An August 2013 academic study of children water-associated trauma (WAT) advises the boating industry to prevent exposure to boat propellers with this statement:

“manufacturers should be strongly advised to consider redesigning some of the components of watercraft known to induce major injuries in victims in these accidents, including preventing exposure to propellers for instance.”

They go on to state, “the public should be educated on the potential dangers of towed tubing and watercraft associated trauma.”

Children Tubing
image courtesy U.S. Coast Guard

The study was published in the Journal of Pediatric Surgery (an Elsevier Journal):

Watercraft and Watersport Injuries in Children: Trauma Mechanisms and Proposed Prevention Strategies.
Richard Keijzer, Geni F. Smith, Keith E. Georgeson, and Oliver J. Muensterer.
Journal of Pediatric Surgery.
Volume 48. (August 2013) Pages 1757-1761.

The authors studied Watercraft-associated trauma (WAT) in children at the Children’s Hospital of Alabama for a ten year period from September 1999 – August 2009. Among their primary findings were:

• Towed tubing was the most prevalent form of accident treated and resulted in higher injury severity than other types of boating accidents involving children. Several children were swinging out wide on turns and running into stationary objects.
• Two female patients underwent partial lower extremity amputations after propeller accidents.
• There were no fatalities after being admitted
• Alcohol appears to be rarely involved with accidents involving children

Recommendations included:

• Mandatory wearing use of protective gear such as helmets, life vests, and easily visible floatation devices by children.
• Preventing exposure to propellers
• Reducing speeds when children are involved
• Educating the public on the dangers of towed tubing and watercraft associated trauma
• Developing an education program for those being towed and for those towing them

The paper can be purchased from Science Direct. Before you purchase or view a copy of the actual study, we encourage you to think about what trauma means. The study includes several color photos of children injured by boat propellers that are not for the faint of heart.

We commend these researchers for calling attention to children being injured while tubing and to children being struck by boat propellers.

The authors mention the need for children to have “easily visible floatation devices.” We would like to add our comments encouraging research into on water visibility issues of towed sports. We posted our coverage of water visibility issues in July 2013 after the Mansour accident to encourage college students to select class projects in this field.

Propeller Safety History Repeats Itself, Repeats Itself, …

As we have mentioned before, propeller safety history often repeats itself. After we first posted this article we heard a few responses that seemed to think this was the first time medical professionals ever called for “preventing exposure to propellers.” As a result, we listed some similar historical calls below.

Charles T. Price M.D. and Charles W. Moorfield M.D. published a paper in 1987. Dr. Price is Director of Pediatric Orthopaedics at Orlando Regional Medical Center. Dr. Moorefield is and Emergency Medicine Physician in Orlando.

Motorboat Propeller Injuries
Charles T. Price M.D. and Charles W. Moorfield M.D.
The Journal of the Florida Medical Association
Vol.74. No.6. (June 1987).

Their paper surveys Florida Orthopedic Society members about the number of propeller injuries they encountered from 1979-1983. About half the members responded with a total of 305 propeller injuries vs. the 30 injuries reported to Florida officials during that period. The paper ends with this quote:

“We have made several attempts to meet with boating manufacturers to discuss safety modifications. These efforts were met with either resistance or reluctance on the part of boating representatives to get involved.
Specifically for propeller injuries, boat engine manufacturers should investigate the possible development of propeller guards to reduce the toll of these severe injuries.”

Stephen W. Hargarten, MD, MPH of the Medical College of Wisconsin responded to a U.S. Coast Guard request for public comment on a proposed houseboat propeller safety issues in a June 13, 1995 two page letter to which he attached a paper he co-authored titled, Motorboat Propeller Injuries in Wisconsin: Enumeration and Prevention.

Motorboat Propeller Injuries in Wisconsin: Enumeration and Prevention
Stephen w. Hargarten M.D. MPH, Trudy Karlson Phd, Jon S. Vernick JD, and Charles Aprahamian M.D.
The Journal of Trauma
Vol.37. No.2. (August 1994) Pgs.187-190.

Dr. Hargarten’s letter strongly urges the Coast Guard to promote the use of propeller guards. His letter and paper are available as USCG-2001-10299 Docket Item #27.

The paper ends with this quote:

“We believe that the medical community can be instrumental in preventing propeller injuries by advocating for better data from regulating agencies and for propeller guards from boat engine manufacturers.”

Dennis G. Zielinski, Vice President and CEO of Samaritan Health System, Lake Havasu City, Arizona (near Lake Havasu) responded to a U.S. Coast Guard request for public comment on houseboat propeller safety issues in a July 10, 1995 two page letter.

