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Cenderadewi M, Devine SG, Peden AE, Franklin RC. Burden of unintentional drowning in Indonesia: insights from the Global Burden of Disease Study 2019. Inj Prev 2024:ip-2024-045274. [PMID: 39107101 DOI: 10.1136/ip-2024-045274] [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: 02/07/2024] [Accepted: 06/22/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION A high burden of unintentional fatal drowning has been reported in low- and middle-income countries. However, little is known about unintentional drowning in Indonesia. METHODS This population-based retrospective cohort study analysed unintentional drowning data for Indonesia sourced from The Global Burden of Disease Study 2019. Estimates of trends, mortality rates, incidence rates, years lived with disability (YLDs) and disability adjusted life years were generated. RESULTS A decline in unintentional drowning mortality rates was observed, with an average annual mortality rate of 2.58/100 000. Males were 1.81 (95% CI 1.79 to 1.84) times more likely than females to unintentionally drown. Average annual mortality rates were highest among the under-5 age group (9.67/100 000) and 70 and over (5.71/100 000 for males; 5.14/100 000 for females). Distributions of drowning deaths vary depending on region, with mortality rates higher in Papua, Kalimantan, Sulawesi, Maluku, Sumatra and Nusa Tenggara regions. DISCUSSION While a decline in drowning mortality rates in Indonesia was identified between 2005 and 2019, mortality rates for unintentional drowning remained high among children under 5 years, the elderly population and those residing in Papua, Kalimantan, Sulawesi, Maluku, Sumatra and Nusa Tenggara, warranting further focused attention. CONCLUSION A downward trend in the rate of unintentional drowning deaths in Indonesia is observed from 2005 onwards, with risk variation based on age, gender and region. The findings highlight the importance of addressing drowning as a cause of premature mortality and health system burden in Indonesia, including through enhancing drowning data collection systems and identifying drowning risk factors.
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Affiliation(s)
- Muthia Cenderadewi
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Faculty of Medicine, University of Mataram, Mataram, West Nusa Tenggara, Indonesia
| | - Susan G Devine
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Amy E Peden
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
| | - Richard Charles Franklin
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
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2
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Carey RN, Crawford G, Jancey J, Lam T, Nimmo L, Trapp G, Pollard C, Hooper P, Leavy JE. Young people's alcohol use in and around water: A scoping review of the literature. Drug Alcohol Rev 2024; 43:874-896. [PMID: 38461491 DOI: 10.1111/dar.13831] [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: 09/06/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 03/12/2024]
Abstract
ISSUES The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non-fatal drowning, particularly for young people. APPROACH We conducted a scoping review to explore the peer-reviewed literature on the use of alcohol by young people (aged 15-34 years) in the context of aquatic environments. Five electronic academic databases were searched for English-language studies conducted in high-income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies. KEY FINDINGS The review included a total of 24 studies, including those addressing the prevalence of and/or risk factors for alcohol use in aquatic environments among young people (n = 13); the epidemiology of alcohol-related unintentional drowning in young people (n = 9); and interventions to reduce alcohol-related harm around water (n = 3). Findings suggest that young people commonly consume alcohol around water, particularly young men. We found multiple influences on this behaviour, including the perception of risk, location of aquatic activity and presence of others, particularly peers. IMPLICATIONS Understanding the literature addressing alcohol use around water among young people will assist in identifying and setting priorities for drowning prevention, including the need to mitigate the effects of alcohol advertising which promotes drinking in and around water. CONCLUSION There is a clear imperative to address the use of alcohol by young people in aquatic environments. These findings have key implications for public health policy, advocacy and practice.
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Affiliation(s)
- Renee N Carey
- School of Population Health, Curtin University, Perth, Australia
| | - Gemma Crawford
- Collaboration for Evidence Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Jonine Jancey
- Collaboration for Evidence Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Tina Lam
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Lauren Nimmo
- Research, Media and Communications, Royal Life Saving Society Western Australia, Perth, Australia
| | - Gina Trapp
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | | | - Paula Hooper
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Justine E Leavy
- Collaboration for Evidence Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
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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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Leavy JE, Della Bona M, Abercromby M, Crawford G. Drinking and swimming around waterways: The role of alcohol, sensation-seeking, peer influence and risk in young people. PLoS One 2022; 17:e0276558. [PMID: 36331939 PMCID: PMC9635690 DOI: 10.1371/journal.pone.0276558] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
The role of individual and sociocultural factors contributing to drowning risk for young adults is complex and poorly understood. This study examined the relationship between behaviour in and around waterways and: 1) alcohol consumption; 2) resistance to peer influence; 3) sensation-seeking; 4) perception of risk among people aged 15–24 in Western Australia. A cross-sectional online survey was conducted at three time-points with a convenience sample. Predictor variables included: Alcohol Use Disorder Identification Test Consumption (AUDIT_C); Resistance to Peer Influence; Brief Sensation Seeking scale; Benthin’s Perception of risk. Pearson chi-squared tests determined the association between demographic and predictor variables. Logistic regression explored influence of potential predictor variables on behaviour in and around water. The final sample (n = 730) participants, consisted of females (n = 537, 74.5%), metropolitan dwelling (n = 616, 84.4%), and attended university (n = 410, 56.9%). Significant associations were found for those who swum after drinking alcohol compared with those that had not by age, gender, education. For every 1-unit increase in AUDIT-C participants were 60% more likely to swim after drinking (OR 95% CI 1.60 1.44–1.78). Participants who considered an adverse event serious were 15% less likely to have swum after drinking alcohol (OR 0.85 95% CI 0.73–0.99). The complex relationship between social participation in activities in and around waterways, higher drowning rates, propensity for risk, and the meaning young adults attach to risk locations and practices present unique challenges for drowning prevention research. Findings should be used to improve the awareness and education components of future youth water safety strategies in high-income settings.
