Drowning

Drowning is a type of suffocation induced by the submersion of the mouth and nose in a liquid. Submersion injury refers to both drowning and near-miss incidents. Most instances of fatal drowning occur alone or in situations where others present are either unaware of the victim's situation or unable to offer assistance. After successful resuscitation, drowning victims may experience breathing problems, confusion, or unconsciousness. Occasionally, victims may not begin experiencing these symptoms until several hours after they are rescued. An incident of drowning can also cause further complications for victims due to low body temperature, aspiration, or acute respiratory distress syndrome (respiratory failure from lung inflammation).

Drowning is more likely to happen when spending extended periods near large bodies of water.[1][2] Risk factors for drowning include alcohol use, drug use, epilepsy, minimal swim training or a complete lack of training, and, in the case of children, a lack of supervision.[2] Common drowning locations include natural and man-made bodies of water, bathtubs, and swimming pools.[3][4]

Drowning occurs when a person spends too much time with their nose and mouth submerged in a liquid to the point of being unable to breathe. If this is not followed by an exit to the surface, low oxygen levels and excess carbon dioxide in the blood trigger a neurological state of breathing emergency, which results in increased physical distress and occasional contractions of the vocal folds.[5] When significant amounts of water enter the lungs, it is most often later in the process, when they irrestistibly force an inhalation.[1][6]

While the word "drowning" is commonly associated with fatal results, drowning may be classified into three different types: drowning that results in death, drowning that results in long-lasting health problems, and drowning that results in no health complications.[7] Sometimes the term "near-drowning" is used in the latter cases. Among children who survive, health problems occur in about 7.5% of cases.[4]

Steps to prevent drowning include teaching children and adults to swim and to recognise unsafe water conditions, never swimming alone, use of personal flotation devices on boats and when swimming in unfavourable conditions, limiting or removing access to water (such as with fencing of swimming pools), and exercising appropriate supervision.[2][8] Treatment of victims who are not breathing should begin with opening the airway and providing five breaths of mouth-to-mouth resuscitation.[4] Cardiopulmonary resuscitation (CPR) is recommended for a person whose heart has stopped beating and has been underwater for less than an hour.[4]

## Contents

* 1 Causes
* 1.1 Risk factors
* 1.2 Freediving
* 2 Pathophysiology
* 2.1 Oxygen deprivation
* 2.2 Water aspiration
* 2.3 Cold-water immersion
* 3 Diagnosis
* 3.1 Forensics
* 4 Prevention
* 5 Water safety
* 6 Time limits
* 7 Management
* 7.1 Rescue
* 7.1.1 Start and rescue methods from the ground
* 7.1.2 Rescue by swimming
* 7.2 First aid
* 7.3 Medical care
* 8 Prognosis
* 8.1 Children
* 8.1.1 Long-term effects of drowning in children
* 8.1.2 Infant risk
* 9 Epidemiology
* 9.1 South Asia
* 9.2 Africa
* 9.3 United States
* 10 Society and culture
* 10.1 Old terminology
* 10.2 Dry drowning
* 10.3 Capital punishment
* 11 Experience
* 12 See also
* 13 References
* 14 External links

## Causes

Children have drowned in buckets and toilets.

A major contributor to drowning is the inability to swim. Other contributing factors include the state of the water itself, distance from a solid footing, physical impairment, or prior loss of consciousness. Anxiety brought on by fear of drowning or water itself can lead to exhaustion, thus increasing the chances of drowning.

Approximately 90% of drownings take place in freshwater (rivers, lakes, and a relatively small number of swimming pools); the remaining 10% take place in seawater.[9] Drownings in other fluids are rare and often related to industrial accidents.[10] In New Zealand's early colonial history, so many settlers died while trying to cross the rivers that drowning was called "the New Zealand death".[11]

Hundreds of people drowned during the fire and sinking of the PS General Slocum in New York City in 1904

People have drowned in as little as 30 mm (1.2 in) of water while lying face down.[12]

Death can occur as a result of complications following an initial drowning. Inhaled fluid can act as an irritant inside the lungs. Even small quantities can cause the extrusion of liquid into the lungs (pulmonary edema) over the following hours; this reduces the ability to exchange the air and can lead to a person "drowning in their own body fluid". Vomit and certain poisonous vapors or gases (as in chemical warfare) can have a similar effect. The reaction can take place up to 72 hours after the initial incident and may lead to a serious injury or death.[13]

### Risk factors

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Many behavioral and physical factors are related to drowning:[14][15]

* Drowning is the most common cause of death for people with seizure disorders, largely in bathtubs. Epileptics are more likely to die due to accidents such as drowning. However, this risk is especially elevated in low and middle-income countries compared to high-income countries.[16]
* The use of alcohol increases the risk of drowning across developed and developing nations. Alcohol is involved in approximately 50% of fatal drownings, and 35% of non-fatal drownings.[17]
* Inability to swim can lead to drowning. Participation in formal swimming lessons can reduce this risk. The optimal age to start the lessons is childhood, between one and four years of age.[18]
* Feeling overly tired reduces swimming performance. This exhaustion can be aggravated by anxious movements motivated by fear during or in anticipation of drowning. An overconfident appraisal of one's own physical capabilities can lead to "swimming out too far" and exhaustion before returning to solid footing.
* Free access to water can be hazardous, especially to young children. Barriers can prevent young children from gaining access to the water.
* Ineffective supervision, since drowning can occur anywhere there is water, even in the presence of lifeguards.
* Risk can vary with location depending on age. Children between one and four more commonly drown in home swimming pools than elsewhere. Drownings in natural water settings increase with age. More than half of drownings occurring among those fifteen years and older occurred in natural water environments.[18]
* Familial or genetic history of sudden cardiac arrest (SCA) or sudden cardiac death (SCD) can predispose children to drown.[19] Extensive genetic testing and/or consultation with a cardiologist should be done when there is a high suspicion of familial history and/or clinical evidence of sudden cardiac arrest or sudden cardiac death.
* Individuals with undetected primary cardiac arrhythmias, as cold water immersion or aquatic exercise can induce these arrhythmias to occur.[20]

Population groups at risk in the US are the old and the young.[14]

* Youth: drowning rates are highest for children under five years of age and people fifteen to twenty-four years of age.
* Minorities: the fatal unintentional drowning rate for African Americans above the age of 29 between 1999 and 2010 was statistically significantly higher than that of white people above the age of 29.[21] The fatal drowning rate of African American children of ages from five to fourteen is almost three times that of white children in the same age range and 5.5 times higher in swimming pools. These disparities might be associated with a lack of basic swimming education in some minority populations.

### Freediving

Some additional causes of drowning can also happen during freediving activities:

* Ascent blackout, also called deep water blackout, is caused by hypoxia during ascent from depth. The partial pressure of oxygen in the lungs under pressure at the bottom of a deep free dive is adequate to support consciousness, but drops below the blackout threshold as the water pressure decreases on the ascent. It usually occurs when arriving near the surface as the pressure approaches normal atmospheric pressure.[22]
* Shallow water blackout caused by hyperventilation prior to swimming or diving. The primary urge to breathe is triggered by rising carbon dioxide (CO
2) levels in the bloodstream.[23] The body detects CO
2 levels accurately and relies on this to control breathing.[23] Hyperventilation reduces the carbon dioxide content of the blood but leaves the diver susceptible to a sudden loss of consciousness without warning from hypoxia. There is no bodily sensation that warns a diver of an impending blackout, and people (often capable swimmers swimming under the surface in shallow water) become unconscious and drown quietly without alerting anyone to the fact that there is a problem. They are typically found at the bottom.

## Pathophysiology

Drowning is split into four stages:[24]

1. Breath-hold under voluntary control until the urge to breathe due to hypercapnia becomes overwhelming
2. Fluid is swallowed and/or aspirated into the airways
3. Cerebral anoxia stops breathing and aspiration
4. Cerebral injury due to anoxia becomes irreversible

People who do not know how to swim can struggle on the surface of the water for only 20 to 60 seconds before being submerged.[25] In the early stages of drowning, a person holds their breath to prevent water from entering their lungs.[4] When this is no longer possible, a small amount of water entering the trachea causes a muscular spasm that seals the airway and prevents further passage of water.[4] If the process is not interrupted, loss of consciousness due to hypoxia is followed by cardiac arrest.

### Oxygen deprivation

A conscious person will hold their breath (see: Apnea) and will try to access air, often resulting in panic, including rapid body movement. This uses up more oxygen in the bloodstream and reduces the time until unconsciousness. The person can voluntarily hold their breath for some time, but the breathing reflex will increase until the person does try to breathe, even when submerged.[26]

The breathing reflex in the human body is weakly related to the amount of oxygen in the blood but strongly related to the amount of carbon dioxide (see: Hypercapnia). During an apnea, the oxygen in the body is used by the cells and excreted as carbon dioxide. Thus, the level of oxygen in the blood decreases, and the level of carbon dioxide increases. Increasing carbon dioxide levels lead to a stronger and stronger breathing reflex, up to the breath-hold breakpoint, at which the person can no longer voluntarily hold their breath. This typically occurs at an arterial partial pressure of carbon dioxide of 55 mm Hg but may differ significantly between people.

When the body is submerged into cold water, breath-holding time is significantly shorter than that in air due to the cold shock response.[27] The breath-hold breakpoint can be suppressed or delayed, either intentionally or unintentionally. Hyperventilation before any dive, deep or shallow, flushes out carbon dioxide in the blood, resulting in a dive commencing with an abnormally low carbon dioxide level: a potentially dangerous condition known as hypocapnia. The level of carbon dioxide in the blood after hyperventilation may then be insufficient to trigger the breathing reflex later in the dive.

Following this, a blackout may occur before the diver feels an urgent need to breathe. This can occur at any depth and is common in distance breath-hold divers in swimming pools. Both deep and distance free divers often use hyperventilation to flush out carbon dioxide from the lungs to suppress the breathing reflex for longer. It is important not to mistake this for an attempt to increase the body's oxygen store. The body at rest is fully oxygenated by normal breathing and cannot take on any more. Breath-holding in water should always be supervised by a second person, as by hyperventilating, one increases the risk of shallow water blackout because insufficient carbon dioxide levels in the blood fail to trigger the breathing reflex.[28]

A continued lack of oxygen in the brain, hypoxia, will quickly render a person unconscious, usually around a blood partial pressure of oxygen of 25–30 mmHg.[28] In some instances, laryngospasm closes the airways, and the drowning victim is found to have gone into cardiac arrest as a result of asphyxiation without inhaling water;[29] an unconscious person rescued with a sealed airway stands a good chance of a full recovery. Artificial respiration is also much more effective without water in the lungs. At this point, the person stands a good chance of recovery if attended to within minutes.[28] More than 10% of drownings may involve laryngospasm, but the evidence suggests that it is not usually effective at preventing water from entering the trachea. The lack of water found in the lungs during autopsy does not necessarily mean there was no water at the time of drowning, as small amounts of freshwater are absorbed into the bloodstream. Hypercapnia and hypoxia both contribute to laryngeal relaxation, after which the airway is open through the trachea. There is also bronchospasm and mucous production in the bronchi associated with laryngospasm, and these may prevent water entry at terminal relaxation.[5]

The hypoxemia and acidosis caused by asphyxia in drowning affect various organs. There can be central nervous system damage, cardiac arrhythmia, pulmonary injury, reperfusion injury, and multiple-organ secondary injury with prolonged tissue hypoxia.[30]

A lack of oxygen or chemical changes in the lungs may cause the heart to stop beating. This cardiac arrest stops the flow of blood and thus stops the transport of oxygen to the brain. Cardiac arrest used to be the traditional point of death, but at this point, there is still a chance of recovery. The brain cannot survive long without oxygen, and the continued lack of oxygen in the blood, combined with the cardiac arrest, will lead to the deterioration of brain cells, causing first brain damage and eventually brain death after six minutes from which recovery is generally considered impossible. Hypothermia of the central nervous system may prolong this. In cold temperatures below 6 °C, the brain may be cooled sufficiently to allow for a survival time of more than an hour.[31][32]

The extent of central nervous system injury, to a large extent, determines the survival and long-term consequences of drowning. In the case of children, most survivors are found within 2 minutes of immersion, and most fatalities are found after 10 minutes or more.[30]

### Water aspiration

If water enters the airways of a conscious person, the person will try to cough up the water or swallow it, often inhaling more water involuntarily.[33] When water enters the larynx or trachea, both conscious and unconscious people experience laryngospasm, in which the vocal cords constrict, sealing the airway. This prevents water from entering the lungs. Because of this laryngospasm, in the initial phase of drowning, water enters the stomach, and very little water enters the lungs. Though laryngospasm prevents water from entering the lungs, it also interferes with breathing. In most people, the laryngospasm relaxes sometime after unconsciousness due to hypoxia in the larynx, and water can then enter the lungs, causing a "wet drowning". However, about 7–10% of people maintain this seal until cardiac arrest.[26] This has been called "dry drowning", as no water enters the lungs. In forensic pathology, water in the lungs indicates that the person was still alive at the point of submersion. An absence of water in the lungs may be either a dry drowning or indicates a death before submersion.[34]

Aspirated water that reaches the alveoli destroys the pulmonary surfactant, which causes pulmonary edema and decreased lung compliance, compromising oxygenation in affected parts of the lungs. This is associated with metabolic acidosis, secondary fluid, and electrolyte shifts. During alveolar fluid exchange, diatoms present in the water may pass through the alveolar wall into the capillaries to be carried to internal organs. The presence of these diatoms may be diagnostic of drowning.

