QUESTION: Over the years I’ve read about so many people drowning while snorkeling. What are the causes, and why does that happen so often?

ANSWER: From 2006 through 2010 the state Department of Health lists drowning as one of the “Leading Causes of Fatal Injuries in Hawaii,” mainly in the ocean as opposed to a pool or stream.

Among nonresidents, drowning was the No. 1 cause of fatal injuries, usually while snorkeling or swimming.

The statistics don’t go into what might have led to the drownings, such as a physiological condition or strong underwater current.

However, among nonresidents it “absolutely” could be concluded that many victims simply were not aware of the dangers of the ocean, said Dan Galanis, an epidemiologist with the Health Department’s Injury Prevention and Control Program.

It’s an ongoing challenge for ocean safety officials to educate visitors about the risks in the ocean, he said.

“It’s amazing to me that half of the drowning victims are not residents,” Galanis said. Their numbers are small compared with residents, but because many are here for leisure activities, they might spend relatively more time in the ocean.

But that’s “not to say that all locals have water knowledge for all the spots they go to, either,” Galanis said.

Regarding actual causes, pre-existing health conditions may have been factors for both residents and nonresidents, notably older men, he said.

From 2006 through 2010, among residents, suicide was the leading cause of fatal injuries at 747 (23 percent); followed by falls, 514 (16 percent); poisoning, 432 (13 percent); motor vehicle accidents (occupant), 330 (10 percent); and drowning, 160 (5 percent).

Among nonresidents, drowning accounted for 159 deaths (46 percent), followed by motor vehicle accidents, 36 (10 percent); suicide, 29 (8 percent); falls, 27 (8 percent); and poisoning, 19 (5 percent).

Regarding suicides among residents, Galanis said health issues were cited as a reason for about half of the older victims, while among younger ones, romantic issues or breakups were involved. Although many people believe economic issues may be a significant factor these days, they showed up as a reason “relatively less” than the other two, he said.

During the five-year period from 2006 through 2010, the following activities led to drownings (for residents and nonresidents, respectively): boat accident, 8 and none; fell in/swept in, 19 and 18; fishing/shorecasting, 15 and one; picking opihi, 10 and none; free diving, 19 and three; scuba diving, six and 14; snorkeling, 13 and 83; swimming, 47 and 82; surfing/bodyboarding, 18 and eight; other activity (kayaking, kiteboarding, jet-skiing, etc.), 22 and 13; unknown activity, 47 and 46.

“Unintentional immersions,” such as boat accidents and fishing, were more common among residents, while nonresidents were more likely to have been snorkeling or swimming.

Overall, Galanis said “there is no clear trend in the annual number of ocean drownings, which varied from 41 to 68 over the last 10 years.”

Numbers for 2011, however, were relatively high, with increases among both resident and nonresident victims. There were 65 drownings last year — 34 nonresidents and 31 residents. That compares with 68 (32/36) in 2005, 59 in 2006 (34/25), 46 in 2007 (22/24), 52 in 2009 (29/23) and 48 in 2010 (24/24).

Mahalo

To the honest person who found and turned in my husband’s wedding ring at Kahala Mall on April 20. He realized his loss only after arriving home. When we contacted Kahala Mall, they said they had the ring. It would have been easy to get cash for that ring of gold, but that person’s act of kindness cured our heartbreak. We have matching inscribed rings. Mahalo also to Kahala Mall security officers. — Grateful in Kaimuki

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