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Affiliation(s)
- J. E. Leavy
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia,* E-mail:
| | - M. Della Bona
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
| | - M. Abercromby
- Royal Life Saving Society Western Australia, Perth, Western Australia, Australia
| | - G. Crawford
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
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Strasiotto L, Ellis A, Daw S, Lawes JC. The role of alcohol and drug intoxication in fatal drowning and other deaths that occur on the Australian coast. JOURNAL OF SAFETY RESEARCH 2022; 82:207-220. [PMID: 36031248 DOI: 10.1016/j.jsr.2022.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/16/2021] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Alcohol and drug (illicit or prescription) intoxication impairs motor skills, coordination, decision making abilities, hazard perception, and is known to increase the risk of death in coastal environments. Prior coastal safety research has focused largely on the impact of alcohol on drowning, with less research on the influence of drugs and leaving a significant number of other non-drowning fatalities largely excluded, despite being preventable with mitigation of injuries or medical factors. METHOD This retrospective cross-sectional study explored the impact of alcohol and drugs on unintentional Australian drowning deaths and other coastal fatalities over a 16-year period to identify higher-risk populations and coastal activity groups for which alcohol/drug use is increased. RESULTS It was found that alcohol, benzodiazepines/sedatives, and amphetamine usage was prevalent in coastal deaths. Of the 2,884 coastal deaths, 80.6% of decedents had known toxicological data. Alcohol and/or drug intoxication contributed to 23% of coastal drowning deaths and 19% of fatalities. For drowning and other fatalities combined, 8.7% were due to alcohol, 8.7% due to drugs, and 4.1% due to both alcohol and drugs. Australian-born decedents were more likely to involve alcohol (RR = 1.7, 95%CI = 1.26-2.3, p < 0.001), drugs (RR = 2.62, 95%CI = 1.85-3.7, p < 0.001), or both alcohol and drugs (RR = 4.43, 95%CI = 2.51-7.82, p < 0.001) with an increased risk identified in Indigenous Australian populations (RR = 2.17, 95%CI = 1.12-4.24, p = 0.04). The impact of alcohol and drug intoxication varied by activity, with Personal Watercraft users more likely to die due to alcohol intoxication (RR = 2.67, 95%CI = 1.23-5.78, p = 0.035), while scuba divers (RR = 0, p < 0.001), snorkelers (RR = 0.14, 95%CI = 0.036-0.57, p < 0.001), and rock fishers (RR = 0.46, 95%CI = 0.22-0.96, p = 0.03) were less likely. Recreational jumping and fall-related coastal deaths were more likely to involve alcohol and alcohol/drugs combined. PRACTICAL APPLICATIONS This study identifies factors to further investigate or target with prevention strategies to decrease the holistic burden of mortality due to alcohol and/or drug usage on the Australian coast.
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Affiliation(s)
- Luke Strasiotto
- Surf Life Saving Australia, Bondi Beach, NSW 2026, Australia
| | - Annabel Ellis
- Surf Life Saving Australia, Bondi Beach, NSW 2026, Australia
| | - Shane Daw
- Surf Life Saving Australia, Bondi Beach, NSW 2026, Australia
| | - Jasmin C Lawes
- Surf Life Saving Australia, Bondi Beach, NSW 2026, Australia
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Yadav J, John D, Menon GR, Franklin RC, Peden AE. Nonfatal drowning-related hospitalizations and associated healthcare expenditure in India: An analysis of nationally representative survey data. JOURNAL OF SAFETY RESEARCH 2022; 82:283-292. [PMID: 36031256 DOI: 10.1016/j.jsr.2022.06.003] [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: 09/23/2021] [Revised: 01/11/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Drowning is a global public health challenge, with significant burden in low- and middle-income countries. There are few studies exploring nonfatal drowning, including the economic and social impacts. This study aimed to quantify unintentional drowning-related hospitalization in India and associated healthcare expenditure. METHOD Unit level data on unintentional drowning-related hospitalization were obtained from the 75th rounds of the National Sample Survey of Indian households conducted in 2018. The outcome variables were indices of health care cost such as out of pocket expenditure (OOPE), health care burden (HCB), catastrophic health expenditure (CHE), impoverishment, and hardship financing. Descriptive statistics and multivariate analysis were conducted after adjusting for inflation using the pharmaceutical price index for December 2020. The association of socio-demographic characteristics with the outcome variable was reported as relative risk with 95% CI and expenditure reported in Indian Rupees (INR) and United States dollars (USD). RESULTS 174 respondents reported drowning-related hospitalization (a crude rate of 15.91-31.34 hospitalizations per 100,000 population). Proportionately, more males (63.4%), persons aged 21-50 years (44.9%) and rural dwelling respondents (69.9%) were hospitalized. Drowning-related hospitalization costs on average INR25,421 ($345.11USD) per person per drowning incident. Costs were higher among older respondents, females, urban respondents, and longer lengths of hospital stays. About 14.4% of respondents reported hardship financing as a result of treatment costs and 9.0% of households reported pushed below the poverty line when reporting drowning-related hospitalization. CONCLUSIONS Drowning can be an economically catastrophic injury, especially for those already impacted by poverty. Drowning is a significant public health problem in India. Investment in drowning prevention program will reduce hospitalization and economic burden. PRACTICAL APPLICATIONS This study provides support for investment in drowning prevention in India, including a need to ensure drowning prevention interventions address the determinants of health across the lifespan.
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Affiliation(s)
- Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi 110029, India
| | - Denny John
- Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bangalore - 560054, Karnataka, India; Department of Public Health, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, Kerala, India; Center for Public Health Research, MANT, Kolkata-700078, West Bengal, India
| | - Geetha R Menon
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi 110029, India.
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.
| | - Amy E Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Royal Life Saving Society - Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine, UNSW Sydney, Kensington, New South Wales, Australia.
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7
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Peden AE, Işın A. 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: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Affiliation(s)
- Amy E Peden
- School of Population Health, UNSW Sydney, Samuels Building, UNSW Sydney, Kensington, NSW, 2052, Australia.
