between noon and 6:00 p.m. The median water temper ture at the time of the fatal incidents was 54°F (12°C) (range 31°F-78°F [0.6°C-26°C]); 75% of the fatalities occurre in water with a temperature <60°F (<16°C).

Among the 38 fatalities, 35 (92%) decedents were mai median age was 48 years (range: 16-77 years). Two dece dents were aged 17 years, and one was aged 16 years; the other 35 were adults. Among the 22 fatalities for which such information was available, 10 decedents had <20 hours of experience in their vessels.

Reported by: T Mangione, PhD, John Snow, Inc., Boston, Massachuse A Johnson, US Coast Guard. M Sawyer, Maine Dept of Inland Fishere and Wildlife; B Greenwald, MD, Maine Office of Chief Medical Examiner A Pelletier, MD, Maine Dept of Health and Human Svcs. J Gilchrist, MD Div of Unintentional Injury Prevention, National Center for Inj Prevention and Control; JE Tongren, PhD, EIS Officer, CDC. Editorial Note: During 2000-2006,* the percentage of boating fatalities associated with paddle sports vessels ir Maine (49%) was three times the national percentage (13%) recorded in the U.S. Coast Guard Boating Acciden Report database for the same period (2). However, other findings in this report were similar to national data. In thi analysis, factors associated with paddle sports deaths included being male, not using PFDs, using alcohol, incxperience, and capsizing the vessel. On the national level during 2000-2006, males accounted for 91% of all boating fatalities (2), a percentage similar to that observed in this analysis. In the United States, during 1999–2006, th: percentage of adults using PFDs was estimated at 99% for all vessels, 23% for canoes, and 85% for kayaks (3). In Maine, PFD use in paddle sports is mandated only for chidren aged <10 years, and noncompliance results in a $5. fine (4). Increased use of PFDs might be encouraged + education, enforcement, and incentives, such as programs that loan PFDs to paddle sports participants at a minimi charge or for free (5).

Approximately 16% of paddle sports decedents in Mains who were tested had BACs ≥0.08 g/dL, the legal limit för driving or boating in the state. Education and enforcement might reduce alcohol use among persons operating padd. sports vessels. Some states have prohibited alcohol sales neat parks and water sources to reduce the risk for alcoho related incidents and deaths (6).

Education aimed at paddle sports participants might hep offset inexperience and reduce capsizing incidents. Five states require registration of paddle sports vessels, but none ma?date boating safety education specifically for paddle sports

2007 data on national boating fatalities are not yet available. Maine Revised Statutes Title 12 §13068-A. Operating watercraft; prohibitions Available at http://janus.state.me.us/legis/statutes/12/title12sec 13068-a.pat

). Registration offers an opportunity to determine the imber of paddle sports participants and require boating fety education that might encourage PFD use, discoure alcohol use, and underscore the dangers of cold water ock and immersion (8). In Maine, paddle sports vessels › not require registration or boating education, although gislation mandating boating safety education was prosed in 2007.S

The findings in this report are subject to at least two nitations. First, data for certain variables (e.g., paddle orts experience, BAC, and water temperature) were not ailable for all decedents and incidents. Second, no data re available for the number of paddle sports vessels in aine or the frequency of their use; therefore fatality rates sed on these denominators could not be calculated. United States Power Squadrons, a nonprofit educational ganization dedicated to promoting boating safety, offers Paddle SmartTM seminar with safety information specific paddle sports (9). This seminar and other prevention ategies that promote PFD use, discourage alcohol use fore and during boating, and support boating safety eduion, might help reduce paddle sports fatalities in Maine. aluations of boating safety education programs should conducted to determine which are most effective at preating fatalities.

