Improving coastal safety for international visitors to Australia.

OBJECTIVES

International visitors are a high-risk group for drowning and other fatalities at Australian coastal locations due to lower visitation and familiarity than the resident population. This review of pre-COVID-19 (2005-2019) Australian international visitor coastal fatalities aimed to assess changes in mortality rates and evaluate differences between international visitor and resident death profiles to inform safety measures.

STUDY DESIGN

Descriptive, retrospective epidemiological analysis.

METHODS

Analysis of unintentional coastal fatalities among international visitors to Australia from 2005 to 2019 was conducted using coronial data for fatalities and short-term visitor arrival data. Descriptive analysis comprised demographic, and incident-based variables, while cumulative (2005-2019) and annual fatality rates and 95 % confidence intervals per 100,000 short-term arrivals were calculated. Length of stay was incorporated into the risk measurement per 100,000 visitor-years. Joinpoint regression analysed trends in annual visitor coastal fatality rates.

RESULTS

Among coastal deaths 62 % were due to drowning; 12.8 % were international visitors; 7.83 residents died for each visitor fatality with an annual average of 22.5 visitor deaths. The cumulative visitor coastal fatality rate was 0.37 deaths per 100,000 international arrivals (95 %CI: 0.33-0.42), which decreased at a statistically significant level by an annual average of 5.8 % (95 %CI: 9.5 % to -1.9 %; p = 0.007) from 2005 to 2019. Visitors record an exposure-adjusted coastal fatality rate of 6.0/100,000 visitor-years. Visitor coastal deaths occurred in higher proportions in Queensland, at offshore locations, in more remote areas, while snorkelling, and during organised activities.

CONCLUSIONS

Sustained efforts will require focus on high-risk visitor groups by diverse sectors including tourism, government, and water safety practitioners.