-
International Journal of Legal Medicine May 2023If a dead body is discovered in water, it nearly always raises the question about the cause of death, often associated with the persistent problem to differentiate...
If a dead body is discovered in water, it nearly always raises the question about the cause of death, often associated with the persistent problem to differentiate between a drowning incident and post-mortem immersion. In numerous cases, a reliable confirmation of death by drowning is often only possible by a combination of diagnoses obtained from autopsy and additional investigations. As to the latter, the use of diatoms has been suggested (and debated) since decades. Based on the consideration that diatoms are present in almost every natural waterbody and are unavoidably incorporated when water is inhaled, their presence in the lung and other tissues can provide evidence of drowning. However, the traditional diatom test methods are still subject of controversial discussion and suspected of erroneous outcome, predominantly through contamination. A promising alternative to minimize the risk of erroneous outcome seems to be disclosed by the recently suggested MD-VF-Auto SEM technique. Especially the establishment of a new diagnostic marker (L/D ratio), which represents the factorial proportion between the diatom concentration in lung tissue and the drowning medium, allows for clearer distinction of drowning and post-mortal immersion and is largely robust to contamination. However, this highly elaborated technique requires specific devices which are frequently unavailable. We therefore developed a modified method of SEM-based diatom testing to enable the use on more routinely available equipment. Process steps such as digestion, filtration, and image acquisition were thoroughly broken down, optimized, and ultimately validated in five confirmed drowning cases. Taking certain limitations into consideration, L/D ratio analysis provided promising results, even in cases of advanced decomposition. We conclude that our modified protocol indeed opens a way for a broader use of the method in forensic drowning investigation.
Topics: Humans; Diatoms; Drowning; Forensic Pathology; Lung; Water
PubMed: 36869250
DOI: 10.1007/s00414-023-02970-x -
Fa Yi Xue Za Zhi Feb 2022To retrospectively analyze diatom test cases of corpses in water and discuss the value of quantitative analysis of diatoms in the diagnosis of drowning.
OBJECTIVES
To retrospectively analyze diatom test cases of corpses in water and discuss the value of quantitative analysis of diatoms in the diagnosis of drowning.
METHODS
A total of 490 cases of water-related death were collected. They were divided into drowning group and postmortem immersion group according to the cause of death. Diatoms in lung, liver, kidney tissue and water sample were analyzed quantitatively by microwave digestion-vacuum filtration-automated scanning electron microscopy (MD-VF-Auto SEM) method. The ratios of content of diatoms in lung tissue and water sample (/) were calculated.
RESULTS
The results of diatom test for three organs (lung, liver and kidney) were all positive in 400 cases (85.5%); the content of diatom in lung, liver, kidney tissues, and water samples of drowning group were (113 235.9±317 868.1), (26.7±75.6), (23.3±52.2) and (12 113.3±21 760.0) cells/10 g, respectively; the species of diatom were (7.5±2.8), (2.6±1.9), (2.9±2.1) and (8.9±3.0) types, respectively; the / of drowning group and postmortem immersion group were (100.6±830.7) and (0.3±0.4), respectively.
CONCLUSIONS
Quantitative analysis of diatoms can provide supportive evidence for the diagnosis of drowning, and the parameter / can be introduced into the analysis to make a more accurate diagnosis of drowning.
Topics: Autopsy; Diatoms; Drowning; Humans; Lung; Retrospective Studies; Water
PubMed: 35725713
DOI: 10.12116/j.issn.1004-5619.2021.410707 -
Applied Ergonomics Apr 2023Ensuring that pool lifeguards develop the skills necessary to detect drowning victims is challenging given that these situations are relatively rare, unpredictable and...
BACKGROUND
Ensuring that pool lifeguards develop the skills necessary to detect drowning victims is challenging given that these situations are relatively rare, unpredictable and are difficult to simulate accurately and safely. Virtual reality potentially provides a safe and ecologically valid approach to training since it offers a near-to-real visual experience, together with the opportunity to practice task-related skills and receive feedback. As a prelude to the development of a training intervention, the aim of this research was to establish the construct validity of virtual reality drowning detection tasks.
