MPWCs are defined by the Waterways Authority (NSW) (formerly, the Maritime Services Board) as a vessel of no more than 3.5 m in length with a fully enclosed hull, which is power driven and designed to be operated by a person standing, sitting astride or kneeling on the craft, but the driver is not sealed inside the vessel. They are distinct from non-motorised personal watercraft (e.g., surf skis, surfboards, canoes and kayaks) and are capable of speeds of up to 72 kt (125 km/h). They are also being trialled as rescue craft by Surf Life Saving Australia Limited.

There are many regulations controlling their use which are governed by the Waterways Authority (see Box 1). There are 4300 registered MPWC owners in NSW. ⁴ During a recent campaign to assess irresponsible use of MPWCs, 1466 MPWCs were stopped and 68 infringement notices were issued. Of these, 55% related to licensing and registration and 21% concerned safety issues. ⁴

We report six patients who presented to the Royal North Shore Hospital (RNSH) Emergency Department in Sydney over a four-year period (1992-1996) with serious or fatal injuries sustained while riding an MPWC. Four patients were identified by a search of hospital medical records from 1990 to 1995 and another from a search of the trauma database. Another patient was identified after an analysis of Waterways Authority data. The St John Ambulance Service (NSW), Water Police, Surf Life Saving Australia Limited and the Australian Institute of Health and Welfare National Injury Surveillance Unit did not have data on MPWC injuries. Four patients gave permission to publish their case histories, one declined, and the other was unable to be contacted.

Case 1
Case 2
Case 3
Case 4

Discussion

The six patients who presented to our emergency department show that MPWCs can cause accidents that may result in injury or even death. In total, these patients accounted for over 130 hospital-days (18 in the intensive care unit). At time of writing, two patients are still in hospital and there has been one death. Their average age was 31 years, which is similar to that of the 25 cases of MPWC incidents reported to the Waterways Authority (Box 2). Unofficial data collected by the Surfriders Foundation Australia suggest there have been three fatalities in NSW (J Bradley, officer in charge of MPWCs, personal communication).

The first report of MPWC injury was in 1989, and involved 13 people injured over the previous three-year period, including two fatalities.⁵ Three other overseas studies reported injuries to 134 people caused by MPWCs.^6-8 None of these studies reported fatalities. The only Australian study pertaining to MPWCs was a case report of a full-thickness vaginal laceration extending to the peritoneal cavity. ⁹

All that is needed to obtain a boat driver's licence in NSW is to pass a written test set by the Waterways Authority, and the person must be at least 16 years of age. There are no restrictions on MPWC engine capacity; recent models are 1100 cc and weigh over 250 kg without passengers. ¹⁰ New licensees can immediately drive any size machine at any speed, whereas (in NSW and some other States) newly licensed motorbike riders are restricted to machines of engine capacity of no greater than 250 cc.

Another area of concern is the lack of reporting of MPWC incidents. A requirement of having a boating licence is that when an accident results in death or injury to a person, or damage to property, a written report must be forwarded to the Waterways Authority within 24 hours. ² Only three of the six cases presenting to our hospital were reported to the Waterways Authority.

The United States Coast Guard estimated that only 10% of non-fatal watersports accidents were reported.⁸ Case 4 was not reported, despite aninvestigation by the NSW Police Service at the time. Anecdotal reports suggest that there is a high incidence of personal injury to MPWC drivers (particularly inexperienced drivers), with bruising to the groin region the most common injury. However, MPWC drivers are often reluctant to report incidents because they fear that this will lead to increased regulation of their sport.

All holders of a boat driver's licence are restricted to a blood alcohol level of less than 0.05% (or 5 g/100 mL). Under the Marine (Boating Safety -- Alcohol and Drugs) Act 1991 (NSW), people who present to a hospital after an injury incurred while in charge of a boat or MPWC must have blood taken for blood alcohol testing. Five of the six people who presented to our hospital were not tested for blood alcohol levels (one tested negative). No data are available on whether alcohol was involved in any of the incidents reported to the Waterways Authority. United States data suggest that more than half of boating deaths are associated with alcohol.¹¹ An Australian review of alcohol and accidental drowning reported that, of 29 male victims of moving water-transport accidents, 10 had postmortem blood alcohol concentrations of over 15 g/100 mL.¹²

The Australasian Jet Sports Boating Association (AJSBA) conducts races in Australia and New Zealand each week and has strict safety regulations. Competitors must wear helmets and many also wear leg protectors and back protectors. Some form of medical coverage is provided at all competitions, and all competitors are covered by insurance. In 10 years of competition there have been no fatalities and no serious injuries. The average age of racers is 30 years. The AJSBA is assisting some States to formulate regulations (M DeBie, General Manager, AJSBA, personal communication).

Conclusions

Present deficiencies in the reporting of MPWC accidents need to be addressed. The Waterways Authority accepts reports from anyone involved, not just the licensee. Alerting ambulance and police officers, lifesavers and hospital emergency department staff of the need for reporting incidents would be an effective approach. Emergency department staff also need to be aware that blood must be taken after MPWC accidents to determine blood alcohol concentrations.

A simple preaddressed form (similar to the adverse drug reaction report form used by the Australian Drug Evaluation Committee) could be made available to emergency services and hospitals and also to registered MPWC owners and holders of boating licences. A comprehensive reporting system would assist in further research into the incidence, severity and causes of MPWC accidents.

Acknowledgement

References

1. Lewis D. It's war on the water: a blitz on jetskiers. Sydney Morning Herald 1996 Mar 23; Sect 1: 4.
2. Waterways Authority. NSW safe boating handbook. Sydney: Waterways Authority, May 1995.
3. The Royal Life Saving Society - Australia. Swimming and lifesaving. 3rd ed. Sydney: Mosby Lifeline, 1995.
4. New South Wales Department of Public Works and Services. Media Release. 1996; May 19.
5. Vernberg D, Fine EG, Jagger J. Personal water craft injuries [letter]. JAMA 1989; 261: 1883.
6. Francis RA, Vize R. Personal water craft injuries: experience at a community hospital. Missouri Med 1994; 91: 241-243.
7. Jeffery RS, Caiach S. Waterbike injuries. Br J Sports Med 1991; 25: 232-234.
8. Hamman BL, Miller FB, Fallat ME, Richardson JD. Injuries resulting from motorized personal watercraft. J Pediatr Surg 1993; 28: 920-922.
9. Wein P, Thompson DJ. Vaginal perforation due to jet ski accident. Aust N Z J Obstet Gynaecol 1990; 30: 384-385.
10. Personal watercraft buyers guide. In: King M, editor. Jet Action; 1996 May-June: 54.
11. Bradley J. Growing public menace caused by ineffective control of motorised personal watercraft in the surf. Proceedings of the Local Governments Authority Fourth Annual NSW Coastal Council Conference; 1994 Oct 18-20; Terrigal, NSW.
12. Plueckhahn VD. Alcohol and accidental drowning. Med J Aust 1984; 141: 22-25.