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Friday, 20 August, 1999, 02:19 GMT 03:19 UK
Cold water increases drowning risk
Cold water impairs the ability to swim
Most people who fall into cold water die from drowning and not hypothermia as commonly thought, researchers have found.

Deaths associated with immersion in cold water have been attributed to hypothermia, since many of those who die are judged to be competent swimmers.

But a report in The Lancet medical journal suggests that these deaths may actually be caused by drowning as a result of swimming impairment induced by the coldness of the water.

Dr Michael Tipton and colleagues, from the University of Portsmouth, and the National Defence Research Establishment, Sweden, asked ten volunteers to do three self-paced breaststroke swims in water at 25°C, 18°C, and 10°C for a maximum of 90 minutes.

During the swims, the researchers measured the volunteers' oxygen consumption, rectal temperature, swim speed and angle, and stroke rate and length.

All ten swimmers completed the 90-minute swims in the water with a temperature of 25°C, eight completed the swims at 18°C, and five completed the swim at 10°C.

At 10°C, the swimmers used faster and shorter strokes, became more upright, and used more oxygen per metre swum, than in warmer water.

Limb difficulty

The swimmers reported that it became increasingly difficult to straighten their limbs and co-ordinate their swimming movements at the coldest temperature.

This finding was more pronounced in those with a smaller amount of fat on their arms.

None of the swimmers developed hypothermia.

Impaired performance, and the initial response by the heart and lungs to immersion, are probably the major dangers to people who fall into cold water, the researchers say.

Consequently, treatment should be aimed at symptoms resulting from near-drowning rather than severe hypothermia.

In a commentary, Dr John Ryan, of the Royal Sussex County Hospital, Brighton, UK, explores the implications these findings have for the management of immersion victims.

The management of drowning and near drowning must primarily involve protection of the brain, so early resuscitation is necessary.

He said: "Although the research adds new details about the mechanism of immersion-related death, further research in this area will no doubt help us distinguish futile from worthwhile resuscitation".

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10 Feb 99 | Medical notes
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