METHOD
Using a repeated measures design, a total of 38 qualified lifeguards and 33 non-lifeguards completed 13 min and 23 min simulated drowning detection tasks that were intended to reflect different levels of sustained attention. During the simulated tasks, participants were asked to monitor a virtual pool and identify any drowning targets with accuracy, response latency, and dwell time recorded.
RESULTS
During the simulated scenarios, pool lifeguards detected drowning targets more frequently and spent less time than non-lifeguards fixating on the drowning target prior to the drowning onset. No significant differences in response latency were evident between lifeguards and non-lifeguards nor for first fixations on the drowning target.
CONCLUSION
The results provide support for the construct validity of virtual reality lifeguarding scenarios, thereby providing the basis for their development and introduction as a potential training approach for developing and maintaining performance in lifeguarding and drowning detection.
APPLICATION
This research provides support for the construct validity of virtual reality simulations as a potential training tool, enabling improvements in the fidelity of training solutions to improve pool lifeguard competency in drowning detection.
Topics: Humans; Drowning; Attention; Reaction Time
PubMed: 36566527
DOI: 10.1016/j.apergo.2022.103954 -
BMC Public Health Feb 2022Incompleteness of fatal drowning statistics is a familiar problem impeding public health measures. Part of the problem may be that only data on accidental drowning are...
INTRODUCTION
Incompleteness of fatal drowning statistics is a familiar problem impeding public health measures. Part of the problem may be that only data on accidental drowning are used and not the full potential of accessible data.
METHODS
This study combines cause-of-death certificates and public prosecutor's court documents between 1998 and 2017 to obtain an aggregated profile. Data are also used as a basis for a trend analysis.
RESULTS
The dataset includes 5571 drowned persons (1.69 per 100,000). The highest risk group are persons above the age of 50. Demographic differences are observed between suicide by drowning, accidental drowning, and drowning due to transportation (0.72, 0.64, 0.28 per 100.000) and between native Dutch, and Dutch with western and non-western background (1.46, 1.43, 1.76 per 100.000). Non-residents account for another 12.2%. When comparing the periods 1998-2007 with 2008-2017, the Standard Mortality declines for suicide drowning and accidental drowning among persons with a native Dutch and non-western background. Single regression analysis confirms a decrease of drowning over the full period, breakpoint analysis shows an increase in the incidence of the total number of drowning, suicide by drowning and accidental drowning starting in 2007, 2008 resp. 2012.
DISCUSSION
Compared to the formal number of fatal accidental drowning in the Netherlands (n = 1718; incidence 0.52 per 100,000), the study identifies 350% more drowning. Differences in demographic data and the recent increase needs to be explored for public health interventions.
Topics: Drowning; Ethnicity; Humans; Incidence; Netherlands; Suicide
PubMed: 35177025
DOI: 10.1186/s12889-022-12620-3 -
Forensic Science, Medicine, and... Dec 2017
Topics: Drowning; Humans; Risk Factors; Rivers
PubMed: 28580497
DOI: 10.1007/s12024-017-9883-4 -
Australian and New Zealand Journal of... Jun 2021This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia.
OBJECTIVE
This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia.
METHODS
A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia.
RESULTS
There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25-34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85-8.25), Taiwan (2.29/100,000 95%CI: 0.27-13.44), and Nepal (2.15/100,000 95%CI: 0.23-11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001).
CONCLUSIONS
Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities.
Topics: Accidents; Adolescent; Adult; Age Distribution; Aged; Australia; Drowning; Female; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Sex Distribution; Transients and Migrants
PubMed: 33900674
DOI: 10.1111/1753-6405.13102 -
PloS One 2013Drowning deaths are devastating and preventable. Public perception does not regard hot weather as a common scenario for drowning deaths. The objective of our study was...
BACKGROUND
Drowning deaths are devastating and preventable. Public perception does not regard hot weather as a common scenario for drowning deaths. The objective of our study was to test the association between hot weather and drowning risk.
MATERIALS AND METHODS
We conducted a retrospective case-crossover analysis of all unintentional drowning deaths in Ontario, Canada from 1999 to 2009. Demographic data were obtained from the Office of the Chief Coroner. Weather data were obtained from Environment Canada. We used the pair-matched analytic approach for the case-crossover design to contrast the weather on the date of the drowning with the weather at the same location one week prior (control period).
