Hanauma Bay

A Connection Between Hawaii Snorkeling Drowning and Air Travel?

Is there a relationship between air travel and snorkeling deaths?

Hawaii visitor deaths by drowning are far too common. Another drowning earlier this summer raised the same question about a possible correlation between travel and snorkeling deaths. That one occurred near the luxurious Mauna Kea Beach Hotel on Big Island. The deceased was 61-year-old John Mackenzie of Oregon. An autopsy was performed, but there was no further information about any causal relationship.

A study snorkel safety study funded by the State of Hawaii found there may be a relationship between travel and snorkel drownings. You can read the report below.

The five main snorkeling safety study takeaways are:

  1. Do not snorkel within the first few days of a transpacific flight. This applies to visitors and Hawaii residents returning from the mainland.
  2. The safest snorkel doesn’t have tip modifications to keep water from entering.
  3. It is safer to snorkel where you can touch the ocean bottom.
  4. If you can’t swim, you shouldn’t snorkel.
  5. Snorkeling is the most common activity associated with visitor drownings.

Low oxygen levels and not inhaled water may cause many drownings.

The study says that most of these deaths aren’t related to inhaling water, as some had thought. Instead, drownings are mainly due to low oxygen levels related to fluid buildup in the lungs. It is called rapid onset pulmonary edema (ROPE), which is induced by hypoxia. Will this answer the question we’ve asked countless times, why do visitors die from snorkel-related drowning so much more than residents?

Age, gender, and coronary correlation.

The study found that pre-existing coronary conditions, gender, and age are other factors in Hawaii visitor drownings. A specific heart condition impacts middle-aged men more than others.

One interesting finding is that those who die this way do not struggle in the way one would when inhaling water. That is why victims are often found face down in the water, as was the case this week at Anini Beach. ROPE results in muscle fatigue and then loss of consciousness.

90% are visitors in the last 200 Hawaii snorkeling deaths.

On average, one visitor dies this way each week here in the islands. The risk of serious incidents happening to visitors is 10x that for residents.

A new Hawaii state ocean safety website can help.

Designed to raise awareness of risk factors, it includes information on lifeguarded beaches, ocean conditions, warnings, which beaches have the most injuries, and other ocean accident data. DOH coordinator Bridget Velasco said, “Keeping everyone who goes to the ocean safe is a top priority.”

“If in doubt, don’t go out” is the common theme you will hear.

It is easy to think that you are as powerful as the ocean, but that is never the case. Our advice is only to snorkel when the surface is smooth and be mindful of your distance from the shore. The drowning victim this week was 300 feet from shore.

Even though we (BOH editors) are both experienced swimmers, we usually follow the shoreline rather than swim straight out. Also, as anyone will tell you, swimming in a controlled environment like a pool is not the same as being in the ocean.

Top Ten Hawaii Beach Safety Tips.

Issues can include strong currents, wave surges, and seasonal variations in ocean conditions, among others. Be alert, do not turn your back on the ocean, and follow these suggestions for your Hawaii vacation:

1. Minimize risk by being highly aware and respectful of ocean conditions’ dangers.
2. Choose to swim at Hawaii beaches that are lifeguard protected. Also, look for rescue station tubes at many beaches.
3. Follow Hawaii beach warnings and closures.
4. Check with a lifeguard if in any doubt.
5. Observe the water for some time before entering to look for more giant waves appearing in groups.
6. Review ocean safety brochures that are provided in visitor accommodations.
7. Visit ocean safety websites, including the new one referenced above and the Hawaii Beach Safety website from the Hawaii Lifeguard Association. Check for frequent updates on Hawaii surf conditions and warnings for all islands.
8. Understand rip currents and how to deal with them.
9. Avoid painful jellyfish stings – read our updated Hawaii jellyfish update and calendar.
10. Don’t get caught on wet rocks where unexpected waves can suddenly appear. Also, look for hidden underwater rocks at beaches.

Can This Happen to You?

Drowning can happen to anyone at any beach, no matter how famous you are or how good shape. There were 84 drownings in the latest year studied. Other accidents were primarily attributable to hiking and car crashes.

