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The Lancet. Public Health Sep 2021Drowning is a leading killer, particularly of children and young adults, yet has been greatly neglected. Despite accounting for a higher number of deaths than many other... (Review)
Review
Drowning is a leading killer, particularly of children and young adults, yet has been greatly neglected. Despite accounting for a higher number of deaths than many other substantial public health issues, drowning has not benefitted from the targeted attention it requires, which is particularly tragic because low cost and effective drowning prevention interventions exist. Therefore, the recent UN General Assembly's adoption of a resolution on global drowning prevention is a historic first, and offers an exciting opportunity by providing a comprehensive framework and a practical roadmap that a range of actors and sectors, including governments, can follow to address the challenge of drowning prevention.
Topics: Drowning; Global Health; Humans; Public Health; United Nations
PubMed: 34310906
DOI: 10.1016/S2468-2667(21)00165-1 -
Bulletin of the World Health... Mar 2015To examine the extent to which effective interventions to prevent unintentional child injury are reflected in the laws and regulations of China. (Review)
Review
OBJECTIVE
To examine the extent to which effective interventions to prevent unintentional child injury are reflected in the laws and regulations of China.
METHODS
We focused on the six common causes of fatal child injuries - drowning, road traffic injury, falls, poisoning, burns and suffocation. We investigated 27 interventions recommended by the United Nations Children's Fund, the World Health Organization or the European Child Safety Alliance. We searched China National Knowledge Infrastructure and Lawyee for Chinese legislations using keywords and synonyms for the 27 interventions. We reviewed the identified legislations for statements specifying the responsible implementation department.
FINDINGS
Seven national laws, nine regulations of the State Council and 46 departmental regulations were found to relate to at least one of the interventions. Although seven of the 27 internationally recommended interventions were covered by Chinese laws, 10 were not covered by any current Chinese law or regulation. None of the interventions against drowning and falls that we investigated was covered by national laws. The implementation responsibilities for effective interventions were either not specified or were assigned to multiple governmental departments in 11 or 20 legislative documents, respectively.
CONCLUSION
In Chinese laws and regulations, interventions proven to prevent major causes of unintentional child injuries are underrepresented and the associated implementation responsibilities are often poorly defined. China should include all such interventions in laws and regulations, and assign implementation responsibility for each to a single department of the national government.
Topics: Accident Prevention; Accidental Falls; Accidents; Accidents, Traffic; Adolescent; Adult; Burns; Child; Child Welfare; Child, Preschool; China; Drowning; Female; Head Protective Devices; Humans; Infant; Male; Wounds and Injuries; Young Adult
PubMed: 25838612
DOI: 10.2471/BLT.14.139998 -
The American Journal of Forensic... Sep 2016Adipocere is an unusual product of fatty tissue decomposition that may occasionally be found in bodies. Two cases of diving fatalities in a limestone cave filled with...
Adipocere is an unusual product of fatty tissue decomposition that may occasionally be found in bodies. Two cases of diving fatalities in a limestone cave filled with fresh water are reported to demonstrate the features of adipocere, with a literature review. The bodies of a 20-year-old male and 22-year-old female diver were retrieved 11 and 10 months after their deaths, respectively. Both bodies were putrefied with extensive adipocere formation characterized by the absence of epidermis with loss of cellular detail, with residual collagen fibers, and occasional hair follicles in the dermis. The most likely cause of death was accidental drowning possibly contributed to by equipment malfunction at depth. Adipocere formation is an unusual finding in bodies, particularly in Australia, that is facilitated by cold, wet, and anaerobic environments. If found at autopsy, it may give some indication of the environmental conditions that a body has been exposed to.
Topics: Australia; Caves; Diving; Drowning; Fatty Acids; Female; Fresh Water; Humans; Immersion; Male; Postmortem Changes; Young Adult
PubMed: 27356012
DOI: 10.1097/PAF.0000000000000251 -
Preventive Medicine Oct 2020Children on Canadian farms are at high risk for fatal injury. Ongoing surveillance of these deaths is required to affirm recurrent patterns of injury, and to determine...
