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Abstract

Drowning is the number one cause of unintentional injury death on the Hawaiian Island of Kauai. Steep submarine slopes, large waves, and variable coastlines combine to create hazardous conditions year round. Most victims (3/4) have been visitors (avg. age 46.2 years; 85% male), dying at more than 40 coastal localities. From 1970 to 2009, 300 people died at the island’s coastline, the death rate increasing from 5.5/yr (1970-79) to 10.1/yr (2000-09). Paradoxically, the number of lifeguards increased from a handful at two 1970’s stations to 45 at 10 stations by 2009. Kauai County provides lifeguards; the State of Hawaii emphasizes liability protection with an abundance of relatively uninformative warning signs. The tourism industry provides little direct information as to the hazardous nature of the alluring coastline. A paradigm shift in water safety/drowning prevention is proposed emphasizing informative site-specific and hazard-specific signage at both the many unguarded and guarded hazardous localities.

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