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JMIR Public Health and Surveillance Jul 2023Drowning is a serious public health problem worldwide. Previous epidemiological studies on the association between meteorological factors and drowning mainly focused on...
BACKGROUND
Drowning is a serious public health problem worldwide. Previous epidemiological studies on the association between meteorological factors and drowning mainly focused on individual weather factors, and the combined effect of mixed exposure to multiple meteorological factors on drowning is unclear.
OBJECTIVE
We aimed to investigate the combined effects of multiple meteorological factors on unintentional drowning mortality in China and to identify the important meteorological factors contributing to drowning mortality.
METHODS
Unintentional drowning death data (based on International Classification of Diseases, 10th Edition, codes W65-74) from January 1, 2013, to December 31, 2018, were collected from the Disease Surveillance Points System for Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces, China. Daily meteorological data, including daily mean temperature, relative humidity, sunlight duration, and rainfall in the same period were obtained from the Chinese Academy of Meteorological Science Data Center. We constructed a time-stratified case-crossover design and applied a generalized additive model to examine the effect of individual weather factors on drowning mortality, and then used quantile g-computation to estimate the joint effect of the mixed exposure to meteorological factors.
RESULTS
A total of 46,179 drowning deaths were reported in the 5 provinces in China from 2013 to 2018. In an effect analysis of individual exposure, we observed a positive effect for sunlight duration, a negative effect for relative humidity, and U-shaped associations for temperature and rainfall with drowning mortality. In a joint effect analysis of the above 4 meteorological factors, a 2.99% (95% CI 0.26%-5.80%) increase in drowning mortality was observed per quartile rise in exposure mixture. For the total population, sunlight duration was the most important weather factor for drowning mortality, with a 93.1% positive contribution to the overall effects, while rainfall was mainly a negative factor for drowning deaths (90.5%) and temperature and relative humidity contributed 6.9% and -9.5% to the overall effects, respectively.
CONCLUSIONS
This study found that mixed exposure to temperature, relative humidity, sunlight duration, and rainfall was positively associated with drowning mortality and that sunlight duration, rather than temperature, may be the most important meteorological factor for drowning mortality. These findings imply that it is necessary to incorporate sunshine hours and temperature into early warning systems for drowning prevention in the future.
Topics: Humans; Cross-Over Studies; Drowning; China; Meteorological Concepts; Temperature
PubMed: 37471118
DOI: 10.2196/46792 -
China CDC Weekly Nov 2023This study seeks to elucidate the evolving trend and identify disparities among subgroups in the mortality rate due to unintentional drowning in individuals under the...
INTRODUCTION
This study seeks to elucidate the evolving trend and identify disparities among subgroups in the mortality rate due to unintentional drowning in individuals under the age of 20 from the timeframe of 2013 to 2021 in China.
METHODS
Data retrieved from the National Mortality Surveillance System served as a foundation for estimating the unintentional drowning mortality rate. The inadvertent drowning mortality rate for individuals below the age of 20 was computed, differentiated by categorization groups such as age, gender, areas, and regions within each given year. The linear regression model was employed to calculate the annual percent of change (APC) with its 95% confidence interval (), providing a depiction of the mortality rate's shifting trend.
RESULTS
In 2021, the inadvertent drowning fatality rate for individuals under 20 years of age in China was recorded at 3.28 per 100,000. A steady reduction was observed in the national drowning mortality rate from 6.60 per 100,000 in 2013 down to 3.28 per 100,000 in 2021, signifying a cumulative decrease of 50.30% [APC=-9.06% (95% : -11.31%, -6.76%)]. Across all sexes, regions, age groups, and residential areas, a consistent decline in mortality rates was evident between 2013 and 2021.
CONCLUSION
An analysis of the data from 2013 to 2021 reveals a declining trend in the mortality rate due to unintentional drowning among individuals under 20 years of age in China. However, the rate of decline varied when stratified by sex, urban versus rural locations, age-specific groups, and geographical regions.
PubMed: 38047245
DOI: 10.46234/ccdcw2023.198 -
BMC Public Health Feb 2024Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a...
INTRODUCTION
Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a focus on data sources, epidemiology, risk factors and prevention strategies.
METHODS
Literature searches were conducted using PubMed, SPORTSDiscus, Scopus, Web of Science, Turk MEDLINE, Google Scholar and Google Akademik (Turkish language). Studies (limited to original research written in English and Turkish) reporting drowning (unintentional and intentional; fatal and non-fatal) of residents and tourists in Türkiye were independently dual screened at the title and abstract and full text stages. Study quality was assessed using JBI checklists and evidence level assessed based on study design.
