Lifeguard assistance at Spanish Mediterranean beaches: Jellyfish prevail and proposals for improving risk management

Although beaches can be hazardous environments, few studies have identified injuries in broad coastal areas. We performed a retrospective descriptive study of injuries and other services provided by lifeguards during 2012 along the Spanish Mediterranean beaches. The trend in jellyfish stings was also examined for the period 2008–2012 using a standardised Sting Index. Obtaining data relied on voluntary cooperation of local authorities, resulting in data provided from 183 cities out of 234 present in the study area and 760 beach lifeguard stations (LGS) out of about 1200. Lifeguard stations provided an average of 89 days of service per year, from late June to the beginning of September. A total of 176,021 injuries were reported, of which jellyfish stings were the main need for assistance with 59.7% (n = 116,887) of the injuries and 257.0/LGS, followed by wounds (14.4%, 50.9/LGS), and sunburn (3.3%, 15.8/LGS). Apart from attending injuries, beach lifeguard services provided 21,174 other services such as help to disabled people (57.9/LGS), blood pressure measurements (12.7/LGS), rescues at sea (6.5/LGS), lost children (5.7/LGS), and transfers to the hospital (4.6/LGS). Official reported fatalities for all the beaches in 2012 were 24. We proposed a Sting Index (SI) to allow comparisons of the incidence of stings between years and/or localities by standardising jellyfish stings by the total of all injuries. Historical data were consistent enough to calculate SI between 2010 and 2012 and showed an oscillating pattern without a clear trend (2008: 2.4, 2009: 1.3, 2010: 2.4, 2011: 2.0, 2012: 2.6). Estimation of total number of jellyfish stings for all the beaches present in the area would reach 184,558 for 2012. There were very few fatalities in comparison with other coastal regions, probably due to the combination of a calm sea, a low number of high dangerous situations, and a high percentage of lifeguarded beaches during the bathing season. Nevertheless, although Spanish Mediterranean beaches could be described as low risk, we propose measures to facilitate a precautionary management to prevent injuries based on a real-time beach assistance database of injuries to identify high-incidence assistance categories.