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Jin Y, Ye P, Tian M, Duan L, Peden AE, Franklin RC. Burden of unintentional drowning in China from 1990 to 2019 and exposure to water: findings from the Global Burden of Disease 2019 study. Inj Prev 2024:ip-2023-045089. [PMID: 38991718 DOI: 10.1136/ip-2023-045089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 04/08/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Drowning is an important contributor to the burden of deaths in China. Exposure to open water is a risk factor for drowning, but few studies quantify its impact on drowning. The purpose of this study was to provide an up-to-date analysis of unintentional drowning in China, including impact of exposure to open water. METHODS Chinese provincial data from the Global Burden of Disease Study 2019 were used to describe the burden of unintentional drowning in 33 provinces and changes from 1990 to 2019. Provincial outdoor open water resource data were used to explore the relationship between outdoor open water resources and drowning burden using K-median clustering analysis. RESULTS Between 1990 and 2019, the unintentional drowning incidence, mortality and disability adjusted life years (DALY) rates declined by 31.2%, 68.6% and 74.9%, respectively, with differences by age, sex and province. In 2019, the DALY rate for drowning was relatively higher in children under 20 year, the elderly over 80 years than other age groups and was relatively higher in men. There was no statistical difference in overall incidence rate by sex. Provincial differences in unintentional drowning burden show a positive relationship with the availability and size of outdoor open water. CONCLUSIONS As expected availability of water increases drowning risk. There is a need to address drowning environmental risk especially among children and the elderly. Localised water safety plans which consider drowning burden and environmental risk factors are needed in China to ensure a sustained decline of unintentional drowning.
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Affiliation(s)
- Ye Jin
- Division of Injury Prevention, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Pengpeng Ye
- Division of Injury Prevention, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maoyi Tian
- School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Leilei Duan
- Division of Injury Prevention, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Amy E Peden
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, James Cook University, Queensland, Australia
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2
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Peden AE, Scarr J, Doan Minh T, Latif R, Le Thi Anh D, Chong TL, Fong D, Mei GC, Suvanprakorn A, Suwanrit S, Chien GC, Navarra JAA, Dharma A, Tek Geh T, Phoumin B, Lawton B. Drowning prevention challenges and opportunities: An exploratory study of perspectives of delegates from ASEAN nations. PLoS One 2024; 19:e0304138. [PMID: 38843123 PMCID: PMC11156313 DOI: 10.1371/journal.pone.0304138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
The South East Asian region has the world's second highest fatal drowning burden. This study reports analysis of survey data from representatives from nations within the Association of South East Asian Nations regarding current efforts, challenges and future opportunities for drowning prevention. Twenty-two responses were received from respondents from all ASEAN nations excepting Cambodia and Myanmar. Drowning prevention initiatives varied across ASEAN nations, with most efforts focused on public education and raising awareness, including the provision of drowning data to the media. The lack of comprehensive, national level data collection was identified as a challenge, necessitating strengthened data collection capacity. Governmental involvement spanned one to six different ministries, highlighting the multi-sectoral nature of drowning prevention. However, a lead ministry could be identified in only two countries. Despite the challenges identified, there remain many opportunities to strengthen drowning prevention across ASEAN nations, addressing a significant regional public health threat.
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Affiliation(s)
- Amy E. Peden
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia
- Royal Life Saving Society–Australia, Sydney, Australia
| | - Justin Scarr
- Royal Life Saving Society–Australia, Sydney, Australia
| | | | | | - Dao Le Thi Anh
- Hue University of Sciences, Thành phố Huế, Thừa Thiên Huế, Vietnam
- Hue Help, Thuận Thành Thành phố Huế, Thừa Thiên Huế, Vietnam
| | | | | | - Geh Cheow Mei
- Life Saving Society Malaysia, Penang Life Saving Society Malaysia, Tanjung Bungah, Penang, Malaysia
- Universiti Sains Malaysia (USM), Gelugor, Penang, Malaysia
| | | | - Sirirat Suwanrit
- Division of Injury Prevention, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Geh Cheow Chien
- Life Saving Society Malaysia, Penang Life Saving Society Malaysia, Tanjung Bungah, Penang, Malaysia
| | | | - Agus Dharma
- Balawista Indonesia (Indonesian Lifeguard Association) and Udayana University, Bali, Indonesia
| | - Thuan Tek Geh
- Life Saving Society Malaysia, Penang Life Saving Society Malaysia, Tanjung Bungah, Penang, Malaysia
| | - Bouathep Phoumin
- Faculty of Medical Technologies, University of Health Sciences, Sisattanak District Vientiane, Lao PDR
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3
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Peden AE, Chisholm S, Meddings DR, Abrahams J. Drowning and disasters: climate change priorities. Lancet Planet Health 2024; 8:e345-e346. [PMID: 38849173 DOI: 10.1016/s2542-5196(24)00090-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/17/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Amy E Peden
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; Royal Life Saving Society, Sydney, NSW, Australia
| | - Sean Chisholm
- Monash University Disaster Resilience Initiative, Monash University, Clayton, VIC, Australia
| | | | - Jonathan Abrahams
- Monash University Disaster Resilience Initiative, Monash University, Clayton, VIC, Australia