Children on Canadian farms are at high risk for fatal injury. Ongoing surveillance of these deaths is required to affirm recurrent patterns of injury, and to determine whether historical approaches to prevention have resulted in declines in the occurrence of these traumatic events. We analyzed epidemiological patterns and trends in the occurrence of fatal pediatric farm injuries over 23 years. Records of deaths were obtained from the Canadian Agricultural Injury Reporting system. To contrast more recent data with injury patterns described historically, cases were compared between two time periods. An intentional consensus process was used to finalize key patterns and their clinical or social importance. 374 fatal farm injuries to children in Canada were identified over the 23 years of study; 253 in period 1 and 121 in period 2. While machinery and non-machinery causes of death varied between the two study periods, mean annual rates of fatal injury (approximately 4 per 100,000 children) remained similar. Notably emergent types of injury in recent years included those caused by all-terrain vehicles, skid steer loaders, and drownings. Observed declines in the numbers of fatal farm injuries are most likely attributable to analogous declines in the number of registered farms in Canada. Our findings call into question the effectiveness of pediatric farm safety initiatives that primarily focus on education. Second, while CAIR fatality data are maintained, surveillance of hospitalized injuries has been disbanded and the fatality records require updating. Only by doing so will such surveillance findings provide comprehensive information to inform prevention.
Topics: Agriculture; Canada; Child; Drowning; Farms; Humans; Wounds and Injuries
PubMed: 32800973
DOI: 10.1016/j.ypmed.2020.106233 -
Deutsche Medizinische Wochenschrift... Jul 2015In Germany the postmortem examination has to be performed by a physician. It has to include the determination of at least one sign of death, a statement about the time...
In Germany the postmortem examination has to be performed by a physician. It has to include the determination of at least one sign of death, a statement about the time and cause of death and the distinction between a "death by natural causes" in the sense of the law and its opposite.
Topics: Accidents; Autopsy; Cause of Death; Death; Death Certificates; Germany; Homicide; Humans; Postmortem Changes; Suicide
PubMed: 26230067
DOI: 10.1055/s-0041-103283 -
The American Journal of Emergency... Jan 2021Drowning is a leading cause of preventable mortality and morbidity in children. Its high fatality rate and frequent severe sequelae (e.g. brain damage and permanent loss...
BACKGROUND
Drowning is a leading cause of preventable mortality and morbidity in children. Its high fatality rate and frequent severe sequelae (e.g. brain damage and permanent loss of functioning) place a premium on preventive efforts.
METHODS
A retrospective analysis of patients ≤21 years of age admitted between 2010 and 2017 to a pediatric trauma center was conducted to identify factors associated with drowning admissions, fatal drowning, and severe outcome (ventilator use, ICU admission, or death). Outcomes were modeled and estimated by use of logistic regression and Poisson regression.
RESULTS
Drowning accounted for 153/4931 (3.1%) trauma admissions between 2010 and 2017. The risk of death (13.1% vs. 1.5%, p < .01), and severe outcome (24.8% vs. 7.8%, p < .01) was significantly higher for drownings vs. other causes. All 20 drowning deaths occurred among children left unattended. In Poisson regression analysis, weekends, summer breaks, and hotter days were independently associated with a higher probability of drowning admissions. Additionally, in analyses excluding indicators of severity, the odds of severe outcome were higher for children age ≤ 2 years [adjusted odds ratio (AOR) = 3.88 95% CI (1.58, 9.53)], and injury downtime of >5 min or unknown length [AOR = 6.66 95% CI (2.74-16.15)]. Immediate intervention after the discovery was associated with ~70% lower odds of a severe outcome.
CONCLUSIONS
Drowning admissions were both more severe and more often fatal compared to other pediatric injury causes of admission. Enhanced and targeted educational messages for parents of young children, focused on prevention behaviors on high-risk days and immediate bystander intervention, may reduce the occurrence and severity of these tragic accidents.
TABLE OF CONTENTS SUMMARY
A retrospective multi-year cohort study to identify modifiable factors associated with drowning admissions, severe complications, and death from a large trauma registry database.
WHAT'S KNOWN ON THIS SUBJECT
Drowning is a leading cause of unintentional injury that results in severe morbidity and a high rate of mortality. Children are disproportionately affected by drowning and have a higher risk of long term sequelae and death.
WHAT THIS STUDY ADDS
This study identified high-risk populations and periods for drowning, the importance of supervision, and the effectiveness of immediate intervention in reducing unfavorable outcomes after drowning. It also highlights a need for heightened local intervention for drowning prevention.
Topics: Accidents; Adolescent; Cause of Death; Child; Child, Preschool; Drowning; Female; Florida; Hospitalization; Humans; Infant; Logistic Models; Male; Multivariate Analysis; Registries; Retrospective Studies; Risk Factors; Trauma Centers
PubMed: 31956049
DOI: 10.1016/j.ajem.2020.01.025 -
Journal of Forensic Sciences Jan 2016A manner of death may be ruled undetermined by the forensic pathologist when there is insufficient information about the circumstances surrounding the death to make a...
