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Williams J, McMillan F, Peden AE. Yarning about river safety: A qualitative study exploring water safety beliefs and practices for First Nations People. Health Promot J Austr 2024; 35:662-671. [PMID: 37607553 DOI: 10.1002/hpja.792] [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: 03/27/2023] [Revised: 06/29/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
ISSUE ADDRESSED Water is vital to Australian First Nations Peoples' connection to country and culture. Despite this cultural significance, and epidemiological studies identifying elevated drowning risk among Australian First Nations Peoples, extremely limited qualitative research explores water safety beliefs and practices of First Nations Peoples. This study addressed this knowledge gap via qualitative research with Wiradjuri people living in Wagga Wagga, New South Wales. METHODS Under Aboriginal Reference Group guidance, a local researcher recruited participants using purposive sampling for yarning circles across four groups: young people aged 18-30 years, parents of children under 5, parents of older children and adolescents and Elders. Yarning circles were audio recorded, transcribed and thematically coded using an inductive approach. RESULTS In total, 10 First Nations individuals participated. Yarning led to rich insights and yielded five themes: families as first educators; importance of storytelling, lived experience and respect for knowledge holders; the river as a place of connection; historical influence on preference for river over pool and river is unpredictable and needs to be respected. CONCLUSIONS This study demonstrates the importance of First Nations culture to water safety practices, particularly around the river. To reduce drowning risk among First Nations populations, knowledge holders need to be embedded in the design and delivery of community water safety education. SO WHAT?: Co-designing water safety initiatives with First Nations Peoples will have dual benefits; developing culturally appropriate and locally relevant water safety education, while also continuing First Nations culture across generations.
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Affiliation(s)
- Jasmine Williams
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Faye McMillan
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amy E Peden
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Cornell S, Brander R, Peden A. Selfie-Related Incidents: Narrative Review and Media Content Analysis. J Med Internet Res 2023; 25:e47202. [PMID: 37756044 PMCID: PMC10568398 DOI: 10.2196/47202] [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: 03/11/2023] [Revised: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Selfie-related injury has become a public health concern amid the near ubiquitous use of smartphones and social media apps. Of particular concern are selfie-related deaths at aquatic locations; areas often frequented because of their photogenic allure. Unfortunately, such places exhibit hazards inherent with their environment. OBJECTIVE This study aimed to ascertain current evidence regarding selfie-related injuries and recommended risk treatment measures in the academic literature as well as how selfie-related injuries and deaths were being reported by the media, allowing us to identify key challenges facing land managers and public health practitioners in mitigating selfie-related injuries and deaths. METHODS Between October and December 2022, we performed a narrative review of peer-reviewed literature published since January 2011. Literature was screened to identify causal factors implicated in selfie-related deaths and injuries, as well as risk treatments recommended. Furthermore, we used an environmental scan methodology to search for media reports of selfie-related injuries and deaths at aquatic locations in Australia and the United States. Individual cases of selfie-related aquatic injuries and deaths sourced from news reports were analyzed to assess epidemiological characteristics, and a thematic content analysis was conducted to identify key themes of news reporting on selfie-related deaths and injuries. RESULTS In total, 5 peer-reviewed studies were included. Four studies identified falls from height as the most common injury mechanism in selfie incidents. Drowning was the second most common cause of death. Recommended risk treatments were limited but included the adoption of "no selfie zones," physical barriers, signage, and provision of information on dangerous locations to social media users. In total, 12 cases were identified from media reports (4 injuries and 8 fatalities; 7 in Australia and 5 in the United States). The mean age of the reported victims was 22.1 (SD 6.93) years with victims more likely to be female tourists. Content analysis revealed 3 key themes from media reports: "blame," "warning," and "prevention and education." Few media reports (n=8) provided safety recommendations. CONCLUSIONS The selfie-related incident phenomenon should be viewed as a public health problem that requires a public health risk communication response. To date, little attention has been paid to averting selfie-related incidents through behavior change methodologies or direct messaging to users, including through social media apps. Although previous research has recommended "no selfie zones," barriers, and signage as ways to prevent selfie incidents, our results suggest this may not be enough, and it may be prudent to also engage in direct safety messaging to social media users. Media reporting of selfie incidents should focus on preventive messaging rather than blame or warning.
