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Australian and New Zealand Journal of... Feb 2022To quantify unintentional drowning trends and risk factors for children under five years of age in Aotearoa, New Zealand.
OBJECTIVE
To quantify unintentional drowning trends and risk factors for children under five years of age in Aotearoa, New Zealand.
METHODS
A population-based analyses of fatal and non-fatal (hospitalisations and Accident Compensation Corporation [ACC] claims) unintentional drowning of children 0-4 years of age between 2005 and 2019 was conducted using DrownBase™ data. Analyses comprises calculation of linear temporal trends, crude drowning rates per 100,000 and relative risk (95% confidence interval) and ratios of fatal to non-fatal drowning.
RESULTS
557 incidents (16.0% fatal) were recorded. Fatalities declined (y=-0.0769x+2.5678;R2=0.01509), while hospitalisations increased (y=0.1418x+9.1093;R2=0.0979). Males were overrepresented. One year-olds recorded the highest rates (fatal=4.39/100,000) and (non-fatal=2.14/100,000). 'Other' ethnicity (8.77/100,000) and Māori (2.49/100,000) children recorded the highest fatal drowning rates. Home pools were the leading fatal location, while domestic environments attracted the highest hospitalisation rate. For every one fatal drowning there were 6.9 hospitalisations and 74.7 ACC claims.
CONCLUSIONS
Drowning among young children represents a preventable cause of injury-related harm. While fatalities are declining, non-fatal drowning is increasing. Implications for public health: Strategies to prevent drowning among young children are well understood, particularly restricting water access and active adult supervision. Further investment in effective prevention strategies for young children will deliver significant social, economic and health system savings.
Topics: Accidents; Adult; Child; Child, Preschool; Drowning; Humans; Infant; Male; New Zealand; Retrospective Studies; Risk Factors
PubMed: 34529307
DOI: 10.1111/1753-6405.13157 -
Frontiers in Public Health 2024Although previous research has examined the risk factors for drowning behavior among adolescents, it is unclear whether this association is influenced by water safety...
INTRODUCTION
Although previous research has examined the risk factors for drowning behavior among adolescents, it is unclear whether this association is influenced by water safety knowledge. This study aimed to examine whether water safety knowledge is associated with adolescents' drowning risk behaviors and whether drowning risk perceptions and attitudes could have a chain mediating role in the association between water safety knowledge and adolescents' drowning risk behaviors.
METHODS
This study included 7,485 adolescents from five Chinese provinces and cities. We used the Drowning Risk Behaviors Scales (DRBS) to evaluate the risk of drowning behaviors. The Water Safety Knowledge Scale (WSKS) was used to evaluate the competence level of water safety knowledge. The Drowning Risk Perceptions Scale (DRPS) was used to evaluate the risk level of perceptions, and the Drowning Risk Attitudes Scale (DRAS) was used to evaluate the risk level of attitudes.
RESULTS
The results of the mediating effect test showed that water safety knowledge (WSK) affected drowning risk behaviors (DRB) through three indirect paths. Drowning risk perceptions (DRP) and attitudes (DRA) have significantly mediated the association between WSK and DRB. In conclusion, DRP and DRA can act as mediators between WSK and DRB, not only individually, but also as chain mediators, where the direct effect is-0.301, the total indirect effect is-0.214, and the total mediated indirect effect is 41.5%.
DISCUSSION
Water safety knowledge negatively predicts adolescents' drowning risk behaviors; water safety knowledge has an inhibitory effect on drowning risk perceptions. Water safety knowledge can directly influence adolescents' drowning risk perceptions and indirectly affect drowning risk behaviors through the mediation of drowning risk perceptions and attitudes comprising three paths: (1) the drowning risk perceptions mediation path, (2) the drowning risk attitudes mediation path, and (3) the drowning risk perceptions and attitudes mediation paths.
Topics: Humans; Drowning; Adolescent; Health Knowledge, Attitudes, Practice; Female; Male; China; Risk-Taking; Surveys and Questionnaires; Risk Factors; Safety; Adolescent Behavior
PubMed: 38799683
DOI: 10.3389/fpubh.2024.1354231 -
The Cochrane Database of Systematic... 2000In most industrialized countries, drowning ranks second or third behind motor vehicles and fires as a cause of unintentional injury deaths to children under the age of... (Review)
Review
BACKGROUND
In most industrialized countries, drowning ranks second or third behind motor vehicles and fires as a cause of unintentional injury deaths to children under the age of 15. Death rates from drowning are highest in children less than five years old. Pool fencing is a passive environmental intervention designed to reduce unintended access to swimming pools and thus prevent drowning in the preschool age group. Because of the magnitude of the problem and the potential effectiveness of fencing we decided to evaluate the effect of pool fencing as a drowning prevention strategy for young children.