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Guy K, Ritchie A, Tumuhimbise P, Balinda E, Nasim K, Kalanzi M, Wipfli H. Mixed-methods community assessment of drowning and water safety knowledge and behaviours on Lake Victoria. Inj Prev 2024:ip-2023-045106. [PMID: 38604661 DOI: 10.1136/ip-2023-045106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/01/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Drowning is a major cause of death in Uganda, especially among young adults with water-based occupations and livelihoods. Information about drowning and other water-related deaths and injuries is limited. To address this gap in knowledge, study partners assessed knowledge, attitudes and beliefs about drowning and drowning prevention interventions in the Mayuge district of eastern Uganda. METHODS This study consisted of a mixed-methods, cross-sectional community health assessment. Research was conducted in 10 landing sites of 6 subcounties within Mayuge district bordering Lake Victoria and focused on 505 head-of-household interviews, 15 key informant interviews, 10 landing site observations and 3 focus group discussions with 10 young adults each. RESULTS While landing site observations revealed high lake use, households reported limited community drowning prevention knowledge and revealed risky behaviours and attitudes towards water safety. Less than one-third (30.9%) of participants reported that at least one family member can swim. 64.2% of all respondents reported no existing safety measures (eg, signage, fences) around the lake and 95.8% reported no aquatic emergency response system in their community. The majority of households (85.7%) had experienced a drowning incident in their area. Key informants and focus group participants were eager for community-based interventions and offered solutions that reflected international drowning prevention recommendations. CONCLUSIONS The results reveal gaps in services, access and knowledge and highlight a need for water safety services and interventions in lakeside communities in Uganda and throughout the Lake Victoria Basin.
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Affiliation(s)
- Kyra Guy
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Ava Ritchie
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | | | | | - Khoban Nasim
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | | | - Heather Wipfli
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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Berger S, Siekmeyer M, Petzold-Quinque S, Kiess W, Merkenschlager A. Drowning and Nonfatal Drowning in Children and Adolescents: A Subsequent Retrospective Data Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:439. [PMID: 38671656 PMCID: PMC11049416 DOI: 10.3390/children11040439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Fatal and nonfatal drowning are among the leading causes of death and lifelong severe neurological impairment among children and adolescents. This study aimed to complement research from Leipzig 1994-2008 to seek trends within risk factors, treatments, and outcomes throughout the last decade. We retrospectively investigated data of 47 inpatients aged 0-18 admitted to Leipzig University Department of Pediatrics who matched ICD-10 code T75.1 from 2008 to 2020 and compared them to a preceding study at the same institution. We also examined the prognostic value of parameters regarding the patients' outcomes. There were three median incidents per annum. The median age was 2.75 years; 76% of incidents happened in males. An accumulation was seen during the summer months and weekends. Most drowning incidents occurred in private ponds or pools (48.9%). Thirty-nine children were discharged without resulting morbidity, four showed neurological impairment, and three died. Risk factors concerning age, sex, and incident characteristics were confirmed. Special supervision needs still apply to 1-3-year-old male children or children with pre-existing health conditions around private pools and ponds. Hospitalization duration shortened, and morbidity and lethality decreased since the previous study. There was structural improvement in primary care and medical documentation. Parameters suggesting good outcomes include a submersion time < 5 min, GCS > 3 points, spontaneous movement upon admission, remaining pupillary light response, the absence of cardiovascular arrest, body temperature ≥ 32 °C, pH > 7, blood glucose < 15 mmol/L, lactate < 14 mmol/L, base excess ≥ -15 mmol/L, and the absence of ARDS. Clear legislation can contribute to improved private home water safety. Further studies should include a broad in- and outpatient spectrum and standardized incident documentation presupposing Utstein-style reporting. Regular reinvestigation of consistent geographical regions facilitates process evaluations of drowning epidemiology and therapy evolution.
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Affiliation(s)
- Sebastian Berger
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
| | - Manuela Siekmeyer
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Stefanie Petzold-Quinque
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University Hospital Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Andreas Merkenschlager
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
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Scarr JP, Jagnoor J. Conceptual definition for drowning prevention: a Delphi study. Inj Prev 2024; 30:145-152. [PMID: 37945328 PMCID: PMC10958290 DOI: 10.1136/ip-2023-045085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Expanding support for drowning prevention is evidenced by interlinked Resolutions at the United Nations (2021) and World Health Assembly (2023). While progress has accelerated, a universally agreed definition for drowning prevention remains absent. Here, we aim to develop a conceptual definition of drowning prevention using the Delphi method. METHODS First, we conducted a document review to guide our development and consensus-building process. Then, we formed an advisory group and recruited participants with diverse expertise to contribute to Delphi-method surveys. In the first round, participants selected from draft concepts to build a definition and delineate between the terms drowning prevention and water safety. In the second round, we presented a codeveloped definition, and three statements based on first-round findings. We then sought participant feedback where ≥70% support was considered consensus-based agreement. RESULTS Participants (n=134) were drawn from community (7.46%), policy (26.87%), research (40.30%) and technical backgrounds (25.37%), and low-income and middle-income countries (38.06%). In the first- round, half (50.74%) disagreed with the proposition that drowning prevention was synonymous to water safety, while 40.30% agreed. The second- round achieved consensus-based agreement (97.27%) for the definition: Drowning prevention is defined as a multidisciplinary approach that reduces drowning risk and builds resilience by implementing evidence-informed measures that address hazards, exposures and vulnerabilities to protect an individual, community or population against fatal and non-fatal drowning. CONCLUSION The Delphi method enabled the codevelopment of our conceptual definition for drowning prevention. Agreement on the definition forms the basis for strengthened multisectoral action, and partnerships with health and sustainable development agendas. Defining drowning prevention in terms of vulnerability and exposure might increase focus on social determinants and other upstream factors critical to prevention efforts.