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Affiliation(s)
- Samuel Cornell
- School of Population Health, University of New South Wales, Sydney, Australia
- Beach Safety Research Group, University of New South Wales, Sydney, Australia
| | - Robert Brander
- Beach Safety Research Group, University of New South Wales, Sydney, Australia
- School of Environmental, Earth, and Biological Sciences, University of New South Wales, Sydney, Australia
| | - Amy Peden
- School of Population Health, University of New South Wales, Sydney, Australia
- Beach Safety Research Group, University of New South Wales, Sydney, Australia
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3
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Landolt J, Olumbe A, Thompson M. Comparing drowning (unintentional and intentional) and immersion deaths, Gold Coast, Queensland, Australia: a 6-year retrospective study. AUST J FORENSIC SCI 2022. [DOI: 10.1080/00450618.2022.2152095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Jairus Landolt
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Haskayne School of Business, University of Calgary, Calgary, Alberta, Canada
| | - Alex Olumbe
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Forensic and Scientific Services, Health Support Queensland, Brisbane, Queensland, Australia
| | - Melissa Thompson
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Forensic and Scientific Services, Health Support Queensland, Brisbane, Queensland, Australia
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Disadvantaged by More Than Distance: A Systematic Literature Review of Injury in Rural Australia. SAFETY 2022. [DOI: 10.3390/safety8030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.
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Peden AE, Taylor DH, Franklin RC. Pre-Existing Medical Conditions: A Systematic Literature Review of a Silent Contributor to Adult Drowning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8863. [PMID: 35886717 PMCID: PMC9324568 DOI: 10.3390/ijerph19148863] [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] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
Medical conditions can increase drowning risk. No prior study has systematically reviewed the published evidence globally regarding medical conditions and drowning risk for adults. MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest) and SPORTDiscus databases were searched for original research published between 1 January 2005 and 31 October 2021 that reported adult (≥15 years) fatal or non-fatal drowning of all intents and pre-existing medical conditions. Conditions were grouped into the relevant International Classifications of Diseases (ICD) codes. Eighty-three studies were included (85.5% high-income countries; 38.6% East Asia and Pacific region; 75.9% evidence level III-3). Diseases of the nervous system (n = 32 studies; 38.6%), mental and behavioural conditions (n = 31; 37.3%) and diseases of the circulatory system (n = 25; 30.1%) were the most common categories of conditions. Epilepsy was found to increase the relative risk of drowning by 3.8 to 82 times, with suggested preventive approaches regarding supervised bathing or showering. Drowning is a common suicide method for those with schizophrenia, psychotic disorders and dementia. Review findings indicate people with pre-existing medical conditions drown, yet relatively few studies have documented the risk. There is a need for further population-level research to more accurately quantify drowning risk for pre-existing medical conditions in adults, as well as implementing and evaluating population-level attributable risk and prevention strategies.
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Affiliation(s)
- Amy E. Peden
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW 2052, Australia;
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Danielle H. Taylor
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
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6
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Soga M, Gaston KJ. The dark side of nature experience: Typology, dynamics and implications of negative sensory interactions with nature. PEOPLE AND NATURE 2022. [DOI: 10.1002/pan3.10383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Masashi Soga
- Graduate School of Agricultural and Life Sciences The University of Tokyo Bunkyo Tokyo Japan
| | - Kevin J. Gaston
- Environment and Sustainability Institute University of Exeter Penryn UK
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7
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Miller L, Franklin RC, Watt K, Leggat PA. Travel-weary to travel-worry: the epidemiology of injury-related traveller deaths in Australia, 2006-2017. Aust N Z J Public Health 2022; 46:407-414. [PMID: 35298075 DOI: 10.1111/1753-6405.13217] [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: 09/01/2021] [Revised: 12/01/2021] [Accepted: 01/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore injury deaths in international and domestic interstate travellers, together with those newly arrived to Australia. METHODS A population-based cohort study of all injury-related deaths between 1January 2006 and 31 December 2017 registered with Births Death and Marriages in Australia was conducted using Australian Bureau of Statistics' (ABS) Cause of Death information. Population data on travellers were obtained from Tourism Research Australia. RESULTS There were 4,503 injury-related traveller deaths (domestic interstate:3,055; international:934; new arrivals:514). The average annual age-standardised mortality rates in domestic interstate travellers was 0.75 per 100,000, compared with 2.22 per 100,000 in international travellers. Leading causes of injury-related death were land transport incidents (n=1495, 33.2%), self-harm (n=786, 17.5%) and falls (n=513, 11.4%), with differences in mechanism by state/territory, traveller type and age group. Intentional self-harm was common amongst all visitor types, however, it was the primary cause of death in new arrivals Conclusion: Age-standardised mortality rates were almost three-fold higher in international than domestic travellers. New arrivals, international and domestic travellers have different injury profiles, and each require specific prevention strategies. IMPLICATIONS FOR PUBLIC HEALTH While COVID has restricted travel to and within Australia, this has provided an opportunity for exploration, reflection, and consideration of risk factors for travellers, and to develop targeted injury prevention strategies for visitor types, so travel experience can be optimised and the magnitude of harm can be reduced.
