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VACATION
INJURIES

continued from page 15

Recommended strategies to reduce injuries while abroad (continued)

HAZARD PREVENTION STRATEGIES Table 2-12.

Road Traffic Crashes

BUS TRAVEL Avoid riding in overcrowded, overweight, or top-heavy buses or minivans.

PEDESTRIAN Be alert when crossing streets, especially in countries where motorists drive on the left side of the road.
HAZARDS Walk with a companion or someone from the host country.

Other Tips Avoid using local, unscheduled aircraft. If possible, fly on larger planes (>30 seats), in good weather, during
the daylight hours, and with experienced pilots. Children <2 years should sit in a child safety seat, not on
AIRPLANE TRAVEL a parent’s lap. Whenever possible, parents should travel with a safety seat for use before, during, and after
a plane ride.

DROWNING Avoid swimming alone or in unfamiliar waters. Wear life jackets while boating or during water recreation
activities.

BURNS In hotels, stay below the sixth floor to maximize the likelihood of being rescued in case of a fire. Bring your
own smoke alarm.

WATER AND AQUATIC INJURIES dents, and deaths classified as “other unintentional injuries” ac-
Drowning accounts for 13% of all deaths of US citizens abroad. counted for 22% of deaths to healthy US citizens abroad (Figure 2-
02). Fires can be a substantial risk in developing countries where
Although risk factors have not been clearly defined, these deaths are building codes do not exist or are not enforced, there are no smoke
most likely related to unfamiliarity with local water currents and alarms, there is no access to emergency services, and the fire depart-
conditions, inability to swim, and the absence of lifeguards on duty. ment’s focus is on putting out fires rather than on fire prevention or
Rip currents can be especially dangerous, as are sea animals such as victim rescue.
urchins, jellyfish, coral, and sea lice. Alcohol also contributes to
drowning and boating mishaps. Travel by local, lightweight aircraft in many countries can be risky.
From 2011 through 2013, an estimated 82 US citizens abroad were
Drowning was the leading cause of injury death to US citizens killed in aircraft crashes. Travel on unscheduled flights, in small air-
visiting countries where water recreation is a major activity, such as craft, at night, in inclement weather, and with inexperienced pilots
Fiji, the Bahamas, Jamaica, and Costa Rica. Young men are partic- carries the highest risk.
ularly at risk of head and spinal cord injuries from diving into shal-
low water, and alcohol is a factor in some cases. Before flying with children, parents and caregivers should check
to make sure that their child restraint system is approved for use on
Boating can be a hazard, especially if boaters are unfamiliar with an aircraft. This approval should be printed on the system’s infor-
the boat, do not know proper boating etiquette or rules for water- mation label or on the device itself. The Federal Aviation Adminis-
craft navigation, or are new to the water environment in a foreign tration (FAA) recommends that a child weighing <20 lb use a
country. From 2011 through 2013, maritime accidents accounted rear-facing child restraint system. A forward-facing child safety seat
for 8% of deaths to healthy Americans abroad. Many boating fatal- should be used for children weighing 20–40 lb. FAA has also ap-
ities result from inexperience or failure to wear lifejackets. proved a harness-type device for children weighing 22–44 lb.

Scuba diving is a frequent pursuit of travelers in coastal destina- Travel health providers, vendors of travel
tions. The death rate among all divers worldwide is thought to be services, and travelers themselves should
15–20 deaths per 100,000 divers per year. Travelers should either consider the following:
be experienced divers or dive with a reliable dive shop and instruc- • Purchasing special travel health and medical evacuation insurance
tors. See the Scuba Diving section later in this chapter for a more
detailed discussion about diving risks and preventive measures. if their destinations include countries where there may not be ac-
cess to good medical care (see the Travel Insurance, Travel Health
OTHER INJURIES Insurance, & Medical Evacuation Insurance section later in this
From 2011 through 2013, aviation incidents, drug-related inci- chapter).

16 San Antonio Medicine • May 2016