Epidemiologic Notes and Report
Diving-Associated Spinal Cord Injuries During Drought Conditions --
Wisconsin, 1988
From June 1 through July 15, 1988, eight patients with cervical
spinal cord injuries (SCIs) that occurred from diving into water
were
reported to two spinal injury centers in Milwaukee, Wisconsin.
During
similar periods in 1986 and 1987, five and three such injuries,
respectively, were reported to these centers.
The injured persons ranged in age from 15 to 23 years, and all
eightt
were male. One was injured in a swimming pool and is not included
in
this report. The other seven were injured in natural bodies of
water,
and six of the seven were familiar with these bodies of water. All
patients believed the water was deeper than it actually was. Five
patients have some degree of quadriplegia with or without fracture
(Table 1), and two have either no neurologic deficits or no
residual
neurologic deficits.
Wisconsin, like other states in the Midwest and Southeast, has
experienced drought conditions. This year's rainfall has averaged
about
6 inches below that of last year for these regions. Water levels in
inland lakes are between 10 inches and 10 feet below normal levels.
Reported by: DJ Maiman, MD, Veterans Administration Hospital,
Milwaukee ;
D Kunelius, Wisconsin Dept of Natural Resources; H Weiss, MPH, HA
Anderson, MD, JP Davis, MD, State Epidemiologist, Wisconsin Dept of
Health and Social Svcs. Div of Field Svcs, Epidemiology Program
Office;
Div of Injury Epidemiology and Control, Center for Environmental
Health
and Injury Control, CDC.
Editorial Note
Editorial Note: Each year, 10,000-20,000 new SCIs occur in the
United
States (1). As many as 1,000 of these injuries result when
persons--predominantly males aged 15-25 years--dive into swimming
pools
or natural bodies of water (1,2). In a 1970-1971 case series in
California, 15 cases of quadriplegia were reported. One resulted
from a
dive into a swimming pool; the other 14 cases resulted from dives
into
rivers, streams, lakes, or oceans (3). Only three of these injured
persons from California had objective evidence of the depth of the
waterr
at the time of injury; most of the divers had underestimated it.
This summer's drought, affecting most midwestern and many
southern
states, has resulted in record-low water levels in rivers, lakes,
and
streams. These conditions probably increase the risk of SCIs from
diving, even in natural bodies of water previously considered safe.
Because of extremely low water levels, no one should dive--even
into a
familiar body of water--until the depth of the water has been
objectively measured.
Several strategies to prevent diving-associated SCIs have been
suggested. States can closely monitor water levels in natural
bodies of
water during periods of low rainfall and can post warning signs to
alertt
potential divers of hazards. In some localities, public education
and
poster campaigns have been used, and areas that are too shallow for
diving have been posted as being hazardous. Other strategies urge
diverss
to determine the depth of the water by wading into it before diving
or
by first jumping feet first into the water (4).
In 1987, the Council of State and Territorial Epidemiologists
recommended that traumatic SCIs be designated as reportable
injuries
(5). Strengthening state-based surveillance of SCIs will help
identify
hazardous diving conditions under which SCIs may be more likely to
occur. Surveillance can also assist in implementing and evaluating
measures to prevent SCIs.
References
Kraus JF. Epidemiological aspects of acute spinal cord injury: a
review of incidence, prevalence, causes, and outcome. In: Becker
DP,
Povlishock JT, eds. Central nervous system trauma status
report--1985.
Bethesda, Maryland: National Institute of Neurological and
Communicativee
Disorders and Stroke, National Institutes of Health, 1985:313-22.
National Coordinating Council on Spinal Cord Injury. Head and
spinal
cord injury prevention. NCCSCI Dialogue 1988;(July):3.
Kewalramani LS, Kraus JF. Acute spinal-cord lesions from
diving--epidemiological and clinical features. West J Med
1977;126:353-61.
Pierson P, Pierson E, Gelber B. A spinal cord injury prevention
program. Nebr Med J 1986;71:133.
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