Of people who have survived drowning, almost one-third will experience complications such as acute lung injury (ALI) or acute respiratory distress syndrome (ARDS).[35] ALI/ARDS can be triggered by pneumonia, sepsis, and water aspiration. These conditions are life-threatening disorders that can result in death if not treated promptly.[35] During drowning, aspirated water enters the lung tissues, causes a reduction in pulmonary surfactant, obstructs ventilation, and triggers a release of inflammatory mediators which results in hypoxia.[35] Specifically, upon reaching the alveoli, hypotonic liquid found in freshwater dilutes pulmonary surfactant, destroying the substance.[36] Comparatively, aspiration of hypertonic seawater draws liquid from the plasma into the alveoli and similarly causes damage to surfactant by disrupting the alveolar-capillary membrane.[36] Still, there is no clinical difference between salt and freshwater drowning. Once someone has reached definitive care, supportive care strategies such as mechanical ventilation can help to reduce the complications of ALI/ARDS.[35]

Whether a person drowns in freshwater or salt water makes no difference in respiratory management or its outcome.[37] People who drown in freshwater may experience worse hypoxemia early in their treatment; however, this initial difference is short-lived.[37]

### Cold-water immersion

Submerging the face in water cooler than about 21 °C (70 °F) triggers the diving reflex, common to air-breathing vertebrates, especially marine mammals such as whales and seals. This reflex protects the body by putting it into energy-saving mode to maximise the time it can stay underwater. The strength of this reflex is greater in colder water and has three principal effects:[38]

* Bradycardia, a slowing of the heart rate to less than 60 beats per minute.[39]
* Peripheral vasoconstriction, the restriction of the blood flow to the extremities to increase the blood and oxygen supply to the vital organs, especially the brain.
* Blood shift, the shifting of blood to the thoracic cavity, the region of the chest between the diaphragm and the neck, to avoid the collapse of the lungs under higher pressure during deeper dives.

The reflex action is automatic and allows both a conscious and an unconscious person to survive longer without oxygen underwater than in a comparable situation on dry land. The exact mechanism for this effect has been debated and may be a result of brain cooling similar to the protective effects seen in people who are treated with deep hypothermia.[40][41]

The actual cause of death in cold or very cold water is usually lethal bodily reactions to increased heat loss and to freezing water, rather than any loss of core body temperature. Of those who die after plunging into freezing seas, around 20% die within 2 minutes from cold shock (uncontrolled rapid breathing and gasping causing water inhalation, a massive increase in blood pressure and cardiac strain leading to cardiac arrest, and panic), another 50% die within 15 – 30 minutes from cold incapacitation (loss of use and control of limbs and hands for swimming or gripping, as the body 'protectively' shuts down the peripheral muscles of the limbs to protect its core),[42] and exhaustion and unconsciousness cause drowning, claiming the rest within a similar time.[43] A notable example of this occurred during the sinking of the Titanic, in which most people who entered the −2 °C (28 °F) water died within 15–30 minutes.[44]

> [S]omething that almost no one in the maritime industry understands. That includes mariners [and] even many (most) rescue professionals: It is impossible to die from hypothermia in cold water unless you are wearing flotation, because without flotation – you won't live long enough to become hypothermic.

— Mario Vittone, lecturer and author in water rescue and survival[42]

Submersion into cold water can induce cardiac arrhythmias (abnormal heart rates) in healthy people, sometimes causing strong swimmers to drown.[45] The physiological effects caused by the diving reflex conflict with the body's cold shock response, which includes a gasp and uncontrollable hyperventilation leading to aspiration of water.[46] While breath-holding triggers a slower heart rate, cold shock activates tachycardia, an increase in heart rate.[45] It is thought that this conflict of these nervous system responses may account for the arrhythmias of cold water submersion.[45]

Heat transfers very well into water, and body heat is therefore lost quickly in water compared to air,[47] even in 'cool' swimming waters around 70 °F (~20 °C).[43] A water temperature of 10 °C (50 °F) can lead to death in as little as one hour, and water temperatures hovering at freezing can lead to death in as little as 15 minutes.[43] This is because cold water can have other lethal effects on the body. Hence, hypothermia is not usually a reason for drowning or the clinical cause of death for those who drown in cold water.

Upon submersion into cold water, remaining calm and preventing loss of body heat is paramount.[48] While awaiting rescue, swimming or treading water should be limited to conserve energy, and the person should attempt to remove as much of the body from the water as possible; attaching oneself to a buoyant object can improve the chance of survival should unconsciousness occur.[48]

Most people who experience cold-water drowning do not develop hypothermia quickly enough to decrease cerebral metabolism before ischemia and irreversible hypoxia occur. The neuroprotective effects appear to require water temperatures below about 5 °C (41 °F).[49]

## Diagnosis

The World Health Organization in 2005 defined drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid."[7] This definition does not imply death or even the necessity for medical treatment after removing the cause, nor that any fluid enters the lungs. The WHO classifies this as death, morbidity, and no morbidity.[7] There was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used.[7]

Experts differentiate between distress and drowning. * Distress – people in trouble, but who can still float, signal for help, and take action.

* Drowning – people suffocating and in imminent danger of death within seconds.

### Forensics

Drowning would be considered a possible cause of death if the body was recovered from a body of water, near a fluid that could plausibly have caused drowning, or found with the head immersed in a fluid. A medical diagnosis of death by drowning is generally made after other possible causes of death have been excluded by a complete autopsy and toxicology tests. Indications of drowning are unambiguous and may include bloody froth in the airway, water in the stomach, cerebral edema and petrous or mastoid hemorrhage. Some evidence of immersion may be unrelated to the cause of death, and lacerations and abrasions may have occurred before or after immersion or death.[24]

Diatoms should normally never be present in human tissue unless water was aspirated. Their presence in tissues such as bone marrow suggests drowning; however, they are present in soil and the atmosphere, and samples may be contaminated. An absence of diatoms does not rule out drowning, as they are not always present in water.[24] A match of diatom shells to those found in the water may provide supporting evidence of the place of death. Drowning in saltwater can leave different concentrations of sodium and chloride ions in the left and right chambers of the heart, but they will dissipate if the person survived for some time after the aspiration, or if CPR was attempted,[24] and have been described in other causes of death.{{Citation needed|date=December 2019|reason=removing citation to content from predatory publisher}

## Prevention

This 1825 newspaper article explains how keeping limbs beneath the water surface provides buoyancy, and describes treading water.[50]

It is estimated that more than 85% of drownings could be prevented by supervision, training in water skills, technology, and public education. Measures that help to prevent drowning include the following:[51][33]

* Learning to swim: Being able to swim is one of the best defences against drowning. It is recommended that children learn to swim in a safe and supervised environment when they are between 1 and 4 years old, but learning to swim is recommended at any age.
* Surveillance: The surveillance of swimmers, especially children, is essential, because drownings may be silent and go unnoticed. A drowning person may be unable to wave, shout or even speak, and remain below the surface or unconscious. The highest rates of drowning globally are among children under five years-old.[52] People who already know how to swim could need certain surveillance too.[53] Many pools and bathing areas have lifeguards or a drowning detection system, and local legislation may require surveillance methods.[54] Non-professional bystanders are important in detecting and notifying drownings.[55] Lifeguards can be called by mobile phone in many cases. Evidence shows that alarms in pools are unreliable.[4] The World Health Organization recommends that the most crowded hours be addressed by increasing the number of lifeguards at those times.

A prevention-of-drowning campaign in Ghana

* Education and awareness: The WHO recommends wide training of the public in first aid, including cardiopulmonary resuscitation (CPR), and to behave safely in the water. Swimmers need to understand how to swim within their own abilities with regard to currents, depth, temperature or waves, and to be informed of the state of the sea. Even good swimmers may drown due to hazardous water conditions and other circumstances, so it is recommended that everyone learns how to select safe places to swim that have surveillance, to understand the local conditions, and to follow the rules. Many people who drown fail to follow the local safety guidelines or pay attention to signs indicating swimming restrictions and lifeguard duties.
* Shallow water and obstructions: Local conditions may include shallow water and obstructions. It is not prudent to jump into the water without knowing the depth, especially if entering head-first.[56] Between 1.2% and 22% of all spinal injuries are from accidents diving into shallow water or hitting hidden obstructions such as submerged trees. Up to 21% of shallow-water diving accidents cause spinal injury, risking permanent paralysis, or death.[57]
* Alcohol and drugs: Alcohol and drugs increase the risk of drowning, and this risk increases for bars near water and parties on boats. For example, Finland sees several alcohol-implicated drownings every year at the Midsummer weekend as Finns celebrate in and around lakes and beaches.[58][59][60]Lifejacket
* Anxiety and panic in water: The anxious movements produced by fear during drowning can render swimmers exhausted. Additionally, underestimating one's own stamina can cause a situation in which the swimmer finds themselves too exhausted to exit the water.[61] Reducing the rhythm of swimming can mitigate the chances of suffering a cramp or contracture (muscle spasm),[62] it is recommended to keep calm, move towards the shore (or pool's border), and ask for help if necessary. The stings of forms of marine life can also produce panic, but after receiving a sting of most types, it is possible to get out of the water without serious problems, even if some pain appears. For most swimming problems, it can be useful to assume a horizontal position in the water, facing up, because it can reduce the effort required to float.
* Awareness of medical conditions: Some medical conditions, such as epilepsy, syncope, cramps or seizures, demand caution when in water, or near water. They may require controlled conditions for swimming (and even washing)[63] and a good understanding of the individual's limitations.[64]
* State of the water: It is recommended to be aware of turbulences, dangerous waves, undertow, wind and weather conditions, dangerous animals, and water temperature. Currents of water (as river currents and sea rip currents) can carry the swimmers away with great force, so authorities in safety often recommend to the users of swimming areas avoiding useless efforts in the opposite direction, but, instead, taking some advantage of the current direction while swimming or floating outwards.[65][66]Lifebuoy on a boat
* Safety equipment: All boats and pools must be equipped with adequate safety equipment, such as lifejackets or lifebuoys; often this is a regulatory requirement. Any recreational activity on a boat or near water requires that a lifejacket be worn, especially by children who cannot swim and others at risk of drowning. Lifejackets must be well-fitting and properly fastened, and their wearers must understand that they have to jump into water with one of them, and use it by fastening the strap properly and grabbing the front neck area with both hands. Emergency flotation equipment, such as a circular lifebuoy, can be thrown to the swimmer if available, but, if not, any other flotation device, including inner tubes, water wings or foam tubes, can be used.[51]
* Navigation safety: Navigation accidents are a cause of drowning that can be prevented[67] staying informed about the state of the sea, having the proper safety instruments (especially lifejackets on board, as mentioned before) and with any other advisable measure that can be applied.[68]
* Rescue robots and drones: Remote-controlled devices may assist a water rescue. Floating rescue robots can navigate to the victim to hold on to and even help to recover them. Aerial drones are fast, can help locate victims, and even drop life jackets.[69][70]
* Swimming in pairs ("buddy system"): Pairing up swimmers, so they keep surveillance of each other, and are available to help in case of any problem (because of a purpose of safety, not for competitive reasons).[71]
* Drain hole in a poolPool fencing: Every private and public swimming pool should be fully fenced, with child-proof latches on the gates.[72] Many countries, including most Australian states since 1998 and France since 2003, require the fencing of pools.[73] Objects (such as toys and others) can attract children to the water.
* Pool drains: Swimming pools may have filtration systems that circulate the water. Filtration drains without covers, or too strong, can injure swimmers by trapping hair or other parts of the body, leading to immobilization and drowning.[74] Many small drainage holes are usually preferred to a single large one. Periodic inspections can check that the system is safe.
* Paying heed to warning signs, flags and advices: Because they indicate the safety of swimming and warn about any danger.[53][75]

## Water safety

The concept of water safety involves the procedures and policies that are directed to prevent people from drowning or from becoming injured in water.[76]

## Time limits

The time a person can safely stay underwater depends on many factors, including energy consumption, number of prior breaths, physical condition, and age. An average person can last between one and three minutes before falling unconscious[30] and around ten minutes before dying.[77][30][31] In an unusual case with the best conditions, a person was resuscitated after 65 minutes underwater.[78]

## Management

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### Rescue

When a person is drowning or a swimmer becomes missing, a fast water rescue may become necessary, to take that person out of the water as soon as possible. Drowning is not necessarily violent or loud, with splashing and cries; it can be silent.[79]

#### Start and rescue methods from the ground

Advice given to would-be rescuers of a drowning victim

Rescuers should avoid endangering themselves unnecessarily; whenever it is possible, they should assist from a safe ground position,[33] such as a boat, a pier, or any patch of land near the victim. The fastest way to assist is to throw a buoyant object (such as a lifebuoy or a broad branch). It is very important to avoid aiming directly at the victim, since even the lightest lifebuoys weight over 2 kilograms, and can stun, injure or even render a person unconscious if they impact on the head.[80] Another way to assist is to reach the victim with an object to grasp, and then pull both of them out of the water. Some examples include: ropes, oars, broad branches, poles, one's own arm, a hand, etc. This carries the risk of the rescuer being pulled into the water by the victim, so the rescuer must take a firm stand, lying down, as well as securing to some stable point. Any rescue with vehicles would have to avoid trampling or damaging the victim in another manner. Also, there are modern flying drones that can drop life jackets.