Acknowledgments

The findings in this report are based, in part, on contributions by Corkum, A Sites, MPH, Maine Dept of Health and Human Svcs. Chaplin, Maine Dept of Inland Fisheries and Wildlife. K Bisgard, 'M, Office of Workforce Development, CDC.

ferences

National Marine Manufacturers Association. 2006 recreational boating tatistical abstract. Chicago, IL: National Marine Manufacturers Association; 2007. Available at http://www.nmma.org/facts/boatingstats/ 2006/files/abstract.pdf.

US Coast Guard. Boating statistics 2006. Washington, DC: US Department of Homeland Security; 2007. Available at http://www.uscg oating.org/statistics/boating_statistics_2006.pdf.

Mangione T. Observational study of PFD wear rates in adults in the JS, 1996–2006. Boston, MA: John Snow, Inc.; 2007.

tate of Maine Department of Inland Fisheries and Wildlife. State of Maine boating: 2007 laws and rules. Augusta, ME: State of Maine Department of Inland Fisheries and Wildlife. Available at http://www. maine.gov/ifw/laws_rules/pdf/boatinglaws2007.pdf.

joat US Foundation. Life jacket loaner program. Annapolis, MD: BoatUS oundation; 2007. Available at http://www.boatus.com/foundation/ljlp/ dex.htm.

awrence B, Miller T. Recent research on recreational boating accients and the contribution of boating under the influence. Calverton, 1D: Pacific Institute of Research and Evaluation; 2006. Available at ttp://uscgboating.org/statistics/bui_study_final.pdf.

act to require boating safety education, LD 2067. Available at http://www. inelegislature.org/legis/bills/billtexts/ld206701.asp.

7. Moore C, Sarver R, eds. Reference guide to state boating laws. 6th ed. Lexington, KY: National Association of State Boating Law Administrators; 2000. Available at http://uscgboating.org/regulations/nasbla_ref_ guide_6.pdf.

8. Brooks CJ. Survival in cold waters. Ottawa, Canada: Transport Canada; 2007. Available at http://www.tc.gc.ca/marinesafety/tp/tp13822/menu.htm. 9. United States Power Squadrons. Paddle smart boating seminar. Raleigh, NC: United States Power Squadrons; 2008. Available at http://www.usps.org/e_stuff/seminars/paddlesmart_sem.htm.

Notice to Readers

Click It or Ticket Campaign

May 19-June 1, 2008

During 2006, motor-vehicle crashes resulted in 32,092 deaths to motor-vehicle occupants (excluding motorcyclists), and 2.7 million occupants were treated for injuries in emergency departments in the United States (1,2). Safety belts are an effective means of preventing serious injury and death in the event of a crash. However, millions of persons continue to travel unrestrained, and some groups, including men and young adults (ages 18-34 years), are less likely to be restrained than others (3). Consequently, young adult males have high rates of crash fatalities (2).

Click It or Ticket, May 19-June 1, 2008, is a national campaign, coordinated by the National Highway Traffic Safety Administration, to increase the proper use of safety belts. Law enforcement agencies across the nation participate in the campaign by conducting intensive, highvisibility enforcement of safety belt laws. This year, the campaign will focus on young adult males and will include daytime and nighttime enforcement activities. Additional information regarding Click It or Ticket activities is available from the National Highway Traffic Safety Administration website at http://www.nhtsa.gov. Additional information on preventing motor-vehicle crash injuries is available at http://www.cdc.gov/ncipc/duip/mvsafety.htm.

References

1. National Highway Traffic Safety Administration. Traffic safety facts: 2006 data. Washington, DC: US Department of Transportation; 2008 (publication no. DOT-HS-810-809).

2. CDC. WISQARS (Web-based Injury Statistics Query and Reporting System). Atlanta, GA: US Department of Health and Human Services, CDC. Available at http://www.cdc.gov/ncipc/wisqars.

3. Beck LF, Shults RA, Mack KA, Ryan GW. Associations between sociodemographics and safety belt use in states with and without primary enforcement laws. Am J Public Health 2007;97:1619-24.

