardous
Not at all hazardous
Can't say
NCSS2020 HAZARD PERCEPTION OF FREQUENT VS OCCASIONAL SNORKELLERS Q. How hazardous do you believe snorkelling to be?
50% FREQUENT SNORKELLERS BELIEVE SNORKELLING IS SOMEWHAT/VERY HAZARDOUS
44% 38% 25%
6% 0%
0%
Extremely hazardous
Frequent Occassional
48%
SURF LIFE SAVING AUSTR ALIA
25%
9%
2%
0%
Very hazardous
29
Somewhat hazardous Not very hazardous Not at all hazardous
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
3%
Can't say
F R E E - D I V I N G & B R E AT H - H O L D B L A C K O U T S
Diving without a supplementary oxygen supply or ‘freediving’ has been around for thousands of years, an activity used by coastal communities for fishing and to collect pearls or corals. Since recreational freediving has become increasingly popular, the limits of human underwater breath-holding abilities continue to be pushed11. Unfortunately, breathholding for too long can result in a loss of consciousness and may result in an individual drowning. Here we discuss two different types of blackouts that can occur while snorkelling or diving, how they occur and how you can stay safe.
such as freediving and spearfishing, an hypoxic blackout most commonly occurs due to due to extended breath-holding with or without pre-immersion hyperventilation. Hyperventilation (which in this context involves taking a series of breaths with extended exhalation) decreases the concentration of carbon dioxide in the blood (or induces a state of hypocapnia), allowing swimmers and divers to stay immersed for longer and deeper11. In normal breathing, as oxygen is converted to carbon dioxide through the process of respiration, the concentration of carbon dioxide in the blood increases and culminates in a breakpoint triggering an urge to breathe11. By hyperventilating pre-immersion, the time until the breakpoint can be prolonged allowing for longer dives. However, if oxygen levels are not replenished the body experiences hypoxia and a loss of consciousness potentially occurs (hypoxic blackout11). An hypoxic blackout in the water is incredibly dangerous as it often leads to a drowning event; usually fatal. This blackout mechanism can occur quickly and with little or no warning.
Underwater blackouts can occur at any depth, although the term ‘shallow water blackout’ has been used by the media to describe these events. A more appropriate term is “breathhold blackout”. The following describes two mechanisms that cause breath-hold blackouts to occur. HYPOXIC OR BREATH-HOLD BLACKOUT An hypoxic blackout is the loss of consciousness due to a substantial drop in blood oxygen levels and can occur on land or in the water11,12. In predominantly underwater activities
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30
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
An ascent blackout, or hypoxia of ascent, is the loss of consciousness due to a drop of water pressure acting on the chest and lungs as a swimmer or diver ascends towards the surface from depth13. The high surrounding (ambient) pressure at depth increases the partial pressure of oxygen in the lungs and partly compensates for the reducing oxygen levels from breathholding11. However, when ascending to the surface, the sudden decrease in water pressure causes a reduction in the pressure driving oxygen to the blood and, hence, other organs including the brain. Similar to hypoxic blackouts, an ascent blackout can result in a loss of consciousness underwater, leading to drowning and even death. Both of these mechanisms can occur when a breath-hold diver is ascending from depth. WHO IS AT RISK? Anyone who participates in activities which require breath-holding underwater at any depth is at risk of hypoxic blackout. This includes diving snorkellers, free-divers and spear fishers as well as individuals involved in breath-holding games or hypoxic training to increase breath-holding abilities12,14. Those whose breath-holding involves diving to greater depths, such as freedivers and spearfishers, are at greater risk of blackouts due to the reduction of pressure from ascent13. Between 2001-2013, breath-hold blackouts resulted in 22 drowning deaths in Australia4. In this study, eleven were spearfishing, five were practicing breathholding in the ocean, five occurred while practicing breath-holding in swimming pools, and one occurred in a mine shaft4. HOW TO STAY SAFE WHILE SNORKELLING AND DIVING* *adapted from Hong (1990)15 • Never snorkel or dive alone and keep a close eye on your buddy • Breathe normally during a compressed air dive (scuba or SSBA) and never hold your breath during ascent • Do not hyperventilate before a breath-hold dive • Never ignore the urge to breathe during a breath-hold dive and immediately head to the surface for air if you need to • Take breaks of appropriate durations between breath-hold dives to rest and stabilise • Don’t hesitate to drop your weight belt if you are beginning to feel faint • Ensure that you are physically and medically fit for diving. All scuba divers 45 years or older should undergo a diving medical examination • Learn the basics of CPR and think about adapting them to your diving arena, whether diving from shore or a vessel
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COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
REFERENCES
Surf Life Saving Australia National Coastal Safety Report 2020 The Surf Life Saving Australia National Coastal Safety Report (NCSR) is published annually and contains information on Australian community behaviours and attitudes to the coast; SLS capability and membership capacity; rescues and emergency response; and coastal drowning deaths. The NCSR2020 represents the statistics from the period of 1 July 2019 to 30 June 2020. Trend analyses from 2004-20 are also included. All care is taken to ensure the statistical information included within this report is correct. However, pending the outcome of ongoing coronial investigations and as SLS state/territory entities update their operational information, this data may be amended. Surf Life Saving Australia National Coastal Safety Surveys The annual Surf Life Saving Australia National Coastal Safety Surveys (NCSS) collect Information about community swimming ability, behaviours and attitudes to coastal safety. The NCSS2020 is conducted by Newspoll Market Research and Omnipoll and is run online over a ten-day period among a national sample of approximately 1,600 respondents aged 16 and above. The study is carried out in compliance with ISO 20252 - Market, Social and Opinion Research. To reflect the population distribution, results were postweighted (on age, gender, geographic strata and education) and projected to Australian Bureau of Statistics data. Data illustrated in figures may not always add up to 100% due to rounding.