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, 4811, Australia.
| | - Ali Işın
- Department of Coaching Education, Faculty of Sports Sciences, Akdeniz University, 07070, Antalya, Turkey
- Institute of Health Sciences, Akdeniz University, 07070, Antalya, Turkey
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8
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Hamilton K, Keech JJ, Willcox - Pidgeon S, Peden AE. An evaluation of a video-based intervention targeting alcohol consumption during aquatic activities. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2022. [DOI: 10.1080/00049530.2022.2029221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Kyra Hamilton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Jacob J. Keech
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
- School ofApplied Psychology, Griffith University, Brisbane, Australia
| | - Stacey Willcox - Pidgeon
- Royal Life Saving Society – Australia, Broadway, Sydney, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Amy E. Peden
- Royal Life Saving Society – Australia, Broadway, Sydney, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
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9
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Queiroga AC, Seabra R, Franklin RC, Peden AE. Trends in drowning mortality in Portugal from 1992 to 2019: comparing Global Burden of Disease and national data. Inj Prev 2021; 28:318-324. [PMID: 34972682 DOI: 10.1136/injuryprev-2021-044415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/26/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Imprecise data systems hinder understanding of drowning burden, even in high-income countries like Portugal, that have a well-implemented death certificate system. Consequently, national studies on drowning mortality are scarce. We aimed to explore drowning mortality in Portugal using national data and to compare these to Global Burden of Disease (GBD) estimates. METHODS Data were obtained from the National Institute of Statistics (INE) for 1992-2019, using International Classification of Diseases (ICD)-9 and ICD-10 codes, by sex, age group and cause (unintentional; water transport and intentional). GBD unintentional drowning data were obtained online. Age-standardised drowning rates were calculated and compared. RESULTS INE data showed 6057 drowning deaths, 4327 classified as unintentional (75.2% male; 36.7% 35-64 years; 31.5% 65+years; 15.2% 0-19 years). Following 2001, an increase in accidental drowning mortality and corresponding decrease in undetermined intent was observed, coincident with Portugal's ICD-10 implementation. GBD modelled estimates followed a downward trend at an overall rate of decrease of -0.41/decade (95% CI (-0.45 to -0.37); R2 adj=0.94; p<0.05). Conversely, INE data showed an increase in the rate of drowning deaths over the last decade (0.35/decade; 95% CI (-0.18 to 0.89)). GBD estimates were significantly different from the INE dataset (alpha=0.05), either underestimating as much as 0.567*INE in 1996 or overestimating as much as 1.473*INE in 2011. CONCLUSIONS While GBD mortality data estimates are valuable in the absence of routinely collected data, they smooth variations, concealing key advocacy opportunities. Investment in country-level drowning registries enables in-depth analysis of incident circumstances. Such data are essential to informing National Water Safety Plans.
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Affiliation(s)
- Ana Catarina Queiroga
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal .,EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal.,IDRA - International Drowning Researchers' Alliance, Kuna, Idaho, USA.,Drowning Prevention Commission, International Lifesaving Federation, Leuven, Belgium
| | - Rui Seabra
- IDRA - International Drowning Researchers' Alliance, Kuna, Idaho, USA.,CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Universidade do Porto, Vairao, Porto, Portugal.,BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Vairão, Portugal
| | - Richard Charles Franklin
- IDRA - International Drowning Researchers' Alliance, Kuna, Idaho, USA.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,Royal Life Saving Society Australia, Broadway, New South Wales, Australia
| | - Amy E Peden
- IDRA - International Drowning Researchers' Alliance, Kuna, Idaho, USA.,Drowning Prevention Commission, International Lifesaving Federation, Leuven, Belgium.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,Royal Life Saving Society Australia, Broadway, New South Wales, Australia.,School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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10
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Influence of a Survival Swimming Training Programme on Water Safety Knowledge, Attitudes and Skills: A Randomized Controlled Trial among Young Adults in Sri Lanka. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111428. [PMID: 34769944 PMCID: PMC8583420 DOI: 10.3390/ijerph182111428] [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: 09/15/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022]
Abstract
Drowning among young adults is high in Sri Lanka. Water safety education is a recommended strategy for drowning prevention but is often overlooked for young adults. This study aimed to evaluate the effectiveness of an adapted educational intervention, "Swim for Safety" on improving water safety knowledge, attitudes and survival swimming skills among undergraduates (19-28 years) in Sri Lanka. This study employed a parallel-group, two-arm randomized controlled trial design. The intervention group (n = 78) received a face-to-face, 12-lesson education programme, and the control group (n = 78) received a brochure and weekly mobile phone messages for six consecutive weeks. Baseline, post-intervention and three-month follow-up knowledge, attitudes and skills were evaluated. Knowledge and attitudes were assessed using a self-administered questionnaire and skills were evaluated following a skills assessment protocol. In total 116 participants, 60 intervention group and 56 control group, completed the study. At baseline there were no differences between groups in median scores of water safety knowledge, attitudes and survival swimming skills. The intervention group demonstrated statistically significant increases in median water safety knowledge, attitudes and survival swimming skill scores compared with the control group, following the intervention and maintained at three-month follow-up (p < 0.05). The adapted Swim for Safety programme significantly improved water safety knowledge, attitudes, and survival swimming skills among young adults in Sri Lanka. Therefore, it is recommended that the SfS programme be implemented widely to prevent drowning in young adults.
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11
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Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, Yusuf S, Weiss J, Hoffman B. Prevention of Drowning. Pediatrics 2021; 148:peds.2021-052227. [PMID: 34253571 DOI: 10.1542/peds.2021-052227] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Drowning is a leading cause of injury-related death in children. In 2018, almost 900 US children younger than 20 years died of drowning. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in prevention of drowning.