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Affiliation(s)
- Justin-Paul Scarr
- Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
| | - Jagnoor Jagnoor
- Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Injury Division, The George Institute for Global Health, New Delhi, India
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7
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Jiang Z, Lin Z, Li Z, Yu M, He G, Hu J, Meng R, Hou Z, Zhu S, Zhou C, Xiao Y, Huang B, Xu X, Jin D, Qin M, Xu Y, Liu T, Ma W. Joint effects of heat-humidity compound events on drowning mortality in Southern China. Inj Prev 2024:ip-2023-045036. [PMID: 38443161 DOI: 10.1136/ip-2023-045036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Several previous studies have examined the association of ambient temperature with drowning. However, no study has investigated the effects of heat-humidity compound events on drowning mortality. METHODS The drowning mortality data and meteorological data during the five hottest months (May to September) were collected from 46 cities in Southern China (2013-2018 in Guangdong, Hunan and Zhejiang provinces). Distributed lag non-linear model was first conducted to examine the association between heat-humidity compound events and drowning mortality at city level. Then, meta-analysis was employed to pool the city-specific exposure-response associations. Finally, we analysed the additive interaction of heat and humidity on drowning mortality. RESULTS Compared with wet-non-hot days, dry-hot days had greater effects (excess rate (ER)=32.34%, 95% CI: 24.64 to 40.50) on drowning mortality than wet-hot days (ER=14.38%, 95%CI: 6.80 to 22.50). During dry-hot days, males (ER=42.40%, 95% CI: 31.92 to 53.72), adolescents aged 0-14 years (ER=45.00%, 95% CI: 21.98 to 72.35) and urban city (ER=36.91%, 95% CI: 23.87 to 51.32) showed higher drowning mortality risk than their counterparts. For wet-hot days, males, adolescents and urban city had higher ERs than their counterparts. Attributable fraction (AF) of drowning attributed to dry-hot days was 23.83% (95% CI: 21.67 to 26.99) which was significantly higher than that for wet-hot days (11.32%, 95% CI: 9.64 to 13.48%). We also observed that high temperature and low humidity had an additive interaction on drowning mortality. CONCLUSION We found that dry-hot days had greater drowning mortality risk and burden than wet-hot days, and high temperature and low humidity might have synergy on drowning mortality.
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Affiliation(s)
- Zhiying Jiang
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Zhixing Li
- Department of Public Health, Jinan University, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Min Yu
- Division of NCD Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
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8
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Baffsky R, Koshiba C, Muna EL, Maua RF, Ivers R, Peden AE. Assessing violence and injury prevention plans, strategies and indicators in eighteen Pacific Islands countries: an environmental scan. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 44:100985. [PMID: 38226330 PMCID: PMC10788529 DOI: 10.1016/j.lanwpc.2023.100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Abstract
Background Similar to many other resource poor settings, due to competing priorities, injury is often neglected in the Pacific Islands despite being a prevalent cause of death and disability. This study identifies, and synthesises existing plans and strategies, and assesses progress against indicators for the prevention of violence and injury in 18 Pacific Islands nations to identify gaps and highlight opportunities. Methods An environmental scan of known government repositories and Google Advanced was conducted to identify publicly available documents describing/evaluating national-level injury prevention strategies and plans in the Pacific Islands. Data were extracted on the strategy/plan, country, government department responsible, indicators and related progress. Findings We identified 44 relevant documents. Most were published in more resourced countries (e.g., Fiji, Cook Islands) and described strategies/plans relating to traffic injury, injury from natural disaster and/or intimate partner violence. No strategies/plans to prevent injury mechanisms of drowning, falls, suffocation, burns, or electrocution were identified. Progress against only one indicator was reported for road traffic injury in the Commonwealth of the Northern Mariana Islands. Interpretation This study suggests that there would be benefit in Pacific Islands nations to develop more robust data systems to assess progress against indicators of existing strategies and plans for traffic-injury, natural disaster and intimate partner violence. Development of strategies and implementation plans to address neglected injury areas such as drowning and falls which account for a significant burden of injury in the Pacific Islands is also recommended. Funding This work was funded by the World Health Organization Regional Office for the Western Pacific (RG 221962).
