a comparison of attitudes and knowledge of beach safety in australia for beachgoers, rural residents...

2012 online AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia

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Going to the beach is the most popular

tourism activity for Australians

and international visitors,1 but

accidental drowning is a potential risk. There

is limited data specifically on beach drowning

in Australia. Mackie2 estimated that the

overall accidental non-boat drowning rate

was 1.44 per 100,000 population per year

and that around 22% occurred in ocean or

estuary areas and 10% on surf beaches. A

recent descriptive study of surf beaches in

Victoria3 estimated that the rate of accidental

drowning deaths on surf beaches was 0.16

per 100,000 population per year, amounting

to around 32 beach drownings each year. In

contrast, the Australian Water Safety Council4

indicates there as an average of 52 drowning

deaths on Australia surf beaches each year.

These deaths are all preventable and all the

more tragic because they occur when people

are engaged in activities they enjoy.

Research provides some evidence on the

most important risk factors for accidental

drowning on beaches. These include gender,

age, familiarity with Australian beach

conditions and exposure to specific hazards

on the beach. For example, Mackie2 showed

that more than three-quarters of drownings

in Australia involved males. Morgan et

al.3 found that males had almost double

the average beach drowning rate (0.28 per

100,000) and that beach drowning was most

common in the 20-29 years age group. The

higher involvement of males and younger

people is not surprising: these are common

characteristics of beach users and have

been linked with higher rates for other

unintentional injuries.5

A number of studies have pointed to the

involvement of international tourists in

beach drowning. Two reports and a Medical

Journal of Australia editorial2,6,7 identified

the relatively high rate of drowning deaths

involving overseas tourists. Similarly, in

a study of beach drowning,3 international

tourists comprised 25% of drowning cases,

with an estimated crude beach drowning

rate of 2.36 per 100,000 population for

A comparison of attitudes and knowledge of

beach safety in Australia for beachgoers,

rural residents and international tourists

Ann WilliamsonSchool of Aviation, University of New South Wales

Julie HatfieldNSW Injury Risk Management Research Centre, University of New South Wales

Shauna SherkerNSW Injury Risk Management Research Centre, University of New South Wales; Surf Lifesaving Australia, New South Wales

Robert BranderBiological, Earth and Environmental Sciences, University of New South Wales

Andrew HayenSchool of Public Health, The University of Sydney, New South Wales

Submitted: July 2011 Revision requested: October 2011 Accepted: December 2011Correspondence to: Professor Ann Williamson, School of Aviation, University of New South Wales, Sydney 2052; e-mail: [email protected]

Abstract

Objectives: To compare attitudes and

knowledge of beach safety in Australia of

beachgoers, rural inland residents and

international tourists.

Method: This analysis is part of the 2007

baseline survey for the Science of the Surf

project and involved interviews of 367 people

on beaches in New South Wales (NSW),

62 rural residents of a moderate-sized inland

town and 73 international tourists visiting

Sydney beaches. Participants were asked

about various aspects of beach safety and

shown photographs of beaches and asked to

indicate where they would swim and to identify

the location of any rip currents. Logistic

regression analysis was used to evaluate the

predictors of swimming choice.

Results: Most beachgoers were aware that

swimming between flags indicating a patrolled

section of beach was the safe swimming

option, but a significant proportion chose not

to swim there. Rural residents were more

likely than the other two groups to make safe

choices about where to swim in the presence

of flags. The odds of international tourists

making a safe swimming choice in the vicinity

of a rip current were three times lower than

usual beachgoers and rural inland residents.

Conclusions and Implications: Improving

beach safety will require more refined

strategies for specific target groups rather

than a series of one-size-fits-all approaches.

Key words: drowning; beach safety; tourists;

survey

Aust NZ J Public Health. 2012; Online

doi: 10.1111/j.1753-6405.2012.00888.x

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2012 online© 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia

Williamson et al.

international inbound tourists. Explanations for the higher

involvement of overseas tourists in surf-related drowning suggest

lack of knowledge or experience of beach conditions in general,

and Australian conditions in particular,2,6 and, in some cases, lack of

English language skills.6,7 Similar arguments have been advanced for

the higher involvement of people who do not go to the beach very

often, such as rural residents. Analysis of coronial data indicated

that population death rates for drowning were 1.7 times higher for

rural and remote location residents compared to residents of urban

areas who typically live closer to the coast.8 Franklin et al. cited

ocean and beaches as the most common locations for drowning

for rural and remote residents, accounting for 30% of drownings.