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Affiliation(s)
- Lauren Miller
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland
| | - Richard C Franklin
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland
| | - Kerrianne Watt
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland
| | - Peter A Leggat
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland
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8
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Calverley HLM, Birch R, Strugnell G, Santiago AC, Baker S, Matthews BL. Bush Nippers: Evaluating the effectiveness of the Nipper Education Program in regional inland Victoria, Australia. Health Promot J Austr 2021; 33:852-860. [PMID: 34929060 DOI: 10.1002/hpja.566] [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: 09/13/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Internationally, inland waterways are identified as leading locations for drowning. 'Nippers' programs provide coastal lifesaving and water safety knowledge and skills to children aged 5-14 years in Australia. However, a 49% increase in Victorian inland waterway drowning compared with the 10-year average, necessitated adapting the Nippers water safety program to inland regions: Bush Nippers. METHODS Overall, 105 participants from two age groups (under 9 and under 12) were involved across three Bush Nippers programs delivered at river and/or pool locations in regional Victoria, Australia. Surveys and observations assessed participants' water safety knowledge and competencies , and used alongside interviews to obtain program feedback from parents, instructors, and communities. Costs were compared to other aquatic programs to determine feasibility of replicating the program. RESULTS Significant increases in knowledge from pre to immediate post-test were recorded (p<.05) and water competencies were high post-test. Communities were grateful for the regional program delivery and understood the necessity of learning lifesaving skills, particularly in open water environments. Costs were akin to other similar programs indicating program replicability and enhancing likelihood of uptake. CONCLUSIONS Bush Nippers increased water safety knowledge in children and was well received by the community. Wider uptake of the program is encouraged to diversify aquatic education for regional Victorian children. SO WHAT?: Given the high regard and demand for the program, and importance of learning lifesaving skills, provision of a scalable lifesaving program in inland regions may address the drowning trend and improve aquatic participation.
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Affiliation(s)
- Hannah L M Calverley
- Life Saving Victoria, 200 The Boulevard, Port Melbourne VIC 3207, Australia.,The International Drowning Researchers' Alliance, Kuna, Idaho, USA
| | - Rhiannon Birch
- Life Saving Victoria, 200 The Boulevard, Port Melbourne VIC 3207, Australia
| | - Grace Strugnell
- Life Saving Victoria, 200 The Boulevard, Port Melbourne VIC 3207, Australia
| | - Allana C Santiago
- Life Saving Victoria, 200 The Boulevard, Port Melbourne VIC 3207, Australia
| | - Shayne Baker
- University of Southern Queensland, West Street, Toowoomba, QLD, 4350, Australia.,The International Drowning Researchers' Alliance, Kuna, Idaho, USA
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9
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Lazarević K, Bogdanović D, Milićević S, Dolićanin Z, Milić D. Mortality from external causes among 1-14 years old children in Serbia, 1997-2016. Cent Eur J Public Health 2021; 29:83-89. [PMID: 34245546 DOI: 10.21101/cejph.a5922] [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: 08/20/2019] [Accepted: 05/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Globally, child mortality from external causes is in decline, but it is still among the leading causes of child deaths. The aim of this first national study was to determine trends of mortality rates from external causes among children aged 1-14 years in Serbia. METHODS Mortality data were collected from the database of the Statistical Office of Serbia. Joinpoint analysis was used to assess the average annual percentage change (APC) and the corresponding 95% confidence interval (CI) in mortality from 1997 to 2016. RESULTS In the 1997-2016 period, there were 1,388 child deaths from external causes. They contributed to 29.4% of child mortality in total, from 34.8% in 1997 to 21.8% in 2016. Mortality rate was two times higher among boys (8.1 per 100,000) than girls (4.1 per 100,000). Transport accidents (37.6%), followed by drowning and submersion (18.2%), represented more than half of all deaths due to external causes. Since 1997, mortality rate showed a significant downward trend in boys by -5.4% (95% CI -6.8 to -3.9) yearly for unintentional injuries and significantly by -10% (95% CI -19.0 to 0.1) yearly for intentional injuries. Among girls, death rate for unintentional injuries decreased significantly by -7.1% (95% CI -9.0 to -5.1) yearly and decreased insignificantly for intentional injuries by -2.1% (95% CI -15.3 to 13.1) yearly. CONCLUSIONS The external causes of death, despite the substantial decline in mortality, are still present among children aged 1-14 years in Serbia. Therefore, implementation of nationwide programmes for prevention of external causes of death is urgent.