Bystanders should immediately call for help. A lifeguard should be called, if present. If not, an emergency telephone number should be contacted as soon as possible, to get the help of professionals and paramedics. In some cases of drowning, victims have been rescued by professionals from a boat or a helicopter. Less than 6% of people rescued by lifeguards need medical attention, and only 0.5% need CPR. The statistics worsen when rescues are made by bystanders .

If lifeguards or paramedics are unable to be called, bystanders must rescue the drowning person. It can be done using vehicles that the victim can reach, as rowboats or even modern robots, when they navigate across the water.

#### Rescue by swimming

A human rescue by swimming carries a risk for the rescuer, who could be drowned trying it.[81][82][83] Death of the would-be rescuer can happen because of the water conditions, the instinctive drowning response of the victim, the physical effort, and other problems.

Water rescue simulation. After controlling the position of a victim (most dangerous part when the victim is anxious), the rescuer tows him from behind. It is recommended to carry a flotation object for making the rescue easier.

First contact and gripping

In a swimming intervention, it is recommended to carry a floating object that makes the rescue easier. That is especially important at the moment when the rescuer reaches the victim's area, because a drowning person in distress could cling to the rescuer in an attempt to stay above the water surface, which could sink both of them. In more affordable situations, the victim is exhausted, or has suffered a cramp, and stays calmer or fainted. But, in the worst cases, the victim will be anxious and with vigor. Then, the rescuer can approach the panicking person offering an object for flotation (as a rescue buoy), or any other, or even a hand, so the victim has something to grasp. In other situations, an expert rescuer could take one of the victim's arms and press it against the victim's back to restrict unnecessary movement. Communication is also important for coordination and allowing the rescue maneuvers.

If the victim clings to the rescuer, and there is not any flotation object, and the rescuer cannot control the situation (by simple communication, or by immobilizing, or by getting rid of the victim), a possibility is to dive underwater (as drowning people tend to move in the opposite direction, seeking the water surface) and consider a different approach to help the drowning victim.

Ascending an already sunk victim to the water surface

'Head splint' grip: victim's arms are grabbed between elbows and shoulders and pressed around the victims' ears. Many rescuers use it to hold the neck position of victims of spinal injury while carrying them to the water surface with a diagonal dive. Some injured victims can cling dangerously to the rescuer.

Sometimes, the victim is already sunk beneath the water surface. If this has happened, the rescue requires caution, as the victim could be conscious and cling to the rescuer underwater desperately. Victims with suspected serious spinal injuries (which limit the movements) would need special care and specific grips to be ascended properly.

In the best of cases, the sunk victim is unconscious, floating shallowly under the water surface, and can be lifted to the surface by grabbing either (or both) of the victim's arms and swimming, which pulls forward and upward, making the task easier (and enticing the victim to move). After reaching the water surface, a victim will always have to be placed in a face-up horizontal position, or at least in any other position with nose and mouth above the water, to be towed to firm ground.

When a victim is located deeper underwater, the rescuer should dive, take the victim from behind, and ascend vertically to the water surface holding the victim.

Moving a victim out of the water by towing

After a successful first physical contact with the victim (usually the most dangerous part, because victims can cling anxiously to the rescuers), the victim must be taken out of the water to a firm ground. This is achieved by a towing maneuver. It would be commonly a 'supporting tow': placing the victim body in a face-up horizontal position, and passing one hand under the victim's armpit to then grab the jaw with it, and towing by swimming backwards. The victim's mouth and nose must be kept above the water surface.

If the person is cooperative, the towing may be done in a similar fashion with the hands going under the victim's armpits. Other styles of towing are possible, but all of them keeping the victim's mouth and nose above the water.

Unconscious people may be pulled in an easier way: pulling on a wrist, or on the neck area of the shirt, while they are in a face-up horizontal position. Victims with suspected spinal injuries can require a more specific grip, and special care for their management, and a backboard (spinal board) may be needed for their rescue.[84]

For unconscious people, an in-water resuscitation could increase the chances of survival by a factor of about three, but this procedure requires both medical and swimming skills, and it becomes impractical to send anyone besides the rescuer to execute that task. Chest compressions require a suitable platform, so an in-water assessment of circulation is pointless. If the person does not respond after a few breaths, cardiac arrest may be assumed, and getting them out of the water becomes a priority.[33]

### First aid

Traditional medical method to expel water from the lungs in victims of drowning, currently inhabitual.

The checks for responsiveness and breathing are carried out with the person lying in a horizontally supine position (face up).

The traditional medical treatment for the drowned started expelling water from their lungs, tilting the victim face down (see drawing at right).[85] However, handling the weight of the body could cost time and efforts in some cases, especially in victims with spinal injury (at the neck or the back) that affected their mobility, which requires special care.

If the victim is unconscious, but breathing, the recovery position is appropriate (laying on a side, usually the right, the left is recommended in women since ​7 1⁄2 months of pregnancy approximately).[86]

Rescue breaths

If the victim is not breathing, rescue ventilation is necessary. In cases when drowning produces a gasping pattern of apnea while the heart is still beating, ventilation alone could be sufficient. But in the cases when ventilation is not enough, a complete cardiopulmonary resuscitation (CPR) should be used. Guides for victims of drowning indicate calling to an emergency telephone number if not yet done; a rescuer alone with the victim would do it after two minutes of cardiopulmonary resuscitation (CPR).

The cardiopulmonary resuscitation (CPR) would follow an 'airway-breathing-circulation' ('ABC') sequence, starting with rescue breaths rather than with compressions as it is typical in cardiac arrest,[87] because the problem is the lack of oxygen.

For a not-breathing adult or child (someone bigger than a baby), patient's head would be tilted back, to improve the rescue breaths. It is recommended to start the cardiopulmonary resuscitation (CPR) with 2 initial rescue breaths, because of the lack of oxygen[88] and the possibility of water in the airway; the rescue breaths are made by pinching the victim's nose and blowing air mouth-to-mouth, not excessively.[89] Next, it is applied a continual alternation of 30 chest compressions (pressing on the lower half of the sternum, the vertical bone of the middle of the chest) and 2 rescue breaths (in the same manner that the initial ones). This alternation is repeated until vital signs are re-established, the rescuers are unable to continue, or emergency medical services arrive.[33] Additionally, an amount of victims of drowning may have suffered a type of cardiorespiratory arrest that requires a defibrillator (AED) to correct it (read further below).

Chest compressions (proper rhythm)

For not-breathing babies (very small sized infants), the procedure is the same than above but slightly modified: the baby's head is not tilted back, but left straight, looking forward, which is necessary for the rescue breaths, because of the neck's size in babies.[90] In each series of 2 rescue breaths (and the 2 initial breaths), the rescuer's mouth covers the baby's mouth and nose simultaneously (because a baby's face is too small). And, in the intercalated series of 30 chest compressions, they are also applied by pressing on the lower half of the sternum, the vertical bone of the middle of the chest, but with only two fingers (because the body of the baby being more fragile). Additionally, some infants may have suffered a type of cardiorespiratory arrest that requires a defibrillator (AED) to correct it (read below).

Defibrillators (AED) can be found in many public places. They produce a defibrillation (electric shocks) that can restore the pulse of a victim. Anyway, they would only work in some specific cases. Defibrillators are easy to use, as they emit their instructions with voice messages. Before trying a defibrillation, the victim and the rescuer must be out of the water, and the victim's body must be dried. If the body of the victim is extremely cold, it would have to be warmed to improve defibrillation.[91]

Methods to expel water from the airway such as abdominal thrusts (Heimlich maneuver) or positioning the head downwards, should be avoided, due to there being no obstruction by solids, and they delay the start of ventilation, and increase the risk of vomiting. The risk of death is increased, as the aspiration of stomach contents is a common complication of the resuscitation efforts.[33][92]

Treatment for hypothermia may also be necessary. However, in those who are unconscious, it is recommended their temperature not be increased above 34 degrees C.[93] Because of the diving reflex, people submerged in cold water and apparently drowned may revive after a long period of immersion.[94] Rescuers retrieving a child from water significantly below body temperature should attempt resuscitation even after protracted immersion.[94]

### Medical care

People with a near-drowning experience who have normal oxygen levels and no respiratory symptoms should be observed in a hospital environment for a period of time to ensure there are no delayed complications.[95] The target of ventilation is to achieve 92% to 96% arterial saturation and adequate chest rise. Positive end-expiratory pressure will improve oxygenation. Drug administration via peripheral veins is preferred over endotracheal administration. Hypotension remaining after oxygenation may be treated by rapid crystalloid infusion.[33] Cardiac arrest in drowning usually presents as asystole or pulseless electrical activity. Ventricular fibrillation is more likely to be associated with complications of pre-existing coronary artery disease, severe hypothermia, or the use of epinephrine or norepinephrine.[33]

While surfactant may be used, no high-quality evidence exist that looks at this practice.[3] Extracorporeal membrane oxygenation may be used in those who cannot be oxygenated otherwise.[3] Steroids are not recommended.[3]

## Prognosis

Drowning outcomes (after hospital treatment)

Duration of submersion  | Risk of death or poor outcomes[33]
0–5 min  | 10%
6–10 min  | 56%
11–25 min  | 88%
>25 min  | nearly 100%
Signs of brain-stem injury predict death or severe neurological consequences

People who have drowned who arrive at a hospital with spontaneous circulation and breathing usually recover with good outcomes.[94] Early provision of basic and advanced life support improve the probability of a positive outcome.[33]

A longer duration of submersion is associated with a lower probability of survival and a higher probability of permanent neurological damage.[94]

Contaminants in the water can cause bronchospasm and impaired gas exchange and can cause secondary infection with delayed severe respiratory compromise.[94]

Low water temperature can cause ventricular fibrillation, but hypothermia during immersion can also slow the metabolism, allowing longer hypoxia before severe damage occurs.[94] Hypothermia that reduces brain temperature significantly can improve the outcome. A reduction of brain temperature by 10 °C decreases ATP consumption by approximately 50%, which can double the time the brain can survive.[33]

The younger the person, the better the chances of survival.[94] In one case, a child submerged in cold (37 °F (3 °C)) water for 66 minutes was resuscitated without apparent neurological damage.[94] However, over the long term significant deficits were noted, including a range of cognitive difficulties, particularly general memory impairment, although recent magnetic resonance imaging (MRI) and magnetoencephalography (MEG) were within normal range.[96]

### Children

Drowning is a major worldwide cause of death and injury in children. An estimate of about 20% of non-fatal drowning victims may result in varying degrees of ischemic and/or hypoxic brain injury. Hypoxic injuries refers to a lack or absence of oxygen in certain organs or tissues. Ischemic injuries on the other hand refers inadequate blood supply to certain organs or part of the body. These injuries can lead to an increased risk of long-term morbidity.[97] Prolonged hypothermia and hypoxemia from nonfatal submersion drowning can result in cardiac dysrhythmias such as ventricular fibrillation, sinus bradycardia, or atrial fibrillation.[98] Long-term neurological outcomes of drowning cannot be predicted accurately during the early stages of treatment. Although survival after long submersion times, mostly by young children, has been reported, many survivors will remain severely and permanently neurologically compromised after much shorter submersion times. Factors affecting the probability of long-term recovery with mild deficits or full function in young children include the duration of submersion, whether advanced life support was needed at the accident site, the duration of cardiopulmonary resuscitation, and whether spontaneous breathing and circulation are present on arrival at the emergency room.[99] Prolonged submersion in water for more than 5–10 minutes usually leads to poorer prognosis.[100]

Data on the long-term outcome are scarce and unreliable. Neurological examination at the time of discharge from the hospital does not accurately predict long-term outcomes. Some people with severe brain injury who were transferred to other institutions died months or years after the drowning and are recorded as survivors. Nonfatal drownings have been estimated as two-to-four times more frequent than fatal drownings.[99]

#### Long-term effects of drowning in children

Long-term effects of nonfatal drowning include damage to major organs such as the brain, lungs, and kidneys. Prolonged submersion time is attributed to hypoxic ischemic brain injury in susceptible areas of the brain such as the hippocampus, insular cortex, and/or basal ganglia. Severity in hypoxic ischemic damage of these brain structures corresponds to the severity in global damage to areas of the cerebral cortex.[101] The cerebral cortex is a brain structure that is responsible for language, memory, learning, emotion, intelligence, and personality.[102] Global damage to the cerebral cortex can affect one or more of its primary function. Treatment of pulmonary complication from drowning is dependent on the amount of lung injury that occurred during the incident. These lung injuries can be contributed by water aspiration and also irritants present in the water such as microbial pathogens leading to complications such as lung infection that can develop in adult respiratory disease syndrome later on in life.[103] Some literature suggests that occurrences of drowning can lead to acute kidney injury from lack of blood flow and oxygenation due to shock and global hypoxia. These kidney injury can cause irreversible damage to the kidneys and may require long-term treatment such as renal replacement therapy.[104]