RESULTS
We identified 1243 drowning deaths. The mean age was 40 years, 82% were male, and most events (71%) occurred in open water. The pair-matched analytic approach indicated that temperatures exceeding 30°C were associated with a 69% increase in the risk of outdoor drowning (OR = 1.69, 95% CI 1.23-2.25, p = 0.001). For indoor drowning, however, temperatures exceeding 30°C were not associated with a statistically significant increase in the risk of drowning (OR = 1.50, 95% CI 0.53-4.21, p = 0.442). Adult men were specifically prone to drown in hot weather (OR 1.67, 95% CI 1.19-2.34, p = 0.003) yet an apparent increase in risk extended to both genders and all age groups.
CONCLUSION
Contrary to popular belief, hot weather rather than cold stormy weather increases the risk of drowning. An awareness of this risk might encourage greater use of drowning prevention strategies known to save lives.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Comorbidity; Drowning; Female; Hot Temperature; Humans; Infant; Infant, Newborn; Male; Middle Aged; Ontario; Young Adult
PubMed: 23977112
DOI: 10.1371/journal.pone.0071689 -
Injury Prevention : Journal of the... Dec 2019To examine the change in the racial disparity in drowning in Florida from 1970 to 2015 and to analyse the contextual factors associated with white, black and Hispanic...
OBJECTIVES
To examine the change in the racial disparity in drowning in Florida from 1970 to 2015 and to analyse the contextual factors associated with white, black and Hispanic drowning rates in Florida from 2007 to 2015.
METHODS
Our outcome variable is county-level annual drowning rates by race, ethnicity, sex and age group. We computed county-level contextual data, including emergency weather events, temperature, extreme weather, number of pools, quality of pools, coastline, swimming participation rates and prominent black competitive swim teams.
RESULTS
Between 1970 and 1990, the disparity in drowning rates between white and black males in Florida decreased dramatically. By 2005, the overall age-adjusted drowning rates converged. This convergence was most striking for those aged 10-34 and 35-64. While the gap has declined dramatically, there remains a racial disparity in drownings among those aged 10-34.
CONCLUSIONS
Overall, racial disparities in drowning have disappeared in Florida. However, some disparities remain. There is a persistent disparity in drownings among those aged 10-34.
Topics: Accidents; Adolescent; Adult; Black or African American; Age Factors; Child; Databases, Factual; Drowning; Ethnicity; Female; Florida; Health Status Disparities; Hispanic or Latino; Humans; Male; Middle Aged; Retrospective Studies; Seasons; Swimming; Swimming Pools; White People; Young Adult
PubMed: 30352797
DOI: 10.1136/injuryprev-2018-042872 -
Scandinavian Journal of Trauma,... Mar 2018The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to... (Review)
Review
BACKGROUND
The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD.
METHODS
A search in Pubmed, Embase, the Cochrane Library, Web of Science and Scopus was performed to identify studies that used the USFD and were published between 01-10-2003 and 22-03-2015. We also searched in Pubmed, Embase, the Cochrane Library, Web of Science, and Scopus for all publications that cited the two publications containing the original ILCOR advisory statement introducing and recommending the USFD. In total we identified 14 publications by groups that explicitly used elements of the USFD for collecting and reporting their data.
RESULTS
Of the 22 core and 19 supplemental USFD parameters, 6-19 core (27-86%) and 1-12 (5-63%) supplemental parameters were used; two parameters (5%) have not been used in any publication. Associations with outcome were reported for nine core (41%) and five supplemental (26%) USFD parameters. The USFD publications also identified non-USFD parameters related to outcome: initial cardiac rhythm, time points and intervals during resuscitation, intubation at the drowning scene, first hospital core temperature, serum glucose and potassium, the use of inotropic/vasoactive agents and the Paediatric Index of Mortality 2-score.
CONCLUSIONS
Fourteen USFD based drowning publications have been identified. These publications provide valuable information about the process and quality of drowning resuscitation and confirm that the USFD is helpful for a structured comparison of the outcome of drowning resuscitation.
Topics: Biomedical Research; Cardiopulmonary Resuscitation; Drowning; Humans; Publications
PubMed: 29566700
DOI: 10.1186/s13049-018-0488-z -
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