Another potential risk factor identified for beach drowning is the

nature of hazardous surf conditions, especially the involvement of

rip currents. Exposure to rips was implicated in 22% of drowning

deaths in the Victorian surf beach study.3 It is well established that

rips are the main natural hazard for beachgoers at surf beaches

around the world.9-11 Their importance as a risk factor for drowning

is reinforced by evidence on the protection afforded for swimmers in

areas patrolled by lifesavers and lifeguards. Many popular Australian

beaches provide safe areas for swimming, demarcated by a pair of

red and yellow flags, and patrolled by professional lifeguards or

volunteer lifesavers, or both. These areas are promoted through

campaigns such as Surf Lifesaving Australia’s (SLSA) ‘Swim

Between the Flags’. There is evidence from Australian12 and Israeli11

research that swimmers are safer if they comply with this message.

Beachgoers’ choices of where to swim play a clear role in the

risk of surf beach drowning. Characteristics like gender, age and

knowledge or familiarity of hazards on surf beaches are all likely

to influence where beachgoers choose to swim. Patrolled areas help

swimmers to avoid rips, which pose a considerable drowning risk.

The aim of this study is to compare attitudes and knowledge about

beach safety for Australian beachgoers, Australian rural inland

residents and international tourists visiting Australian beaches.

To design the most effective approaches to reducing preventable

drowning on beaches it is essential to first understand what risk

factors to target and how they might be tailored to different groups.

The objective of this analysis is to provide better evidence on which

to base beach-safety interventions.

MethodSampling strategy

This study was part of a larger study of beach safety, the Science

of the Surf project. The sampling strategy involved:

1. A survey of Australian beachgoers in two coastal regions

of New South Wales that are popular holiday destinations:

Pacific Palms and Mollymook, about 300 km north and south

of Sydney, respectively.

2. A survey of international tourists visiting beaches in the

same regions as above and on three popular tourist beaches

in Sydney (Manly, Bondi and Coogee).

3. A survey of residents in Orange, NSW, a moderate-sized

regional town around 300 km west of Sydney and the coast.

Survey instrumentThe survey, involving 26 questions in a face-to-face interview, has

been published elsewhere.13 Only the questions that were analysed

for the current paper are described here. The first set of questions

involved details of frequency of beach visits. The next set asked

about respondents’ knowledge of rips and patrolled beaches. These

questions involved colour photographs showing a beach with a rip

current, and the same beach with red and yellow flags indicating a

patrolled section of beach (and no rip current). Respondents were

asked to indicate where they would swim in each photograph, why

they chose that location and whether there was anywhere they

wouldn’t swim and why. They were also asked why they thought

lifesavers place flags where they do and to describe a rip. They were

then shown another photograph of a beach with a rip and asked to

point out the location of the rips, if any, and to rate their confidence in

their answer on a seven-point Likert scale. Respondents were asked

to describe what a rip looks like and what they would do if they

were caught in one. They were then asked to rate on a seven-point

scale, from very low to very high, their swimming ability and their

ability to get out of a rip. They were also asked to describe their

experience of getting into difficulties in the water at the beach. The

final questions were about language spoken at home, age grouping,

gender, postcode of residence, whether the respondent had children

with them at the beach and, if so, the children’s ages.

Survey procedureThe Australian beachgoer survey was conducted in the two coastal

regions over the four-day Easter holiday period in 2007. In each

region, four trained interviewers, working in pairs and supervised

by a field manager, surveyed people on patrolled and unpatrolled

beaches between 9 am and 5 pm. In each region, the weather was

poor on at least one day, so interviews on this day were conducted

at the local retail area and golf or recreation clubs close to the

beach. The international tourist survey was conducted on one day

for each of the three Sydney beaches, with interviews conducted

in English by a pair of trained interviewers over the same hours as

for the beachgoers’ survey. The rural survey was conducted at two

shopping malls over a four-day period in June, including one public

holiday, again, by a pair of trained interviewers.