A manner of death may be ruled undetermined by the forensic pathologist when there is insufficient information about the circumstances surrounding the death to make a ruling. The aim of our study was to retrospectively analyze a series of autopsy cases that were classified as undetermined manner of death after complete investigations. In all, 48 cases were examined. In 23 cases (48%), the cause of death was determined. The most frequent cause of death was toxic death (n = 11). More than one manner of death was deemed conceivable for most cases (n = 39). The most frequent and the most probable manner of death was accident (n = 37). Homicide was not excluded in about 23% of the cases. Our study showed that the manner of death may remain undetermined despite an established cause of death, and even when two or more conceivable causes of death are considered. Our study pointed out that undetermined manner of death covers a wide range of situations and that homicide may be underestimated.
Topics: Accidents; Autopsy; Cause of Death; Death; Homicide; Humans
PubMed: 26234640
DOI: 10.1111/1556-4029.12924 -
Journal of Forensic Sciences May 2018Two cases of accidental deaths caused by the sharp ends of fence or gate posts are reported. Case 1: A 47-year-old man was found hanging by his ankle in an inverted...
Two cases of accidental deaths caused by the sharp ends of fence or gate posts are reported. Case 1: A 47-year-old man was found hanging by his ankle in an inverted position on fencing. He had attempted a shortcut to a railway platform by climbing over a metal rail fence. He had slipped and been impaled through his ankle by the sharp end of the fence post, resulting in death from positional asphyxia. Case 2: An 18-year-old male slipped while climbing over a gate and died after being impaled on a spear tip finial, which had lacerated his external iliac vein. Death was due to exsanguination. These cases demonstrate two rare examples of accidental deaths from impalement by the ends of sharp fence posts. Mechanisms of death in such circumstances involve suspension with positional asphyxia and vascular injury with exsanguination.
Topics: Accidents; Adolescent; Asphyxia; Exsanguination; Humans; Male; Middle Aged; Posture; Wounds, Penetrating
PubMed: 28940542
DOI: 10.1111/1556-4029.13654 -
The New Zealand Medical Journal Dec 2018Sudden death is used to define a death under suspicious circumstances, where there is no clear indication of existing medical illness (natural cause) that accounts for...
AIM
Sudden death is used to define a death under suspicious circumstances, where there is no clear indication of existing medical illness (natural cause) that accounts for the death or clear indication for the cause of death. This includes all deaths from suicide, unintentional poisoning, drowning, falls and violence. Sudden death contributes to the increased mortality in people with serious mental illness (premature mortality) but is far less frequently studied and understood. This study analyses data of all sudden deaths of patients who had been under the care of the Canterbury District Health Board's Specialist Mental Health Service, New Zealand's second-largest population region. The study identifies key sociodemographic, diagnostic, legal and causative factors in the study population. This study aims to identify targeted interventions to mitigate premature mortality in this population.
METHOD
Data was obtained from the clinical files and the coroner's findings for all sudden death patients with established contact with Specialist Mental Health Services in the Canterbury region of New Zealand, between 2005 and 2009.
RESULTS
A total of 313 patients were identified. The median age at the time of death was 42 years (IQ Range 32.5-53 years). Of these, 65% (n=203) were male. Seventy-six percent (n=239) were of European descent and 9% Māori (n=29); 68% (n=280) were under care at the time of their death and 15% (n=32) were under the Mental Health Act. The sudden death rate was 0.36% for those under voluntary care and 0.7% for those under compulsory care. The most common primary diagnoses were alcohol or other drug abuse (29%); depression (25%); psychotic disorders (18%); BPAD (9%) and personality disorder (5%). The most common cause of death was suicide (51.8%) followed by motor vehicle crashes and falls, (23.3%) medical causes (17.6%) and homicide (1.3%). Of those that died by suicide, 75% were male. Hanging was the most common method (48%) followed by carbon monoxide poisoning (9.3%); medication overdose (5.8%) and falls from a height (3.5%).
CONCLUSIONS
The most common cause of sudden death was suicide, which was overwhelmingly the leading cause of sudden death in patients discharged or lost to follow up. The most potent predisposing factor appeared to be drug and alcohol problems. Mental health services should therefore advocate for comprehensive and evidence-based alcohol and drug policies, including access and availability to treatment programmes.
Topics: Accidents; Adult; Age Distribution; Cause of Death; Coroners and Medical Examiners; Death, Sudden; Female; Humans; Inpatients; Male; Mental Disorders; Mental Health Services; Mentally Ill Persons; Middle Aged; New Zealand; Racial Groups; Registries; Sex Distribution; Suicide
PubMed: 30543613
DOI: No ID Found -
Archivos de Bronconeumologia Apr 2019
Topics: Accidents; Asphyxia; Humans; Male; Middle Aged; Sand
PubMed: 30049558
DOI: 10.1016/j.arbres.2018.06.011