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Affiliation(s)
- Rachel Baffsky
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Candace Koshiba
- Prevention Unit, Division of Behavioural Health, Ministry of Health and Health Services, Palau
| | - Esther L. Muna
- Commonwealth Healthcare Corporation, Saipan, MP, Northern Mariana Islands
| | | | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Amy E. Peden
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
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9
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Hills SP, Hobbs M, Brown P, Tipton M, Barwood M. Association between air temperature and unintentional drowning risk in the United Kingdom 2012-2019: A nationwide case-crossover study. Prev Med 2024; 179:107832. [PMID: 38145877 DOI: 10.1016/j.ypmed.2023.107832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Drowning is a leading cause of death. The World Health Organization (WHO) and United Nations (UN) emphasise the need for population-level data-driven approaches to examine risk factors to improve water safety policies. Weather conditions, have the potential to influence drowning risk behaviours as people are more likely to spend time around water and/or undertake risky activities in aquatic spaces as a behavioural thermoregulatory response (e.g., seeking coolth). METHODS A case-crossover approach assessed associations between changes in daily maximum air temperature (data from the nearest weather station to each drowning event) and unintentional drowning risk using anonymous data from the validated UK Water Incident Database 2012-2019 (1945 unintentional deaths, 82% male). Control days were selected using a unidirectional time-stratified approach, whereby seven and 14 days before the hazard day were used as the controls. RESULTS Mean maximum air temperature on case and control days was 15.36 °C and 14.80 °C, respectively. A 1 °C increase in air temperature was associated with a 7.2% increase in unintentional drowning risk. This relationship existed for males only. Drowning risk was elevated on days where air temperature reached 15-19.9 °C (Odds Ratio; OR: 1.75), 20-24.9 °C (OR: 1.87), and ≥ 25 °C (OR: 4.67), compared with days <10 °C. The greatest elevations in risk appeared to be amongst males and when alcohol intoxication was suspected. Precipitation showed no significant association with unintentional drowning risk. CONCLUSIONS Identifying such relationships highlights the value of considering weather conditions when evaluating environmental risk factors for drowning, and may inform water safety policy and allocating resources to prevention and rescue.
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Affiliation(s)
- Samuel P Hills
- Faculty of Health and Social Sciences, Bournemouth University, United Kingdom.
| | - Matthew Hobbs
- Faculty of Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Paul Brown
- Faculty of Science and Technology, Bournemouth University, United Kingdom
| | - Mike Tipton
- The Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Martin Barwood
- Department of Sport and Wellbeing, Leeds Trinity University, Leeds, United Kingdom
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10
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Wright CY, Kapwata T, Naidoo N, Asante KP, Arku RE, Cissé G, Simane B, Atuyambe L, Berhane K. Climate Change and Human Health in Africa in Relation to Opportunities to Strengthen Mitigating Potential and Adaptive Capacity: Strategies to Inform an African "Brains Trust". Ann Glob Health 2024; 90:7. [PMID: 38312714 PMCID: PMC10836170 DOI: 10.5334/aogh.4260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/20/2023] [Indexed: 02/06/2024] Open
Abstract
Background Africa faces diverse and complex population/human health challenges due to climate change. Understanding the health impacts of climate change in Africa in all its complexity is essential for implementing effective strategies and policies to mitigate risks and protect vulnerable populations. This study aimed to outline the major climate change-related health impacts in Africa in the context of economic resilience and to seek solutions and provide strategies to prevent or reduce adverse effects of climate change on human health and well-being in Africa. Methods For this narrative review, a literature search was conducted in the Web of Science, Scopus, CAB Abstracts, MEDLINE and EMBASE electronic databases. We also searched the reference lists of retrieved articles for additional records as well as reports. We followed a conceptual framework to ensure all aspects of climate change and health impacts in Africa were identified. Results The average temperatures in all six eco-regions of Africa have risen since the early twentieth century, and heat exposure, extreme events, and sea level rise are projected to disproportionately affect Africa, resulting in a larger burden of health impacts than other continents. Given that climate change already poses substantial challenges to African health and well-being, this will necessitate significant effort, financial investment, and dedication to climate change mitigation and adaptation. This review offers African leaders and decision-makers data-driven and action-oriented strategies that will ensure a more resilient healthcare system and safe, healthy populations-in ways that contribute to economic resiliency. Conclusions The urgency of climate-health action integrated with sustainable development in Africa cannot be overstated, given the multiple economic gains from reducing current impacts and projected risks of climate change on the continent's population health and well-being. Climate action must be integrated into Africa's development plan to meet the Sustainable Development Goals, protect vulnerable populations from the detrimental effects of climate change, and promote economic development.