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Affiliation(s)
- Sarah A Denny
- Nationwide Children's Hospital and College of Medicine, The Ohio State University, Columbus, Ohio;
| | - Linda Quan
- Pediatric Emergency Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | | | - Tracy McCallin
- Children's Hospital of San Antonio, San Antonio, Texas.,Baylor College of Medicine, Houston, Texas
| | - Rohit Shenoi
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Shabana Yusuf
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jeffrey Weiss
- Phoenix Children's Hospital Medicine, Phoenix Children's Hospital, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; and
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12
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Abercromby M, Crawford G, Nimmo L, Leavy JE. "I never had a thought about drowning". Exploring water safety attitudes and practices among older adults in Western Australia. Health Promot J Austr 2021; 33:524-532. [PMID: 34278642 DOI: 10.1002/hpja.522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/04/2021] [Accepted: 07/15/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore factors associated with drowning among older adults aged 65 years and over in Western Australia. METHODS This paper was concerned with illuminating older adults experience and perspectives of water safety and drowning prevention. The study used in-depth, semi-structured interviews (n = 15) to examine knowledge, attitudes, beliefs and behaviours. The interviews were analysed using a phenomenological hermeneutical interpretation whereby three steps were taken to identify common patterns of meaning from individual's lifeworld. DISCUSSION Interviews captured the voices of those who identified as swimmers and those who identified as nonswimmers and revealed nine constitutive patterns which support a central theme of life around water. This study provides insights into perceptions and experiences of water safety as individuals' age. The findings suggest individuals who perceived themselves as strong swimmers had a decreased perception of risk, while participants who self-identified as weak swimmers were more likely to avoid risks and modified their behaviour accordingly. Findings highlighted low water safety literacy and suggest that older people not only underestimate their drowning risk, but also lack an understanding of the risk factors for drowning. SO WHAT?: The findings from this study will have a direct impact on the development of a WA health promotion program to prevent drowning among older adults.
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Affiliation(s)
- Meg Abercromby
- Collaboration for Evidence, Research and Impact in Public Health, Perth, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, Perth, Australia
| | - Lauren Nimmo
- Royal Life Saving Society of Western Australia, Perth, Australia
| | - Justine E Leavy
- Collaboration for Evidence, Research and Impact in Public Health, Perth, Australia
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Descriptive Epidemiology of Rescue-Related Fatal Drowning in Turkey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126613. [PMID: 34205391 PMCID: PMC8296404 DOI: 10.3390/ijerph18126613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 01/17/2023]
Abstract
Drowning is a public-health threat and a leading cause of injury-related death. In Turkey, drowning results in 900 fatalities annually, and the rate is rising. As data on rescue-related drowning are scarce, this retrospective study explores the epidemiology of fatal drowning among rescuers in Turkey. As there are no routinely collected death registry data on drowning in Turkey, data were sourced from media reports of incidents between 2015 and 2019. Rescuer fatalities were analysed by age, sex, activity prior to rescue, location, incident day of week and season, and place of death. Statistical analyses comprised X2 tests of significance (p < 0.05) and calculation of relative risk (95% confidence interval) using fatality rates. In total, 237 bystander rescuers drowned (90% male; 35% 15–24 years). In 33% of cases, the primary drowning victim (PDV) was successfully rescued, while in 46% of cases the rescue resulted in multiple drowning fatalities (mean = 2.29; range 1–5 rescuers). Rescues were more likely to be successful in saving the PDV if undertaken at the beach/sea (X2 = 29.147; p < 0.001), while swimming (X2 = 12.504; p = 0.001), or during summer (X2 = 8.223; p = 0.029). Risk of bystander rescue-related fatal drowning was twice as high on weekdays compared to on weekends (RR = 2.04; 95%CI: 1.56–2.67). While bystanders play an important role in reducing drowning, undertaking a rescue is not without risk and can lead to multiple drowning incidents. Training in rescue and resuscitation skills (especially the prioritization of non-contact rescues) coupled with increasing awareness of drowning risk, are risk-reduction strategies which should be explored in Turkey.
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Roberts K, Thom O, Devine S, Leggat PA, Peden AE, Franklin RC. A scoping review of female drowning: an underexplored issue in five high-income countries. BMC Public Health 2021; 21:1072. [PMID: 34090385 PMCID: PMC8178917 DOI: 10.1186/s12889-021-10920-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/26/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning. METHODS A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines. RESULTS The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females). CONCLUSION Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning.
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Affiliation(s)
- Kym Roberts
- Emergency Department, Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Sunshine Coast, Queensland Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
| | - Ogilvie Thom
- Emergency Department, Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Sunshine Coast, Queensland Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
| | - Susan Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
| | - Peter A. Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Amy E. Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
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15
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Peden AE, Scarr JP, Mahony AJ. Analysis of fatal unintentional drowning in Australia 2008-2020: implications for the Australian Water Safety Strategy. Aust N Z J Public Health 2021; 45:248-254. [PMID: 34028908 DOI: 10.1111/1753-6405.13124] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/01/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine temporal trends in drowning in Australia against targets set in the Australian Water Safety Strategy (AWSS) 2008-2020 and to inform the development of the next iteration of the Strategy. METHODS A national analysis of unintentional fatal drowning rates per 100,000 population over 16 years (2004/05-2019/20) was conducted. Baseline rates (three-year average 2004/05-2006/07) were compared to the current three-year average (2017/18-2019/20) by sex, age group, drowning location and jurisdiction. RESULTS The overall rate of unintentional fatal drowning during the period decreased by 28%. Substantial reductions were observed in children 0-4 years (-63%) and 5-14 years (-56%). Progress has been less pronounced among people aged 75 years and over (-11%) and 15-24-year-olds (-14%). All locations and jurisdictions recorded reductions, aside from rocks (+46%). CONCLUSIONS Although the strategy fell short of its aspirational target of a 50% reduction in drowning by the year 2020, this target was exceeded in key age groups, including children. Implications for public health: The AWSS is a powerful tool to align drowning prevention sector actions to agreed objectives. Forthcoming strategies must take into consideration demographic and social change, areas where limited progress has been made and the latest evidence to guide future priorities.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, New South Wales.,School of Population Health, Faculty of Medicine, UNSW Sydney, New South Wales
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16
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Willcox-Pidgeon S, Franklin RC, Leggat PA, Devine S. Epidemiology of unintentional fatal drowning among migrants in Australia. Aust N Z J Public Health 2021; 45:255-262. [PMID: 33900674 DOI: 10.1111/1753-6405.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. METHODS A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. RESULTS There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25-34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85-8.25), Taiwan (2.29/100,000 95%CI: 0.27-13.44), and Nepal (2.15/100,000 95%CI: 0.23-11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001). CONCLUSIONS Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities.
