Lots to think about from this one.
Flush drowning – have you heard about it?
Flush drowning is where the victim is not held in place, but is rather denied air by rough water or being held underwater by the force of water itself.
More info here.
Flush Drowning
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One of the issues might also be that contemporary bouyancy aids do not provide enough head up space. Paddling big rivers in Eastern Europe, the rafters and kayakers use considerably more personal bouyancy partially to ensure that they have less face time with the water when swimming. Good team work.