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Affiliation(s)
- Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Natasha Naidoo
- Environment and Health Research Unit, South African Medical Research Council, Durban, South Africa
| | | | - Raphael E. Arku
- School of Public Health & Health Sciences, University of Massachusetts Amherst, USA
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Lynn Atuyambe
- Makerere University, School of Public Health, Uganda
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11
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Peden AE, Mason HM, King JC, Franklin RC. Examining the relationship between heatwaves and fatal drowning: a case study from Queensland, Australia. Inj Prev 2024; 30:7-13. [PMID: 37678903 DOI: 10.1136/ip-2023-044938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Globally, drowning is a leading cause of injury-related harm, which is heavily impacted by environmental conditions. In Australia, fatal unintentional drowning peaks in summer, yet the impact of prolonged periods of hot weather (heatwave) on fatal drowning has not previously been explored. METHODS Using a case-crossover approach, we examined the difference in drowning risk between heatwave and non-heatwave days for the Australian state of Queensland from 2010 to 2019. Heatwave data, measured by the excess heat factor, were acquired from the Bureau of Meteorology. Incidence rate ratios (IRRs) were calculated by sex, age of drowning decedent, category of drowning incident (International Classification of Diseases-10 codes) and heatwave severity. Excess drowning mortality during heatwaves was also calculated. RESULTS Analyses reveal increased fatal drowning risk during heatwave for males (IRR 1.22, 95% CI 0.92 to 1.61), people aged 65+ years (IRR 1.36, 95% CI 0.83 to 2.24), unintentional drowning (IRR 1.28, 95% CI 0.98 to 1.69) and during severe heatwaves (IRR 1.26, 95% CI0.88 to 1.82). There were 13 excess drowning deaths due to heatwave over the study period. DISCUSSION The findings confirm an increased risk of fatal drowning during heatwaves. With increased likelihood and severity of heatwaves, this information should be used to inform drowning prevention, in particular the timing of public awareness campaigns and patrolling of supervised aquatic locations. CONCLUSIONS Water safety and patrolling organisations, as well as first responders, need to prepare for more drowning deaths during heatwave conditions. In addition, drowning prevention education ahead of heatwaves is needed for recreational swimmers, and older people, particularly those with comorbidities which may be further exacerbated by a heatwave.
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Affiliation(s)
- Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
| | - Hannah M Mason
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
| | - Jemma Chandal King
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Queensland, Australia
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12
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Vincenten JA, Meddings DR, Eardley K, Sufiur Rahman M, White N. Advancing child survival: commitment to act on drowning prevention and opportunity for impactful change. BMJ Glob Health 2023; 8:e014633. [PMID: 38081773 PMCID: PMC10728994 DOI: 10.1136/bmjgh-2023-014633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
| | - David R Meddings
- Department of the Social Determinants of Health, Division of UHC/Healthier Populations, World Health Organization, Geneva, GE, Switzerland
| | - Kate Eardley
- International Programme, Royal National Lifeboat Institution, Poole, UK
| | - Mohammad Sufiur Rahman
- Ambassador and Permanent Representative of Bangladesh, Permanent Mission of Bangladesh to the United Nations, Geneva, Switzerland
| | - Noel White
- Ambassador and Permanent Representative of Ireland, Permanent Mission of Ireland to the United Nations, Geneva, Switzerland
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13
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Huang Z, Li Z, Hu J, Zhu S, Gong W, Zhou C, Meng R, Dong X, Yu M, Xu X, Lin L, Xiao J, Zhong J, Jin D, Xu Y, Liu T, Lin Z, He G, Ma W. The association of heatwave with drowning mortality in five provinces of China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166321. [PMID: 37586513 DOI: 10.1016/j.scitotenv.2023.166321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/29/2023] [Accepted: 08/13/2023] [Indexed: 08/18/2023]
Abstract
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.
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Affiliation(s)
- Zhongguo Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Zhixing Li
- Department of Nosocomial Infection Management, Nanfang Hospital, Southern Medical University, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Disease Control and Prevention Institute, Jinan University, Guangzhou 511443, China.
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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14
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Leavy JE, Crawford G, Scarr JP, Meddings DR. Drowning prevention: A global health promotion imperative, now more than ever. Health Promot J Austr 2023. [PMID: 38009891 DOI: 10.1002/hpja.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Affiliation(s)
- Justine E Leavy
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Gemma Crawford
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Justin P Scarr
- Royal Life Saving Society, Sydney, New South Wales, Australia
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - David R Meddings
- Department of the Social Determinants of HealthDivision of UHC/Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
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Oporia F, Kibira SPS, Jagnoor J, Kobusingye O, Makumbi FE, Isunju JB, Nuwaha F. Peer-led training improves lifejacket wear among occupational boaters: Evidence from a cluster randomized controlled trial on Lake Albert, Uganda. PLoS One 2023; 18:e0292754. [PMID: 37862363 PMCID: PMC10588873 DOI: 10.1371/journal.pone.0292754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/21/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda. METHODS We conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials. RESULTS Self-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value <0.001) and observed wear (26.8%- 8.8% = 18%, p-value <0.001) showed statistically significant differences between the intervention and non-intervention arm. Self-reported lifejacket wear was higher among boaters who received peer training than those who did not (Adj. PR 1.78, 95% CI 1.38-2.30). CONCLUSION This study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Balakrishnan B, Callahan SJ, Cherian SV, Subramanian A, Sarkar S, Bhatt N, Scholand MB. Climate Change for the Pulmonologist: A Focused Review. Chest 2023; 164:963-974. [PMID: 37054776 DOI: 10.1016/j.chest.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/15/2023] Open
Abstract
Climate change adversely impacts global health. Increasingly, temperature variability, inclement weather, declining air quality, and growing food and clean water supply insecurities threaten human health. Earth's temperature is projected to increase up to 6.4 °C by the end of the 21st century, exacerbating the threat. Public and health care professionals, including pulmonologists, perceive the detrimental effects of climate change and air pollution and support efforts to mitigate its effects. In fact, evidence is strong that premature cardiopulmonary death is associated with air pollution exposure via inhalation through the respiratory system, which functions as a portal of entry. However, little guidance is available for pulmonologists in recognizing the effects of climate change and air pollution on the diverse range of pulmonary disorders. To educate and mitigate risk for patients competently, pulmonologists must be armed with evidence-based findings of the impact of climate change and air pollution on specific pulmonary diseases. Our goal is to provide pulmonologists with the background and tools to improve patients' health and to prevent adverse outcomes despite climate change-imposed threats. In this review, we detail current evidence of climate change and air pollution impact on a diverse range of pulmonary disorders. Knowledge enables a proactive and individualized approach toward prevention strategies for patients, rather than merely treating ailments reactively.