In each location, the interviewers randomly approached as

many people as possible between 9 am and 5 pm. Interviews were

only conducted with people 14 years and over. Each interviewer

introduced themselves and stated that they were conducting a survey

on behalf of the University of New South Wales and Surf Life Saving

Australia, and invited the person to participate in a survey estimated

to take around 10 minutes. If the person agreed, the interviewer

proceeded with the interview. If they did not agree, the interviewer

thanked the person for their time and, where possible, recorded their

reason for non-participation and their estimated age and gender.

Refusal informationThe overall response rate for the Australian Beachgoer data

collection was 67.1% (see Table 1) Most of the refusals occurred


Attitudes and knowledge of beach safety in Australia

when, due to poor weather, interviews were conducted in local

shopping areas or recreation clubs. The combination of poor

weather and locations that people were only visiting briefly meant

that refusals in shopping areas or recreation clubs were largely due

to lack of time. It is notable that the response rate on beaches was

91.7%. Of the 362 people approached on beaches across both areas,

only 30 declined to participate. The same influences were evident in

response rates for tourist and rural samples. The response rate for

tourists was very high with all interviews conducted on beaches.

In contrast, for rural residents who were interviewed in shopping

malls, the response rate was much lower and similar to that obtained

when beachgoers were interviewed in shopping areas.

Data analysisData were analysed using SPSS Version 17.14 In preliminary

analysis, nine people interviewed as part of the Australian beachgoer

group were found to be international tourists and were transferred to

that group for the main analyses. Some respondents in the Australian

beachgoer survey were from inland rural areas (12.3%), but were

not moved as, by definition, they were beachgoers. The objective

of the inland rural resident survey included assessing frequency of

beach visits, and to include those who were already at the beach

could have biased the sample.

The analysis was conducted in two stages. The first involved a

bivariate analysis to examine the characteristics of the participant

sample groups: Australian beachgoers, international tourists

and rural inland residents. This analysis looked at demographic

characteristics; beach, swimming and water safety experiences;

and awareness and knowledge of water safety, for each of the three

sample groups. Chi-square tests were used for each comparison.

The second stage involved a multivariable analysis involving logistic

regression in which the dependent or outcome variables were

swimming choice in the presence of a rip and swimming choice

in the presence of flags. In each case, the predictor variables were

sample group, self-rated swimming ability, and self-rated chance

of drowning, as well as age and gender.

ResultsThe demographic characteristics of each group show patterns

that might be expected given the interview location (see Table 2).

The sample groups differed in distribution of age with Australian

beachgoers mainly over 30 years of age, international tourists largely

in the 20-29 year age group, and rural residents evenly distributed

across age groups. There were no gender differences between

the sample groups. Fewer international tourists spoke English at

home, although the majority were from English-speaking countries

including the UK and Ireland (42.5%) and US and Canada (39.7%).

The remainder were from European countries (28.8%) and a small

number from South-East Asia (2.7%). Based on their postcode of

residence, most Australian beachgoers (87.7%) lived in coastal

regions (see Table 3).

Swimming choice answers were coded as correct if respondents

gave a correct answer to both where they would swim (not in the

rip, between the flags); and where they would not swim (in the rip,

not between the flags); otherwise swimming choice was coded as

incorrect. Fewer than half in each sample group made the safest

or correct choice of where to swim in the presence of a rip (i.e. to

avoid swimming in the rip), but international tourists were least

likely to make the safest choice (Table 4). While most of the people

interviewed from all three sample groups made the correct or safest

choice about where to swim in the presence of flags, rural residents

were most likely to make the correct choice. Australian beachgoers

and international tourists were significantly less likely than rural

Table 1: Response rates and reasons for non-response for sample groups: Australian beachgoers, international tourists and rural inland residents.