Hawaii beaches are accessible year-round, so you can always find a beach that’s suitable for you. Surf conditions change rapidly and during the seasonal change. For example, if you visited Hanalei Bay in summer, you found a mostly calm surface for swimming. In the winter, however, the surf at Hanalei can be a dangerous 30 feet or more. Even on one day, the surf can start calm and end wild. It can change in minutes.

Some of the Deadliest Hawaii Beaches.

Surprisingly, the deadliest beaches may not be those that first come to mind. Many drownings occur at some of the smoothest water beaches where visitors are snorkeling or swimming.

Hanauma Bay – Oahu (pictured above)
Waikiki Beach
Black Rock – Maui
Kahanamoku Beach and Lagoon – Oahu
Molokini – Islet off Maui

Some of the Most Dangerous Hawaii Beaches.

Dangerous beaches in terms of injury but not mortality include the following. If your beach isn’t listed, it doesn’t mean you shouldn’t have concerns:

Makena Beach – Maui
Hapuna Beach – Big Island
Sandy Beach – Oahu
Brennecke Beach (Poipu) – Kauai
Laaloa Beach – Big Island

Please add your thoughts about ocean safety! Mahalo.

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39 thoughts on “A Connection Between Hawaii Snorkeling Drowning and Air Travel?”

  1. Hello, my husband died last year, on September 17th, snorkeling in Maui’s beautiful Napili Bay.
    He was an excellent swimmer and very comfortable swimming in the ocean. He passed away within 24 hours of our much anticipated vacation. We couldn’t wait to get snorkel equipment from Snorkel Bob’s, little did we know that this would be fatal. Had we any knowledge that snorkeling could be fatal, we would have waited at least a few days to go out. His death is listed as “probable Hypertensive Cardiovascular Disease” but I was with him and I know that he died of ROPE. I am glad that there is more awareness about this issue, but people are still dying. Why? Because people don’t know about it. This needs to become widespread public knowledge.

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    1. I am so sorry for your loss. I hope hotels and websites start sharing the information about ROPE. I never really heard about it until now after looking up causes of drownings in Hawaii. I was born in Hawaii and visit almost every year. I can understand hypoxia because I am a RN and think it’s crazy that it’s taken so long for people to realize the cause of death for so many people who snorkel.

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  2. Thank you for this info! I have a snorkeling trip lined up 4 days after I arrive. Now I’m wondering if I should push it to the last day I’m there just to be safe!

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    1. Kelly, I would think that waiting 4 days should be long enough, but if you’re going with an organized group, I would make sure that they are aware of the possible dangers.

      Enjoy and be safe.

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  3. Excellent article, helpful info. Statistics were eye opening! Always used separate mask and snorkel. Breathing from your mask probably makes you inhale too much CO2 not being blown out of the mask. The buildup will kill you.

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    1. Very good point! I have spent hundreds of hours snorkeling & free diving over the last 60 years or so, and was SCUBA certified in the late ’70’s, though I did not stay with it – too much gear & prep for the water time!
      We were just on Kauai, and noticed that a lot of people, obviously new, had those full face masks with the snorkel on top – others had more conventional masks, but fancy snorkels with lots of gadgets top and bottom.
      I have a very simple US dives snorkel with a wide diameter, simple, close curve at the mouth piece, and straight pipe after that. Gives good volume, and very easy to clear even if I don’t have much of a breath left after a dive or taking on water in a wave.

  4. It may be the same reason why young people fall off their feet, pilots die during flight… unknown cause of death 🤫

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  5. The snorkeling mask should be goggles separate from the Breathing tube. Do not use the full face combination type where you can breathe through the nose.

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  6. I think it would be helpful to have a water safety instructional video shown on every flight. It should include warning signs, how to identify unsafe conditions etc. Not every hotel, airbnb or condo has a booklet.

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  7. Thanks for the great info. I’m an excellent swimmer in my 50’s, who just enjoyed a week swimming the beaches of Oahu, including Waikiki. I noticed that calm beaches can become more treacherous in just minutes and would advise anyone to not take chances, no matter how well they swim. Never swim too far from shore and always know where shallow water is in case trouble ensues in the water. Also, always swim beaches that are protected by lifeguards.