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Affiliation(s)
- Konstansa Lazarević
- Department for Biomedical Science, State University of Novi Pazar, Novi Pazar, Serbia
| | - Dragan Bogdanović
- Department for Biomedical Science, State University of Novi Pazar, Novi Pazar, Serbia
| | - Saša Milićević
- Department for Biomedical Science, State University of Novi Pazar, Novi Pazar, Serbia
| | - Zana Dolićanin
- Department for Biomedical Science, State University of Novi Pazar, Novi Pazar, Serbia
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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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11
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Dunne C, Madill J, Peden A, Valesco B, Lippmann J, Szpilman D, Queiroga A. An underappreciated cause of ocean-related fatalities: A systematic review on the epidemiology, risk factors, and treatment of snorkelling-related drowning. Resusc Plus 2021; 6:100103. [PMID: 34223365 PMCID: PMC8244300 DOI: 10.1016/j.resplu.2021.100103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 11/21/2022] Open
Abstract
AIM Snorkelling is a popular aquatic activity which may result in fatal and non-fatal drowning. However, little is known about the scale of injury, factors impacting risk and strategies for prevention. This review assesses the current literature on snorkelling-related drowning with the aim of assessing available data, improving safety recommendations and reducing the global mortality burden. METHODS A systematic review of peer-reviewed literature in English, Spanish and Portuguese language published between 1 January 1980 and 31 October 2020 was conducted using the PRISMA guidelines. CINAHL Complete, Embase, Medline (Ovid), PubMed, SafetyLit, SportDiscus and grey literature were searched to identify studies reporting the incidence of fatal and non-fatal snorkelling-related drowning, or associated risk factors, prevention strategies, treatments or casualty characteristics. Quality was assessed using the NIH Quality Assessment Tool. RESULTS Forty-three studies were included (26 reporting population data, 17 case series), of which 27 (62.8%) studies reported data from Australia. Incidence was reported as about 8% of total ocean-related drownings. Case series documented 144 fatalities over 17 years. Frequent casualty characteristics include male (82.6%), pre-existing heart disease (59.4%), tourists (73%) who were inexperienced (71.0%), and lack of a buddy system (89.6%). Two at-risk profiles identified were older adult tourists with pre-existing medical conditions and local, experienced spearfishers. Twenty-two expert recommendations were developed to improve the safety of snorkellers related to individuals, tourism companies, government agencies and diving organisations. CONCLUSION Snorkelling-related drownings are not infrequent, and there are many opportunities to improve the safety of this activity based on available data.
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Affiliation(s)
- C.L. Dunne
- Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada
- Medical Committee, Internatinoal Life Saving Federation, Belgium
- International Drowning Researchers’ Alliance (IDRA), Idaho, United States
| | - J. Madill
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - A.E. Peden
- International Drowning Researchers’ Alliance (IDRA), Idaho, United States
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - B. Valesco
- International Drowning Researchers’ Alliance (IDRA), Idaho, United States
- Office of Public Health Preparedness, Maui District Health, Hawaii State Health Department, Wailuku, HI, United States
| | - John Lippmann
- Australasian Diving Safety Foundation (ADSF), Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - D. Szpilman
- Medical Committee, Internatinoal Life Saving Federation, Belgium
- International Drowning Researchers’ Alliance (IDRA), Idaho, United States
- Brazilian Lifesaving Society (SOBRASA), Barra da Tijuca, Rio de Janeiro, Brazil
| | - A.C. Queiroga
- International Drowning Researchers’ Alliance (IDRA), Idaho, United States
- EPI-Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
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12
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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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13
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Mapping Trends in Drowning Research: A Bibliometric Analysis 1995-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084234. [PMID: 33923578 PMCID: PMC8073390 DOI: 10.3390/ijerph18084234] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
Drowning is public health issue requiring global, national and community responses. The multisectoral nature of drowning prevention reinforces the need for multidisciplinary research, which can play a key role in identifying patterns, factors and interventions and contributes to evidence-informed prevention. This study presents a biometric analysis of drowning research published in 1995–2020 and identifies temporal trends in research themes, journals, countries and authorship to assist in the planning of future research. This study identified 935 studies, representing authors from 80 countries. Publications grew 103-fold, and 41.2% (n = 385) were published since 2014. The top 20 journals are all injury prevention, public health, or medical journals. The top 5 accounted for 24.5% (n = 229) of total publications (TP). Research from the United States (TP = 313, 25.0%) and Australia (TP = 192, 15.3%) dominates the field. Growth is highest in low–middle-income countries (LMICs) including China (TP = 54, 4.3%, 32-fold), India (TP = 30, 2.4%, 17-fold) and Bangladesh (TP = 47, 3.7%, 7-fold). The study identifies significant growth in epidemiologic studies reporting burden and risk factors. Research in LMICs is increasing but lags relative to the burden. The role of multilateral and nongovernment organisations in evidence generation is evident and needs investigation, as do gaps in evidence for interventions and partnerships to progress the drowning prevention field.