OBJECTIVES
To determine if pool fencing prevents drowning in young children.
SEARCH STRATEGY
We used Cochrane Collaboration search strategy of electronic databases, searched reference lists of past reviews and review articles, Cochrane International Register of RCT's, studies from government agencies in the United States and Australia, and contacted colleagues from International Society for Child and Adolescent Injury Prevention, World Injury Network, and CDC funded Injury Control and Research Centers.
SELECTION CRITERIA
In order to be selected a study had to be designed to evaluate pool fencing in a defined population and provide relevant and interpretable data which objectively measured the risk of drowning or near drowning or provided rates of these outcomes in fenced and unfenced pools. The completed studies meeting selection criteria employed a case-control design. No randomized controlled studies have been identified.
DATA COLLECTION AND ANALYSIS
Three published studies met selection criteria. Data were extracted by two reviewers using standard abstract form. Odds ratios with 95% CI, and incidence rates, were calculated for drowning and near-drowning. Attributable Risk percent (AR%) was calculated to report the reduction in drowning due to pool fencing.
MAIN RESULTS
Case control studies which evaluate pool fencing interventions indicate that pool fencing significantly reduces the risk of drowning. Odds ratio for the risk of drowning or near drowning in a fenced pool compared to an unfenced pool is 0.27 95%CI (0.16, 0.47). Isolation fencing (enclosing pool only) is superior to perimeter fencing (enclosing property and pool) because perimeter fencing allows access to the pool area through the house. Odds ratio for the risk of drowning in a pool with isolation fencing compared to a pool with three sided fencing is 0.17 95%CI (0.07, 0.44)
REVIEWER'S CONCLUSIONS
Pool fences should have a dynamic and secure gate and isolate (i.e., four-sided fencing) the pool from the house. Legislation should require isolation fencing with secure, self-latching gates for all pools, public, semi-public and private.
Topics: Accident Prevention; Child, Preschool; Drowning; Humans; Swimming; Swimming Pools
PubMed: 10796742
DOI: 10.1002/14651858.CD001047 -
Journal of the Royal Society of Medicine Aug 1991
Topics: Adult; Alcohol Drinking; Child, Preschool; Drowning; Humans; Safety; Suicide; United Kingdom
PubMed: 1886111
DOI: No ID Found -
British Medical Journal (Clinical... Apr 1981
Topics: Drowning; Eukaryota; Forensic Medicine; Humans; Immersion
PubMed: 6786486
DOI: No ID Found -
Injury Prevention : Journal of the... Jun 2020Some populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account...
INTRODUCTION
Some populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies.
METHODS
A literature review undertaken systematically using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was conducted of peer-reviewed literature in English, published between 1990 and 2018 from high-income countries. Search terms included drowning, water safety, ethnic minority, migrant, and culturally diverse.
RESULTS
In total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0-18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found; two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry; an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement.
DISCUSSION
Limited literature exists pertaining to drowning among adults from high-risk populations. There is a need to increase the sophistication of drowning prevention strategies addressing the disparities in drowning from a culturally appropriate perspective. Acknowledging the role of the social determinants of health in drowning prevention is essential in order to improve drowning outcomes for high-risk populations globally.
Topics: Accident Prevention; Adolescent; Adult; Child; Child, Preschool; Drowning; Ethnicity; Female; Health Knowledge, Attitudes, Practice; Humans; Infant; Infant, Newborn; Male; Minority Groups; Native Hawaiian or Other Pacific Islander; Population Groups; Risk Factors; Rural Population; Social Class; Social Determinants of Health; Swimming; Transients and Migrants
PubMed: 31907207
DOI: 10.1136/injuryprev-2019-043432 -
International Journal of Environmental... Sep 2021Limited access to health care and the lack of robust data systems means non-fatal drownings are largely missed in low-and middle-income countries. We report morbidity...
Limited access to health care and the lack of robust data systems means non-fatal drownings are largely missed in low-and middle-income countries. We report morbidity among individuals who experienced non-fatal drowning in the Barishal Division, Bangladesh. A representative household survey was conducted in the Barishal Division in southern Bangladesh between September 2016 and February 2017, covering a population of 386,016. The burden of non-fatal drowning was assessed using the WHODAS 2.0 disability assessment tool, a generic assessment instrument for health and disability. A total of 5164 non-fatal drowning events occurred in the one year preceding the survey. Among these 18% were multiple events. From these, 4235 people were administered the WHODAS 2.0 questionnaire. Non-fatal drowning incidence rates were highest in children aged 1-4 years at 5810 per 100,000 population, and among males. Non-fatal drowning was associated with lower socio-economic status and larger family sizes. Few respondents (6.5%; 95% CI: 4.5-8.4%) reported some level of disability (WHODAS-12 score > 8). Incidence of non-fatal drowning is high in the population, however limited impact on morbidity was found. There is a need to develop tools and methodologies for reliable and comparable data for non-fatal drowning, especially to capture post-event disability in children.