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Affiliation(s)
- Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, New South Wales.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Richard C Franklin
- Royal Life Saving Society - Australia, New South Wales.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Susan Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
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17
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Coastal drowning: A scoping review of burden, risk factors, and prevention strategies. PLoS One 2021; 16:e0246034. [PMID: 33524054 PMCID: PMC7850505 DOI: 10.1371/journal.pone.0246034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/12/2021] [Indexed: 11/19/2022] Open
Abstract
Objective Coastal drowning is a global public health problem which requires evidence to support safety initiatives. The growing multidisciplinary body of coastal drowning research and associated prevention countermeasures is diverse and has not been characterised as a whole. The objective of this scoping review was to identify key concepts, findings, evidence and research gaps in the coastal drowning literature to guide future research and inform prevention activities. Methods We conducted a scoping review to identify peer reviewed studies published before May 2020 reporting either (i) fatal unintentional coastal drowning statistics from non-boating, -disaster or -occupational aetiologies; (ii) risk factors for unintentional fatal coastal drowning; or (iii) coastal drowning prevention strategies. Systematic searches were conducted in six databases, two authors independently screened studies for inclusion and one author extracted data using a standardised data charting form developed by the study team. Results Of the 146 included studies, the majority (76.7%) were from high income countries, 87 (59.6%) reported coastal drowning deaths, 61 (41.8%) reported risk factors, and 88 (60.3%) reported prevention strategies. Populations, data sources and coastal water site terminology in the studies varied widely; as did reported risk factors, which most frequently related to demographics such as gender and age. Prevention strategies were commonly based on survey data or expert opinion and primarily focused on education, lifeguards and signage. Few studies (n = 10) evaluated coastal drowning prevention strategies. Discussion Coastal drowning is an expansive, multidisciplinary field that demands cross-sector collaborative research. Gaps to be addressed in coastal safety research include the lack of research from lower resourced settings, unclear and inconsistent terminology and reporting, and the lack of evaluation for prevention strategies. Advancing coastal drowning science will result in a stronger evidence base from which to design and implement effective countermeasures that ultimately save lives and keep people safe.
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18
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Richardson K, Peden AE. Another gender data gap: female drowning in Aotearoa, New Zealand. Inj Prev 2021; 27:535-541. [PMID: 33431574 DOI: 10.1136/injuryprev-2020-044072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION A gender gap is present in drowning research and prevention interventions, resulting in an inequitable focus on males. This study aimed to address the gender data gap, exploring female drowning in Aotearoa, New Zealand. METHODS National data on female fatal and non-fatal drowning requiring hospitalisation between 2003 and 2019 were sourced from DrownBase, Water Safety New Zealand's drowning database. Univariate and χ2 analyses were conducted for fatal and hospitalisation data. Crude rates were calculated and used to explore temporal trends and RR by age groups and ethnicity for fatal and non-fatal drowning. Ratios for drowning-related hospitalisations and Accident Compensation Corporation (ACC) claims to drowning deaths were also calculated. RESULTS From 2003 to 2019, a total of 1087 female drowning fatalities and non-fatal (76.0%) drowning incidents requiring hospitalisation occurred. Linear trends indicate hospitalisations increased (y=0.0766x+1.4271; R2=0.4438), while fatal drowning decreased (y=-0.0101x+0.7671; R2=0.1011). The highest fatal (1.60) and non-fatal (8.22) drowning rates were seen among children aged 0-4 years. For every one female drowning fatality, there are 3.46 hospital admissions and 675.55 ACC claims. DISCUSSION Female drowning represents a significant burden on the health system and the community in New Zealand. Further investment in interventions targeting females about their own risky behaviours around water (not only children in their care) is suggested, including interventions focused on hazardous conditions and alcohol consumption. CONCLUSION For decades, the focus of drowning prevention among adolescents and adults has been on males. However, efforts must be broadened to prevent any further increase in drowning-related incidents among females in Aotearoa, New Zealand.
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Affiliation(s)
| | - Amy E Peden
- School of Population Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.,Royal Life Saving Society - Australia, Broadway, NSW, Australia
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19
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Lawes JC, Ellis A, Daw S, Strasiotto L. Risky business: a 15-year analysis of fatal coastal drowning of young male adults in Australia. Inj Prev 2020; 27:442-449. [PMID: 33239312 DOI: 10.1136/injuryprev-2020-043969] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Drowning is a leading cause of unintentional death, especially for males. In Australian coastal waters, young male adults account for 25% of the burden of male drowning. This study aims to describe young male coastal drowning deaths and to examine the prevalence of risk factors, especially alcohol and drugs. METHODS Characteristics of unintentional fatal drowning involving males (15-34 years) were compared with other adults (15 years and older). Data were sourced from the National Coronial Information System (Australia) and Surf Life Saving incident reports (2004/2005-2018/2019). Relative risk was calculated and χ2 tests of independence were performed (p<0.05). Blood alcohol and drug concentrations were analysed with permutational analyses of variance. RESULTS Young males drowned more while jumping (9.85 times), swimming/wading (1.41 times), at rock/cliff locations (1.42 times) and on public holidays (1.8 times). Young males drowned less while boating (0.81 times), scuba diving (2.08 times), offshore (1.56 times) or due to medical factors (3.7 times). Young males drowned more (1.68 times) after consuming illicit drugs (amphetamines 2.26 times; cannabis 2.25 times) and less with prescription drugs (benzodiazepines 2.6 times; opiates 4.1 times; antidepressants 7.7 times). Blood serum concentrations of cannabis were higher in young males, while amphetamine and alcohol were lower. DISCUSSION Unsafe behaviours alongside certain activities or locations create deadly combinations of risk factors. A relationship between age, activity, attitude and affluence is proposed, where young males drown more in affordable activities with fewer regulations. Our results support multilevel strategies (spanning life stages) to reduce young male coastal drowning.
