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Injuries Continued

Interviews with 46 (71%) of the injured persons identified two primary locations at which injuries occurred- the 45-degree drops and the final outlets. Of the 46, 32 (70%) reported being injured while going over the drops or shortly thereafter, either by landing on the buttocks or lower back or by being knocked off balance and thrown against the sides of the tube; 11 (24%) were upended by the current at the outlet, striking their heads on the sharpedged lip of the tube. The injuries occurred on the first or second ride in two-thirds of the 46 cases.

The slide operators instituted several changes to reduce the number of injuries, including removing a curve from one tube on July 23, requiring every slider to wear a helmet on the first two rides after August 1, rounding the edge of the outlet lip on August 12, and placing extra warning and instruction signs on August 31. Rates of injury declined during July and early August, but rose again in the latter half of August (Figure 1). Improvements in rates were not closely related in time to the specific corrective measures taken. No slide-related injuries were reported by medical-care sources after August 31. Reported by S Marks, MD, C Hyatt, MD, Snohomish County, S Milham, MD, Epidemiology Section, Div of Health, Washington Dept of Social and Health Svcs; Div of Field Svcs, Epidemiology Program Office, Special Studies Br, Chronic Diseases Div, Center for Environmental Health, CDC. Editorial Note: Water slides are “recreational devices designed to provide a descending ride into a splash-down pool at the base of the slide ... by providing a flowing water film" (1). An estimated 600 are in operation in the United States, and operators of large slides may sell an estimated 500,000 tickets per year (2). In 1983, according to the National Electronic Injury Surveillance System of the Consumer Products Safety Commission, water slides accounted for the largest single share, 30% (2,941 cases), of injuries that occurred at amusement rides

FIGURE 1. Rates of water slide injury, by week of slide operation

Washington, 1983

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Injuries Continued and were treated in emergency rooms in the United States. Several water slide-associated fatalities have also been reported (3).

Guidelines based largely on theoretical, engineering considerations have been published for the structure and operation of water slides (1). There is yet no experience or empirical knowledge relating risks of injury to specific design features. The relative severity of the injuries reported in this investigation- fractures and cerebral concussions in 25 (38%) of 65 cases - suggests that excessive speed and loss of body control occurred during the ride. These factors and the association of injuries with two specific sections of the slide in 94% of cases interviewed suggest that design considerations were important in this episode. Whether the rates or severity of injury at this slide are unusually high cannot be determined without comparable studies at other sites.

There is no obvious explanation for the observed changes in injury rates over the summer. No alterations were made in the 45-degree drop sections of the course, and the curve that was removed was not determined in patient interviews to be a high-risk location. The use of helmets and the rounding of the outlet lip are likely to have reduced head injuries, lacerations,

(Continued on page 387)

TABLE I. Summary-cases specified notifiable diseases, United States

Disease

July 7.
1984

27 th Week Ending
July 9,

Median
1983 1979-1983

Cumulative, 27th Week Ending July 7, July 9,

Median 1984

1983 1979-1983

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Acquired Immunodeficiency Syndrome (AIDS)
Asoptic meningitis
Encephalitis. Primary (arthropod-bome

& unspec.)

Post-infectious Gonorrhea Civilian

Military
Hepatitis

Type A
Type B
Non A, Non B

Unspecified
Legionellosis
Leprosy
Malaria
Measles Total

Indigenous

Imported Meningococcal infections: Total

Civilian

Military
Mumps
Pertussis
Rubella (German measles)
Syphilis (Primary & Secondary): Civilian

Military
Toxic Shock syndrome
Tuberculosis
Tularemia
Typhoid fever
Typhus fever, tick-borne (RMSF)
Rabies, animal

410,779

10,435
10.691
12,714

1,889
3.050

287

23

2 17,629

656 431 363

N 145

N 7 34 44 N N 44 4.4

15,021

495 270 405

72 101

3 5 17 14 13

1 47 47

118

26

440

53 490,017 14,187 13,084 10,257

N 5,159

N 102

506 2.290

N

N 1,739 1.723

11 3.928

602 1,746 15.376 193

N 13,550

95 205

434 3.402

452,862

12.374
10.944
12,019
1.752
3,700

354
131
360
1,109

934

175 1,739 1.723

16 2.113

984

685 16.628

223

248
11,683

120
176

408
3,402

26

39
37

4
418

3 12 391 11

4 41 76

411 1,878 1.701

177 1,664 1,660

4 1.944 1,014

437 14,304

175

222 10.907

92 157

323 2,609

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TABLE II. Notifiable diseases of low frequency, United States

Cum 1984

Cum 1984

Anthrax

1
Plague

11 Botulism: Foodborne

6
Poliomyelitis. Total

2 Infant

47
Paralytic

2 Other

3
Psittacosis (Calit. 2)

43 Brucellosis (Calif. 1)

50

Rabies, human Cholera

Tetanus (Mo. 1, Ark 1)

24 Congenital rubella syndrome

3
Trichinosis (Conn 1)

40 Diphtheria

Typhus fever, flea-borne (endemic, murine)

9 Leptospirosis (Va. 1)

9 'One of the 118 reported cases for this week was imported from a foreign country or can be directly traceable to a known internationally imported case within two generations,

TABLE III. Casas of specified notifiablo diseases, United States, wooks ending

July 7, 1984 and July 9, 1983(27th Wook)
Aseptic Encephalitis

Hepatitis (Viral), by type

Gonorrhea
AIDS Menin-

Post-in

(Civilian) Primary

Unspecigitis

А

B NA,NB
tectious

fied
Cum.
Cum. Cum.

Cum.
1984

Cum.
1984 1984

1984 1984
1984
1984 1984 1984

1983

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Reporting Area

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TABLE III. (Contd.) Cases of specified notifiable diseases, United States, weeks ending

July 7, 1984 and July 9, 1983 (27th Wook)

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TABLE III. (Contd.) Cases of specified notifiable diseases, United States, wooks ending

July 7, 1984 and July 9, 1983 (27th Wook)

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