Topics: Bangladesh; Child; Drowning; Humans; Incidence; Infant; Male; Risk Factors; Surveys and Questionnaires
PubMed: 34574663
DOI: 10.3390/ijerph18189738 -
Pediatric Critical Care Medicine : a... Aug 2016
Topics: Bayes Theorem; Decision Making; Drowning; Heart Arrest; Hypothermia, Induced; Out-of-Hospital Cardiac Arrest
PubMed: 27500613
DOI: 10.1097/PCC.0000000000000799 -
Annals of Saudi Medicine 2021Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming...
BACKGROUND
Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming pools are more prevalent in high-income countries. In Saudi Arabia, injuries and drowning are a significant threat to population health. Local data is limited, which affects an understanding of the extent of the burden and the development of prevention strategies.
OBJECTIVE
Determine the epidemiological characteristics, risk factors, and clinical outcomes of drowning among children.
DESIGN
Retrospective chart review.
SETTING
Patients admitted to the tertiary care unit of a hospital in Riyadh.
PATIENTS AND METHODS
Data was collected on children who drowned (age 0-14) between January 2015 and August 2020. Cases were identified from the electronic health record system where the diagnosis was drowning. Differences in characteristics and outcomes between nonfatal cases with no neurological damage and fatal cases with neurological damage were analyzed.
MAIN OUTCOME MEASURE
Drowning mortality and morbidity.
SAMPLE SIZE
99.
RESULTS
Of the 99 drowning cases, 22 (22.2%) had a fatal outcome or resulted in neurological damage. The most-reported drowning site was private pools (82%). The majority of cases involved children younger than the age of two (54%). Eighty-four cases (84.8%) occurred on holidays. Cardiopulmonary resuscitation was performed in 61 (61.6%) of cases. A significant association was found between the delay in initiating resuscitation and an unfavorable outcome (<.01). A high Glasgow Coma Scale score upon admission was a predictor of normal recovery (<.01).
CONCLUSION
These findings warrant investment to increase public awareness of the risks of leaving children unsupervised in swimming pools. In addition, there is a need to ensure early resuscitation of drowning victims by promoting life support courses in order to facilitate positive outcomes.
LIMITATIONS
The study was conducted in one tertiary center located in a non-coastal city so the results may not be generalizable.
CONFLICT OF INTEREST
None.
Topics: Adolescent; Cardiopulmonary Resuscitation; Child; Child, Preschool; Drowning; Humans; Infant; Infant, Newborn; Retrospective Studies; Saudi Arabia; Trauma Centers
PubMed: 34085546
DOI: 10.5144/0256-4947.2021.157 -
Medicina (Kaunas, Lithuania) Sep 2019: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in...
: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in low- and middle-income countries with inadequate prevention measures. The highest rates of drowning are observed in Africa. The aim of this review is to describe the epidemiology of drowning and identify the risk factors and strategies for prevention of drowning in Africa. : A review of multiple databases (MEDLINE, CINAHL, PsycINFO, Scopus and Emcare) was conducted from inception of the databases to the 1st of April 2019 to identify studies investigating drowning in Africa. The preferred reporting items for systematic review and meta-analysis (PRISMA) was utilised. : Forty-two articles from 15 countries were included. Twelve articles explored drowning, while in 30 articles, drowning was reported as part of a wider study. The data sources were coronial, central registry, hospital record, sea rescue and self-generated data. Measures used to describe drowning were proportions and rates. There was a huge variation in the proportion and incidence rate of drowning reported by the studies included in the review. The potential risk factors for drowning included young age, male gender, ethnicity, alcohol, access to bodies of water, age and carrying capacity of the boat, weather and summer season. No study evaluated prevention strategies, however, strategies proposed were education, increased supervision and community awareness. There is a need to address the high rate of drowning in Africa. Good epidemiological studies across all African countries are needed to describe the patterns of drowning and understand risk factors. Further research is needed to investigate the risk factors and to evaluate prevention strategies.
Topics: Accident Prevention; Africa; Drowning; Health Knowledge, Attitudes, Practice; Health Promotion; Humans; Public Health; Risk Factors; Swimming
PubMed: 31557943
DOI: 10.3390/medicina55100637