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Journal of Safety Research Dec 2023Lifeguards must maintain alertness and monitor an aquatic space across extended periods. However, lifeguard research has yet to investigate a lifeguard's ability to...
INTRODUCTION
Lifeguards must maintain alertness and monitor an aquatic space across extended periods. However, lifeguard research has yet to investigate a lifeguard's ability to maintain performance over time and whether this is influenced by years of certified experience or the detection difficulty of a drowning incident. The aim of this study was to examine whether lifeguard experience, drowning duration, bather number, and time on task influences drowning detection performance.
METHOD
A total of 30 participants took part in nine 60-minute lifeguard specific tasks that included 11 drowning events occurring at five-minute intervals. Each task had manipulated conditions that acted as the independent variables, including bather number and drowning duration.
RESULTS
The experienced group detected a greater number of drowning events per task, compared to novice and naïve groups. Findings further highlighted that time, bather number, and drowning duration has a substantial influence on lifeguard specific drowning detection performance.
PRACTICAL APPLICATIONS
It is hoped that the outcome of the study will have applied application in highlighting the critical need for lifeguard organizations to be aware of a lifeguard's capacity to sustain attention, and for researchers to explore methods for minimizing any decrement in vigilance performance.
Topics: Humans; Drowning; Wakefulness; Attention; Awareness
PubMed: 38081714
DOI: 10.1016/j.jsr.2023.08.014 -
Journal of Travel Medicine Jan 2024Tropical infectious diseases and vaccine-preventable emergencies are the mainstay of pre-travel consultations. However, non-communicable diseases, injuries and accidents... (Review)
Review
BACKGROUND
Tropical infectious diseases and vaccine-preventable emergencies are the mainstay of pre-travel consultations. However, non-communicable diseases, injuries and accidents that occur during travel are not emphasized enough in these settings.
METHODS
We performed a narrative review based on a literature search of PubMed, Google Scholar, UpToDate, DynaMed and LiSSa and on reference textbooks and medical journals dedicated to travel, emergency and wilderness medicine. Relevant secondary references were extracted. We also aimed to discuss newer or neglected issues, such as medical tourism, Coronavirus Disease 2019, exacerbations of co-morbidities associated with international travel, insurance coverage, health care seeking abroad, medical evacuation or repatriation and tips for different types of travellers' emergency medical kits (personal, group, physician handled).
RESULTS
All sources reviewed led to the selection of >170 references. Among epidemiological data on morbidity and deaths while abroad, only retrospective data are available. Deaths are estimated to occur in 1 in 100 000 travellers, with 40% caused by trauma and 60% by diseases, and <3% linked to infectious diseases. Trauma and other injuries acquired during travel, such as traffic accidents and drowning, can be reduced by up to 85% with simple preventive recommendations such as avoiding simultaneous alcohol intake. In-flight emergencies occur on 1 in 604 flights on average. Thrombosis risk is two to three times greater for travellers than for non-travellers. Fever during or after travel can occur in 2-4% of travellers, but in up to 25-30% in tertiary centres. Traveller's diarrhoea, although rarely severe, is the most common disease associated with travel. Autochthonous emergencies (acute appendicitis, ectopic pregnancy, dental abscess) can also occur.
CONCLUSIONS
Pre-travel medicine encounters must include the topic of injuries and medical emergencies, such as the risk-taking behaviours and foster better planning in a comprehensive approach along with vaccines and infectious diseases advices.
Topics: Humans; Retrospective Studies; Emergencies; Communicable Diseases; Vaccines; Travel
PubMed: 37405992
DOI: 10.1093/jtm/taad088 -
The Science of the Total Environment Dec 2023Drowning is a serious public health problem in the world. Several studies have found that ambient temperature is associated with drowning, but few have investigated the...