#### Infant risk

Children are overrepresented in drowning statistics, with children aged 0–4 years old having the highest number of deaths due to unintentional drowning.[105] In 2019 alone, 32,070 children between the ages of 1 and 4 years died as a result of unintentional drowning, equating to an age-adjusted fatality of 6.04 per 100,000 children.[105] Infants are particularly vulnerable because while their mobility develops quickly, their perception concerning their ability for locomotion between surfaces develops slower.[105] An infant can have full control of their movements, but will not recognize that water does not provide the same support for crawling as hardwood floors would. An infant's capacity for movement needs to be met with an appropriate perception of surfaces of support (and avoidance of surfaces that do not support locomotion) to avoid drowning.[105] By crawling and interacting with their environment, infants learn to distinguish surfaces offering support for locomotion from those that do not, and their perception of surface characteristics will improve, as well as their perception of falls risk, over several weeks.[105]

## Epidemiology

In 2019, roughly 236,000 people died from drowning, thereby causing it to be the third leading cause of unintentional death globally, trailing traffic injuries and falls.[106][107]

In many countries, drowning is one of the main causes of preventable death for children under 12 years old. In the United States in 2006, 1100 people under 20 years of age died from drowning.[108] The United Kingdom has 450 drownings per year, or 1 per 150,000, whereas in the United States, there are about 6,500 drownings yearly, around 1 per 50,000. In Asia suffocation and drowning were the leading causes of preventable death for children under five years of age;[109][110] a 2008 report by UNICEF found that in Bangladesh, for instance, 46 children drown each day.[111]

Due to a generally increased likelihood for risk-taking, males are four times more likely to have submersion injuries.[112]

In the fishing industry, the largest group of drownings is associated with vessel disasters in bad weather, followed by man-overboard incidents and boarding accidents at night, either in foreign ports or under the influence of alcohol.[112] Scuba diving deaths are estimated at 700 to 800 per year, associated with inadequate training and experience, exhaustion, panic, carelessness, and barotrauma.[112]

Template:Owidslider

Template:Owidslider

### South Asia

Deaths due to drowning is high in the South Asian region with India, China, Pakistan and Bangladesh accounting for up to 52% of the global deaths.[113] Death due to drowning is known to be high in the Sundarbans region in West Bengal and in Bihar.[114][115]

According to the Daily Times in rural Pakistan, boats are the preferred mode of transport where available. Due to the influence of female modesty culture in Pakistan, women are not encouraged to swim.[116]

In the Iranian Sistan province there have been numerous instances of children dying in hootak water holes.[117][118][119]

### Africa

In lower-income countries, cases of drowning and deaths caused by drowning are under reported and data collection is limited.[120] Many low-income countries in Africa have the highest rates of drowning, with incidence rates calculated from population-based studies across 15 different countries (Burkina Faso, Côte d'Ivoire, Egypt, Ethiopia, the Gambia, Ghana, Guinea, Kenya, Malawi, Nigeria, Seychelles, South Africa, Uganda, Tanzania, and Zimbabwe) ranging from 0.33 per 100,000 population to 502 per 100,000 population.[121] Potential risk factors include young age, being male, having to commute across or work on the water (e.g. fishermen), quality and carrying capacity of the boat, and poor weather.[121]

### United States

In the United States, drowning is the second leading cause of death (after motor vehicle accidents) in children aged 12 and younger.[122]

People who drown are more likely to be male, young, or adolescent.[122] There is a racial disparity found in drowning incidents. According to CDC data collected from 1999 to 2019, drowning rates among Native Americans was 2 times higher than among non-Hispanic whites while the rate among African-Americans was 1.5 times higher.[123][124] Surveys indicate that 10% of children under 5 have experienced a situation with a high risk of drowning. Worldwide, about 175,000 children die through drowning every year.[125] The causes of drowning cases in the US from 1999 to 2006 were as follows:

31.0% | Drowning and submersion while in natural water

|

27.9% | Unspecified drowning and submersion
14.5% | Drowning and submersion while in swimming pool
9.4% | Drowning and submersion while in bathtub
7.2% | Drowning and submersion following fall into natural water
6.3% | Other specified drowning and submersion
2.9% | Drowning and submersion following fall into swimming pool
0.9% | Drowning and submersion following fall into bathtub

According to the US National Safety Council, 353 people ages 5 to 24 drowned in 2017.[126]

## Society and culture

### Old terminology

The word "drowning"—like "electrocution"—was previously used to describe fatal events only. Occasionally, that usage is still insisted upon, though the medical community's consensus supports the definition used in this article. Several terms related to drowning which have been used in the past are also no longer recommended.[4] These include:

* Active drowning: people, such as non-swimmers and the exhausted or hypothermic at the surface, who are unable to hold their mouth above water and are suffocating due to lack of air. Instinctively, people in such cases perform well-known behaviors in the last 20–60 seconds before being submerged, representing the body's last efforts to obtain air.[7][33] Notably, such people are unable to call for help, talk, reach for rescue equipment, or alert swimmers even feet away, and they may drown quickly and silently close to other swimmers or safety.[7]
* Dry drowning: drowning in which no water enters the lungs.[7][33]
* Near drowning: drowning which is not fatal.[7][33]
* Wet drowning: drowning in which water enters the lungs.[7][33]
* Passive drowning: people who suddenly sink or have sunk due to a change in their circumstances. Examples include people who drown in an accident due to sudden loss of consciousness or sudden medical condition.[33]
* Secondary drowning: physiological response to foreign matter in the lungs due to drowning causing extrusion of liquid into the lungs (pulmonary edema) which adversely affects breathing.[7][33]
* Silent drowning: drowning without a noticeable external display of distress.[7][127]

### Dry drowning

"Dry drowning" is an urban legend according to which some people, notably children, die of drowning hours or days after swimming or ingesting water. Misinformation about this supposed phenomenon is spread cyclically, mostly at the beginning of summer, over social media.[128]

As a medical condition, "dry drowning" has never had an accepted definition, and the term is discredited.[129][130] Following the 2002 World Congress on Drowning in Amsterdam, a consensus definition of drowning was established: it is the "process of experiencing respiratory impairment from submersion/immersion in liquid."[131] This definition resulted in only three legitimate drowning subsets: fatal drowning, non-fatal drowning with illness/injury, and non-fatal drowning without illness/injury.[132] In response, major medical consensus organizations have adopted this definition worldwide and have discouraged any medical or publication use of the term "dry drowning".[129] Such organizations include the International Liaison Committee on Resuscitation,[133] the Wilderness Medical Society,[48] the American Heart Association,[134] the Utstein Style system,[133] the International Lifesaving Federation,[135] the International Conference on Drowning,[131] Starfish Aquatics Institute,[136] the American Red Cross,[137] the Centers for Disease Control and Prevention (CDC),[138][139][140] the World Health Organization[141] and the American College of Emergency Physicians.[142]

Drowning experts have recognized that the resulting pathophysiology of hypoxemia, acidemia, and eventual death is the same whether water entered the lung or not. As this distinction does not change management or prognosis but causes significant confusion due to alternate definitions and misunderstandings, it is established that pathophysiological discussions of "dry" versus "wet" drowning are not relevant to drowning care.[143]

"Dry drowning" is cited in the news with a wide variety of definitions.[144] and is often confused with "secondary drowning" or "delayed drowning".[145] Various conditions including spontaneous pneumothorax, chemical pneumonitis, bacterial or viral pneumonia, head injury, asthma, heart attack, and chest trauma have been misattributed to the erroneous terms "delayed drowning", "secondary drowning", and "dry drowning". Currently, there has never been a case identified in the medical literature where a person was observed to be without symptoms and who died hours or days later as a direct result of drowning alone.[129] However, forensic pathologist Dr. Cyril H. Wecht has published at least one opinion asserting that the cause of death of a 16-year-old student was due to "delayed drowning".[146]

### Capital punishment

The Drownings at Nantes, anonymous period painting, Musée d'histoire de Nantes

In Europe, drowning was used as capital punishment. During the Middle Ages, a sentence of death was read using the words cum fossa et furca, or "with pit and gallows".[147]

Drowning survived as a method of execution in Europe until the 17th and 18th centuries.[148] England had abolished the practice by 1623, Scotland by 1685, Switzerland in 1652, Austria in 1776, Iceland in 1777, and Russia by the beginning of the 1800s. France revived the practice during the French Revolution (1789–1799) and it was carried out by Jean-Baptiste Carrier at Nantes.Cite error: Invalid `<ref>` tag; refs with no name must have content

## Experience

People who have experienced drowning have reported slowing of time, but this is suggested to be a function of recollection, not perception.[149] If the person is conscious after the initial struggle and breath-holding, they may feel a burning or tearing sensation on aspirating water. This burning sensation does not depend on the type of water. Following this painful feeling, many report peaceful perceptions, hallucinations, diminished pain and even euphoria. Sensations of tranquility are not limited to drowning, and similar perceptions have also been reported in near-death experiences from other causes.[150] The euphoria and calmness can be attributed to cerebral hypoxia and consequent changes in neurotransmitters.[151][152] These experiences vary by person, because the rate of oxygen loss in the blood (and resulting hypoxia) depends on the circumstances.