RESULTS
From a total of 917 studies, 49 met the inclusion criteria. Most (51%) focused on unintentional fatal drowning. Included studies were most commonly analytical cross-sectional studies (n = 23) and case series (n = 20) meaning the evidence level was low or very low for 48 (98%) studies. Fifteen studies examined drowning at the national level, while sub-national studies (n = 30) focused on urban areas across three provinces: Antalya (n = 6), Istanbul (n = 6), Izmir (n = 4). There was little consensus on risk factors beyond male drowning risk, and no data reported on implemented or evaluated drowning prevention interventions.
DISCUSSION
There is a need for more national-level studies to identify the causes of drowning and to guide intervention implementation and evaluation to inform policy makers and donors. Currently official data is limited in its detail, providing age and gender data only, hampering efforts to identify, and thus address, causal factors for drowning.
PRACTICAL APPLICATIONS
There is currently very little evidence to inform investment in effective drowning prevention interventions in Türkiye. To improve this, data collection systems on drowning in Türkiye need to be strengthened via the development a national drowning registry.
TRIAL REGISTRATION
#CRD42022382615.
Topics: Humans; Male; Drowning; Cross-Sectional Studies; Turkey; Risk Factors; Public Health
PubMed: 38378496
DOI: 10.1186/s12889-024-18032-9 -
Journal of Safety Research Dec 2023This research evaluated existing health equity frameworks as they relate to social determinants of health (SDOHs) and individual factors that may impact injury outcomes...
INTRODUCTION
This research evaluated existing health equity frameworks as they relate to social determinants of health (SDOHs) and individual factors that may impact injury outcomes and identify gaps in coverage using the Healthy People (HP) 2030 key domains.
METHODS
The study used a list of health equity frameworks sourced from previous literature. SDOHs and individual factors from each framework were identified and categorized into the Healthy People 2030 domains. Five injury topic areas were used as examples for how SDOHs and individual factors can be compared to injury topic-specific health disparities to identify health equity frameworks to apply to injury research.
RESULTS
The study identified 59 SDOHs and individual factors from the list of 33 health equity frameworks. The number of SDOHs and individual factors identified varied by Healthy People 2030 domain: Neighborhood and Built Environment contained 16 (27.1%) SDOHs and individual actors, Social and Community Context contained 22 (37.3%), Economic Stability contained 10 (16.9%), Healthcare Access and Quality contained 10 (16.9%), and Education Access and Quality contained one (1.7%). Twenty-three (39.0%) SDOHs/individual factors related to traumatic brain injury, thirteen (22.0%) related to motor vehicle crashes and suicide, 11 (18.6%) related to drowning and older adult falls. Eight frameworks (24.2%) covered all HP 2030 key domains and may be applicable to injury topics.
CONCLUSIONS
Incorporating health equity into research is critical. Health equity frameworks can provide a way to systematically incorporate health equity into research. The findings from this study may be useful to health equity research by providing a resource to injury and other public health fields.
PRACTICAL APPLICATIONS
Health equity frameworks are a practical tool to guide injury research, translation, evaluation, and program implementation. The findings from this study can be used to guide the application of health equity frameworks in injury research for specific topic areas.
Topics: Humans; Aged; Social Determinants of Health; Health Equity; Delivery of Health Care; Public Health
PubMed: 38081722
DOI: 10.1016/j.jsr.2023.10.001 -
Radiography (London, England : 1995) Jan 2024Drowning is a comprehensive and exclusive diagnosis at autopsy. Autopsy findings such as pleural effusion and waterlogged lungs contribute to the diagnosis. Herein, we...
INTRODUCTION
Drowning is a comprehensive and exclusive diagnosis at autopsy. Autopsy findings such as pleural effusion and waterlogged lungs contribute to the diagnosis. Herein, we aim to reveal the practical usefulness and postmortem changes of the maxillary sinus fluid volume to diagnose drowning.
METHODS
We evaluated 52 drowning and 59 nondrowning cases. The maxillary sinus fluid volume was measured using a computed tomography (CT) scan, and pleural effusion volume and lung weight were manually measured at autopsy. The utility of these three indices for diagnosing drowning and its postmortem changes was evaluated.
RESULTS
The maxillary sinus fluid volume was significantly higher in drowning cases than in other external causes and cardiovascular death cases. Receiver operating characteristic curve analysis revealed that a total maxillary sinus fluid volume >1.04 mL more usefully indicated drowning (odds ratio, 8.19) than a total pleural effusion volume >175 mL (odds ratio, 7.23) and a total lung weight >829 g (odds ratio, 2.29). The combination of maxillary sinus fluid volume and pleural effusion volume more effectively predicted drowning than one index alone. Moreover, the maxillary sinus fluid volume was less influenced by the postmortem interval than the other two indices up to a week after death.