His letter is available as USCG-2001-10163 Docket Item #94. go to pdf pages #20 and 21 to view his comments

Mr. Zielinksi’s letter reviews some of their experiences with propeller accidents, notes that it is not unusual for them to receive several propeller injuries over a single weekend, and states:

“We at Havasu Samaritan Regional Hospital encourage your efforts to establish reasonable guidelines requiring injury prevention guards on commercial recreational vessels; particularly those rented to inexperienced boaters from livery operators.”

Federico A. Grabiel M.D. Medical Director of Emergency Department and Trauma at Mercy Medical Center Redding California (near Lake Shasta), a level II Trauma Center, responded to the U.S. Coast Guard request for public comment on houseboat propeller safety issues in an October 17, 1995 letter.

His letter is available as USCG-2001-10299 Docket Item # 1754. go to pdf page #45 to view his comments.

Dr. Grabiel’s letter includes this comment:

“Propeller injuries are unnecessary and preventable. The use of jet drives and propeller guards would virtually eliminate these problems.”

Eric Gorovitz JD MPH Legal Director the the Trauma Foundation testified before the U.S. Coast Guard National Boating Safety Advisory Council (NBSAC) in San Francisco, California on April 29, 1996.

The Trauma Foundation is a non-profit dedicated to the prevention of traumatic injury. They are located at the San Franciso General Hospital. Mr. Gorovitz noted the then current position of the courts recognizing Federal Pre-emption of the 1971 Boating Safety Act was preventing consumers injured by propellers from seeking redress in the courts. He saw that until NBSAC recommended USCG required the use of propeller guards, “the toll of predictable and completely preventable injuries and fatalities caused by unguarded propellers will continue to rise.”

Mr. Gorovitz closed his presentation to NBSAC with:

“I urge you to accept the responsibility that comes with your charge, and to require the industry which profits from the sale of dangerous propellers to make their products safe by installing propeller guards.”

Miguel A. Mendez-Fernandez, M.D., F.A.C.S., Plastic Surgery Associates of Redding (California) responded to U.S. Coast Guard’s call for public comment on a proposed houseboat propeller safety regulation in a February 6, 2002 letter to which he attached a copy of his paper:

Motorboat Propeller Injuries
Miguel A. Mendez-Fernandez, M.D., FACS, FICS
Annals of Plastic Surgery
Vol.41. No.2 (August 1998). Pgs.113-118.

His letter and paper are available as USCG-2001-10163 Docket Item #28.

Dr. Mendez-Fernandez’s paper reviews his experiences with several propeller accident victims (many from Lake Shasta) and includes this statement:

“I feel strongly that most of these accidents could have been prevented. The utilization of propeller guards in houseboats, patio boats, and low-speed rental boats should be encouraged, if not mandated (as it is on desktop cooling fans!)”

Hemant Garg MB BS, Reto Twerenbold MD, Rene Zellweger MB BS MD FRACS of the Royal Perth Hospital in Western Australia published a paper in 2011.

Propeller and Jet-Ski Injuries During Christmas and New Year in Western Australia
Hemant Garg MB BS, Reto Twerenbold MD, Rene Zellweger MB BS MD FRACS
Medical Journal of Australia
Vol.5. No.19. (December 2011) Pgs.704-705.

The article reviews the cases of five patients seen over the 2010-2011 Christmas holiday in Western Australia. Three were propeller strikes. Their paper includes these quotes:

A concept worth mentioning is that of a propeller guard. The guard provides a barrier to the cutting edge of the blades and eliminates the risk of a person making contact with a running propeller.” … “We believe that the medical community should provide accurate and relevant data, and embrace our role as leaders and health advocates by working with government and other non-governmental organisations to build effective public awareness campaigns and to drive manufacturers and retailers to produce and sell safer products.”

D. Sladden, A. Casha, A. Manche Cardiac professionals in Malta published a paper in 2014.

Chest Wall Reconstruction Following a Speedboat Propeller Injury.
Malta Medical Journal.
Vol.26. No.2. 2014. Pgs.48-51.

“This report highlights the importance of legislation in preventing propeller injuries by restricting swimmer zones and introducing propeller guards or jet drive systems.”

Summary

In summary, as seen above, history repeats itself, repeats itself, …

Every few years medical professionals speak out for preventing contact with exposed propellers, but nothing is done about it. We can only hope that the recent paper about children water-associated trauma is better received.