Drowning is a serious public health problem in the world. Several studies have found that ambient temperature is associated with drowning, but few have investigated the effect of heatwave on drowning. This study aimed to explore the associations between heatwave and drowning mortality, and further estimate the mortality burden of drowning attributed to heatwave in China. Drowning mortality data were collected in 71 prefectures in China during 2013-2018 from provincial vital register system. Meteorological data at the same period were collected from European Centre for Medium-Range Weather Forecasts (ECMWF). A distributed lag non-linear model (DLNM) was first to explore the association between heatwave and drowning mortality in each prefecture. Secondly, the prefecture-specific associations were pooled using meta-analysis. Finally, attributable fractions (AFs) of drowning deaths caused by heatwave were estimated. Compared to normal day, the mortality risk of drowning significantly increased during heatwave (RR = 1.20, 95%CI: 1.18-1.23). Higher risks were observed in males (RR = 1.23, 95%CI: 1.20-1.27) than females (RR = 1.18, 95%CI: 1.13-1.23), in children aged 5-14 years old (RR = 1.24, 95%CI: 1.15-1.33) than other age groups, in urban city (RR = 1.32, 95%CI: 1.28-1.36) than rural area (RR = 1.09, 95%CI: 1.07-1.12) and in Jilin province (RR = 2.85, 95%CI: 1.61-5.06) than other provinces. The AF of drowning deaths due to heatwave was 11.4 % (95%CI: 10.0 %-12.9 %) during heatwave and 1.0 % (95%CI: 0.9 %-1.1 %) during study period, respectively. Moreover, the AFs during study period were higher for male (1.2 %, 95%CI: 1.0 %-1.3 %), children 5-14 years (1.1 %, 95%CI: 0.7 %-1.6 %), urban city (1.6 %, 95%CI: 1.4 %-1.8 %) than their correspondents. These differences were also observed in AFs during heatwave. We found that heatwave may significantly increase the mortality risk of drowning mortality, and its mortality burden attributable to heatwave was noteworthy. Targeted intervention should be carried out to decrease drowning mortality during heatwave.
PubMed: 37586513
DOI: 10.1016/j.scitotenv.2023.166321 -
International Journal of Legal Medicine Jul 2023Drowning is a common cause of accidental death worldwide, and it continues to be a serious public health problem. However, diagnosing drowning is a challenging task in...
Drowning is a common cause of accidental death worldwide, and it continues to be a serious public health problem. However, diagnosing drowning is a challenging task in forensic investigation because it is difficult to prove actual drowning and other submerged deaths with the autopsy techniques that are currently in use. Here, we show biomarkers that may be helpful for the diagnosis of drowning. We divided the experimental animals into four groups (drowning, postmortem submersion, hypoxia, and control) to evaluate the expression patterns of extracellular signal-regulated kinase 1/2 (ERK1/2). On gene expression analysis, only ERK2 was found to be significantly increased in the drowning groups compared to the other cases. In the immunoblot analysis, phosphorylated ERK2 (p-ERK2) was found to be upregulated in the drowning groups. Immunohistochemical staining also showed that p-ERK in alveolar cells revealed a granular pattern in the drowning groups. However, the expression pattern of ERK2 over time after drowning differed between the freshwater and seawater drowning groups. Taken together, these results indicate that ERK2 may be useful for distinguishing between drowning and postmortem submersion if the postmortem interval (PMI) of drowning is short. Conversely, if the PMI is long from the time that death occurs until the discovery of dead bodies, it is possibly more helpful for identifying between freshwater and seawater drowning.
Topics: Animals; Drowning; Mitogen-Activated Protein Kinase 1; Forensic Medicine; Autopsy; Biomarkers; Forensic Pathology
PubMed: 36973587
DOI: 10.1007/s00414-023-02992-5 -
BMC Public Health Sep 2023Drowning is one of the leading causes of death among children and youth worldwide. This study aims to examine differences in the rates of drowning (fatal and non-fatal...