## See also

* Instinctive drowning response

## References

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2. ↑ 2.0 2.1 2.2 "Drowning". 2020. https://www.who.int/news-room/fact-sheets/detail/drowning.
3. ↑ 3.0 3.1 3.2 3.3 "Drowning – Injuries; Poisoning – Merck Manuals Professional Edition". September 2017. https://www.merckmanuals.com/professional/injuries-poisoning/drowning/drowning.
4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Mott, TF; Latimer, KM (1 April 2016). "Prevention and Treatment of Drowning". American Family Physician 93 (7): 576–582. PMID 27035042.
5. ↑ 5.0 5.1 North, Robert (December 2002). "The pathophysiology of drowning". South Pacific Underwater Medicine Society Journal 32 (4). https://www.researchgate.net/publication/228699347. Retrieved 4 October 2020.
6. ↑ Dietrich, Graham (13 May 2025). "When Survival Instincts Betray Us: How the Body Drowns Itself". https://swim.org.au/when-survival-instincts-betray-us-how-the-body-drowns-itself/.
7. ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 van Beeck, EF; Branche, CM; Szpilman, D; Modell, JH; Bierens, JJ (November 2005). "A new definition of drowning: towards documentation and prevention of a global public health problem". Bulletin of the World Health Organization 83 (11): 853–6. PMID 16302042.
8. ↑ Preventing drowning: an implementation guide. WHO. 2015. p. 2. ISBN 978-92-4-151193-3. https://apps.who.int/iris/bitstream/handle/10665/255196/9789241511933-eng.pdf. Retrieved 9 August 2018.
9. ↑ Handley, Anthony J. (16 April 2014). "Drowning". BMJ 348. doi:10.1136/bmj.g1734. ISSN 0959-8138. PMID 24740929. https://www.bmj.com/content/348/bmj.g1734. Retrieved 4 October 2020.
10. ↑ "Accident Search Results Page". https://www.osha.gov/pls/imis/AccidentSearch.search?acc_keyword="Drown"&keyword_list=on.
11. ↑ Young, David (13 July 2012). "Rivers – The impact of European settlement". The Encyclopedia of New Zealand. http://www.teara.govt.nz/en/rivers/page-4.
12. ↑ Gulli, Benjamin; Ciatolla, Joseph A.; Barnes, Leaugeay (2011). Emergency Care and Transportation of the Sick and Injured. Sudbury, Massachusetts: Jones and Bartlett. p. 1157. ISBN 978-0-7637-7828-6. https://books.google.com/books?id=IqDOCwAAQBAJ&pg=PA1157.
13. ↑ Clarke, E. B.; Niggemann, E. H. (November 1975). "Near-drowning". Heart & Lung: The Journal of Critical Care 4 (6): 946–955. ISSN 0147-9563. PMID 1042029.
14. ↑ 14.0 14.1 Staff (23 September 2014). "Drowning". CDC Tip sheets. Atlanta. Georgia: Centers for Disease Control and Prevention. https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/drowning.html.
15. ↑ Staff (28 April 2016). "Unintentional Drowning: Get the Facts". Home and Recreational Safety. Atlanta, Georgia: Centers for Disease Control and Prevention. https://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.html.
16. ↑ Watila, Musa M.; Balarabe, Salisu A.; Ojo, Olubamiwo; Keezer, Mark R.; Sander, Josemir W. (October 2018). "Overall and cause-specific premature mortality in epilepsy: A systematic review". Epilepsy & Behavior 87: 213–225. doi:10.1016/j.yebeh.2018.07.017. ISSN 1525-5050. PMID 30154056. http://discovery.ucl.ac.uk/10057049/1/MAIN DOCUMENT_CoD Ep&Bev; FINAL_12.6.18 (1).pdf.
17. ↑ Hamilton, Kyra; Keech, Jacob J.; Peden, Amy E.; Hagger, Martin S. (3 June 2018). "Alcohol use, aquatic injury, and unintentional drowning: A systematic literature review". Drug and Alcohol Review 37 (6): 752–773. doi:10.1111/dar.12817. ISSN 0959-5236. PMID 29862582. http://urn.fi/URN:NBN:fi:jyu-201812145135. Retrieved 12 July 2019.
18. ↑ 18.0 18.1 "Drowning". https://www.who.int/news-room/fact-sheets/detail/drowning.
19. ↑ "Drowning: Background, Etiology, Epidemiology". 21 October 2021. https://emedicine.medscape.com/article/772753-overview#:~:text=Drowning may result in an,Hypoxemia is the overriding insult.
20. ↑ "Drowning and sudden cardiac death". Arch Dis Child 96 (1): 5–8. January 2011. doi:10.1136/adc.2010.185215. PMID 20584851.
21. ↑ Gilcrest, Julia; Parker, Erin (May 2014). "Racial/Ethnic Disparities in Fatal Unintentional Drowning Among Persons Aged ≤29 Years — United States, 1999–2010". Morbidity and Mortality Weekly Report. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6319a2.htm?s_cid=mm6319a2_w. Retrieved 1 November 2020.
22. ↑ Campbell, Ernest (1996). "Free Diving and Shallow Water Blackout". Diving Medicine Online. scuba-doc.com. http://www.scuba-doc.com/latenthypoxia.html.
23. ↑ 23.0 23.1 Lindholm, P.; Lundgren, C.E. (2006). "Alveolar gas composition before and after maximal breath-holds in competitive divers". Undersea & Hyperbaric Medicine 33 (6): 463–7. PMID 17274316. https://www.researchgate.net/publication/6530979.
24. ↑ 24.0 24.1 24.2 24.3 Harle, Lindsey (August 2012). "Drowning". Forensic pathology: Types of injuries. PathologyOutlines.com. http://www.pathologyoutlines.com/topic/forensicsdrowning.html.
25. ↑ Pia, Frank (1974). "Observations on the drowning of non-swimmers". Journal of Physical Education 71 (6): 164–7.
26. ↑ 26.0 26.1 Gorman, Mark (2008). Jose Biller. ed. Interface of Neurology and Internal Medicine. Lippincott Williams & Wilkins. pp. 702–6. ISBN 978-0-7817-7906-7. https://books.google.com/books?id=SRIvmTVcYBwC&pg=PA702. Retrieved 9 May 2013.
27. ↑ Tipton, M. J. (1989). "The initial responses to cold-water immersion in man". Clinical Science 77 (6): 581–8. doi:10.1042/cs0770581. ISSN 0143-5221. PMID 2691172.
28. ↑ 28.0 28.1 28.2 Lindholm, Peter (2006). "Physiological mechanisms involved in the risk of loss of consciousness during breath-hold diving". in Lindholm, P.; Pollock, N. W.; Lundgren, C. E. G.. Durham, NC: Divers Alert Network. p. 26. ISBN 978-1-930536-36-4. http://www.drivehq.com/file/df.aspx/shareID4128542/fileID186208691/UHMS-DAN_BH_2006.pdf#page=31. Retrieved 24 January 2017.
29. ↑ "Secondary Drowning (Dry Drowning)". 14 November 2025. https://my.clevelandclinic.org/health/diseases/secondary-drowning.
30. ↑ 30.0 30.1 30.2 30.3 Cantwell, G Patricia (5 July 2016). "Drowning: Pathophysiology". Drugs & Diseases - Emergency Medicine. Medscape. http://emedicine.medscape.com/article/772753-overview#a3.
31. ↑ 31.0 31.1 Hill, Erin (10 October 2020). "How Long Can the Brain Be without Oxygen before Brain Damage?". https://www.wisegeek.com/how-long-can-the-brain-be-without-oxygen-before-brain-damage.htm.
32. ↑ Tipton, Michael J.; Golden, Frank St C. (2011). "A proposed decision-making guide for the search, rescue and resuscitation of submersion (head under) victims based on expert opinion". Resuscitation 82 (7): 819–824. doi:10.1016/j.resuscitation.2011.02.021. ISSN 1873-1570. PMID 21458133.
33. ↑ 33.00 33.01 33.02 33.03 33.04 33.05 33.06 33.07 33.08 33.09 33.10 33.11 33.12 33.13 33.14 33.15 33.16 Szpilman, David; Bierens, Joost J.L.M.; Handley, Anthony J.; Orlowski, James P. (4 October 2012). "Drowning". The New England Journal of Medicine 366 (22): 2102–10. doi:10.1056/NEJMra1013317. PMID 22646632.
34. ↑ DiMaio, Dominick; DiMaio, Vincent J.M. (28 June 2001). Forensic Pathology (2nd ed.). Taylor & Francis. pp. 405–. ISBN 978-0-8493-0072-1. https://books.google.com/books?id=XyG3802xSdwC&pg=PA405. Retrieved 9 May 2013.
35. ↑ 35.0 35.1 35.2 35.3 Jin, Faguang; Li, Congcong (5 April 2017). "Seawater-drowning-induced acute lung injury: From molecular mechanisms to potential treatments". Experimental and Therapeutic Medicine 13 (6): 2591–8. doi:10.3892/etm.2017.4302. PMID 28587319.
36. ↑ 36.0 36.1 "Physiology Of Drowning: A Review". Physiology (Bethesda) 31 (2): 147–66. March 2016. doi:10.1152/physiol.00002.2015. PMID 26889019. https://researchportal.port.ac.uk/portal/en/publications/physiology-of-drowning(3a9033db-4499-44e8-a968-ed39c8521f68).html.
37. ↑ 37.0 37.1 Michelet, Pierre; Dusart, Marion; Boiron, Laurence; Marmin, Julien; Mokni, Tarak; Loundou, Anderson; Coulange, Mathieu; Markarian, Thibaut (3 August 2018). "Drowning in fresh or salt water". European Journal of Emergency Medicine 26 (5): 340–4. doi:10.1097/mej.0000000000000564. ISSN 0969-9546. PMID 30080702.
38. ↑ Tipton, Mike (1 December 2003). "Cold water immersion: sudden death and prolonged survival". The Lancet 362: s12–s13. doi:10.1016/S0140-6736(03)15057-X. ISSN 0140-6736. PMID 14698111.
39. ↑ "Bradycardia - Symptoms and causes". https://www.mayoclinic.org/diseases-conditions/bradycardia/symptoms-causes/syc-20355474.
40. ↑ Lundgren, Claus E. G.; Ferrigno, Massimo, eds (1985). "Physiology of Breath-hold Diving. 31st Undersea and Hyperbaric Medical Society Workshop". UHMS Publication Number 72(WS-BH)4-15-87.. Undersea and Hyperbaric Medical Society. http://archive.rubicon-foundation.org/7992. Retrieved 24 April 2009.
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42. ↑ 42.0 42.1 Vittone, Mario (21 October 2010). "The Truth About Cold Water". Survival. Mario Vittone. http://mariovittone.com/2010/10/the-truth-about-cold-water/.
43. ↑ 43.0 43.1 43.2 "Hypothermia safety". United States Power Squadrons. 23 January 2007. http://www.usps.org/national/ensign/uspscompass/compassarchive/compassv1n1/hypothermia.htm.
44. ↑ Butler, Daniel Allen (1998). Unsinkable: The Full Story of RMS Titanic. Mechanicsburg, PA: Stackpole Books. ISBN 978-0-8117-1814-1. https://archive.org/details/unsinkablefullst00butl.
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47. ↑ Sterba, J.A. (1990). Field Management of Accidental Hypothermia during Diving (Technical report). US Navy Experimental Diving Unit. NTIS ADA219560. Retrieved 11 June 2008.
48. ↑ 48.0 48.1 48.2 Schmidt, AC; Sempsrott JR; Hawkins SC (2016). "Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Drowning". Wilderness & Environmental Medicine 27 (2): 236–51. doi:10.1016/j.wem.2015.12.019. PMID 27061040. http://www.wemjournal.org/article/S1080-6032(16)00003-X/fulltext. Retrieved 25 August 2017.
49. ↑ Cantwell, G Patricia (5 July 2016). "Drowning: Prognosis". Drugs & Diseases - Emergency Medicine. Medscape. http://emedicine.medscape.com/article/772753-overview#a6.
50. ↑ "Bathing". The Maryland Republican (Annapolis, Maryland, U.S.): p. 2. 1 November 1825. https://newspaperarchive.com/annapolis-maryland-republican-and-political-agricultural-museum-nov-01-1825-p-2/.
51. ↑ 51.0 51.1 Centers for Disease Control and Prevention. "Water-Related Injuries". https://cdc.gov/homeandrecreationalsafety/water-safety/waterinjuries-factsheet.html#tabs-1-3.
52. ↑ "Drowning". https://www.who.int/news-room/fact-sheets/detail/drowning.
53. ↑ 53.0 53.1 "USLA's Top Ten Beach and Water Safety Tips - United States Lifesaving Association". 3 July 2021. https://usla.org/page/safety-tips.
54. ↑ Borzo, Jeanette (26 November 2001). "Business Innovation Awards (A Special Report): Silver 
 Poseidon Technologies Makes a Big Splash With Swimming Pool Monitoring System 
 Computer System Saves Life of Drowning Teen 
 In Big Pools, Lifeguards Can't Do It All". The Wall Street Journal (Brussels): p. 26. ISSN 0921-9986.
55. ↑ Pia, Frank (June 1984). "The RID factor as a cause of drowning". Parks & Recreation. http://pia-enterprises.com/rid.rtf.
56. ↑ "Spinal Injury Prevention at the Beach - United States Lifesaving Association". 20 July 2021. https://usla.org/page/SPINAL.
57. ↑ Borius, Pierre-Yves (3 December 2009). "Cervical spine injuries resulting from diving accidents in swimming pools: outcome of 34 patients". European Spine Journal 19 (4): 552–7. doi:10.1007/s00586-009-1230-3. PMID 19956985.
58. ↑ Näyhä, Simo (18 December 2007). "Heat mortality in Finland in the 2000s". International Journal of Circumpolar Health 66 (5): 418–424. doi:10.3402/ijch.v66i5.18313. PMID 18274207.
59. ↑ "Ovi Magazine: Finnish midsummer consumed by alcohol by Thanos Kalamidas". https://www.ovimagazine.com/art/5955.
60. ↑ "Summer Solstice - Midsummer in Finland". https://www.homesofmyrtlebeach.com/blog/401/Summer+Solstice+-+Midsummer+In+Finland.
61. ↑ USCG AUX (United States Coast Guard Auxiliary) (4 October 2023). "Safety Programs". https://wow.uscgaux.info/content.php?unit=V-DEPT&category=safety-programs.
62. ↑ Dr. Collins, Jason; Dawson-Cook, Susan (12 November 2020). "How to Beat Muscle Cramps | U.S. Masters Swimming". https://usms.org/fitness-and-training/articles-and-videos/articles/how-to-beat-muscle-cramps.
63. ↑ "Managing epilepsy. Safety at home. Bathroom." (in en-AU). https://epilepsyfoundation.org.au/managing-epilepsy/health-and-wellbeing/safety-at-home/bathroom/.
64. ↑ Bain, Eva (20 June 2018). "Drowning in epilepsy: A population-based case series". Epilepsy Research 145: 123–6. doi:10.1016/j.eplepsyres.2018.06.010. PMID 29957568. https://www.sciencedirect.com/science/article/abs/pii/S0920121118302183#!. Retrieved 29 September 2020.
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66. ↑ "Rip Currents - United States Lifesaving Association". 3 July 2021. https://usla.org/page/ripcurrents.
67. ↑ "Resources - Safe Boating Campaign". 9 December 2023. https://safeboatingcampaign.com/resources/.
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87. ↑ Hazinski, Mary Fran, ed (2010). "﻿Guidelines for CPR and ECC﻿". Highlights of the 2010 American Heart Association (American Heart Association): 2. http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf. Retrieved 2 January 2017.
88. ↑ Red Cross (2016). CPR/AED Handbook. p. 133.
89. ↑ American Heart Association (2015). "Guidelines for CPR and ECC". http://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf.
90. ↑ Red Cross (2 March 2024). "How to Perform Child and Baby CPR". pp. 1, 3.3. http://redcross.org/take-a-class/cpr/performing-cpr/child-baby-cpr.
91. ↑ Manino, Leonardo Andrés; Pizzini, Diego Augusto (2019). Drowning: special situation of reanimation.
92. ↑ MedlinePlus Encyclopedia Near drowning
93. ↑ Wall, Ron (2017). Rosen's Emergency Medicine: Concepts and Clinical Practice (9 ed.). Elsevier. p. 1802. ISBN 978-0-323-35479-0.
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95. ↑ "Drowning - Symptoms, diagnosis and treatment". BMJ Best Practice. https://bestpractice.bmj.com/topics/en-gb/657.
96. ↑ Hughes, S. K.; Nilsson, D. E.; Boyer, R. S.; Bolte, R. G.; Hoffman, R. O.; Lewine, J. D.; Bigler, E. D. (2002). "Neurodevelopmental outcome for extended cold water drowning: A longitudinal case study". Journal of the International Neuropsychological Society 8 (4): 588–596. doi:10.1017/s1355617702814370. PMID 12030312.
97. ↑ "Near drowning: consensus and controversies in pulmonary and cerebral resuscitation". Heart Lung 16 (5): 474–82. September 1987. PMID 3308778.
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100. ↑ Quan, Linda; Wentz, Kim R.; Gore, Edmond J.; Copass, Michael K. (1 October 1990). "Outcome and Predictors of Outcome in Pediatric Submersion Victims Receiving Prehospital Care in King County, Washington". Pediatrics 86 (4): 586–593. doi:10.1542/peds.86.4.586. ISSN 0031-4005. PMID 2216625.
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103. ↑ Bierens, Joost J. L.M.; Knape, Johannes T.A.; Gelissen, Harry P. M.M. (December 2002). "Drowning". Current Opinion in Critical Care 8 (6): 578–586. doi:10.1097/00075198-200212000-00016. ISSN 1070-5295. PMID 12454545.
104. ↑ Zeraati, Abbas Ali; Amini, Shahram; Mortazi, Hasan; Zeraati, Tina; Zeraati, Dorsa (1 May 2018). "Sp238The Effect of Selenium on Prevention of Acute Kidney Injury After On-Pump Cardiac Surgery". Nephrology Dialysis Transplantation 33 (suppl_1): i423–i424. doi:10.1093/ndt/gfy104.sp238. ISSN 0931-0509.
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107. ↑ "Drowning". https://www.who.int/news-room/fact-sheets/detail/drowning.
108. ↑ ((Committee on injury, violence, and poison prevention)) (2010). "Policy Statement—Prevention of Drowning". Pediatrics 126 (1): 178–185. doi:10.1542/peds.2010-1264. PMID 20498166.
109. ↑ "Drowning, Homicide and Suicide Leading Killers for Children in Asia". The Salem News. 11 March 2008. http://www.salem-news.com/articles/march112008/asia_child_killers_031108.php.
110. ↑ "UNICEF Says Injuries A Fatal Problem For Asian Children". All Headline News. 13 March 2008. http://www.allheadlinenews.com/articles/7010320559.
111. ↑ "Children Drowning, Drowning Children". The Alliance for Safe Children. http://tasc-gcipf.org/downloads/Drowning in Bangladesh.pdf.
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113. ↑ Franklin, Richard Charles; Peden, Amy E.; Hamilton, Erin B.; Bisignano, Catherine; Castle, Chris D.; Dingels, Zachary V.; Hay, Simon I.; Liu, Zichen et al. (October 2020). "The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study". Injury Prevention 26 (Supp 1): i83–i95. doi:10.1136/injuryprev-2019-043484. ISSN 1475-5785. PMID 32079663.
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## External links