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Affiliation(s)
- Jasmin C Lawes
- Coastal Safety, Surf Life Saving Australia, Bondi Beach, New South Wales, Australia
| | - Annabel Ellis
- Coastal Safety, Surf Life Saving Australia, Bondi Beach, New South Wales, Australia
| | - Shane Daw
- Coastal Safety, Surf Life Saving Australia, Bondi Beach, New South Wales, Australia
| | - Luke Strasiotto
- Coastal Safety, Surf Life Saving Australia, Bondi Beach, New South Wales, Australia
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20
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Willcox-Pidgeon SM, Franklin RC, Leggat PA, Devine S. Identifying a gap in drowning prevention: high-risk populations. Inj Prev 2020; 26:279-288. [PMID: 31907207 PMCID: PMC7279566 DOI: 10.1136/injuryprev-2019-043432] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/19/2019] [Accepted: 11/24/2019] [Indexed: 12/02/2022]
Abstract
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.
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Affiliation(s)
- Stacey M Willcox-Pidgeon
- Royal Life Saving Society Australia, Broadway, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Richard Charles Franklin
- Royal Life Saving Society Australia, Broadway, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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21
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Button C, Brouwer L, Schnitzler C, de Poel HJ. Exploratory Analysis of Treading Water Coordination and the Influence of Task and Environmental Constraints. Front Psychol 2019; 10:2579. [PMID: 31866887 PMCID: PMC6907394 DOI: 10.3389/fpsyg.2019.02579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/31/2019] [Indexed: 11/13/2022] Open
Abstract
The radical embodied cognition approach to behavior requires emphasis upon how humans adapt their motor skills in response to changes in constraint. The aim of this exploratory study was to identify how the typical coordination patterns used to tread water were influenced by constraints representative of open water environments. Twenty-three participants were measured while treading water (TW) in a swimming flume in four conditions: (1) in still water, wearing a bathing suit (baseline); (2) wearing typical outdoor clothing (clothed); (3) with an additional cognitive task imposed (dual task); and (4) against a changing current (flow). Mixed methods kinematic analysis revealed four different TW coordination patterns were used across the conditions. The four TW patterns used represent a hierarchy of expertise in terms of the capacity to generate continuous lift forces, where pattern 1 (the lowest skill level) involved predominantly pushing and kicking limb movements (N = 1); pattern 2 was a movement pattern consisting of legs pushing/kicking and arms sculling (N = 7); pattern 3 was synchronous sculling of all four limbs (N = 6); and pattern 4 was the “eggbeater kick” (the highest skill level), with asynchronous sculling movements of the legs (N = 9). The four TW patterns were generally robust to the modified constraints. The higher skilled patterns (i.e., patterns 3 and 4) appeared to be the most stable coordination patterns. These results suggest that learning to perform more complex patterns to tread water might be an asset to survive in life-threatening situations.
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Affiliation(s)
- Chris Button
- School of Physical Education, Sport and Exercise Science, University of Otago, Dunedin, New Zealand
| | - Luka Brouwer
- School of Physical Education, Sport and Exercise Science, University of Otago, Dunedin, New Zealand.,Center for Human Movement Sciences, University Medical Center Groningen (UMCG), University of Groningen, Groningen, Netherlands
| | - Christophe Schnitzler
- Equipe d'accueil en Sciences Sociales (E3S, EA n°1342), Faculté des Sciences du Sport, Strasbourg University, Strasbourg, France
| | - Harjo J de Poel
- Center for Human Movement Sciences, University Medical Center Groningen (UMCG), University of Groningen, Groningen, Netherlands
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Rahman A, Jagnoor J, Baset KU, Ryan D, Ahmed T, Rogers K, Hossain MJ, Ivers R, Rahman AKMF. Vulnerability to fatal drowning among the population in Southern Bangladesh: findings from a cross-sectional household survey. BMJ Open 2019; 9:e027896. [PMID: 31530589 PMCID: PMC6756443 DOI: 10.1136/bmjopen-2018-027896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/25/2019] [Accepted: 08/30/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study aimed to determine the fatal drowning burden and associated risk factors in Southern Bangladesh. SETTINGS The survey was conducted in 39 subdistricts of all 6 districts of the Barisal division, Southern Bangladesh. PARTICIPANTS All residents (for a minimum 6 months prior to survey) of the Barisal division, Southern Bangladesh. INTERVENTION/METHODS A cross-sectional, divisionally representative household survey was conducted in all six districts of the Barisal division between September 2016 and February 2017, covering a population of 386 016. Data were collected by face-to-face interview with adult respondents using handheld electronic tablets. International Classification of Diseases (ICD)-v. 10 (ICD-10) Chapter XX: External causes of morbidity and mortality codes for drowning, W65-W74, X36-X39, V90, V92, X71 or X92, were used as the operational definition of a drowning event. RESULTS The overall fatal drowning rate in Barisal was 37.9/100 000 population per year (95% CI 31.8 to 43.9). The highest fatal drowning rate was observed among children aged 1-4 years (262.2/100 000/year). Mortality rates among males (48.2/100 000/year) exceeded that for females (27.9/100 000/year). A higher rate of fatal drowning was found in rural (38.9/100 000/year) compared with urban areas (29.3/100 000/year). The results of the multivariable logistic regression identified that the factors significantly associated with fatal drowning were being male (OR 1.7, 95% CI 1.2 to 2.3), aged 1-4 years (OR 3.0, 95% CI 1.4 to 6.4) and residing in a household with four or more children (four or more children OR 1.8, 95% CI 1.1 to 2.9; and five or more children OR 2.1, 95% CI 1.2 to 3.7). CONCLUSION Drowning is a public health problem, especially for children, in the Barisal division of Southern Bangladesh. Male gender, children 1-4 years of age and residing in a household with four or more children were associated with increased risk of fatal drowning events. The Barisal division demands urgent interventions targeted at high-risk groups identified in the survey.