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Affiliation(s)
- Bathmapriya Balakrishnan
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, West Virginia University, Morgantown, WV; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL.
| | - Sean J Callahan
- Division of Pulmonary Medicine, University of Utah Health, Salt Lake City, UT; Division of Pulmonary Medicine, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Sujith V Cherian
- Division of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Abirami Subramanian
- Department of Pulmonary and Critical Care Medicine, Baylor Scott and White Health, Dallas, TX; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Sauradeep Sarkar
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, West Virginia University, Morgantown, WV
| | - Nitin Bhatt
- Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University, Columbus, OH; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
| | - Mary-Beth Scholand
- Division of Pulmonary Medicine, University of Utah Health, Salt Lake City, UT; Occupational and Environmental Health Section, Diffuse Lung Disease and Lung Transplant Network, CHEST, Glenview, IL
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17
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Cenderadewi M, Devine SG, Sari DP, Franklin RC. Fatal drowning in Indonesia: understanding knowledge gaps through a scoping review. Health Promot Int 2023; 38:daad130. [PMID: 37851464 PMCID: PMC10583758 DOI: 10.1093/heapro/daad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Little is known about unintentional drowning deaths in Indonesia, the world's fourth most populous and largest archipelagic country. This study aimed to describe the epidemiology and risk factors of unintentional drowning in Indonesia and explore existing health promotion and drowning prevention approaches in Indonesia within a socio-ecological health promotion framework. A scoping review, guided by PRISMA-ScR, was conducted to locate peer-reviewed studies and government reports/policy documents published until May 2023, in English or Indonesian language, using MEDLINE (Ovid), CINAHL, Informit, PsycINFO (ProQuest), Scopus, SafetyLit, BioMed Central and Google Scholar, Indonesian journal databases (Sinta, Garuda) and government agencies websites around the terms: drown, swim, flood, hurricane, cyclone, disaster, water rescue and maritime/boat safety. This review identified 32 papers. However, a paucity of information on unintentional drowning rates, risk factors and prevention in Indonesia was noted. The unavailability of a coordinated national drowning data collection system in Indonesia, from which national and subnational subcategory data can be collected, underlines the possibility of under-representation of drowning mortality. The association between various exposures and drowning incidents has not been fully investigated. An over-reliance on individual-focused, behaviour-based, preventive measures was observed. These findings highlight the need for improving drowning surveillance to ensure the availability and reliability of drowning data; and strengthening research to understand the risk factors for drowning and delivery of drowning prevention programs. Further policy development and research focusing on health promotion approaches that reflect a socio-ecological approach to drowning prevention in Indonesia is imperative.
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Affiliation(s)
- Muthia Cenderadewi
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Bebegu Yumba Campus, Douglas, QLD 4811, Australia
- Medical Faculty, University of Mataram, Mataram, West Nusa Tenggara 83126, Indonesia
| | - Susan G Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Bebegu Yumba Campus, Douglas, QLD 4811, Australia
| | - Dian Puspita Sari
- Medical Faculty, University of Mataram, Mataram, West Nusa Tenggara 83126, Indonesia
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Bebegu Yumba Campus, Douglas, QLD 4811, Australia
- Royal Life Saving Society – Australia, Broadway, NSW 2007, Australia
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18
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Scarr JP, Jagnoor J. Identifying strategic priorities for advancing global drowning prevention: a Delphi method. BMJ Glob Health 2023; 8:e013303. [PMID: 37709301 PMCID: PMC10503336 DOI: 10.1136/bmjgh-2023-013303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023] Open
Abstract
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.
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Affiliation(s)
- Justin-Paul Scarr
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Injury Division, The George Institute for Global Health, New Delhi, India
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Peden AE, Mayhew A, Baker SD, Mayedwa M, Saunders CJ. Exploring Flood Response Challenges, Training Needs, and the Impact of Online Flood Training for Lifeguards and Water Safety Professionals in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6573. [PMID: 37623158 PMCID: PMC10454401 DOI: 10.3390/ijerph20166573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/26/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Abstract
Flooding is a significant cause of human and economic loss in the African region, including in South Africa. Flood mitigation and response in South Africa is challenging due to a range of environmental, infrastructure, and policy constraints. Lifeguards represent a potential additional workforce to bolster flood mitigation and response. This study aimed to explore the feasibility and acceptability of online flood safety training for water safety professionals in South Africa, as well as assess the current flood response capacity and future needs of this group. Online surveys were completed by a convenience sample of South African water safety professionals (including lifeguards) pre-and post a series of four online flood training workshops. Free text responses were thematically coded and flood knowledge was compared between the pre-and post-workshop survey respondents. Sixty-eight responses were analysed (64.7% pre-workshop phase; 63.2% male, 29.4% aged 50-59 years). A range of challenges in flood mitigation and response were identified including equipment, training, and a lack of government support. However, positives were also identified including respondents' willingness to assist in flood emergencies and good cooperation with neighbouring countries and across the region. Opportunities for better cross-municipal and government communication were discussed. In times of crisis, or in resource poor settings, water safety professionals can bolster traditional flood mitigation and response capacity. Opportunities exist to harness this willingness, but also improve cross-governmental and municipal knowledge sharing to improve future flood mitigation and response efforts in South Africa.