* Canadian Red Cross: Drowning Research: Drownings in Canada, 10 Years of Research **Module 2 – Ice & Cold Water Immersion
* The Psychological Effects of Almost Drowning
* Global Status Report on Drowning Prevention 2024. Geneva: World Health Organization. 13 December 2024. ISBN 978-92-4-010396-2. https://www.who.int/teams/social-determinants-of-health/safety-and-mobility/global-report-on-drowning-prevention.

Classification|

* ICD-11: NF08.1
* ICD-10: T75.1
* ICD-9-CM: 994.1
* DiseasesDB: 3957

|

External resources|

* MedlinePlus: 000046
* eMedicine: emerg/744

* v
* t
* e

Consequences of external causes (T66–T78, 990–995)

Temperature|

| Elevated|

Hyperthermia
Heat syncope

|

Reduced|

Hypothermia
Immersion foot syndromes

Trench foot
Tropical immersion foot
Warm water immersion foot
Chilblains
Frostbite
Aerosol burn
Cold intolerance
Acrocyanosis
Erythrocyanosis crurum

Radiation|

Radiation poisoning
Radiation burn
Chronic radiation keratosis
Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy
Radiation acne
Radiation-induced cancer
Radiation recall reaction
Radiation-induced erythema multiforme
Radiation-induced hypertrophic scar
Radiation-induced keloid
Radiation-induced morphea

Air|

* Hypoxia/Asphyxia
* Barotrauma
* Aerosinusitis
* Decompression sickness
* High altitude
* Altitude sickness
* Chronic mountain sickness
* Death zone
* HAPE
* HACE

Food|

* Starvation

Maltreatment|

* Physical abuse
* Sexual abuse
* Psychological abuse

Travel|

* Motion sickness
* Seasickness
* Airsickness
* Space adaptation syndrome

Adverse effect|

* Hypersensitivity
* Anaphylaxis
* Angioedema
* Allergy
* Arthus reaction

* Adverse drug reaction

Other|

* Electrical injury
* Drowning
* Lightning injuries

Ungrouped
skin conditions
resulting from
physical factors|

* Dermatosis neglecta
* Pinch mark
* Pseudoverrucous papules and nodules
* Sclerosing lymphangitis
* Tropical anhidrotic asthenia
* UV-sensitive syndrome

environmental skin conditions
Electrical burn
frictional/traumatic/sports

Black heel and palm
Equestrian perniosis
Jogger's nipple
Pulling boat hands
Runner's rump
Surfer's knots
Tennis toe
Vibration white finger
Weathering nodule of ear
Wrestler's ear
Coral cut
Painful fat herniation
Uranium dermatosis

iv use

Skin pop scar
Skin track
Slap mark
Pseudoacanthosis nigricans
Narcotic dermopathy

* v
* t
* e

Underwater diving

* Diving modes
* Atmospheric pressure diving
* Freediving
* Saturation diving
* Scuba diving
* Snorkeling
* Surface-supplied diving
* Unmanned diving

Diving equipment

| Basic equipment|

* Diving mask
* Snorkel
* Swimfin

|

Breathing gas|

* Bailout gas
* Bottom gas
* Breathing air
* Decompression gas
* Emergency gas supply
* Heliox
* Nitrox
* Oxygen
* Travel gas
* Trimix

Buoyancy and
trim equipment|

* Buoyancy control device
* Power inflator
* Dump valve
* Diving weighting system
* Ankle weights
* Integrated weights
* Trim weights
* Weight belt

Decompression
equipment|

* Decompression buoy
* Decompression cylinder
* Decompression trapeze
* Dive computer
* Diving shot
* Jonline

Environmental
protection|

* Atmospheric diving suit
* Diving suit
* Dry suit
* Sladen suit
* Standard diving suit
* Rash vest
* Wetsuit
* Dive skins
* Hot-water suit

Helmets
and masks|

* Anti-fog
* Diving helmet
* Free-flow helmet
* Lightweight demand helmet
* Reclaim helmet
* Standard diving helmet
* Diving mask
* Band mask
* Half mask
* Full-face mask

Instrumentation|

* Bottom timer
* Depth gauge
* Dive computer
* Dive timer
* Diving compass
* Diving watch
* Pneumofathometer
* Submersible pressure gauge

Mobility
equipment|

* Diving bell
* Closed bell
* Wet bell
* Diving stage
* Diver propulsion vehicle
* Advanced SEAL Delivery System
* Cosmos CE2F series
* Dry Combat Submersible
* Human torpedo
* Motorised Submersible Canoe
* R-2 Mala-class swimmer delivery vehicle
* SEAL Delivery Vehicle
* Shallow Water Combat Submersible
* Siluro San Bartolomeo
* Wet Nellie
* Wet sub
* Necker Nymph
* Swimfins
* Monofin
* Towboard

Safety
equipment|

* Alternative air source
* Bailout block
* Bailout bottle
* Bolt snap
* Buddy line
* Distance line
* Dive light
* Dive reel
* Diver's cutting tool
* Diver's knife
* Diver's telephone
* Through-water communications
* Diving bell
* Diving safety harness
* Emergency gas supply
* Lifeline
* Screw gate carabiner
* Line marker
* Octopus regulator
* Pony bottle
* Rescue tether
* Safety helmet
* Shark-proof cage
* Surface marker buoy
* Personal locator beacon

Underwater
breathing
apparatus|

* Atmospheric diving suit
* Diving cylinder
* Burst disc
* Diving cylinder valve
* Diving helmet
* Diving regulator
* Single-hose regulator
* Twin-hose regulator
* Regulator malfunction
* Regulator freeze
* Full face diving mask
* Reclaim helmet
* Open-circuit scuba
* Scuba set
* Bailout bottle
* Decompression cylinder
* Independent doubles
* Manifolded twin set
* Scuba manifold
* Pony bottle
* Sidemount
* Sling cylinder
* Scuba replacement
* Standard diving dress
* Diving rebreather
* Carbon dioxide scrubber
* Carleton CDBA
* CDLSE
* Cis-Lunar
* Cryogenic rebreather
* CUMA
* DSEA
* Dolphin
* Electro-galvanic oxygen sensor
* FROGS
* Halcyon PVR-BASC
* Halcyon RB80
* IDA71
* Interspiro DCSC
* KISS
* LAR-5
* LAR-6
* LAR-V
* LARU
* Porpoise
* Dräger Ray
* Siebe Gorman CDBA
* Siva
* Viper
* Surface-supplied diving equipment
* Air line
* Diver's umbilical
* Diving air compressor
* Hookah
* Sea Trek
* Snuba
* Standard diving dress

Diving
equipment
manufacturers|

* AP Diving
* Apeks
* Aqua Lung America
* Aqua Lung/La Spirotechnique
* Beuchat
* René Cavalero
* Cressi-Sub
* Dacor
* DESCO
* Dive Xtras
* Divex
* Diving Unlimited International
* Drägerwerk
* Fenzy
* Maurice Fernez
* Technisub
* Oscar Gugen
* Heinke
* HeinrichsWeikamp
* Johnson Outdoors
* Mares
* Morse Diving
* Nemrod
* Oceanic Worldwide
* Porpoise
* Sub Sea Systems
* Shearwater Research
* Siebe Gorman
* Submarine Products
* Suunto

Diving support equipment

| Breathing gas|

* Air filtration
* Booster pump
* Carbon dioxide scrubber
* Cascade filling system
* Diver's pump
* Diving air compressor
* Diving air filter
* High pressure breathing air compressor
* Low pressure breathing air compressor
* Gas blending
* Gas blending for scuba diving
* Gas panel
* Gas reclaim system
* Gas storage bank
* Gas storage quad
* Gas storage tube
* Helium analyzer
* Nitrox production
* Membrane method of gas concentration
* Pressure swing adsorption
* Oxygen analyser
* Oxygen compatibility

|

Decompression
equipment|

* Built-in breathing system
* Decompression tables
* Dive computer
* Diving bell
* Bell cursor
* Closed bell
* Clump weight
* Launch and recovery system
* Wet bell
* Diving chamber
* Diving stage
* Jersey upline
* Recreational Dive Planner
* Saturation system

Platforms|

* Dive boat
* Boarding stirrup
* Canoe and kayak diving
* Combat Rubber Raiding Craft
* Diving platform (scuba)
* Liveaboard
* Subskimmer
* Diving support vessel
* HMS Challenger (K07)
* Moon pool
* Underwater habitat
* Aquarius Reef Base
* Continental Shelf Station Two
* Helgoland Habitat
* Jules' Undersea Lodge
* Scott Carpenter Space Analog Station
* SEALAB
* Tektite habitat

Remotely operated
underwater vehicles|

* 8A4-class ROUV
* ABISMO
* Atlantis ROV Team
* CURV
* Épaulard
* Global Explorer ROV
* Goldfish-class ROUV
* Kaikō ROV
* Long-Term Mine Reconnaissance System
* Mini Rover ROV
* OpenROV
* ROV KIEL 6000
* ROV PHOCA
* Scorpio ROV
* Sea Dragon-class ROV
* Seabed tractor
* Seafox drone
* Seahorse ROUV
* SeaPerch
* SJT-class ROUV
* T1200 Trenching Unit
* VideoRay UROVs

Safety equipment|

* Diver down flag
* Diving shot
* Hyperbaric lifeboat
* Hyperbaric stretcher
* Jackstay
* Jonline
* Reserve gas supply

General|

* Diving ladder
* Hot water system
* Downline

Freediving

| Activities|

* Aquathlon
* Apnoea finswimming
* Freediving
* Haenyeo
* Pearl hunting
* Ama
* Snorkeling
* Spearfishing
* Underwater football
* Underwater hockey
* Underwater ice hockey
* Underwater rugby
* Underwater target shooting

|

Competitions|

* Nordic Deep
* Vertical Blue
* Disciplines
* Constant weight (CWT)
* Constant weight without fins (CNF)
* Dynamic apnea (DYN)
* Dynamic apnea without fins (DNF)
* Free immersion (FIM)
* No-limits apnea (NLT)
* Static apnea (STA)
* Skandalopetra diving
* Variable weight apnea (VWT)
* Variable weight apnea without fins

Equipment|

* Diving mask
* Diving suit
* Fins
* Hawaiian sling
* Monofin
* Polespear
* Snorkel (swimming)
* Speargun
* Water polo cap

Freedivers|

* Deborah Andollo
* Peppo Biscarini
* Sara Campbell
* Derya Can Göçen
* Goran Čolak
* Carlos Coste
* Robert Croft
* Mandy-Rae Cruickshank
* Yasemin Dalkılıç
* Leonardo D'Imporzano
* Flavia Eberhard
* Şahika Ercümen
* Emma Farrell
* Francisco Ferreras
* Pierre Frolla
* Flavia Eberhard
* Mehgan Heaney-Grier
* Elisabeth Kristoffersen
* Loïc Leferme
* Enzo Maiorca
* Jacques Mayol
* Audrey Mestre
* Karol Meyer
* Stéphane Mifsud
* Alexey Molchanov
* Natalia Molchanova
* Dave Mullins
* Patrick Musimu
* Guillaume Néry
* Herbert Nitsch
* Umberto Pelizzari
* Annelie Pompe
* Michal Risian
* Stig Severinsen
* Tom Sietas
* Aharon Solomons
* Martin Štěpánek
* Walter Steyn
* Tanya Streeter
* William Trubridge
* Devrim Cenk Ulusoy
* Danai Varveri
* Alessia Zecchini
* Nataliia Zharkova

