Mar. 23 --
WEDNESDAY, June 20 (HealthDay News) -- Digging that hole to China on a sandy beach is a summertime rite of passage for many kids.
But a new report reveals that those holes -- even fairly shallow ones -- can collapse and kill.
By sifting through news reports and other sources, researchers found 52 cases of sand-hole collapses in the United States and three other countries -- Australia, Great Britain and New Zealand. Sixty percent of the victims -- 31 people -- died, while many of the others needed rescuing and CPR.
There may be many more cases that weren't reported, said report co-author Dr. Bradley Maron, an internal medicine resident at Boston University Medical Center. "We're trying to increase awareness of something that's generally not associated with a life-threatening event," he said. When people are on the beach, "their concern for safety is directed toward the water," he noted.
Maron became interested in sand-hole dangers in 1995, when he was a lifeguard on the Massachusetts island of Martha's Vineyard. One day, a hole dug in beach sand collapsed around a little girl. Emergency crews were able to locate the girl and provide her with an air pocket while they extricated her, Maron said. She survived.
Maron and his father, Dr. Barry Maron, first wrote about sand-hole collapses in 2001. In a new report published in a letter in the June 21 issue of the New England Journal of Medicine, they now follow up on their previous research by tracking down individual cases, most occurring over the past 10 years.
Of the 52 fatal and non-fatal cases reported, victims ranged from 3 to 21 years of age, with an average age of 12. Most victims (87 percent) were boys.
Sand collapses occur in ordinary holes that people dig -- some only a few feet deep -- and in tunnels that collapse. In some cases, people fall into existing holes and the sand collapses around them.
In many cases, parents and others have a hard time figuring out where the victims are because the sand collapses and leaves no sign of them, the younger Maron said. "That makes serious rescue efforts difficult. It's not clear where you should dig, and you can't use heavy equipment," he said.
Sand collapses occur most often at beaches, but they can happen at other places like lakes or even backyards, Maron said.
Not every beach is susceptible to sand collapse, however, said Chris Brewster, president of the United States Life Saving Association, an organization of beach and open water lifeguards.
Southern California beaches, for example, typically have sand that's too dense to allow deep digging, he said.
"Where this tends to happen is where the sand is quite granular, large-grain sand that's easier to dig," he said.
What to do? Common sense is the answer, Maron said: Don't dig holes that are deeper than your knees when you're standing up in them; this rule goes for kids as well as adults. And if you dig a big hole, cover it up when you leave.
And beaches aren't the only sand-hole danger zone. There have been prior reports of children dying after being buried in sand at construction sites, and even in sandboxes, experts warn.
Learn more about beach safety from the American Red Cross.
SOURCES: Bradley A. Maron, M.D., internal medicine, Boston University Medical Center and Harvard Medical School; Chris Brewster, president, United States Life Saving Association, San Diego; June 21, 2007, New England Journal of Medicine