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Taylor DH, Peden AE, Franklin RC. Next steps for drowning prevention in rural and remote Australia: A systematic review of the literature. Aust J Rural Health 2020; 28:530-542. [PMID: 33215761 DOI: 10.1111/ajr.12674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To examine unintentional drowning by remoteness in Australia. DESIGN A systematic review of both peer-reviewed and grey literature published between January 1990 and December 2019 (inclusive). METHOD Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest), SPORTDiscus and Google Scholar were searched for studies exploring fatal and non-fatal unintentional drowning by remoteness. Epidemiological data, common factors and prevention strategies were extracted and mapped to Australian standard geographical classifications (major cities, inner regional, outer regional, remote and very remote). Level of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation and prevention strategies aligned to the hierarchy of control. RESULT Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control. CONCLUSION Rural populations are proportionately overrepresented in drowning statistics. Proposed prevention strategies have unknown efficacy. Greater research into rural drowning of Australians is needed especially exploring behavioural motivations, program delivery, cost-effectiveness and evaluation. Development and use of a standard definition for remoteness are recommended. Rural populations use water extensively; therefore, there is an urgent need to keep them safe.
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Affiliation(s)
- Danielle H Taylor
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Amy E Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Royal Life Saving Society - Australia, Sydney, NSW, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Royal Life Saving Society - Australia, Sydney, NSW, Australia
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15
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Lawes JC, Rijksen EJT, Brander RW, Franklin RC, Daw S. Dying to help: Fatal bystander rescues in Australian coastal environments. PLoS One 2020; 15:e0238317. [PMID: 32936817 PMCID: PMC7494089 DOI: 10.1371/journal.pone.0238317] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/13/2020] [Indexed: 11/19/2022] Open
Abstract
Bystanders who drown during a rescue attempt in aquatic waterways are becoming an increasingly important issue within drowning prevention. In the Australian context, the majority of these incidents occur in coastal water ways. This study documents and characterizes bystander rescuer fatalities within Australian coastal waterways that occurred between 1 July 2004 and 30 June 2019 in order to provide suggestions for future public safety interventions involving bystander rescuers. Data was sourced through Surf Life Saving Australia's (SLSA) Coastal Fatality Database, which collates information from multiple sources. Sixty-seven bystander rescuer fatalities in coastal waterways were reported during the 15-year period, an average of 4.5 per year, which is a significant proportion of the five fatalities previously reported across all Australian waterways. The majority of coastal bystander rescuer fatality incidents occurred in the state of New South Wales (49%), at beaches (64%), in regional or remote areas (71%), more than 1 km from the nearest lifesaving service (78%), during summer (45%), in the afternoon (72%), in the presence of rip currents (73%), and did not involve the use of flotation devices to assist rescue (97%). The majority of coastal bystander rescuer victims were Australian residents (88%) born in Australia/Oceania (68%), males (81%), aged between 30-44 years old (36%), visitors to the location (55%), either family (69%) or friends (15%) of the rescuee(s), and were attempting to rescue someone younger than 18 years old (64%). Our results suggest future safety intervention approaches should target males, parents and carers visiting beach locations in regional locations during holiday times and should focus on the importance of flotation devices when enacting a rescue and further educating visitors about the rip current hazard. Future research should examine the psychology of bystander rescue situations and evaluate the effectiveness of different safety intervention approaches.
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Affiliation(s)
- Jasmin C. Lawes
- Surf Life Saving Australia, Sydney, NSW, Australia
- School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, NSW, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld., Australia
- * E-mail:
| | | | - Robert W. Brander
- School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld., Australia
| | - Shane Daw
- Surf Life Saving Australia, Sydney, NSW, Australia
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16
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Peden AE, Willcox-Pidgeon S. Autism spectrum disorder and unintentional fatal drowning of children and adolescents in Australia: an epidemiological analysis. Arch Dis Child 2020; 105:869-874. [PMID: 32169851 DOI: 10.1136/archdischild-2019-318658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study explored unintentional fatal drowning among children and adolescents (0-19 years) diagnosed with autism spectrum disorder (ASD) in Australia. DESIGN This total population, cross-sectional audit used data from the Royal Life Saving National Fatal Drowning Database to explore demographic and causal factors in ASD drowning cases between 1 July 2002 and 30 June 2018. Rates and relative risk (RR) with a 95% confidence interval (CI) were calculated for drowning cases with and without ASD, using estimated population-level prevalence data. RESULTS Of the 667 cases of drowning among 0-19 year olds with known medical history, 27 children and adolescents (4.0%) who drowned had an ASD diagnosis. Children and adolescents with ASD were