I work with some serious kayakers, who go out most of the year. But they are prepared with proper clothing, including wetsuits. And their PFDs are worn at all times, even during the summer. I'm not quite as protected when I take my canoe out during duck season, but I do wear my PFD, and keep a change of clothes with me in a dry bag. It's a shame so many lose their lives when it takes so little to prevent it.