Australian beachgoers

International tourists

Rural inland residents

Number invited 560 64 343

Overall response rate 67.1% 97.3% 18.1%

Number non-respondents 184 2 281

Reasons for non-response

n (%) n (%) n (%)

Lack of time 110 (59.8) 179 (63.7)

Not interested 49 (26.5) 2 (100) 65 (23.1)

Other 14 (7.9) 4 (1.4)

unknown 11 (5.8) 33 (11.7)

Table 2: Demographic characteristics of sample groups: Australian beachgoers, international tourists and rural inland residents showing percentages of each group in each case and statistics for comparison.

Australian beachgoers (n=367)

International tourists (n=73)

Rural inland residents (n=62)

Age

14-19 years

20-29 years

30-49 years

≥50 years

n (%)

25 (6.8)

69 (18.8)

181 (49.3)

92 (25.1)

n (%)

5 (6.8)

51 (69.9)

13 (17.8)

4 (5.6)

n (%)

11 (17.7)

16 (25.8)

18 (29.0)

17 (27.4)

χ(6)2=94.95 p<0.001

Gender (%)

Male

Female

170 (46.4)

197 (53.6)

37 (50.7)

36 (49.3)

39 (62.9)

23 (37.1)

χ(2)2=5.83 ns

English Language speaker at home (%)

362 (98.6) 55 (75.3) 62 (100.0) χ(2)2=89.73 p<0.001


Table 3: Experiences of the beach, swimming and water safety for sample groups: Australian beachgoers, international tourists, and rural inland residents showing percentages of each group in each case and statistics for comparison.

Australian Beachgoers (n=367)

n (%)

International Tourists (n=73)

n (%)

Rural Inland Residents (n=62)

n (%)Frequency of going to beach χ(5)

2=27.69 p<0.001a

Every day/ Live at beach 72 (21.4) 0 (0) b

>1 per week 56 (16.6) 9 (12.9) b

1-2 per fortnight 53 (15.7) 9 (12.9) 1 (1.6)

6-12 times per year 65 (19.3) 16 (22.9) 6 (9.7)

<6 times per year 43 (12.8) 15 (21.4) 43 (69.4)

Never/≤1 per 10 years 48 (14.2) 21 (30.0) 11 (17.8)

Missingc 30 (8.2) 3 (4.1) 0 (0)

Estimates of swimming ability χ(4)2=18.07 p<0.001

Low (1-2) 44 (12.6) 8 (11.3) 17 (27.4)

Medium (3-5) 223 (63.7) 56 (78.9) 36 (58.1)

High (6-7) 83 (23.7) 7 (9.9) 9 (14.5)

Missing 17 (4.6) 2 (2.7) 0 (0)

Estimate of swimming distance χ(6)2=9.60 p=0.14

<25 m 21 (5.8) 8 (11.0) 3 (4.8)

25-50 m 50 (13.9) 4 (5.5) 13 (21.0)

50-100 m 67 (18.7) 12 (16.4) 11 (17.7)

>100 m 221 (61.6) 49 (67.1) 35 (56.5)

Missing 8 (2.2) 0 (0) 0 (0)

Estimates of chance of drowning χ(4)2=42.04 p<0.001

Low (1-2) 206 (58.7) 22 (31.0) 18 (29.0)

Medium (3-5) 131 (37.3) 46 (64.8) 34 (54.8)

High (6-7) 14 (4.0) 3 (4.2) 10 (16.1)

Missing 16 (4.4) 2 (2.7) 0 (0)

Estimates of ability to swim out of a rip χ(4)2=18.39 p<0.001

Low (1-2) 60 (17.1) 12 (17.1) 13 (21.0)

Medium (3-5) 195 (55.6) 53 (75.7) 41 (66.1)

High (6-7) 96 (27.4) 5 (7.1) 8 (12.9)

Missing 16 (4.4) 3 (4.1) 0 (0)

Ever experienced difficulties in water at the beach 204 (56.0) 16 (21.9) 18 (29.0) χ(2)2=40.6 p<0.001

Caught in rip (%) 147 (40.2) 8 (11.0) 14 (22.6)

Held under by wave (%) 26 (7.2) 5 (6.8) 4 (6.5)

Got tired/cramp (%) 5 (1.4) 0 (0) 0 (0)

Other (%) 26 (7.2) 3 (4.1) 0 (0)

Ever experienced rescue 57 (15.7) 5 (6.8) 7 (11.3) χ(2)2=38.9 p<0.001

a Comparison of Australian beachgoers and international tourists only due to skewed distribution of rural inland residents on this variable

b Options not asked of rural residence as not plausible given distance from beach

c Missing data is shown for each variable, but is not included in the analysis

residents to report that they would swim between the flags.