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Affiliation(s)
- Aminur Rahman
- Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kamran Ul Baset
- Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Dan Ryan
- Royal National Lifeboat Institution, Moreleigh, Devon, UK
| | - Tahera Ahmed
- Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Kris Rogers
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Rebecca Ivers
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - A K M Fazlur Rahman
- Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
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Peden AE, Franklin RC, Leggat PA. Breathalysing and surveying river users in Australia to understand alcohol consumption and attitudes toward drowning risk. BMC Public Health 2018; 18:1393. [PMID: 30567588 PMCID: PMC6300037 DOI: 10.1186/s12889-018-6256-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/23/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Little is known about people's river usage, a leading drowning location. This study examines alcohol consumption patterns of river users and their attitudes to drowning risk. METHODS A convenience sample of adult (18+ years) river users were surveyed at four river locations. The survey covered eight domains: demographics; river attendance frequency; frequency of engaging in water activities; drinking patterns; alcohol and water safety knowledge; alcohol and water safety attitudes; alcohol consumption; and Blood Alcohol Concentration (BAC). For BAC, participants were asked to record time since their last alcoholic drink and were then breathalysed to record an estimate of their BAC. BAC was examined by BAC reading (negative, positive, ≥0.050%). Hazardous lifetime drinking levels were calculated and their impact on drowning risk evaluated. Univariate and chi square analysis (95% confidence interval) was conducted. RESULTS Six hundred eighty four people participated (51.6% female; 49.0% aged 18-34 years). Sixteen percent (15.9%) had a positive BAC (Mean + BAC = 0.068%; SD ± 0.08; Range = 0.001-0.334%), with 7.2% ≥0.050% (Mean BAC ≥0.050% =0.132%; SD ± 0.06). Those significantly more likely to record a BAC ≥0.050% at the river were: aged 18-34 years, resided in inner regional and low socio-economic areas, visited the river in the afternoon, with friends, on days with higher maximum air temperatures, frequent river users (11+ times in the last 30 days) and those who spend longer in the water (301+ minutes). River users who recorded a BAC ≥0.050% were more likely to self-report engaging in risky activities (i.e. diving into water of unknown depth and jumping into the river from height). River users on Australia day (a national public holiday) were significantly more likely to drink heavily (Mean BAC ≥0.05% = 0.175%; SD ± 0.09). CONCLUSIONS Despite males accounting for 85% of alcohol-related river drowning deaths, similar numbers of males and females were consuming alcohol at the river. This study has addressed a gap in knowledge by identifying river usage and alcohol consumption patterns among those at increased drowning risk. Implications for prevention include delivering alcohol-related river drowning prevention strategies to both males and females; at peak times including during hot weather, afternoons, public holidays and to river users who swim.
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Affiliation(s)
- Amy E. Peden
- Royal Life Saving Society – Australia, PO Box 558, Broadway, NSW 2007 Australia
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland 4811 Australia
| | - Richard C. Franklin
- Royal Life Saving Society – Australia, PO Box 558, Broadway, NSW 2007 Australia
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland 4811 Australia
| | - Peter A. Leggat
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland 4811 Australia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersand, Johannesburg, South Africa
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Peden AE, Franklin RC, Leggat PA. Exploring visitation at rivers to understand drowning risk. Inj Prev 2018; 25:392-399. [PMID: 29875291 DOI: 10.1136/injuryprev-2018-042819] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/10/2018] [Accepted: 05/14/2018] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Globally, rivers are a common drowning location. In Australia, rivers are the leading location for fatal drowning. Limited information exists on exposure and impact on river drowning risk. METHODS Australian unintentional fatal river drowning data (sourced from coronial records) and nationally representative survey data on river visitation were used to estimate river drowning risk based on exposure for adults (18 years and older). Differences in river drowning rates per 100 000 (population and exposed population) were examined by sex, age group, activity prior to drowning, alcohol presence and watercraft usage. RESULTS Between 1 January 2014 and 31 December 2016, 151 people drowned in Australian rivers; 86% male and 40% aged 18-34 years. Of survey respondents, 73% had visited a river within the last 12 months. After adjusting for exposure: males were 7.6 times more likely to drown at rivers; female drowning rate increased by 50% (0.06-0.09 per 100 000); males aged 75+ years and females aged 55-74 years were at highest risk of river drowning; and swimming and recreating pose a high risk to both males and females. After adjusting for exposure, males were more likely to drown with alcohol present (RR=8.5; 95% CI 2.6 to 27.4) and in a watercraft-related incident (RR=25.5; 95% CI 3.5 to 186.9). CONCLUSIONS Calculating exposure for river drowning is challenging due to diverse usage, time spent and number of visits. While males were more likely to drown, the differences between males and females narrow after adjusting for exposure. This is an important factor to consider when designing and implementing drowning prevention strategies to effectively target those at risk.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society-Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Richard C Franklin
- Royal Life Saving Society-Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,School of Public Health, Faculty of Health Sciences, University of the Witwatersand, Johannesburg, South Africa
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Hamilton K, Keech JJ, Peden AE, Hagger MS. Alcohol use, aquatic injury, and unintentional drowning: A systematic literature review. Drug Alcohol Rev 2018; 37:752-773. [PMID: 29862582 DOI: 10.1111/dar.12817] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 11/29/2022]
Abstract
ISSUES Drowning is a global public health issue, and there is a strong association between alcohol and risk of drowning. No previous systematic review known to date has identified factors associated with alcohol use and engagement in aquatic activities resulting in injury or drowning (fatal and non-fatal). APPROACH Literature published from inception until 31 January 2017 was reviewed. Included articles were divided into three categories: (i) prevalence and/or risk factors for alcohol-related fatal and non-fatal drowning and aquatic injury, (ii) understanding alcohol use and aquatic activities, and (iii) prevention strategies. Methodological quality of studies was assessed using National Health and Medical Research Council (NHMRC) Level of Evidence and risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scales. KEY FINDINGS In total, 74 studies were included (57 on prevalence and/or risk factors, 15 on understanding alcohol use, and two on prevention strategies). Prevalence rates for alcohol involvement in fatal and non-fatal drowning varied greatly. Males, boating, not wearing lifejackets, and swimming alone (at night, and at locations without lifeguards) were risk factors for alcohol-related drowning. No specific age groups were consistently identified as being at risk. Study quality was consistently low, and risk of bias was consistently high across studies. Only two studies evaluated prevention strategies. IMPLICATIONS There is a need for higher quality studies and behavioural basic and applied research to better understand and change this risky behaviour. CONCLUSION On average, 49.46% and 34.87% of fatal and non-fatal drownings, respectively, involved alcohol, with large variations among studies observed.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia.,School of Psychology and Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Jacob J Keech
