Dr. Stephen Langendorfer

Dr. Stephen Langendorfer

Langendorfer part of effort to apply science to water safety

Around the turn of the 20th century, when Wilbert “Commodore” Longfellow got involved with the U.S. Volunteer Life Saving Corps (a forerunner of today’s Red Cross lifeguarding program), there were more than 10,000 drownings annually in the United States. The population at that time was about 75 million. Today, though the population has soared to over 300 million, there are only 3,000-4,000 cases of drowning a year, thanks in part to the presence of trained lifeguards at public pools and the prevalence of swimming lessons for children and adults.

But even that reduced number is too many, says Dr. Stephen Langendorfer, kinesiology. An avid Masters swimmer, Langendorfer is engaged in several efforts nationally to update and improve water safety for swimmers through research and sharing of knowledge.

It’s an idea whose time has come, he said. “The aquatics field is extremely tradition-bound and pragmatic,” he explained. “Research has not been an integral part of improving our practices. Recently, there has been a convergence of several organizations and coalitions, whose purposes are to reduce drownings, to identify where research exists, where it is lacking and what we still need to know.”

The American Red Cross, the YMCA of the USA and the U.S. Lifesaving Association (USLA) have joined in one effort, called the U.S. Lifeguarding Standards Coalition, with significant funding from the National Swimming Pool Foundation, an industry trade organization. Two of the three coalition chairs are medical doctors allied with the Red Cross and the USLA, Langendorfer said, which has contributed to the increased interest in identifying and promoting research-based practices.

As part of the effort to both promote and share research, Langendorfer was selected as the editor of the International Journal of Aquatic Research and Education, published by Human Kinetics Publishers. Focusing on all areas of noncompetitive aquatics, the quarterly journal deals with a broad array of topics from lifeguarding and water safety to aquatic exercise and therapy, and contains peer-reviewed research as well as professional and educational articles. Now in its second volume, the journal has had contributors from Europe, South America, Australia and New Zealand, in addition to those from the U.S.

Practice grounded in evidence
Aquatic professionals are concerned that current practices have never been tested and rarely have been revamped, Langendorfer said. “It’s time to take a fresh look at different practices. We need to conduct an evidence-based, scientific review process that involves a literature search on various issues and questions,” he said, in addition to surveying working professionals for best practices. “Ultimately, we need many more people conducting scientifically sound research on the questions to which there are no existing answers or evidence.

For example, he said, using the gains in medical knowledge, one question that needs to be explored is whether, when rescuing a person who is drowning and may have stopped breathing, rescue breathing should begin in the water, or the victim carried as quickly as possible to shore, where CPR can also be started?

In addition, some basic lifeguarding practices are clearly outdated, he said. “Lifeguards typically have been taught to approach a struggling swimmer by diving under the surface, grasping them around the knees, turning them around and then doing a cross-chest carry to tow them to safety. But in the late 1980s, when we asked professional lifeguards if they really do this, they said, ‘Of course not, that’s silly. It doesn’t work.’

“What really happens is that when you provide them a rescue buoy or tube that the lifeguard carries to the victim, they stop struggling and you tow them in. This is a much more effective technique and safer for the rescuer and the victim,” Langendorfer said.

An even more basic question that surprisingly has not been addressed is the degree to which learning to swim prevents or reduces the risk of drowning, he said. Though widely assumed by aquatic professionals to be helpful, “there’s been remarkably little research and thus only a limited amount of evidence. And, if learning to swim is very important, at what age does learning to swim really prevent drowning?” Langendorfer said. “There is very little evidence that learning to swim before the age of 4 or 5 has any significant drowning-prevention effect. Children can and should learn to swim at young ages, but not as a primary drowning-prevention strategy.”

In addition to helping aquatic agencies better target their efforts, having scientific evidence addressing these questions could help professionals respond to potentially spurious claims by some swimming schools promoting “drown-proofing young children,” Langendorfer said.

Recent research already has altered some of the practices aimed at teaching very young babies to swim, he said. One practice of repeatedly submerging young babies was stopped because it was shown that the babies tended to swallow large amounts of water, which could cause dangerous imbalances in their circulatory systems and electrolyte levels.

Once the most pertinent questions and issues have been researched, the findings will be published so the various aquatic agencies can make decisions about what to provide in their lifeguarding, water safety and learn-to-swim courses, Langendorfer said.

“We’re in the midst of an exciting revolution where aquatic agencies realize they have to be more accountable for whatever practices they use,” he said. “There’s been a general recognition by these agencies that they need to look beyond the narrow field of aquatics and consider research drawn from diverse areas such as psychology, pedagogy, biology and technology, among others.”

“The focus on lifeguarding and lifesaving over the past century has done a good job of making our public pools much safer,” he said. “There is now only a miniscule number of drownings in them. Most drownings today happen in natural bodies of water and in private and backyard pools.”

In response to changing lifestyles and trends among potential lifeguard candidates, Langendorfer is exploring whether it would be appropriate to offer online training to lifeguards for some specialized components of the course, instead of continuing the current practice of using only face-to-face instruction.

“Young people are not willing to commit the 40-50 hours required for an all-around lifeguard training,” he said. “Current lifeguard courses are only 20-25 hours long, but training is done for much narrower and limited lifeguarding jobs. There is concern that lifeguards don’t have as many or as strong skills as before.”

Online coursework might work well in helping teach lifeguards the techniques related to observation and judgment about when a situation is becoming dangerous. “Lifeguards must learn vigilance skills since the vast majority of their time on the job is spent watching patrons, not rescuing victims,” he said. “Currently, lifeguarding courses spend most of their time teaching rescue techniques and only mention the importance of scanning and vigilance skills without spending any time helping candidates learn these skills. When you stop and think about it, that doesn’t make sense.”

Langendorfer has been exploring the broad possibilities of online instruction with BGSU’s Center for Teaching, Learning and Technology and IDEAL (Interactive and Distance Education for All Learners), pointing out that firefighter training in Ohio has already begun using online instruction. “It is an appropriate learning tool, especially for this generation,” he said. “If online instruction works for firefighters, it should also work for training lifeguards, who are also first responders.”

The hoped-for outcomes of all this emphasis on scientific review and research will be improved lifeguarding and learn-to-swim practices, Langendorfer predicted, and even fewer water mishaps.

April 7, 2008