CONCLUSION
Maxillary sinus fluid volume can be more useful than pleural effusion volume and lung weight with higher sensitivity and odds ratio for diagnosing drowning.
IMPLICATIONS FOR PRACTICE
Fluid accumulation in both the maxillary sinuses strongly predicts drowning in the postmortem imaging.
Topics: Humans; Drowning; Maxillary Sinus; Autopsy; Pleural Effusion; Postmortem Changes
PubMed: 38091921
DOI: 10.1016/j.radi.2023.12.001 -
BMC Public Health May 2024The United Nations' Millennium Development Goals and Sustainable Development Goals both underscore the critical need to reduce the under-five mortality rate globally....
BACKGROUND
The United Nations' Millennium Development Goals and Sustainable Development Goals both underscore the critical need to reduce the under-five mortality rate globally. China has made remarkable progress in decreasing the mortality rate of children under five. This study aims to examine the trends in child mortality rates from 2002 to 2022 and the causes of deaths among neonates, infants, and children under 5 years of age from 2013 to 2022 in Huangshi.
METHODS
The data resource was supported and provided by the Huangshi Health Commission, Huangshi Maternal and Child Health Hospital, and the Huangshi Statistics Bureau. Figures were drawn using Origin 2021.
RESULTS
The mortality rate among children under 5 years old significantly decreased, from 21.38 per 1,000 live births in 2002 to 3.53 per 1,000 live births in 2022. The infant mortality rate also saw a significant decline, to 15.06 per 1,000 live births. Among the 1,929 recorded child deaths from 2013 to 2022, the top three causes were: F2 (Disorders related to short gestation and low birth weight), accounting for 17.26% (333 deaths); I1 (Accidental drowning and submersion), for 14.83% (286 deaths); and I3 (Other accidental threats to breathing), for 12.29% (237 deaths). Of the 1,929 deaths, 1,117 were male children, representing 57.91%. The gender disparity in the Under-5 Mortality Rate (U5MR) was calculated to be 1.38 (boys to girls). The leading causes of death under the age of five shifted from F2 (Disorders related to short gestation and low birth weight) to I1 (Accidental drowning and submersion) as children aged, highlighting the need for policymakers and parents to intensify care and vigilance for children.
CONCLUSIONS
Huangshi has achieved significant progress in lowering child mortality rates over the past two decades. The study calls for policymakers to enact more effective measures to further reduce the mortality rate among children under 5 years of age in Huangshi. Furthermore, it advises parents to dedicate more time and effort to supervising and nurturing their children, promoting a safer and healthier development.
Topics: Humans; China; Infant; Child Mortality; Child, Preschool; Female; Infant, Newborn; Male; Retrospective Studies; Infant Mortality; Cause of Death
PubMed: 38807078
DOI: 10.1186/s12889-024-18955-3 -
Children (Basel, Switzerland) Dec 2023Drowning remains a prominent global pediatric health concern, necessitating preventive measures such as educational initiatives for children and caregivers. In this...
Drowning remains a prominent global pediatric health concern, necessitating preventive measures such as educational initiatives for children and caregivers. In this study, we aimed to assess the feasibility and educational effectiveness of an interactive puppet show centered on teaching water safety to children and parents. A 30 min original theater performance, featuring two actors and three puppets (a girl, a crab, and a lifeguard), was conducted. Subsequently, 185 children (aged 4 to 8) and their 160 parents (134 mothers and 26 fathers) participated in this quasi-experimental study. Pre- and post-show tests were administered to evaluate knowledge and behaviors regarding aquatic environments. Prior to the puppet show, 78% of the children exhibited basic aquatic competency. Only 33% considered swimming alone risky. Following the intervention, 81.6% of the children changed their perception of the risks of solo beach activities, showing improved knowledge regarding contacting an emergency number (from 63.2% to 98.9%, < 0.001). The intervention increased parents' intention to visit lifeguard-patrolled beaches and improved their CPR knowledge with regard to drowning victims by 58.8%. In conclusion, a drowning prevention puppet show positively impacted children and parents, potentially enhancing safety behaviors during water-related leisure activities, warranting its consideration part of comprehensive drowning prevention strategies.
PubMed: 38255332
DOI: 10.3390/children11010019 -
Australian and New Zealand Journal of... Dec 2023To elicit and summarise collective expert opinion on contemporary child product safety risks, challenges and priorities.