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  8. Thank you, this is really important to know about ROPE as a snorkeling hazard. As a local I never heard about this.

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    1. Let’s not forgwt the full face mask has been link to lack of oxygen. The star advertiser posted about this.

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  9. I’m wondering 🤔 if the use of a pulse oxymeter to measure one’s oxygen saturation can be a fast convenient diagnostic tool to prevent a death…especially shortly,days or hours after air travel,before snorkeling or other water activities. As well as perhaps after visiting high elevation attractions like volcano rims,hikes or one of the observatories which can have extremely high elevations and thinner air,producing lower oxygen saturation levels in an otherwise unsuspecting tourist.

  10. A website is pointless. No one takes the time to research or read. We need airline briefings on the most important things you need to know about Hawaii. Do it the 30 mins before landing. Tell them about the wildlife and how to be a good traveler. Everyone thinks they are strong enough and safe enough until they are not. We need free life vests, good snorkles and free floating devices. Solutions not talk. Also very helpful article thank you!

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    1. Might be a good idea but I hardly think it would work….you suggest the airlines give the briefing to all passengers but in reality what % are going to snorkel so those people aren’t going to pay attention…people don’t listen to the safety briefings in the begin so they surely aren’t going to listen to a briefing that has nothing to do with them. Also I doubt you could get the airlines to “buy off” on giving the briefings, after all what’s in it for them?!? It’s like the old saying….”You can lead a horse to water but …….etc etc”

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  11. I find Maluaka Beach in Makena dangerous. I almost drowned a few years back. 2 younger girls saved me. I’ve been going to beaches here for 40 years and I never had that experience where I couldn’t get out ( I’m 63 ). My daughter mocks me for my apprehension of south Maui beaches. I’m sticking to my pool🌺

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  12. Full face masks are dangerous. Some of these deaths were due to these masks.
    Mahalo for your great work.

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  13. I always tell my visitors, especially mothers of young children, Seniors,to go to a lifeguarded beach and go to the lifeguard station to ask where the safest place to swim is. This does two things: you find out the best place to swim and it alerts the lifeguard he has novices on his or her beach. Beaches can change seasonally and the lifeguard knows best for that day where you should enjoy your day of swimming, snorkeling etc.

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  14. From reading the comments, I think point #2 is being missed: “The safest snorkel doesn’t have tip modifications to keep water from entering.” The extensive study mentioned in another comment points out that purge valves may be a serious problem. It’s time to go back to the old-fashioned strong blast to clear your snorkel.

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  15. I broke my neck boogie boarding off Hamoa Beach because I was not aware of how different the waves are in Hawaii compared to Florida (where I boogie boarded frequently). Thankfully, the hospital and emergency staff took very good care of me. I walk today thanks to a titanium rod in my neck. Respect the ocean and be appreciative of the locals!! One of them saved my life!!

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  16. Aloha, BOH! My husband and I are avid and experienced snorkelers. Our strongest safety suggestion is to snorkel with a buddy. We snorkel together and look around to check on each other frequently. Snorkeling is one of the main reasons that we come to Hawaii and we have snorkeled off of five of the islands. Even so, we carefully choose when and where to go in, and strongly urge everyone to snorkel with a friend. Mahalo for addressing this important topic today! — Susan

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    1. Aloha Susan, I hope you don’t mind me asking, do you take any kind of floatation device? If so, would you mind recommending one? We’ve snorkeled on Maui, but all these drownings tend to frighten me.

      Mahalo!

      Lanell

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  17. I would like the study to include the type of snorkel mask involved if the drowning is associated with snorkeling. Specifically, firtst responders should note whether the mask was a traditional style, “goggle” or “full face” mask. Concerns are that CO2 may build up in the full face models more so than in the snorkeling tube attached to goggles.

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  18. >>Do not snorkel within the first few days of a transpacific flight.

    What’s the rational (medical or otherwise) behind this recommendation?

    I had heard something similar with respect to scuba diving, but not snorkeling.

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    1. We were counseled 40 years ago on a vacation in Jamaica, as to Scuba Diving and I believe it was 48 Hours after landing and after last dive before flying again. One concern should also be the gentleman’s age, all things considered.