three times more likely to drown than those without ASD (RR=2.85; CI 0.61 to 13.24). Among those with ASD, 0-4 year olds record the highest rate (11.60/100 000 diagnosed). Children and adolescents with ASD were significantly more likely to drown when compared with those without ASD: if aged 5-9 years (44.4% of ASD-yes cases; 13.3% of ASD-no cases); in a lake or dam (25.9% vs 10.0%) and during winter (37.0% vs 13.1%). CONCLUSION Heightened awareness of drowning risk for children and adolescents with ASD is required, including adult supervision and barriers restricting water access. Further evaluation of the effectiveness of personal alarms to alert caregivers to an unsupervised child is warranted. Challenges exist regarding accurate estimates of population-level ASD prevalence and identification of ASD in coronial files. As the diagnosis of ASD does not often occur until age five, results may be an underestimate.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia .,School of Public Health and Community Medicine, University of New South Wales Faculty of Medicine, Kensington, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia
| | - Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia
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17
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Işın A, Akdağ E, Turgut A. The epidemiology of fatal drowning in children: a 13-year retrospective study in Turkey. Int J Inj Contr Saf Promot 2020; 27:465-471. [PMID: 32814483 DOI: 10.1080/17457300.2020.1810075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This retrospective study aimed to investigate the prevalence of unintentional fatal drowning in children aged 0-17 years in Turkey between 2005 and 2017 and to determine the risk factors in drowning. This study is based on media reports, and all data were obtained from the media. All data were presented in frequency and percentage. Relative risk and 95% confidence intervals were calculated using the relevant population data. A total of 3,419 children died by drowning in these 13 years. The unintentional fatal child drowning rates in Turkey were 1.16; 1.80 for males and 0.48 for females per 100,000 children, which means males drowned nearly four times more than females. In terms of season, the highest rate of unintentional fatal drowning was in summer (0.69 per 100,000 children), and the lowest rate in winter (0.05 per 100,000 children). The unintentional fatal drowning rate decreased after reaching a peak in 2010 (1.52 per 100,000 children). As of 2015, the rate of unintentional fatal drowning decreased every year and reached a minimum in 2017 (0.66 per 100,000 children). Even if the mortality rate in children has decreased in recent years, more measures are still needed to prevent drowning in children.
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Affiliation(s)
- Ali Işın
- Faculty of Sport Sciences, Akdeniz University, Antalya, Turkey
| | - Eren Akdağ
- Institute of Health Sciences, Akdeniz University, Antalya, Turkey
| | - Adnan Turgut
- Faculty of Sport Sciences, Akdeniz University, Antalya, Turkey
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18
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Cenderadewi M, Franklin RC, Peden AE, Devine S. Fatal intentional drowning in Australia: A systematic literature review of rates and risk factors. PLoS One 2020; 15:e0231861. [PMID: 32442177 PMCID: PMC7244177 DOI: 10.1371/journal.pone.0231861] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Unintentional drowning deaths are only part of the drowning profile, with little attention being paid to intentional drowning in Australia. Strategies for the prevention of intentional drowning deaths are likely to be different from unintentional. Quality documentation, analysis and dissemination of intentional deaths data is crucial for developing appropriate strategies for prevention. OBJECTIVE To conduct a systematic literature review to investigate the mortality rates and risk factors of intentional drowning deaths in Australia. METHODS A systematic search guided by PRISMA was performed using Ovid MEDLINE, CINAHL, PsycINFO (ProQuest), Scopus, Google Scholar, and BioMed Central databases to locate relevant original research articles published between 2007 and 2018. RESULTS Ten papers reporting the mortality rates and risk factors of intentional drowning deaths in Australia published between 2007 and 2018, with study periods of the included articles spanning from 1907 to 2012, were reviewed. Most studies investigated suicidal drowning deaths in Australia, none reported homicidal drowning deaths. The downward trend of fatal suicide drowning was identified in Australia. The annual rate of intentional drowning between 1994 and 2012 can be inferred from eight studies, ranging from 0.06 to 0.21 for nation-wide mortality rates. The highest annual state-wide mortality rate was identified in the state of Queensland, ranging from 0.02 to 0.11 per 100,000 individuals. Of four studies examining the risk factors of fatal intentional drowning in Australia, being of older age groups, being female, and the presence of substance use were identified as important factors for suicidal drowning deaths. The national-scale proportion of suicide drowning in Australia, ranging from 2% to 3% of all intentional self-harm deaths, was also identified. CONCLUSION Limited publications reporting the mortality rates and risk factors of intentional drowning deaths in Australia were identified. Being of older age groups and being female were recognised as factors for suicide drowning deaths, and psychoactive substances were widely identified amongst cases. Future research on improving death reporting systems and the legal framework for medico-legal death investigation, along with the investigation of the risk factors of intentional drowning, are required to inform the planning, implementation, and evaluation of prevention interventions for intentional drowning deaths in Australia.
