Background and aim: To establish the causes and circumstances of fatalities in recreational boating and sub-aqua diving inland or around the United Kingdom during the years 2006 and 2007, to comparefatal accident rates according to the type of boat, to identify causal patterns, and to discuss preventative measures to reduce the fatalities.

Materials and methods: Examinations of marine accident files and reports from the Marine Accident Investigation Branch and other sources, including the Royal National Lifeboat Institution, Maritime and Coastguard Agency, Association of Inland Navigation Authorities and the British Sub-Aqua Diving Club.

Results: There were 102 fatalities in recreational boating and 28 in sub-aqua diving with corresponding fatal accident rates of 12.0 and 48.0 per million participants. In recreational boating, fatal accident rates were highest for motor and power boats (20.2), yachts (19.3) and canal boats (16.0). Most fatalities (64%) occurred from April to September, with a peak during August. In recreational boating, 24% of fatalities were recorded as alcohol-related. These were most prevalent in canal boats, occurring largely during the autumn and winter months rather than during summer holidays, among people living on boats, often asa result of fires and falls overboard.

Conclusions: Causal patterns of the fatalities varied strongly according to the type of recreational boat anddiving. Prevention of fatalities should include raising awareness of hazards, adequate training in diving, yachting and canoeing, etc., installation and maintenance of smoke alarms and fire extinguishers on residential boats, and increases in the use of personal flotation devices in recreational boating.