References 1. Lippmann J. (2021). Fatalities involving divers using surface-supplied breathing apparatus in Australia, 1965 to 2019. Diving Hyperb Med. in press. 2. Lippmann, J., Stevenson, C., McD Taylor, D., & Williams, J. (2016). Estimating the risk of a scuba diving fatality in Australia. Diving Hyperb Med, 46(4), 241-246. 3. Great Barrier Reef Marine Park Authority (2020) Great Barrier Reef tourist numbers. Accessed 18 November 2020. http://www.gbrmpa.gov.au/our-work/ reefstrategies/visitor-contributions/ numbers 4. Lippmann, J. (2019). Snorkelling and breath-hold diving fatalities in Australia, 2001 to 2013. Demographics, characteristics and chain of events. Diving and hyperbaric medicine, 49(3), 192-203. 5. Lippmann, J., Stevenson, C., & Taylor, D. M. (2020). Scuba diving fatalities in Australia, 2001 to 2013: Diver demographics and characteristics. Diving and hyperbaric medicine, 50(2), 105-114. 6. Lippmann, J., & Taylor, D. M. (2020). Medical conditions in scuba diving fatality victims in Australia, 2001 to 2013. Diving and hyperbaric medicine, 50(2), 98-104. 7. Mijacika, T. & Dujic, Z. (2016) Sportsrelated lung injury during breath-hold diving. European Respiratory Review 25: 506-512. 8. Durkan, T. (2017) Understanding freediving blackouts and how to prevent them. The Inertia. Accessed 18 November 2020. https://www. theinertia.com/surf/understandingfreediving-blackouts-and-how-toprevent-them/ 9. Surf Life Saving Western Australia (2020) Abalone Fishing. Accessed 18 November 2020. www.mybeach.com. au/safet yrescue-ser vices/coastalrecreation/abalone
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10. Department of Primary Industries and Regional Development (2020) Abalone recreational fishing guide 2020/21. Accessed 18 November 2020. www.fish. wa.gov.au/Documents/recreational_ fishing/licences/rec_licence_abalone. pdf 11. Fitz-Clarke, JR. 2011. Breath-Hold Diving. Comprehensive physiology, 8, 585-630. 12. Boyd, C., Levy, A., McProud, T., Huang, L., Raneses, E. & Olson, C. 2015. Fatal and nonfatal drowning outcomes related to dangerous underwater breath-holding behaviors – New York State, 1988-2011. Morbidity and Mortality Weekly Report, 64. 518-521. 13. Lindholm, P. & Lundgren, CE. (2009). The physiology and pathophysiology of human breath-hold diving. Journal of Applied Physiology, 106, 284-292. 14. Pearn, J. H., Franklin, R. C., & Peden, A. E. (2015). Hypoxic blackout: diagnosis, risks, and prevention. International Journal of Aquatic Research and Education, 9(3), 9. 15. Hong, SK. 1990. Breath-Hold Diving. In: Bove and Davis, Diving Medicine, 2nd ED., Philadelphia, PA: WB Saunders, pp 59-68. Data correct at 31 October 2020. Changes may occur at a later date. © 2021 Surf Life Saving Australia This publication is copyright. Except as expressly provided in the Copyright Act 1968 and the Copyright Amendment Act 2006, no part of this publication may be reproduced, stored in any retrieval systems or transmitted by any means (including electronic, mechanical, microcopying, photocopying, recording or otherwise) without prior permission from Surf Life Saving Australia. For enquiries concerning reproduction, contact SLSA on: phone 02 9215 8000; email: info@slsa.asn.au
COASTAL SAFET Y BRIEF – DIVING & SNORKELLING
Every attempt has been made to trace and acknowledge copyright, but in some cases this may not have been possible. Surf Life Saving Australia apologises for any accidental infringements and would welcome any information to redress the situation. Acknowledgements Surf Life Saving Australia wishes to thank Frederick Anne (Omnipoll) for provision/ analysis of participation data. and the Australasian Diving Safety Foundation (ADSF) for enabling Dr John Lippmann OAM to provide information from its database and contribute to this report..
Suggested Citation Cooney, N., Lippmann, J. Ellis, A., Daw, S., and Lawes, J. (2021) Coastal Safety Brief: Diving and Snorkelling. Surf Life Saving Australia: Sydney.
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COASTAL SAFET Y BRIEF – DIVING & SNORKELLING