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Affiliation(s)
- Muthia Cenderadewi
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society—Australia, Sydney, Australia
| | - Amy E. Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society—Australia, Sydney, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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19
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Willcox-Pidgeon SM, Peden AE, Scarr J. Exploring children's participation in commercial swimming lessons through the social determinants of health. Health Promot J Austr 2020; 32:172-181. [PMID: 32187399 DOI: 10.1002/hpja.335] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED Drowning is a public health challenge, disproportionately impacting children. Social determinants of health (SDH) such as socio-economic disadvantage and geographic isolation increase drowning risk. Swimming and water safety lessons, in part, have reduced drowning in children, while also enabling healthy aquatic participation. Research suggests that some Australian children receive insufficient swimming and water safety education and are not achieving essential skills. METHODS A cross-sectional retrospective analysis of swimming and water safety skills achieved by a cohort of children (5-12 years) attending commercial swimming lessons in three Australian states was undertaken. Variables included participant demographics (age, gender, and the SDH of socio-economic status [SES], and geographical remoteness) and skills being taught and achieved. Skills achieved were analysed against the National Swimming & Water Safety Framework and the National Benchmark. RESULTS Swim schools were more likely to teach freestyle (87%) and backstroke (83%); and less likely to teach water safety skills like treading water (53%), and survival backstroke (46%). Overall, 40% of 12-year-old children failed to achieve the National Benchmark of 50 metres freestyle, fewer were achieving minimum water safety skills. Children from low socio-economic areas and regional locations were less likely to be achieving 50 metres freestyle. Children in this study were commonly from major cities (94%) and of high socio-economic areas (53%). CONCLUSIONS Swimming lessons must incorporate a broad range of swimming and water safety competencies to ensure children have the skills required to reduce drowning, especially for those deemed at increased risk. SO WHAT Stakeholders must prioritise holistic drowning prevention education strategies, ensuring all children can access swimming and water safety programs regardless of their socio-economic status or geographical location.
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Affiliation(s)
- Stacey M Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,School of Public Health and Community Medicine, UNSW Sydney, Kensington, NSW, Australia
| | - Justin Scarr
- Royal Life Saving Society - Australia, Broadway, NSW, Australia
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20
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Peden AE, Franklin RC. Causes of distraction leading to supervision lapses in cases of fatal drowning of children 0-4 years in Australia: A 15-year review. J Paediatr Child Health 2020; 56:450-456. [PMID: 31667952 DOI: 10.1111/jpc.14668] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/18/2019] [Accepted: 10/04/2019] [Indexed: 11/30/2022]
Abstract
AIM Supervision is a strategy for preventing drowning among children. However, supervision lapses continue to be a contributory factor in child drowning. This study aims to identify, describe and analyse the causes of distraction leading to lapses in supervision in child drowning. METHODS A total population survey of all fatal unintentional drownings among children aged 0-4 years between 1 July 2002 and 30 June 2017 was undertaken using data from the Australian National Coronial Information System. Among closed coronial cases, causes of distraction leading to lapses in supervision were collected as free text from closed case documentation and subsequently thematically grouped into categories. Univariate and χ2 analysis was undertaken (P < 0.01). RESULTS A total of 447 children drowned during the study period (62.0% male; 66.9% aged 1-2 years; 53.3% swimming pools; 79.4% falls into water). Of the 426 (95.3%) closed cases, common supervision lapses were due to indoor household duties (27.6%), outdoor household duties (12.6%) and talking/socialising (11.9%). CONCLUSIONS This study has identified common scenarios for distractions leading to supervision lapses including the link between indoor household duties and bathtub drowning deaths and talking/socialising for deaths in swimming pools and at rivers. Challenges include medical issues impacting sole carers. The 7% of cases where a supervision lapse occurred due to miscommunication are opportunities to further reinforce the need for a designated supervisor, particularly with two or more adults present. Study findings on distraction causes, and strategies to minimise them, should be incorporated into national public awareness campaigns aimed at parents and care givers of this at-risk group.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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21
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Peden AE, Franklin RC, Willcox-Pidgeon S. Media reporting of summer drowning: A partial picture, useful for advocacy. Health Promot J Austr 2019; 31:491-496. [PMID: 31562788 DOI: 10.1002/hpja.297] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/17/2019] [Accepted: 09/24/2019] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Media reporting of drowning deaths can be used for multiple purposes, including advocacy, enhancing data on drowning and supporting policy development. Accurate, current and comprehensive data help ensure the development of effective prevention programs as well as being a tool for advocacy. Advocacy for drowning prevention through the media can create behaviour change aligned to the Health Belief Model (HBM). METHODS This study compares media reports of fatal unintentional drowning across the 2017/18 Australian summer (1-December-2017 to 28-February-2018) with drowning cases in the National Coronial Information System (NCIS). RESULTS Media monitoring identified 84 cases, of which nine (11%), were deaths but not drowning. There were 104 NCIS deaths during this time of which 75 were reported in the media (72% capture). Media captured 100% of drowning incidents involving people 0-24 years and in ocean/harbour locations. Drowning incidents among older people (75+ years; 36% capture), in bathtubs (0% capture), swimming pools (33% capture) and with an unknown activity (27% capture) were poorly reported. CONCLUSIONS Where there are a lack of timely data on drowning, the use of media can help capture deaths, with limitations. Transmission of messages about drowning risk factors and prevention strategies, during summer, may lead to behaviour change at a time when drowning risk is highest. SO WHAT?: Working with the media to help enhance advocacy efforts, in particular the development and use of effective drowning prevention messages, is key to informing the public about risk factors in the HBM to achieve behaviour change.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,School of Public Health and Community Medicine, UNSW Sydney, Kensington, NSW, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