Examination of the reasons for choice of swim location in the

presence of flags (see Table 5) showed that Australian beachgoers

were more likely to make their choice to swim between the flags

and not to swim out side the flags on the basis of safety. Fewer

interviewees in the other sample groups cited safety as their reason

for where to swim, and more of these two groups justified their

choice on a rule-basis: this is what you are supposed to do.

There were statistically significant differences between the three

sample groups in their accuracy of identifying the presence of a rip

when shown a photograph (see Table 4). Around half the Australian

beachgoers and rural residents correctly identified the rip, but

less than one-third of international tourists did so. Importantly, a

significant percentage of Australian beachgoers and rural residents

reported moderate to high confidence in their ability to identify

the rip, even though about one in three of them made an incorrect

choice (31.1% Australian beachgoers and 28.6% rural residents).

The multivariable analysis using logistic regression examined

the predictors of participants’ choices of swimming location in the

presence of a rip and in the presence of flags. Both analyses used

almost all available data (98.8%), with only six missing cases on

the dependent variable. Analysis of outliers also showed no cases

of significance.

The results for predictors of choice of location in presence of

a rip (see Table 6) show that age group, gender, sample group,

self-rated swimming ability and self-rated chance of drowning

were all significantly and independently associated with choice of

swim location in presence of a rip. Inspection of odds ratios (OR)

shows that the odds of making the correct choice of not swimming

in the rip was three times lower for participants in the 20 to 39

Williamson et al.


years age compared to the oldest participants (60+ years). Males

were significantly less likely to make a correct choice compared to

females. Compared to Australian beachgoers, international tourists

were significantly less likely to make a correct choice. In contrast,

participants who rated their swimming ability as high were more

likely to make a correct choice.

The analysis showed that only the sample group was a significant

predictor of correct swim choice in the presence of flags (see Table

7). As indicated by odds ratios, compared to Australian beachgoers,

rural inland residents were significantly more likely to make a

correct choice by swimming in the flagged area, and international

tourists showed a trend to be less likely to make the correct choice.

There was also a trend for participants who rated their swimming

ability as high to be less likely to make a correct choice compared

to those with lower ratings of their swimming ability.

DiscussionThe choice of where to swim is a major contributor to safety and

drowning risk on beaches. Swimming in flagged areas is the safest

swimming choice when the beach is patrolled and, where it is not,

being able to identify where rips are located, and choosing to swim

outside the vicinity of a rip, is the safest swimming choice.

The results of this study showed that most participants from all

sample groups were aware of the correct choice in the presence of

flags and chose to swim between the flags. These findings suggest

that the Swim Between the Flags safety message spread by beach

safety organisations like Surf Lifesaving Australia has had a positive

impact on the Australian population. Rural inland residence was the

only significant predictor of swim choice around flags, with these

rural residents more than twice as likely to make the safe choice

of swimming between the flags. This finding is, on the face of it,

somewhat at odds with the conclusions of previous analysis that

showed higher drowning rates for rural and remote area residents.8

The previous analysis differentiated drowning involving rural

residents and drowning in rural and remote locations, but found

that the results were similar as the main location of drowning

for rural residents was close to where they live. The results of

the current study indicate that the higher drowning risk for rural

residents may not be due to lack of awareness of beach safety, but

to the fact that the beaches where they tend to swim are in rural

and remote locations that are not patrolled. Rural residents in our

study were from an inland region, but the rural and remote residents

in the coronial studies probably included a significant proportion

of coastal rural and remote residents who may have different

attitudes and perceptions of beach safety to our rural participants.

