Safety optimization in an accident-prone aquatic context: A qualitative study of drowning risk detection by public pool lifeguards.

Introduction: Drownings occur in French public swimming pools (PCP) in spite ofconstant supervision by qualified lifeguards. This studyhypothesizesthat organizational aspects may affect the mission of pool supervision andtakes a systemic approach that views safety as an emergent property, and drowning as a multifactorial and long-term process that is not restricted to the end of an accidental sequence.

Method: We conducted a qualitative survey at four municipal poolsin France based on 30 semi-structured interviews.

Results: The findings revealed that several interrelated elements influence the detection by lifeguards of bathers in distress: (a) their training, their conception of the profession, and the reasons that led them to enter this occupation; (b) their representations of the drowning risk and the evaluation of their ability to perceive such situations; (c) the question of regulation; and (d) the methods of dealing with this framework in daily operations, which involves trade-offs and appropriations at each level of the system.

Conclusions: In order to identify the most significant influences, it seems relevant:(a) to shift the focus away from these professionals; and (b) to prioritize an analysis of the functioning of the risk management system as a whole, not just critical or post-accident periods. In order to reduce the risk to swimmers, it seems preferable to identify the source of the constraints that weigh daily on lifeguards in charge of pool supervision.The functioning of PSP's is the end result of joint regulation processes likely to influence, positively or negatively, the identified feedback loops. An analysis of the pool supervision can help to identify early warning signs of vulnerability (which can sometimes be acted upon at low cost),identify the practical implications, and makepreventive recommendations.