Hazards|

* Barotrauma
* Drowning
* Freediving blackout
* Deep-water blackout
* Shallow-water blackout
* Hypercapnia
* Hypothermia

Historical|

* Ama
* Octopus wrestling
* Swimming at the 1900 Summer Olympics – Men's underwater swimming

Organisations|

* AIDA International
* Scuba Schools International
* Australian Underwater Federation
* British Freediving Association
* Confédération Mondiale des Activités Subaquatiques
* Fédération Française d'Études et de Sports Sous-Marins
* Performance Freediving International

Professional diving

| Occupations|

* Ama
* Commercial diving
* Commercial offshore diving
* Hazmat diving
* Divemaster
* Diving instructor
* Diving safety officer
* Diving supervisor
* Haenyeo
* Media diving
* Underwater photography
* Underwater videography
* Military diving
* Army engineer diver
* Clearance diver
* Frogman
* Police diving
* Public safety diving
* Scientific diving
* Underwater archaeology

|

Underwater work|

* Commercial offshore diving
* Dive guide
* Diver training
* Recreational diver training
* Hyperbaric welding
* Nondestructive testing
* Pearl hunting
* Police diving
* Public safety diving
* Salvage diving
* Scientific diving
* Sponge diving
* Submarine pipeline
* Underwater archaeology
* Underwater demolition
* Underwater photography
* Underwater search and recovery
* Underwater videography

Tools & equipment|

* Abrasive waterjet
* Airlift
* In-water surface cleaning
* Brush cart
* Cavitation cleaning
* Pressure washing
* Lifting bag
* Remotely operated underwater vehicle
* Silt screw
* Snoopy loop
* Thermal lance
* Tremie
* Water jetting

Underwater
weapons|

* Limpet mine
* Speargun
* Hawaiian sling
* Polespear

| Underwater
firearm|

* Gyrojet
* Mk 1 Underwater Defense Gun
* Powerhead
* Underwater pistols
* Heckler & Koch P11
* SPP-1 underwater pistol
* Underwater revolvers
* AAI underwater revolver
* Underwater rifles
* ADS amphibious rifle
* APS underwater rifle
* ASM-DT amphibious rifle

|

Recreational diving

| Specialties|

* Altitude diving
* Cave diving
* Deep diving
* Ice diving
* Muck diving
* Open-water diving
* Rebreather diving
* Sidemount diving
* Solo diving
* Technical diving
* Wreck diving

|

Diver
organisations|

* British Sub-Aqua Club (BSAC)
* Cave Divers Association of Australia (CDAA)
* Cave Diving Group (CDG)
* Comhairle Fo-Thuinn (CFT)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* International Association for Handicapped Divers (IAHD)
* National Association for Cave Diving (NACD)
* Woodville Karst Plain Project (WKPP)

Diving tourism
industry|

* Environmental impact of recreational diving
* Scuba diving tourism
* Shark tourism
* Sinking ships for wreck diving sites

Recreational
dive sites|

| Reef diving
regions|

* Arrecifes de Cozumel National Park
* Great Barrier Reef
* iSimangaliso Marine Protected Area
* Poor Knights Islands
* Table Mountain National Park Marine Protected Area

|

Reef dive
sites|

* Artificial reef
* Gibraltar Artificial Reef
* Shark River Reef
* Osborne Reef
* Palancar Reef
* Underwater artworks
* Cancún Underwater Museum
* Christ of the Abyss
* The Diver
* Molinere Underwater Sculpture Park

Wreck diving
regions|

* Chuuk Lagoon
* Maritime Heritage Trail – Battle of Saipan
* Whitefish Point Underwater Preserve
* Wreck Alley, San Diego

Wreck dive
sites|

* HMS A1
* HMS A3
* Engineering:USS Aaron Ward
* Abessinia
* Aeolian Sky
* Albert C. Field
* Andrea Doria
* Antilla
* Antilles
* Aquila
* Engineering:USS Arkansas
* HMS Boadicea
* Bianca C.
* Booya
* HMSAS Bloemfontein
* Breda
* HMAS Brisbane
* Bungsberg
* HMAS Canberra
* Carl D. Bradley
* Carnatic
* SMS Dresden
* Dunraven
* Eastfield
* HMT Elk
* Ellengowan
* RMS Empress of Ireland
* HMS Falmouth
* Fifi
* SS Francisco Morazan
* Fujikawa Maru
* Fumizuki
* SATS General Botha
* USNS General Hoyt S. Vandenberg
* HMS Ghurka
* Glen Strathallan
* SAS Good Hope
* Gothenburg
* Herzogin Cecilie
* Hilma Hooker
* Hispania
* HMS Hood
* HMAS Hobart
* Igara
* James Eagan Layne
* Captain Keith Tibbetts
* King Cruiser
* SMS Kronprinz
* Kyarra
* HMS Laforey
* USAT Liberty
* Louis Sheid
* Engineering:USS LST-507
* SMS Markgraf
* Mikhail Lermontov
* HMS M2
* Maine
* Maloja
* HMS Maori
* Marguerite
* SS Mauna Loa
* USAT Meigs
* Mendi
* USCGC Mohawk
* Mohegan
* RMS Moldavia
* HMS Montagu
* MV RMS Mulheim
* Nagato
* Oceana
* Engineering:USS Oriskany
* Oslofjord
* P29
* P31
* Pedernales
* Persier
* HMAS Perth
* SAS Pietermaritzburg
* Piłsudski
* Pool Fisher
* HMS Port Napier
* Preußen
* President Coolidge
* PS Queen Victoria
* Radaas
* Error: {{Ship}} missing prefix (help)
* RMS Rhone
* Rondo
* Rosehill
* Error: {{Ship}} missing prefix (help)
* Royal Charter
* Rozi
* HMS Safari
* Salem Express
* Engineering:USS Saratoga
* Engineering:USS Scuffle
* HMS Scylla
* HMS Sidon
* Engineering:USS Spiegel Grove
* Stanegarth
* Stanwood
* Stella
* HMAS Swan
* Engineering:USS Tarpon
* Thesis
* Thistlegorm
* Toa Maru
* Torrey Canyon
* SAS Transvaal
* Tulagi
* Tulamben
* U-40
* U-352
* U-1195
* Um El Faroud
* Varvassi
* Walter L M Russ
* Washingtonian (1913)
* HMNZS Wellington
* Engineering:USS Yancey
* Yongala
* Zenobia
* Zealandia
* Zingara

Cave diving
sites|

* Devil's Throat at Punta Sur
* Engelbrecht
* Fossil Cave
* Piccaninnie Ponds
* Pollatoomary
* Sistema Ox Bel Ha
* Sistema Sac Actun
* Sistema Dos Ojos
* Sistema Nohoch Nah Chich

Freshwater
dives|

* Ewens Ponds
* Little Blue Lake

Training sites|

* Capernwray Dive Centre
* National Diving and Activity Centre
* Stoney Cove

Open ocean
diving|

* Blue-water diving
* Black-water diving

Diving safety

* Ergonomics of diving equipment
* Human factors in diving safety
* Life support system
* Safety-critical system

| Diving hazards|

* Trait anxiety
* Cold shock response
* Decompression
* List of diving hazards and precautions
* Nitrogen narcosis
* Overconfidence effect
* Oxygen toxicity
* Panic
* Penetration diving
* Seasickness
* Silt out
* Single point of failure
* Task loading
* Uncontrolled decompression

|

Consequences|

* Barotrauma
* Decompression sickness
* Drowning
* Hypothermia
* Hypoxia
* Hypercapnia
* Hypothermia

Risk
management|

* Checklist
* Hazard identification and risk assessment
* Hazard analysis
* Job safety analysis
* Risk assessment
* Risk control
* Hierarchy of hazard controls
* Incident pit
* Lockout-tagout
* Permit To Work
* Redundancy
* Safety data sheet
* Situation awareness
* Diving team
* Bellman
* Chamber operator
* Diver's attendant
* Diving supervisor
* Diving systems technician
* Life support technician
* Stand-by diver
* Equipment safety
* Breathing gas quality
* Testing and inspection of diving cylinders
* Hydrostatic test
* Sustained load cracking
* Diving regulators
* Breathing performance of regulators
* Occupational safety and health
* Approaches to safety
* Job safety analysis
* Risk assessment
* Toolbox talk
* Housekeeping
* Association of Diving Contractors International
* Code of practice
* Contingency plan
* Diving regulations
* Emergency procedure
* Emergency response plan
* Evacuation plan
* Hazardous Materials Identification System
* Hierarchy of hazard controls
* Administrative controls
* Engineering controls
* Hazard elimination
* Hazard substitution
* Personal protective equipment
* International Marine Contractors Association
* Occupational hazard
* Biological hazard
* Chemical hazard
* Physical hazard
* Psychosocial hazard
* Occupational hygiene
* Exposure assessment
* Occupational exposure limit
* Workplace health surveillance
* Safety culture
* Code of practice
* Health and safety representative
* Operations manual
* Safety meeting
* Standard operating procedure

Diving
procedures|

* Ascending and descending
* Emergency ascent
* Boat diving
* Canoe and kayak diving
* Buddy diving
* Decompression
* Decompression practice
* Pyle stop
* Ratio decompression
* Dive briefing
* Dive log
* Dive planning
* Scuba gas planning
* Diver communications
* Diving hand signals
* Diving line signals
* Diver voice communications
* Diver rescue
* Diver training
* Doing It Right
* Drift diving
* Gas blending for scuba diving
* Night diving
* Solo diving
* Water safety

Incidents|

| Diver rescues|

* Tham Luang cave rescue

|

Early diving|

* John Day (carpenter)
* Charles Spalding
* Ebenezer Watson

Freediving|

* Loïc Leferme
* Audrey Mestre
* Nicholas Mevoli
* Natalia Molchanova

Professional
diving|

* Johnson Sea Link accident
* Offshore diving incidents
* Byford Dolphin diving bell accident
* Drill Master diving accident
* Star Canopus diving accident
* Venture One diving accident
* Waage Drill II diving accident
* Wildrake diving accident
* Professional diver fatalities
* Roger Baldwin
* John Bennett
* Victor F. Guiel Jr.
* Craig M. Hoffman
* Peter Henry Michael Holmes
* Edwin Clayton Link
* Gerard Anthony Prangley
* Pier Skipness
* Robert John Smyth
* Albert D. Stover
* Richard A. Walker
* Lothar Michael Ward
* Joachim Wendler
* Death of Bradley Westell
* Arne Zetterström

Scuba diving
fatalities|

* Ricardo Armbruster
* Allan Bridge
* David Bright
* Berry L. Cannon
* Cotton Coulson
* Cláudio Coutinho
* E. Yale Dawson
* Deon Dreyer
* Milan Dufek
* Sheck Exley
* Maurice Fargues
* Guy Garman
* Steve Irwin
* Jim Jones
* Henry Way Kendall
* Artur Kozłowski
* Chris and Chrissy Rouse
* Kirsty MacColl
* Agnes Milowka
* François de Roubaix
* Dave Shaw
* Wesley C. Skiles
* Dewey Smith
* Rob Stewart
* Esbjörn Svensson
* Josef Velek

Diving medicine

| Diving
disorders|

* List of signs and symptoms of diving disorders
* Cramps
* Motion sickness
* Surfer's ear

| Pressure
related|

* Aerosinusitis
* Air embolism
* Alternobaric vertigo
* Barodontalgia
* Barostriction
* Barotrauma
* Compression arthralgia
* Decompression illness
* Dental barotrauma
* Dysbarism
* Pulmonary barotrauma

| Oxygen|

* Freediving blackout
* Hyperoxia
* Hypoxia
* Oxygen toxicity

|

Inert gases|

* Avascular necrosis
* Decompression sickness
* Isobaric counterdiffusion
* Taravana
* Dysbaric osteonecrosis
* High-pressure nervous syndrome
* Hydrogen narcosis
* Nitrogen narcosis

Carbon dioxide|

* Hypercapnia
* Hypocapnia

Breathing gas
contaminants|

* Carbon monoxide poisoning

Immersion
related|

* Asphyxia
* Drowning
* Hypothermia
* Immersion diuresis
* Instinctive drowning response
* Laryngospasm
* Salt water aspiration syndrome
* Swimming-induced pulmonary edema

Treatment|

* Demand valve oxygen therapy
* First Aid
* Hyperbaric medicine
* Hyperbaric treatment schedules
* In-water recompression
* Oxygen therapy
* Therapeutic recompression

Personnel|

* Diving Medical Examiner
* Diving Medical Practitioner
* Diving Medical Technician
* Hyperbaric nursing