Nevertheless, this study showed that rural and remote residents do

not necessarily lack beach safety knowledge. The Beach to Bush

Surf Safety Program conducted by Surf Lifesaving Australia since

2004, while unlikely to have affected the responses of rural residents

in the current study (as the program targets primary schools), may

reinforce and enhance beach safety knowledge in rural areas.

A very different picture was shown for swim choice in the

vicinity of a rip. Fewer than half the Australian beachgoers and

rural residents made the safe or correct choice in this circumstance

and just over half of each group could correctly identify a rip.

International tourists’ responses were even worse. The predictors

of swim choices around a rip were comparatively complex. Unsafe

Table 4: Awareness and knowledge of water safety for sample groups: Australian beachgoers, international tourists and rural residents showing percentages of each group and statistics for comparison.

Australian beachgoers (n=367) n (%)

International tourists (n=73) n (%)

Rural inland residents (n=62) n (%)

Choice of swimming location in presence of rip (%) Incorrect Correct

209 (56.9)158 (43.1)

62 (84.9)11 (15.1)

38 (61.3)24 (38.7)

χ(2)2=20.1

p<0.001

Choice of swimming location in presence of flags (%) Incorrect Correct

124 (33.8)243 (66.2)

31 (42.5)42 (57.5)

11 (17.7)51 (82.3)

χ(2)2=9.57

p<0.008

Accuracy of identification of rip (%) Incorrect Correct

174 (47.7)191 (52.3)

52 (71.2)21 (28.8)

26 (41.9)36 (58.1)

χ(2)2=15.53

p<0.001

Confidence in identification of rip (%) Low (<4) Moderate to high (4-7)

148 (40.3)219 (59.7)

62 (84.9)11 (15.1)

27 (47.2)35 (56.5)

χ(2)2=48.98,

p<0.001

Table 5: Reasons for choice of swim location in the presence of flags for sample groups: Australian beachgoers, international tourists, and rural inland residents showing percentage of each group who made each choice.

Australian beachgoers (n-367) %

International tourists (n=73) %

Rural inland Riesidents (n=62) %

Reasons for choosing to swim between the flagsa Supposed to Safe

35.879.1

59.753.2

39.047.5

Reasons for choosing NOT to swim between flagsa

Supposed to Safe

30.053.4

42.629.8

47.121.6

a Interviewees could indicate both choices, if they wished



Table 6: Results of logistic regression with predictors of study participants’ choice of swim location in the presence of a rip. Predictor variables Coefficient Standard Error Odds Ratio 95% Confidence

Intervalsp value

Age 14-19 years 20-29 years 30-39 years 40-49 years 50-59 years 60 + yearsa

-0.29-1.25-0.97-0.40-0.66

0.540.480.470.450.46

0.750.290.380.670.52

0.26-2.150.11-0.730.15-0.950.28-1.620.21-1.28

0.0160.590.0090.0380.380.16

Gender Male Femalea

-0.44 0.20 0.64 0.43-0.97 0.03

Sample group International tourist Rural inland resident Australian beachgoera

-1.10-0.16

0.380.30

0.330.85

0.16-0.700.47-1.54

0.0140.0030.59

Self-rated swimming abilityb 0.16 0.07 1.17 1.01-1.35 0.03

Self-rated chance of drowningb -0.16 0.08 0.86 0.74-0.99 0.04

a Reference or comparison category

b Rated on a 7-point scale where higher score indicated better swimming ability and higher chance of drowning respectively.Hosmer and Lemeshow test χ2

(8)=2.41, p=0.97

Table 7: Results of logistic regression with predictors of study participants’ choice of swim location in the presence of flags. Predictor variables Coefficient Standard Error Odds Ratio 95% CI p valueAge 14-19 years 20-29 years 30-39 years 40-49 years 50-59 years 60 + yearsa

0.700.290.20

-0.070.07

0.590.490.480.470.49

2.011.331.220.941.07

0.62-6.450.51-3.480.47-3.150.37-2.360.41-2.78

0.620.240.560.680.890.89

Gender Male Femalea

0.26 0.20 1.3 0.87-1.94 0.20

Sample group International tourist Rural inland resident Australian beachgoera

-0.530.81

0.300.36

0.592.25

0.33-1.061.11-4.56

0.0080.080.025

Self-rated swimming abilityb -0.14 0.07 0.87 0.75-1.01 0.06

Self-rated chance of drowningb -0.01 0.08 0.99 0.85-1.14 0.85

a Reference or comparison category

b Rated on a 7-point scale where higher score indicated better swimming ability and higher chance of drowning respectively.Hosmer and Lemeshow test χ2

(8)=6.36, p=0.61

or incorrect choices were more likely to be made by participants

in the 20-39 age group, who were male, who rated their swimming

ability as high and their chance of drowning as low.