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Amy E Peden
- Royal Life Saving Society-Australia, Sydney, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Martin S Hagger
- School of Applied Psychology, Griffith University, Brisbane, Australia.,School of Psychology and Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Peden AE, Demant D, Hagger MS, Hamilton K. Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review. PLoS One 2018; 13:e0196421. [PMID: 29718971 PMCID: PMC5931488 DOI: 10.1371/journal.pone.0196421] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 04/12/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related factors regarding lifejacket wear has not previously been investigated. METHODS This systematic review examined literature published from inception to December 2016 in English and German languages. The personal, social, and environmental factors associated with lifejacket wear among adults and children were investigated, a quantitative evaluation of the results undertaken, and gaps in the literature identified. RESULTS Twenty studies, with sample sizes of studies ranging between 20 and 482,331, were identified. Fifty-five percent were cross-sectional studies. All studies were scored IV or V on the Australian National Health and Medical Research Council (NHMRC) grading system indicating mostly descriptive and cross-sectional levels of evidence. Factors associated with increased wear included age (mostly children), gender (mostly female), boat type (non-motorised), boat size (small boats), role modelling (children influenced by adult lifejacket wear), and activity (water-skiing, fishing). Factors not associated or inconsistent with lifejacket wear included education, household income, ethnicity, boating ability, confidence in lifejackets, waterway type, and weather and water conditions. Factors associated with reduced lifejacket wear included adults, males, discomfort, cost and accessibility, consumption of alcohol, and swimming ability. Three studies evaluated the impact of interventions. CONCLUSION This review identified factors associated with both increased and decreased lifejacket wear. Future research should address the motivational factors associated with individuals' decisions to wear or not wear lifejackets. This, combined with further research on the evaluation of interventions designed to increase lifejacket wear, will enhance the evidence base to support future drowning prevention interventions.
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Affiliation(s)
- Amy E. Peden
- Royal Life Saving Society - Australia, Sydney, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Daniel Demant
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Martin S. Hagger
- School of Applied Psychology and Menzies Mental Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Psychology and Speech Pathology and Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kyra Hamilton
- School of Applied Psychology and Menzies Mental Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Psychology and Speech Pathology and Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia
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27
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Peden AE, Franklin RC, Queiroga AC. Epidemiology, risk factors and strategies for the prevention of global unintentional fatal drowning in people aged 50 years and older: a systematic review. Inj Prev 2017; 24:240-247. [PMID: 28774894 DOI: 10.1136/injuryprev-2017-042351] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/14/2017] [Accepted: 07/05/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people. METHODS A systematic literature review was undertaken using English-language, Portuguese-language and Spanish-language papers published between 1980 and 2015. The review explores gaps in the literature with a focus on the epidemiology, risk factors and strategies for the prevention of unintentional fatal drowning among people 50 years and over. RESULTS Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies; a lack of consensus on risk factors; a lack of total population, country-level analysis; and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated. CONCLUSION This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ana Catarina Queiroga
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Button C, Croft JL. Sports science needs more interdisciplinary, constraints-led research programmes: The case of water safety in New Zealand. Hum Mov Sci 2017; 56:157-159. [PMID: 28502384 DOI: 10.1016/j.humov.2017.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 04/30/2017] [Indexed: 10/19/2022]
Abstract
In the lead article of this special issue, Paul Glazier proposes that Newell's constraints model has the potential to contribute to a grand unified theory of sports performance in that it can help to integrate the disciplinary silos that have typically operated in isolation in sports and exercise science. With a few caveats discussed in this commentary, we agree with Glazier's proposal. However, his ideas suggest that there is a need to demonstrate explicitly how such an integration might occur within applied scientific research. To help fill this perceived 'gap' and thereby illustrate the value of adopting a constraints-led approach, we offer an example of our own interdisciplinary research programme. We believe our research on water safety is ideally suited to this task due to the diverse range of interacting constraints present and as such provides a tangible example of how this approach can unify different disciplinary perspectives examining an important aspect of sport performance.
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Affiliation(s)
- C Button
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
| | - J L Croft
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand; Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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Rahman A, Alonge O, Bhuiyan AA, Agrawal P, Salam SS, Talab A, Rahman QSU, Hyder AA. Epidemiology of Drowning in Bangladesh: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E488. [PMID: 28475138 PMCID: PMC5451939 DOI: 10.3390/ijerph14050488] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/07/2017] [Accepted: 05/03/2017] [Indexed: 11/01/2022]
Abstract
Over one-quarter of deaths among 1-4 year-olds in Bangladesh were due to drowning in 2003, and the proportion increased to 42% in 2011. This study describes the current burden and risk factors for drowning across all demographics in rural Bangladesh. A household survey was carried out in 51 union parishads of rural Bangladesh between June and November 2013, covering 1.17 million individuals. Information on fatal and nonfatal drowning events was collected by face-to-face interviews using a structured questionnaire. Fatal and non-fatal drowning rates were 15.8/100,000/year and 318.4/100,000/6 months, respectively, for all age groups. The highest rates of fatal (121.5/100,000/year) and non-fatal (3057.7/100,000/6 months) drowning were observed among children 1 to 4 years of age. These children had higher rates of fatal (13 times) and non-fatal drowning (16 times) compared with infants. Males had slightly higher rates of both fatal and non-fatal drowning. Individuals with no education had 3 times higher rates of non-fatal drowning compared with those with high school or higher education. Non-fatal drowning rates increased significantly with decrease in socio-economic status (SES) quintiles, from the highest to the lowest. Drowning is a major public health issue in Bangladesh, and is now a major threat to child survival.
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Affiliation(s)
- Aminur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B162, Road 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Al-Amin Bhuiyan
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B162, Road 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Shumona Sharmin Salam
- Centre for Child and Adolescent Health, icddr,b. 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
| | - Abu Talab
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B162, Road 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Qazi Sadeq-Ur Rahman
- Centre for Child and Adolescent Health, icddr,b. 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
| | - Adnan A Hyder
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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