OBJECTIVE
Drowning is one of the leading causes of death among children and youth worldwide. This study aims to examine differences in the rates of drowning (fatal and non-fatal drowning) among children and youth in Israel stratified by age, sex, sector, place of drowning, and the drowning outcome. In addition, we compared the results of studies reported in other countries in specific age groups based on statistics of about 100,000 drowning cases.
METHOD
A statistical analysis of 474 drownings between 2008 and 2018 was conducted. All cases refer to youngsters aged 7-17 in the State of Israel. Statistical analysis was performed on data obtained from the Beterem - Safe Kids Israel organization and from the Israel Central Bureau of Statistics. Disparities between groups within the examined population were analyzed based on gender, sector (Jewish versus non-Jewish), and drowning site.
RESULTS
Of the 474 drownings that occurred during 2008-2018, 38.4% ended in death. 79% of the cases occurred in pools. The Arab minority sector (21.1% of the general population) accounted for 25.1% of all drownings, males accounted for 70.5% of the drowning cases, and the age group with the most drownings (48.5%) was that of 15-17 years. The Jewish population was involved in more than 75% of drownings in places designated for bathing and in more than 83% of all disaster scenarios, whereas the Arab minority was involved in more than 61% of drownings in places not designated for bathing.
CONCLUSIONS
The results are comparable to those of other studies worldwide. Boys drown twice as much as girls, mainly in the age group of 15-17. This may be explained by overconfidence in boys and a tendency to overestimate their actual swimming abilities. Most drownings occur in pools. Drowning among the Jewish population occurs mainly in designated bathing sites.
PRACTICAL APPLICATIONS
The findings can and, in fact, must be used to inform and educate the younger generation as to the potential dangers involving bathing in designated bathing sites.
Topics: Male; Female; Humans; Adolescent; Child; Drowning; Israel; Arabs; Disasters; Jews
PubMed: 37658286
DOI: 10.1186/s12889-023-16671-y -
The Behavioral and Brain Sciences Sep 2023It has been known for decades that inference concerning genetic causes of human behavioral phenotypes cannot be legitimately made from correlations among relatives. We...
It has been known for decades that inference concerning genetic causes of human behavioral phenotypes cannot be legitimately made from correlations among relatives. We claim that these inferential difficulties cannot be overcome by assigning different names to causes inferred from within-family and population-level genome-wide association studies (GWASs). For educational attainment, for example, unraveling gene-environment interactions requires more than new names for causes.
Topics: Humans; Drowning; Genome-Wide Association Study
PubMed: 37694932
DOI: 10.1017/S0140525X22002278 -
Brain and Behavior Dec 2023According to the Global Report on Drowning: Preventing a Leading Killer and Preventing Drowning: An Implementation Guide, two documents released by the World Health...
BACKGROUND
According to the Global Report on Drowning: Preventing a Leading Killer and Preventing Drowning: An Implementation Guide, two documents released by the World Health Organization in 2014 and 2017, respectively, 372,000 people drown each year globally (approximately 42 per hour), half of whom are below 25 years old. Chinese adolescents aged 18-24 years are the main victim group. Intermediate swimming college students are more susceptible to risk-taking behavior and drowning while swimming. In particular, college students with high-sensation-seeking levels have greater confidence in their swimming ability. Consequently, they tend to overestimate their skills and pursue exciting experiences while underestimating or ignoring the risk factors in the situation. The scores of college students in sensation-seeking show a significant positive correlation with highly risky swimming behavior. However, the correlation with the reaction time to hazards is unclear. In this study, using previous theories, the sensation-seeking scale, and the measurement of the reaction time to hazards, we clearly explain why "college students with higher levels of sensation-seeking have a higher risk of drowning." We examined the reaction time to hazards and eye movement data of intermediate swimming college students with different sensation-seeking levels, while controlling the obviousness of hazards in the videos for the experiment.
