Prolonged breath-holding and underwater activities can prove deadly.

It's a bragging right of kids, competitive swimmers and free divers alike: Who can hold their breath the longest underwater? In far too many cases, however, that one big gulp of air before total immersion is marked as a person's last.

Among 74 aquatics professionals recently surveyed by Tom Griffiths, director of aquatics and safety at Penn State University, nine had experienced water rescue and resuscitation episodes whose root cause was prolonged underwater swimming or breath-holding. Five of those rescue efforts failed to save the individual's life. Griffiths, an author and frequent speaker on water safety (his questionnaire was distributed to attendees of three Griffiths-led educational sessions at the 2006 Athletic Business Conference in November), characterizes his sample as small. But, he adds, the survey findings are nonetheless "significant and startling."

"The point I've been trying to make for the past decade is that every pool in America should have a rule against prolonged breath-holding and underwater swimming," Griffiths says. "Competitive and repetitive underwater activities should be banned."

Too often, they're not even talked about. Only 23 of the 74 survey participants reported having rules prohibiting such activities. Moreover, a mere 14 of these aquatics professionals work at facilities that actually feature signage alerting swimmers to the existence of a breath-holding ban. Griffiths contends that his survey numbers may, in fact, be inflated due to the large percentage of ABC attendees representing the U.S. military, which has been on the leading edge of this issue in terms of awareness. (That said, one of the survey's five identified victims - all males between the ages of 18 and 30 - was a Navy SEAL). Such fatalities are often caused by hypoxia (insufficient oxygen supply to body tissue) or anoxia (complete lack of oxygen in the body) leading to blackout and death. "Unfortunately, too many coroners in this country conclude that drowning is the cause of death whenever there is a pool fatality without exploring other possible explanations," Griffiths says.

Aquatic safety literature likewise has been spotty in identifying the life-or-death risks of prolonged underwater activities, according to Griffiths. "The American Red Cross has very little in its textbooks concerning prolonged breath-holding, whereas the YMCA of the USA, which certifies less than five percent of lifeguards in America, has three pages on it," he says. "I would like to see all training agencies alert lifeguards to this problem. Most lifeguards think that breath-holding is a positive thing. In fact, it's a very negative thing."

Paul Steinbach is Senior Editor of Athletic Business.