Reducing recreational boating fatalities: Do life jacket wear regulations work?

Background. Between 1999 and 2011, boating accident and fatality statistics from the United States Coast Guard showed over 9,200 deaths, with an average of 709 or 5.6 deaths per 100,000 boaters each year. About 71% were drownings; among these, 87% were not wearing life jackets. There is a debate as to the best approach to increase wear rates—mandatory regulations or better education. While the majority of the U.S. boating public is not subject to life jacket wear regulations, some groups are currently mandated in most states: (1) youth under age 13; (2) water skiiers or participants of towed sports; and (3) those using personal water crafts (PWCs). Methods. Using US National Life Jacket Observational Study data (1999-2012), we compare wear rates of boaters who are mandated to wear versus similar boaters who are not mandated to wear. Results. Youth age<13 covered by regulations had a higher wear rate than those who were not covered (86% vs 71%, p<0.0001), versus 29% among teens who are not required to wear. Among adults being towed in the water, 95% wore life jackets compared to 6% of adults on the boat towing them. Among adults on PWCs, 96% wore life jackets versus 8% of adults on power boats <16 feet. Conclusions. As the debate and planning continues on whether to expand mandatory regulations, these data provide evidence that most boaters comply with mandatory regulations.