METHODS
We utilized 16 videos of students swimming as experimental stimuli and employed a mixed experimental design of 2 (sensation-seeking: high, low) × 2 (hazard type: obvious hazard, hidden hazard). Sensation-seeking, the between-subjects variable, was categorized into two levels (high and low). The hazard type, the within-subjects variable, was also divided into two categories (obvious and hidden). We analyzed the disparities in reaction time to hazards and eye-movement data between intermediate swimming college students with high (N = 28) or low (N = 28) levels of sensation-seeking.
RESULTS
Intermediate swimming college students with high levels of sensation-seeking exhibited significantly longer reaction times to both obvious (F = 6.251, p = .000 < .001) and hidden (F = 49.438, p = .000 < .001) hazards compared to their low-sensation-seeking counterparts. The first fixation duration of intermediate swimming college students on obvious hazards was shorter than that on hidden hazards (F = 13.596, p = .000 < .001), and the average fixation duration of intermediate swimming college students with high levels of sensation-seeking on hidden hazards proved to be significantly shorter (F = 5.498, p = .000 < .001).
CONCLUSIONS AND IMPLICATIONS
High-sensation-seeking intermediate swimming college students exhibited longer reaction times to hidden hazards compared to their low-sensation-seeking peers. These findings indicate that a high-sensation-seeking tendency can result in delayed reaction times and a disregard for response measures among intermediate swimming college students.
Topics: Adolescent; Humans; Adult; Drowning; Swimming; Risk Factors; Risk-Taking; Students; Sensation
PubMed: 38031238
DOI: 10.1002/brb3.3338 -
Annals of Intensive Care Apr 2024Drowning-associated pneumonia (DAP) is frequent in drowned patients, and possibly increases mortality. A better understanding of the microorganisms causing DAP could... (Review)
Review
BACKGROUND
Drowning-associated pneumonia (DAP) is frequent in drowned patients, and possibly increases mortality. A better understanding of the microorganisms causing DAP could improve the adequacy of empirical antimicrobial therapy. We aimed to describe the pooled prevalence of DAP, the microorganisms involved, and the impact of DAP on drowned patients.
METHODS
Systematic review and meta-analysis of studies published between 01/2000 and 07/2023 reporting on DAP occurrence and microorganisms involved.
RESULTS
Of 309 unique articles screened, 6 were included, involving 688 patients. All were retrospective cohort studies, with a number of patients ranging from 37 to 270. Studies were conducted in Europe (France N = 3 and Netherland N = 1), United States of America (N = 1) and French West Indies (N = 1). Mortality ranged between 18 to 81%. The pooled prevalence of DAP was 39% (95%CI 29-48), similarly following freshwater (pooled prevalence 44%, 95%CI 36-52) or seawater drowning (pooled prevalence 42%, 95%CI 32-53). DAP did not significantly impact mortality (pooled odds ratio 1.43, 95%CI 0.56-3.67) but this estimation was based on two studies only. Respiratory samplings isolated 171 microorganisms, mostly Gram negative (98/171, 57%) and mainly Aeromonas sp. (20/171, 12%). Gram positive microorganisms represented 38/171 (22%) isolates, mainly Staphylococcus aureus (21/171, 12%). Water salinity levels had a limited impact on the distribution of microorganisms, except for Aeromonas sp. who were exclusively found following freshwater drowning (19/106, 18%) and never following seawater drowning (0%) (p = 0.001). No studies reported multidrug-resistant organisms but nearly 30% of the isolated microorganisms were resistant to amoxicillin-clavulanate, the drug that was the most commonly prescribed empirically for DAP.
CONCLUSIONS
DAP are commonly caused by Gram-negative bacteria, especially Aeromonas sp. which is exclusively isolated following freshwater drowning. Empirical antimicrobial therapy should consider covering them, noting than amoxicillin-clavulanate may be inadequate in about one-third of the cases. The impact of DAP on patients' outcome is still unclear.
PubMed: 38641650
DOI: 10.1186/s13613-024-01287-1 -
BMJ Global Health Sep 2023The burden of drowning is gaining prominence on the global agenda. Two United Nations system resolutions in 3 years reflect rising political support, but priorities...