OBJECTIVE
To elicit and summarise collective expert opinion on contemporary child product safety risks, challenges and priorities.
METHODS
An online survey targeted international experts from a cross-section of product safety fields.
RESULTS
Fifty-five experts participated, representing 1,137 years of product safety experience, from a broad range of fields including industry risk management, product assessment and testing, policy and regulation, research, paediatric medicine, advocacy and product liability. Participants identified the leading product safety hazards across all age brackets as falls, drowning and chemical hazards, with variance in specific age brackets, particularly the threat to breathing hazards for infants. The leading products of concern to experts were electrical connection/distribution products, primarily button batteries and lithium-ion batteries, infant furnishing products and household furniture. Product safety priorities and challenges were identified under five themes: regulatory, surveillance, industry, consumer and product-specific.
CONCLUSIONS
The gains in knowledge, insight and understanding from experts on contemporary child product safety risks and issues should inform policy and future research.
IMPLICATIONS FOR PUBLIC HEALTH
There are significant consequences of unsafe consumer products on population health, and the results are timely as we face new product safety issues emerging from e-commerce, the digital transition and innovative product technologies.
Topics: Child; Infant; Humans; Drowning; Surveys and Questionnaires; Electricity
PubMed: 37980771
DOI: 10.1016/j.anzjph.2023.100103 -
International Journal of Molecular... Feb 2024The study of aquaporins (AQPs) in various forensic fields has offered a promising horizon in response to the need to have reliable elements for the identification of the... (Review)
Review
The study of aquaporins (AQPs) in various forensic fields has offered a promising horizon in response to the need to have reliable elements for the identification of the manner of death and for the individuation of forensic markers for the timing of lesions and vitality of injury. In the literature, various tissues have been studied; the most investigated are the lungs, brain, kidneys, skin, and blood vessels. A systematic literature review on PubMed following PRISMA 2020 guidelines enabled the identification of 96 articles. In all, 34 of these were enrolled to identify Aquaporin-like (AQP-like) forensic markers. The analysis of the literature demonstrated that the most significant markers among the AQPs are as follows: for the brain, AQP4, which is very important in brain trauma and hypoxic damage; AQP3 in the skin lesions caused by various mechanisms; and AQP5 in the diagnosis of drowning. Other applications are in organ damage due to drug abuse and thrombus dating. The focus of this review is to collect all the data present in the literature about the forensic application of AQPs as forensic markers in the most important fields of application. In the current use, the individuation, validation, and application of markers in forensic investigation are very useful in real forensic applications in cases evaluated in court.
Topics: Humans; Aquaporins; Lung; Hypoxia; Brain; Skin
PubMed: 38473914
DOI: 10.3390/ijms25052664 -
Cureus Feb 2024Heat therapy, including saunas, jacuzzi, and hot tub bathing, has gained global popularity. However, the escalating incidents of injuries and fatalities associated with... (Review)
Review
Heat therapy, including saunas, jacuzzi, and hot tub bathing, has gained global popularity. However, the escalating incidents of injuries and fatalities associated with hot tub activities are a significant public health concern. This study aims to comprehensively review and analyze the pathophysiological factors contributing to hot tub-related deaths, addressing the need for awareness and mitigation strategies. A comprehensive search of electronic databases, PubMed and Science Direct, was conducted to identify articles relevant to bath-related deaths. Eligible studies were exported to the Rayyan (Qatar Computing Research Institute, Qatar) software for data analysis. The data extracted from the 18 studies were compiled to elucidate the mechanisms underlying hot tub bath-related deaths and to advocate for the adoption of potential mitigation strategies and future directions to prevent such incidents in the future. The review revealed insights into the current trend of fatalities linked to hot tub bathing. A detailed analysis of pathophysiological aspects, encompassing hemodynamics, electrolyte disturbances, serum glucagon alterations, and the impact of alcohol and substance abuse during hot tub use, was conducted. Furthermore, we explored the effects of temperature and conducted a thorough discussion of postmortem evidence analysis concerning deaths related to bathtub usage. Finally, the paper discusses mitigation strategies to prevent fatalities attributed to hot tub bathing. In conclusion, our review highlights growing public health concerns surrounding injuries and fatalities related to hot tub activities. Through an examination of the incidence rates, pathophysiological factors, and proposed mitigation strategies, we provide crucial insights for enhancing safety and addressing the escalating risks associated with hot tub bathing.
PubMed: 38496149
DOI: 10.7759/cureus.54198