The study raises questions about the reasons rural residents and

Australian beachgoers make such different choices about where to

swim in the presence of flags. These two groups do not differ on

the likelihood of making an unsafe choice to swim in a rip, or rip

identification, or in their level of confidence in making this decision.

Rural inland residents do not visit the beach very often; most get to

the beach only a few times a year, at most. In contrast, around half

the Australian beachgoers visited the beach at least once a fortnight.

Beachgoers had considerably higher reporting than rural residents

of having experienced difficulties when swimming at the beach,

especially of being caught in a rip. Yet the two groups did not differ

on estimated swimming ability or distance, but rural residents tended

to rate their chance of drowning when swimming at the beach as

higher and their ability to out-swim a rip as lower than beachgoers.

The influence of these characteristics may be reflected in the

swimming choices of the two groups. It may be that while both

groups have assimilated beach safety education, promoting the

safety of swimming between the flags, higher exposure to the

beach, to swimming outside the flags, and to being caught in a rip

and surviving, may have diluted the safety message for Australian

beachgoers. Rural inland residents who have less opportunity to

test their water safety skills may rely mainly on their beach safety

education when making swimming choices. A number of theories

accounting for the link between attitudes and behaviour provide a

theory-based platform for such an interpretation. Theories such as

Williamson et al.


the Theory of Planned Behaviour14 and the Theory of Self-efficacy15

incorporate the concept of perceived behavioural control as a

determinant of behaviour. Beachgoers who believe they have control

over rip-related hazards for reasons such as higher prior exposure to

rips will be more likely to choose to swim there, despite knowing

that the safest place to swim on the beach is between the flags. Rural

residents without such exposure and experience of rips would not

have the same perceived level of control.

This study provides evidence for some reasons for the higher

representation of international tourists in drowning statistics.

Strikingly, international tourists showed poor knowledge of beach

safety both in identifying a rip in a photograph and in making safe

choices about where to swim in the presence of a rip. Consistent

with this, international tourists had less exposure to the beach and

few had ever needed to be rescued or even experienced difficulties

while in the water compared to Australian participants. The tourists

did not differ from Australian participants on self-rated swimming

ability or the distance they estimated they could swim. International

tourists also did not differ from the rural resident group in terms of

estimated risk of drowning or ability to recover from a rip, as around

40% of both groups estimated that they had a medium to high chance

of drowning and only about one in 10 estimated their ability to swim

out of a rip as high, whereas the majority of Australian beachgoers

thought there was a low chance of them drowning and they were

twice as likely to rate their chance of swimming out of a rip as high.

It should be noted that as the survey was conducted by interviews

in English, the tourist group only included English speakers, who

may have benefited in any safety information available on the

beaches they visited. This may have overestimated the level of

knowledge of international tourists to Australia.

The use of photographs to test respondents’ swim choices in the

presence of rips is a possible limitation of this study. All the elements

of a rip cannot be shown in a two-dimensional, static photograph

which, it could be argued, would make judgments about where to

swim more difficult. However, the photographs clearly showed the

most important elements of calm-water rips and the results revealed

differences between study groups. It could also be argued that rips

may not be perceived as hazardous by experienced beachgoers,

such as surfers and body boarders who use them to their advantage,

and if over-sampled in this study this may have biased the results.

Certainly, the finding of more unsafe swimming choices by male

respondents in their 20s, who are most likely to fit this category,

supports the contention that this group have a different perception

of rips than other beachgoers. There is no evidence, however,

that this group were over-sampled in this study. Participants were

sampled randomly in all locations and males and respondents in

their 20s were not over-represented on unpatrolled beaches where

surfing is allowed.