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Affiliation(s)
- Amy E. Peden
- School of Population Health, University of New South Wales (UNSW), Kensington, NSW 2052, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Adrian Mayhew
- Surf Life Saving Great Britain, Buckland House, Park 5, Harrier Way, Sowton, Exeter EX2 7HU, UK;
- International Life Saving Federation—Rescue Commission, 3010 Leuven, Belgium;
| | - Shayne D. Baker
- International Life Saving Federation—Rescue Commission, 3010 Leuven, Belgium;
- School of Education, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Mziwoxolo Mayedwa
- Department of Information Systems, University of the Western Cape, Bellville 7535, South Africa;
- Drowning Prevention Committee, Lifesaving South Africa, Durban 4001, South Africa;
| | - Colleen J. Saunders
- Drowning Prevention Committee, Lifesaving South Africa, Durban 4001, South Africa;
- Division of Emergency Medicine, University of Cape Town, Cape Town 7700, South Africa
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20
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Davoudi-Kiakalayeh A, Barshan J, Emami Sigaroudi F, Mirak HM, Naseri Alavi SA. The application of the Haddon matrix in identifying drowning prevention solutions in the north of Iran. Heliyon 2023; 9:e16958. [PMID: 37484249 PMCID: PMC10361018 DOI: 10.1016/j.heliyon.2023.e16958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 07/25/2023] Open
Abstract
The application of the Haddon matrix in identifying drowning prevention solutions in the north of Iran is necessary. We dealt with drownings on three levels of prevention including before, during, and after the injury in northern Iran (Guilan province). This study aimed to investigate the use of Haddon's matrix in preventing three-level drowning cases before, during, and after the accident in the north of Iran. This qualitative study consisted of 9 focus groups with a sample size of 78 people including 48 nursing staff, 21 emergency medicine specialists, and 30 people from non-medical personnel (local community leaders, executive officials of relevant organizations, lifeguards, staff working in health centers, and families of victims). All group discussions were recorded and the questions were based on the focus group table. According to Haddon's table of results, the major risk group was the young and adolescent boys and more in the area of neglect in culture-building and education. In this study, the role of factors was investigated separately and the necessary solutions were presented that can be used as a scientific and practical basis to achieve the main goal of drowning prevention. These strategies require cross-sectoral collaboration, which seems to be a strong interaction with a greater focus on major risk groups to address deficiencies and prevent the recurrence of potential accidents. The study aimed to investigate the use of Haddon's matrix in the prevention of three-level drowning cases before the event, during the event, and after the event in northern Iran.
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Affiliation(s)
| | - Jalal Barshan
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Hamed Mousavi Mirak
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Walls FN, McGarvey DJ. A systems-level model of direct and indirect links between environmental health, socioeconomic factors, and human mortality. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 874:162486. [PMID: 36858240 DOI: 10.1016/j.scitotenv.2023.162486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Major efforts are being made to better understand how human health and ecosystem health are influenced by climate and other environmental factors. However, studies that simultaneously address human and ecosystem health within a systems-level framework that accounts for both direct and indirect effects are rare. Using path analysis and a large database of environmental and socioeconomic variables, we create a systems-level model of direct and indirect effects on human and ecosystem health in counties throughout the conterminous United States. As indicators of human and ecosystem health, we use age-adjusted mortality rate and an index of biological integrity in streams and rivers, respectively. We show that: (i) geology and climate set boundary conditions for all other variables in the model; (ii) hydrology and land cover have predictable but distinct effects on human and ecosystem health; and (iii) forest cover is a key link between the environment and the socioeconomic variables that directly influence human health.
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Affiliation(s)
- Felisha N Walls
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, 1000 West Cary Street, Richmond, VA 23284, USA.
| | - Daniel J McGarvey
- Center for Environmental Studies, Virginia Commonwealth University, 1000 West Cary Street, Richmond, VA 23284, USA.