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  19. This unfortunate drowning was a man in a snorkel mask not described as a mask and snorkel.
    If correct, this is the full face mask described as easier to use and offered at Costco and rental snorkel shops.
    I am a PADI Divemaster and a former recovery diver for the National Park Service.
    My opinion is the situation of breathing recycled stale air in the full face mask when they are not breathing deeply
    From Surface Air.
    That explains to me why there is little or no struggle.
    They just Nod Out.

    A couple of years ago this was studied on Maui.
    They were tracking drowning events and types of masks.
    Then , you could rent them or buy them at a kiosk.
    Kids and adult size.
    I never heard a decision.

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  20. My brother had talked to one of the lifeguards when he was there and they implied that a big cause of rescues was the full face snorkel mask.

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  21. This is completely anecdotal, but I can almost guarantee that these deaths are mostly caused by those terrible masks that combine a snorkel into it such that your entire face is covered. I bought one from Costco for a trip to Hawaii and while using it, I had to lift it off my face every minute or less to catch my breath. I returned it as soon as I got home.

    Any time you snorkel you increase the “dead-air space” that you breathe in. These mask/snorkels must have a much higher volume of dead air than a regular snorkel resulting in a much higher percentage of carbon dioxide being inhaled. I recommend no one use those types of masks, Especially kids.

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  22. Thank You BOH, this informative article may help save lives. I say “may” due to the fact that many will believe that it can’t and won’t happen to them and that attitude contributes to the mortality rate. I’ve heard of drowning deaths, all ages, in fresh water due to cramping, over exertion, heart attacks and other causes. On another note, there Are Snorkels that Do Restrict water from entering.

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  23. I think the biggest contributor to ocean deaths in Hawaii is tourists don’t appreciate the difference between swimming in the ocean and their pools, lakes and ponds in middle mainland. They think that they are strong swimmers and don’t appreciate the differences between their local pond back home and Makapuu beach on Oahu. When we were kids we pulled several bodies from the surf at Sandy Beach and Makapuu. There were signs there warning “Servicemen” to stay out if the water.

    Somehow, we need a more effective method to educate visitors of the differences of swimming in the ocean and the more controlled environments they swim in at home.

    Aloha

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    1. Tourists around the tropical world snorkel right after getting off the plane without creating a high drowning rate in other regions. Sorry, not buying it.

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  24. Re snorkeling. Those one piece masks don’t allow enough air flow and have been linked to deaths. If you try to swim hard and snorkel you might not get enough air flow. They are death traps. Better to get a two piece high quality silicone mask and snorkel set. You won’t have that low capacity intake problem. Do some research and see what I mean.

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  25. I’ve snorkeled hundreds of times at dozens of locations in Maui. The first thing I check is the Maui Snorkel Report before I even take my snorkel out. It gives you a pretty good idea of whether or not you should even consider snorkeling on any particular day. I have seen many inexperienced snorkelers going too far out wearing the full face masks that are known to trap carbon monoxide inside the mask eventually causing serious breathing issues and loss of energy needed to return to shore. One time I had to flag down a kayak to rescue a woman who appeared to be near drowning. It’s better to stick to the basic old fashioned snorkel design.

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  26. Unfortunately this occurs all too often with visitors to Hawai’i and possibly the cause is ROPE-Rapid Onset Pulmonary Edema as your article states.  Carol Wilcox of Oahu did a phenomenal study on this a couple years ago. The Snorkel Safety Study website has very useful info about this. snorkelsafetystudy.com/ She and I have talked about this at great length and it is a very interesting topic. As a snorkeler and diver myself and a frequent visitor to Hawai’i, I have changed my snorkeling habits after I learned about this.

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  27. I was sorry to read about the drowning at Anini, my favorite snorkeling beach. I’d be curious to know if any of these ROPE deaths are possibly related to the type of mask being worn? I have heard the full face masks are not safe and can cause asphyxiation, but I have seen many tourists at Anini wearing them. Thanks for another informative article, guys.

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  28. Did anyone keep track of the deaths that were full face masks instead of the traditional eye/nose mask? The full face one never looked too safe to me.

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