Screening|

* Atrial septal defect
* Fitness to dive
* Psychological fitness to dive

Research|

| Researchers in
diving physiology
and medicine|

* Arthur J. Bachrach
* Albert R. Behnke
* Paul Bert
* George F. Bond
* Robert Boyle
* Albert A. Bühlmann
* John R. Clarke
* Guybon Chesney Castell Damant
* William Paul Fife
* John Scott Haldane
* Robert William Hamilton Jr.
* Leonard Erskine Hill
* Brian Andrew Hills
* Felix Hoppe-Seyler
* Christian J. Lambertsen
* Simon Mitchell
* Charles Momsen
* John Rawlins R.N.
* Charles Wesley Shilling
* Edward D. Thalmann
* Jacques Triger

|

Diving medical
research
organisations|

* Aerospace Medical Association
* Divers Alert Network (DAN)
* Diving Diseases Research Centre (DDRC)
* Diving Medical Advisory Council (DMAC)
* European Diving Technology Committee (EDTC)
* European Underwater and Baromedical Society (EUBS)
* National Board of Diving and Hyperbaric Medical Technology
* Naval Submarine Medical Research Laboratory
* Royal Australian Navy School of Underwater Medicine
* Rubicon Foundation
* South Pacific Underwater Medicine Society (SPUMS)
* Southern African Underwater and Hyperbaric Medical Association (SAUHMA)
* Undersea and Hyperbaric Medical Society (UHMS)
* United States Navy Experimental Diving Unit (NEDU)

Law

* Civil liability in recreational diving
* Duty of care
* List of legislation regulating underwater diving
* Investigation of diving accidents

History of underwater diving

* Aqua-Lung
* History of decompression research and development
* History of scuba diving
* List of researchers in underwater diving
* Porpoise regulator
* Standard diving dress
* Timeline of diving technology
* Underwater diving in popular culture
* Vintage scuba

Publications

| Manuals|

* NOAA Diving Manual
* U.S. Navy Diving Manual
* Basic Cave Diving: A Blueprint for Survival

|

Standards and
Codes of Practice|

* DIN 7876

General non-fiction|

* The Darkness Beckons
* Goldfinder
* The Last Dive
* Shadow Divers

Training and registration

| Diver
training|

* Diving instructor
* Diving school
* Occupational diver training
* Commercial diver training
* Military diver training
* Public safety diver training
* Scientific diver training
* Competence and assessment
* Competency-based learning
* Skill assessment
* Refresher training (diving)
* Diver training standard
* Recreational diver training
* Introductory diving
* Skills
* Diver navigation
* Diver trim
* Ear clearing
* Frenzel maneuver
* Valsalva maneuver
* Finning techniques
* Scuba skills
* Buddy breathing
* Low impact diving
* Diamond Reef System
* Surface-supplied diving skills
* Underwater searches
* Teaching methods
* Muscle memory
* Overtraining
* Stress exposure training

|

Organisations|

* European Underwater Federation (EUF)
* International Diving Regulators and Certifiers Forum (IDRCF)
* International Diving Schools Association (IDSA)
* International Marine Contractors Association (IMCA)
* List of diver certification organizations
* National Oceanic and Atmospheric Administration (NOAA)
* Nautical Archaeology Society
* Universal Referral Program
* World Recreational Scuba Training Council (WRSTC)

| Commercial diver
certification
authorities|

* Australian Diver Accreditation Scheme (ADAS)
* Commercial diver registration in South Africa
* Divers Institute of Technology
* Health and Safety Executive (HSE)
* Department of Employment and Labour

|

Commercial diving
schools|

* Divers Academy International

Free-diving
certification
agencies|

* AIDA International (AIDA)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Performance Freediving International (PI)
* Scuba Schools International (SSI)

Recreational scuba
certification
agencies|

* American Canadian Underwater Certifications (ACUC)
* American Nitrox Divers International (ANDI)
* Association nationale des moniteurs de plongée (ANMP)
* British Sub-Aqua Club (BSAC)
* Comhairle Fo-Thuinn (CFT)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* Federazione Italiana Attività Subacquee (FIAS)
* Global Underwater Explorers (GUE)
* International Association for Handicapped Divers (IAHD)
* International Association of Nitrox and Technical Divers (IANTD)
* International Diving Educators Association (IDEA)
* Israeli Diving Federation (TIDF)
* National Association for Cave Diving (NACD)
* National Academy of Scuba Educators (NASE)
* National Association of Underwater Instructors (NAUI)
* Nederlandse Onderwatersport Bond (NOB)
* Professional Association of Diving Instructors (PADI)
* Professional Diving Instructors Corporation (PDIC)
* Sub-Aqua Association (SAA)
* Scuba Diving International (SDI)
* Scuba Educators International (SEI)
* Scottish Sub Aqua Club (ScotSAC)
* Scuba Schools International (SSI)
* Türkiye Sualtı Sporları Federasyonu (TSSF)
* United Diving Instructors (UDI)
* YMCA SCUBA Program

Recreational scuba
certification
levels|

* Advanced Open Water Diver
* Autonomous diver
* CMAS* scuba diver
* CMAS** scuba diver
* Dive leader
* Divemaster
* Diving instructor
* Introductory diving
* Low Impact Diver
* Master Instructor
* Master Scuba Diver
* Open Water Diver
* Rescue Diver
* Solo diver
* Supervised diver

Scientific diver
certification
authorities|

* American Academy of Underwater Sciences (AAUS)
* CMAS Scientific Committee

Technical
certification
agencies|

* American Nitrox Divers International (ANDI)
* British Sub-Aqua Club (BSAC)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Diving Science and Technology (DSAT)
* Federazione Italiana Attività Subacquee (FIAS)
* Global Underwater Explorers (GUE)
* International Association of Nitrox and Technical Divers (IANTD)
* National Association of Underwater Instructors (NAUI)
* Professional Association of Diving Instructors (PADI)
* Professional Diving Instructors Corporation (PDIC)
* Technical Diving International (TDI)
* Trimix Scuba Association (TSA)
* Technical Extended Range (TXR)

| Cave
diving|

* Cave Divers Association of Australia (CDAA)
* Cave Diving Group (CDG)
* Global Underwater Explorers (GUE)
* National Association for Cave Diving (NACD)
* National Speleological Society#Cave Diving Group (CDG)
* National Association of Underwater Instructors (NAUI)
* Technical Diving International (TDI)

|

Underwater sports

| Surface snorkeling|

* Finswimming (surface swimming & bi-fins)

|

Snorkeling/breath-hold|

* Spearfishing
* Underwater football
* Underwater hockey
* Underwater rugby
* Underwater target shooting

Breath-hold|

* Aquathlon (underwater wrestling)
* Apnoea finswimming
* Freediving
* Underwater ice hockey

Open Circuit Scuba|

* Immersion finswimming
* Sport diving (sport)
* Underwater orienteering
* Underwater photography (sport)

Rebreather|

* Underwater photography (sport)

Sports governing
organisations|

* International
* AIDA International
* Confédération Mondiale des Activités Subaquatiques)
* National
* Australian Underwater Federation
* British Octopush Association
* British Underwater Sports Association
* Comhairle Fo-Thuinn
* Federación Española de Actividades Subacuáticas
* Fédération Française d'Études et de Sports Sous-Marins
* South African Underwater Sports Federation
* Türkiye Sualtı Sporları Federasyonu
* Underwater Society of America)

Freediver Federations|

* AIDA International
* AIDA Hellas
* British Freediving Association (BFA)
* Confédération Mondiale des Activités Subaquatiques (CMAS)

Sports federations|

* Australian Underwater Federation (AUF)
* British Octopush Association (BOA)
* British Underwater Sports Association (BUSA)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* South African Underwater Sports Federation (SAUSF)
* Türkiye Sualtı Sporları Federasyonu (TSSF)
* Underwater Society of America (USOA)

Underwater divers

| Pioneers of diving|

* Aquanaut
* Jacques Cousteau
* Hans Hass
* Arne Zetterström

|

Underwater scientists and archaeologists|

* Michael Arbuthnot
* Robert Ballard
* George Bass
* Mensun Bound
* Louis Boutan
* Hugh Bradner
* Cathy Church
* Eugenie Clark
* James P. Delgado
* Sylvia Earle
* John Christopher Fine
* George R. Fischer
* Anders Franzén
* Honor Frost
* David Gibbins
* Robert F. Marx
* Charles T. Meide
* Mark M. Newell
* John Peter Oleson
* Margaret Rule
* Gunter Schöbel
* E. Lee Spence
* Robert Sténuit
* Peter Throckmorton

Scuba record holders|

* Sheck Exley
* Nuno Gomes

Underwater filmmakers|

* Samir Alhafith
* David Attenborough
* Ramón Bravo
* Ivan Tors
* Andrew Wight

Underwater photographers|

* Tamara Benitez
* Georges Beuchat
* Adrian Biddle
* Jonathan Bird
* Eric Cheng
* Neville Coleman
* Jacques Cousteau
* John D. Craig
* Ben Cropp
* Bernard Delemotte
* David Doubilet
* John Christopher Fine
* Dermot FitzGerald
* Rodney Fox
* Ric Frazier
* Stephen Frink
* Peter Gimbel
* Monty Halls
* Hans Hass
* Henry Way Kendall
* Rudie Kuiter
* Joseph B. MacInnis
* Luis Marden
* Agnes Milowka
* Noel Monkman
* Steve Parish
* Zale Parry
* Pierre Petit
* Leni Riefenstahl
* Peter Scoones
* Brian Skerry
* Wesley C. Skiles
* E. Lee Spence
* Philippe Tailliez
* Ron and Valerie Taylor
* Albert Tillman
* John Veltri
* Stan Waterman
* Jiang Wenhao
* Michele Westmorland
* John Ernest Williamson
* J. Lamar Worzel

Underwater explorers|

* Caves
* Sheck Exley
* Martyn Farr
* Jill Heinerth
* William Hogarth Main
* Rick Stanton
* Bill Stone
* John Volanthen
* Reefs
*   * Wrecks
* Clive Cussler
* Aristotelis Zervoudis

Science of underwater diving

| Diving
physics|

* Breathing performance of regulators
* Buoyancy
* Archimedes' principle
* Neutral buoyancy
* Diffusion
* Molecular diffusion
* Force
* Gas law
* Amontons's law
* Boyle's law
* Charles's law
* Combined gas law
* Dalton's law
* Gay-Lussac's law
* Ideal gas law
* Oxygen fraction
* Permeation
* Pressure
* Absolute pressure
* Ambient pressure
* Atmospheric pressure
* Gauge pressure
* Hydrostatic pressure
* Metre sea water
* Partial pressure
* Psychrometric constant
* Solubility
* Henry's law
* Saturation
* Solution
* Supersaturation
* Surface tension
* Hydrophobe
* Surfactant
* Torricellian chamber
* Underwater vision
* Snell's law
* Weight
* Apparent weight

|

Diving
physiology|

* Artificial gills
* Circulatory system
* Blood shift
* Patent foramen ovale
* Perfusion
* Systemic circulation
* Cold shock response
* Diving reflex
* Equivalent narcotic depth
* Lipid
* Maximum operating depth
* Metabolism
* Physiological response to water immersion
* Respiration
* Blood–air barrier
* Breathing
* CO₂ retention
* dead space
* Gas exchange
* Hypocapnia
* Normocapnia
* Respiratory exchange ratio
* Respiratory quotient
* Respiratory system
* Work of breathing
* Tissue
* Underwater vision

| Decompression
theory|

* Decompression models:
* Bühlmann decompression algorithm
* Haldane's decompression model
* Reduced gradient bubble model
* Thalmann algorithm
* Thermodynamic model of decompression
* Varying Permeability Model
* Equivalent air depth
* Equivalent narcotic depth
* Maximum operating depth
* Oxygen window in diving decompression
* Physiology of decompression
* Pulmonary circulation

|

Diving
environment|

| Diving
environment
classification|

* Altitude diving
* Benign water diving
* Confined water diving
* Deep diving
* Inland diving
* Inshore diving
* Muck diving
* Night diving
* Open water diving
* Open ocean diving
* Black-water diving
* Blue-water diving
* Penetration diving
* Cave diving
* Ice diving
* Wreck diving
* Recreational dive sites
* Underwater environment

|

Environmental
impact|

* Environmental impact of recreational diving
* Low impact diving

Environmental
factors|

* Algal bloom
* Currents:
* Current
* Longshore drift
* Ocean current
* Rip current
* Tidal race
* Undertow
* Upwelling
* Ekman transport
* Halocline
* List of diving hazards and precautions
* Reef
* Coral reef
* Stratification
* Thermocline
* Tides
* Turbidity
* Wind wave
* Breaking wave
* Surf
* Surge
* Wave shoaling

Special interest groups

* Artificial Reef Society of British Columbia (ARSBC)
* CMAS Europe
* Diving Equipment and Marketing Association (DEMA)
* Divers Alert Network (DAN)
* Green Fins
* Historical Diving Society
* Nautical Archaeology Society (NAS)
* Naval Air Command Sub Aqua Club
* Project AWARE
* Reef Life Survey
* Save Ontario Shipwrecks (SOS)
* SeaKeys
* Sea Research Society

Other

* Submarine escape training facility

* Category
* Commons
*   * Glossary
* Indexes: dive sites
* divers
* diving
*   * Outline
* Portal

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