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22
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Tan H, Lin Z, Fu D, Dong X, Zhu S, Huang Z, Liu Y, He G, Yang P, Liu T, Ma W. Change in global burden of unintentional drowning from 1990 to 2019 and its association with social determinants of health: findings from the Global Burden of Disease Study 2019. BMJ Open 2023; 13:e070772. [PMID: 37045572 PMCID: PMC10106071 DOI: 10.1136/bmjopen-2022-070772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE To systematically analyse global, regional and national burden change of unintentional drowning from 1990 to 2019, and to further quantify the contribution of social determinants of health (SDH) on the change. DESIGN Data from the Global Burden of Disease Study 2019 were used in this study. SETTING AND PARTICIPANTS Individuals of all ages and genders from 204 countries and territories. MAIN OUTCOME MEASURES The main outcomes were the age-standardised rates (ASRs) of mortality and disability-adjusted life-years (DALYs) of unintentional drowning. The percentage change in the ASRs were used to estimate the joint effect of SDH on trends in global burden of drowning. RESULTS We observed that the global burden of unintentional drowning declined markedly from 1990 to 2019, with age-standardised mortality rate and DALYs rate decreasing by 61.5% and 68.2%, respectively. Women, children, middle Socio-Demographic Index (SDI) countries, South-East Asia and Western Pacific region had higher reduction. At national level, greater reductions were observed in Armenia and Republic of Korea, but significant increases in Cabo Verde and Vanuatu. We found that every one percentile increase in six SDHs (Gross Domestic Product (GDP) per person, SDI, educational attainment, health spending, health workers and urbanisation) was associated with a decrease of 0.15% and 0.16% in drowning age-standardised mortality rate and DALYs rate globally, respectively. Health spending and GDP per capita were the main contributors to the reduction of drowning globally. CONCLUSIONS The global burden of unintentional drowning significantly declined in the past three decades, and the improvement of SDHs such as GDP per capita and health spending mainly contributed to the decrease. Our findings indicate that improvement of SDHs is critical for drowning prevention and control.
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Affiliation(s)
- Haomin Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Di Fu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Zhongguo Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Yingyin Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Pan Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
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Affiliation(s)
- Deborah C Girasek
- From the Uniformed Services University of the Health Sciences, Bethesda, MD (D.C.G.); and the Medical College of Wisconsin, Milwaukee (S.H.)
| | - Stephen Hargarten
- From the Uniformed Services University of the Health Sciences, Bethesda, MD (D.C.G.); and the Medical College of Wisconsin, Milwaukee (S.H.)
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Peden AE, Passmore J, Queiroga AC, Sweeney R, Jagnoor J. Closing the gap for drowning prevention across Europe. THE LANCET PUBLIC HEALTH 2022; 7:e728-e729. [PMID: 35896121 PMCID: PMC9433330 DOI: 10.1016/s2468-2667(22)00193-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Amy E Peden
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Jonathon Passmore
- Road Safety, Violence and Injury Prevention, WHO Regional office for Europe, Bonn, Germany.
| | - Ana Catarina Queiroga
- Laboratory for Integrative and Translational Research in Population Health [ITR], Porto, Portugal
| | | | - Jagnoor Jagnoor
- The George Institute for Global Health, Newtown, NSW, Australia
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Drowning in the Eastern Mediterranean region: a systematic literature review of the epidemiology, risk factors and strategies for prevention. BMC Public Health 2022; 22:1477. [PMID: 35922840 PMCID: PMC9351066 DOI: 10.1186/s12889-022-13778-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Globally, drowning is a significant cause of preventable mortality and morbidity. The Eastern Mediterranean region (EMR) comprises 22 countries of extreme disparity in income and is a region impacted by conflict and migration. We systematically review literature published on drowning in the EMR. METHODS Peer-reviewed literature (limited to original research) was identified using Embase, PubMed, Scopus, SportsDiscus, and Web of Science databases. Literature was independently dual screened at title/abstract and full text stages with dual data extraction (20% of included studies). Studies were included if they reported epidemiology, risk/protective factors and/or prevention strategies for drowning (unintentional and intentional; fatal and non-fatal) of residents, tourists or migrants in the EMR. Literature was assessed against the [Australian] National Health and Medical Research Council's Levels of Evidence. RESULTS Seventy-two studies were included in this review (epidemiology 68 studies; risk/protective factor 13 studies; prevention strategies 19 studies). Iran (n = 27), Saudia Arabia (n = 11) and Pakistan (n = 10) recorded the largest number of dedicated studies. Studies predominately focused on unintentional drowning. Ninety-two percent of included studies (n = 66) were ranked as being low evidence (level IV). The majority of studies explored drowning among children and adolescents (0-19 years). All-age fatal drowning rates varied from a low of 0.48 per 100,000 (United Arab Emirates; 2002; Ministry of Health death registry data) to a high of 18.5 per 100,000 (Egypt; 2014-15; WHO mortality database). Commonly identified risk factors included being male, young age, submersion time and resident status. Common prevention strategies public education, lifeguard supervision, and cardiopulmonary resuscitation. DISCUSSION Gaps in understanding of drowning burden in some countries within the region, as well as region-wide risk factor identification for adult drowning, intentional and migration-related drowning, impair the ability of nations to advance drowning prevention. There is a need for investment in implementation and evaluation of drowning prevention interventions in the EMR. CONCLUSION Drowning is a significant cause of mortality and morbidity in the EMR. The recent UN declaration on global drowning prevention may provide the impetus to invest in drowning prevention research, policy, and advocacy with the aim of reducing drowning-related harms in the EMR. TRIAL REGISTRATION Registration number: # CRD42021271215 .
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Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019. THE LANCET PUBLIC HEALTH 2022; 7:e657-e669. [PMID: 35779567 PMCID: PMC9329128 DOI: 10.1016/s2468-2667(22)00134-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 01/22/2023] Open
Abstract
Background Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding Bill & Melinda Gates Foundation.
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