INTRODUCTION
The burden of drowning is gaining prominence on the global agenda. Two United Nations system resolutions in 3 years reflect rising political support, but priorities remain undefined, and the issue lacks a global strategy. We aimed to identify strategic priorities for advancing global drowning prevention using a modified Delphi method.
METHODS
An advisory group was formed, and participants recruited with diverse expertise and backgrounds. We used document review, and data extracted from global health partnerships to identify strategic domains and draft priorities for global drowning prevention. Participants rated the priorities in two Delphi rounds, guided by relevance, feasibility and impact on equity, and where consensus was ≥70% of participants rating the priority as critical.
RESULTS
We recruited 134 participants from research (40.2%), policy (26.9%), technical (25.4%) and community (7.5%) backgrounds, with 38.1% representing low- and middle-income countries. We drafted 75 priorities. Following two Delphi rounds, 50 priorities were selected across the seven domains of research and further contextualisation, best practice guidance, capacity building, engagement with other health and sustainable development agendas, high-level political advocacy, multisectoral action and strengthening inclusive global governance. Participants scored priorities based on relevance (43.2%), feasibility (29.4%) and impact on equity (27.4%).
CONCLUSION
Our study identifies global priorities for drowning prevention and provides evidence for advocacy of drowning prevention in all pertinent policies, and in all relevant agendas. The priorities can be applied by funders to guide investment, by researchers to frame study questions, by policymakers to contrast views of expert groups and by national coalitions to anchor national drowning prevention plans. We identify agendas including disaster risk reduction, sustainable development, child and adolescent health, and climate resilience, where drowning prevention might offer co-benefits. Finally, our findings offer a strategic blueprint as the field looks to accelerate action, and develop a global strategy for drowning prevention.
Topics: Adolescent; Child; Humans; Delphi Technique; Drowning; Adolescent Health; Capacity Building; Disasters
PubMed: 37709301
DOI: 10.1136/bmjgh-2023-013303 -
Journal of Thermal Biology Jan 2024Cold water immersion (CWI) evokes the life-threatening reflex cold shock response (CSR), inducing hyperventilation, increasing cardiac arrhythmias, and increasing... (Meta-Analysis)
Meta-Analysis Review
Cold water immersion (CWI) evokes the life-threatening reflex cold shock response (CSR), inducing hyperventilation, increasing cardiac arrhythmias, and increasing drowning risk by impairing safety behaviour. Repeated CWI induces CSR habituation (i.e., diminishing response with same stimulus magnitude) after ∼4 immersions, with variation between studies. We quantified the magnitude and coefficient of variation (CoV) in the CSR in a systematic review and meta-analysis with search terms entered to Medline, SportDiscus, PsychINFO, Pubmed, and Cochrane Central Register. Random effects meta-analyses, including effect sizes (Cohen's d) from 17 eligible groups (k), were conducted for heart rate (HR, n = 145, k = 17), respiratory frequency (f, n = 73, k = 12), minute ventilation (V, n = 106, k = 10) and tidal volume (V, n = 46, k=6). All CSR variables habituated (p < 0.001) with large or moderate pooled effect sizes: ΔHR -14 (10) bt. min (d: -1.19); Δf -8 (7) br. min (d: -0.78); ΔV, -21.3 (9.8) L. min (d: -1.64); ΔV -0.4 (0.3) L . Variation was greatest in V (control vs comparator immersion: 32.5&24.7%) compared to V (11.8&12.1%). Repeated CWI induces CSR habituation potentially reducing drowning risk. We consider the neurophysiological and behavioural consequences.
Topics: Humans; Cold-Shock Response; Habituation, Psychophysiologic; Drowning; Water; Respiratory Rate; Cold Temperature; Immersion
PubMed: 38211547
DOI: 10.1016/j.jtherbio.2023.103775