In the United States, injury is the leading cause of death for persons aged 1-44 years. Prehospital emergency medical services (EMS) have a substantial impact on the care of the injured and on public health. At an injury scene, EMS providers determine the severity of injury, initiate medical management, and identify the most appropriate facility to which to transport the patient.

Every day, under any circumstances, approximately 750,000 EMS providers serve their communities. National EMS Week (May 18-24, 2008) brings together local communities and medical personnel to promote safety and recognize the dedication of paramedics, emergency medical technicians, first responders, firefighters, police, and others who provide often heroic, lifesaving services as a routine part of their jobs.

National EMS Week will feature activities that support this year's theme, Your Life is Our Mission. In support of National EMS Week, CDC is launching a series of fact sheets on the treatment of blast injuries for EMS responders and physicians in trauma and emergency departments. These fact sheets are available online at http://www. emergency.cdc.gov/blastinjuries.

In partnership with the American College of Emergency Physicians, CDC also is sponsoring an online course, Bombings: Injury Patterns and Care, which is designed to provide the latest clinical information regarding blast-related injuries from terrorism. The course is available at http://www. bt.cdc.gov/masscasualties/bombings_injurycare.asp. This online course and the blast injury fact sheets are supported by CDC's Terrorism Injuries Information, Dissemination and Exchange (TIIDE) Project. TIIDE was established through a cooperative agreement to link acute care and EMS to state and local injury-prevention programs for terrorism preparedness and response.

Notice to Readers

National Recreational Water Illness Prevention Week - May 19-25, 2008 The week of May 19-25, 2008, marks the fourth annual National Recreational Water Illness Prevention Week. This yearly observance provides an opportunity for public health agencies to increase awareness of recreational water illness and promote healthy recreational water experiences.

Recreational water illness (RWI) is spread by swallow ing, breathing, or having contact with contaminated wat from swimming pools, water parks, interactive fountains spas, lakes, rivers, or oceans. The most commonly reported RWI is diarrhea caused by pathogens such a Cryptosporidium, Norovirus, Shigella, Escherichia co O157:H7, and Giardia. Children, pregnant women, and persons with compromised immune systems are at greatest risk for RWIs. Infection with Cryptosporidium can be in threatening in persons with weakened immune systems. Other RWIS include various skin, ear, eye, respiratory, and neurologic infections.

In 2007, state and local health departments across the country investigated more RWI outbreaks than ever before This upsurge was driven by an increase in the number of reported RWI outbreaks caused by Cryptosporidium, chlorine-resistant parasite, and was primarily associated with treated recreational water venues, such as pools, water parks. and interactive fountains. Although seven such RWI outbreaks caused by Cryptosporidium were identified in 200: (1), CDC has received preliminary reports of 18 tha: occurred during 2007 (CDC, unpublished data, 2008) and expects to receive more as the 2007 count is finalized Because Cryptosporidium is chlorine resistant, even a well maintained pool can transmit this parasite. Therefore, publ health officials, pool operators, and beach managers should work together to educate the public regarding preventing RWIS by keeping Cryptosporidium and other pathogens out of all recreational waters, treated and untreated (e.g., oceans) and lakes). RWI prevention guidelines for pool staff members are available at http://www.cdc.gov/healthyswimming twelvesteps.htm. Suggestions for pool users are available 2 http://www.cdc.gov/healthyswimming/pdf/pool_user_

tips.pdf.

To help promote healthy recreational water experiences public health officials also can participate in development of the national Model Aquatic Health Code (MAHC Currently, no complete pool code exists at the national level In 2005, local, state, and federal public health officials and representatives from the aquatics sector met to develop a strategic plan to prevent RWIS, with the top recommenda tion calling for a national model code that would provide uniform guidelines for the design, construction, operation. and maintenance of treated recreational water venues Although it will not provide a set of federal regulations MAHC will give state and local agencies a tool with which to update their own codes. Information regarding particpation in the development of MAHC is available at http: www.cdc.gov/healthyswimming/model_code.htm.