Importantly, this study provides some targets for effective

interventions to reduce surf drowning. International tourists clearly

lack beach safety knowledge however, unlike Australian beachgoers

and rural residents, they are aware of this lack of knowledge. Very

few international tourists could identify a rip, but almost all rated

their confidence in making this judgment as low. This indicates that

an education-based intervention emphasising safe places to swim

would likely be an effective first step towards reducing drowning

risk for this group. Appropriate interventions for the two Australian

groups are less obvious. Judging from the success of the Swim

Between the Flags messages, providing education on the danger

of swimming in the vicinity of a rip and on the key identifying

characteristics of rips would help address a lack of knowledge

for some people, at least. It is clear, though, that knowing that the

flagged area is safe is not enough to make some beachgoers choose

to swim there. Better swimming skills were associated with safer

rip-related choices, so encouraging swimming skills training may

be an avenue to enhancing safe swim choices. Further research is

needed, however, to fully understand the reasons for beachgoers’

swimming choices around rips. This information can then inform

further interventions to encourage safe swimming choices.

AcknowledgementsThe authors are grateful to Naomi Dunn for her assistance with

data analysis. This project was supported by an Australian Research

Council Linkage grant (LP0774843) with funding partners, Surf

Lifesaving Australia, NSW Health and NSW Department of Sports

and Recreation. Julie Hatfield was supported by an NHMRC

Population Health Capacity Building Grant in Injury Prevention,

Trauma and Rehabilitation; Ann Williamson by an NHMRC Senior

Research Fellowship; and Shauna Sherker by an NHMRC Post

Doctoral Research Fellowship.

References1. Tourism Research Australia. Activities Fact Sheet − Year Ending June 2009.

Canberra (AUST): Department of Resources, Energy and Tourism; 2009.2. Mackie IJ. Patterns of drowning in Australia, 1992-1997. Med J Aust.

1999;171:587-90.3. Morgan D, Ozanne-Smith J, Triggs T. Descriptive epidemiology of drowning

deaths in a surf beach swimmer and surfer population. Inj Prev. 2008;14:62-5.4. Australian Water Safety Council. Australian Water Safety Strategy 2008-2011.

Sydney (AUST): AWSC; 2008.5. Henley G, Harrison JE. Injury Deaths, Australia 2004-2005. Injury Research

and Statistics Series 51. Canberra (AUST): Australian Institute of Health and Welfare; 2009.

6. Walker RM. Dead in the water: How safe are our water sports [editorial]. Med J Aust. 1999;171:584-6.

7. Edmonds CE, Walker DG. Snorkelling deaths in Australia, 1987-1996. Med J Aust. 1999;171:591-4.

8. Franklin RC, Simmonds EL, Peden A, Scarr J. Drowning Deaths − Rural and Remote Australia. Sydney (AUST): Australian Water Safety Council; 2008.

9. Short AD. Australian Rip Systems – Friend or Foe? J Coastal Res. 2007;50:7-11.10. Short AD. Beach hazards and safety. In: Short AD, editor. Beach and Shoreface

Morphodynamics. Chichester (UK): John Wiley & Sons; 1999. p. 292-304. 11. Hartmann D. Drowning and Beach-Safety Measurement (BSM) along the

Mediterranean beaches of Israel − A long-term perspective. J Coastal Res. 2006;22(6):1505-14.

12. Fenner PJ, Harrison SL, Williamson JA, Williamson BD. Success of surf lifesaving resuscitations in Queensland, 1973-1992. Med J Aust. 1995;163(11-12):580-3.

13. Sherker S, Williamson A, Hatfield J, Brander R, Hayen A. Beachgoer’s beliefs and behaviours in relation to beach flags and rip currents. Accid Anal Prev. 2010;42:1785-1804.

14. Ajzen I. Attitudes, Personality and Behavior. 2nd ed. Milton Keynes (UK): Open University Press; 2005.

15. Bandura A. Self-efficacy: Towards a unifying theory of behavior change. Psych Rev. 84:191-215.


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