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22
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Abstract
Rivers are a leading location for drowning, yet little is known about people’s usage of these waterways. This pilot study aimed to test the use of direct observations to calculate river usage. Direct observations were conducted at regular intervals within defined zones at four river drowning locations in Australia (including weekends and the Australia Day national public holiday). Data recorded were date and time of observation; total people (including males, females, children, and adults); and number of people on, in, and beside the water. Univariate analysis with mean (SD) and range was conducted. Interrater reliability for observations was determined using the intraclass correlation coefficient (ICC) (one-way random-effects, average measures model), with a 95% confidence interval (CI). Across 149 time points, 309 observations resulted in 13,326 river interactions observed by multiple observers. There was an average of 39 people (M = 39.4, SD = 29.4, range = 0–137) per observation, 44 people (M = 44.2, SD = 32.7, range = 0–37) on an average weekend, and 97 people (M = 96.8, SD = 58.1, range = 20–190) on Australia Day. More females (M = 20.6, SD = 16.0, range = 0–83) than males (M = 18.3, SD = 14.5, range = 0–68) were observed. More people were observed in the water (M = 20.6, SD = 20.4, range = 0–84) than beside or on the water. Interrater reliability was excellent, consistently above 0.900 for all variables collected (apart from the variable of beside the river). Despite males accounting for 80% of river drowning fatalities, more females were observed than males. Increased visitation on the Australia Day public holiday may be linked to increased drowning risk. This study detailed a simple approach to data collection, exploring exposure within a defined zone at river locations. River usage is dynamic, with people’s movement in and out of the water changing their risk exposure. Observational-based data collection for drowning, particularly for rivers, is an important yet highly neglected area of research.
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23
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Willcox-Pidgeon S, Peden AE, Franklin RC, Scarr J. Boating-related drowning in Australia: Epidemiology, risk factors and the regulatory environment. JOURNAL OF SAFETY RESEARCH 2019; 70:117-125. [PMID: 31847986 DOI: 10.1016/j.jsr.2019.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/02/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Recreational boating is a popular pastime in many high income countries, and is a leading activity prior to drowning. This study reports on unintentional fatal drowning associated with boating-related incidents in Australia. METHODS A total population, retrospective, cross sectional design examined all boating-related unintentional drowning deaths between July 1, 2005 and June 30, 2015. Variables examined included age, sex, location of drowning incident, vessel type, activity, presence of alcohol/drugs, and lifejacket wear. Relative risk (with a 95% confidence interval) was calculated using fatal drowning rates per 100,000 population and rates per 100,000 registered vessels. Chi square analysis and non-parametric tests for significance were applied. Statistical significance was deemed p < .05. RESULTS A total of 415 people drowned while boating during the study period, 91.8% male and 35.7% aged between 25 and 44 years. Men were 10 times more likely to drown when boating than females (RR = 10.64 CI:7.55-14.97). Over one-quarter (28.7%) of incidents involved alcohol, in 30.6% drugs were identified (31.3% were illegal) and 90.4% were not wearing a lifejacket. Children were more at risk of drowning on a houseboat than adults (RR = 7.13; CI:1.61-31.61). Females were more likely to drown than males when using a personal watercraft (RR = 10.53; CI:2.75-40.33). CONCLUSION Boaters may be taking unnecessary risks by disregarding safety regulations, such as not wearing lifejackets and substance use (such as alcohol and illegal drugs). Boating in remote locations presents a high risk of drowning. While safety regulations are in place, enforcement and behavior change remain challenges. Practical application: Findings support recommendations for increased enforcement of alcohol-related regulations and introducing drug-testing for boaters. Consistency of boating safety regulations, especially around lifejacket wear, is recommended to influence behavior change. The effectiveness of current lifejacket regulations need to be critically evaluated in the context of increasing wear rates for adults and children.
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Affiliation(s)
- Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Amy E Peden
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Justin Scarr
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia.
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24
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Chang SSM, Ozanne-Smith J. Drowning mortality in children aged 0-14 years in Victoria, Australia: detailed epidemiological study 2001-2016. Inj Prev 2019; 26:593-598. [PMID: 31422366 DOI: 10.1136/injuryprev-2019-043307] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Major reductions in child drowning mortality rates have been observed historically in Victoria, Australia, for the period 1863-2000. Despite this trend, drowning remains the leading cause of unintentional child death in Victoria. This study investigates the residual fatal drowning problem in the Victorian child population (0-14 years) for the period 2001-2016. AIMS Describe the epidemiology of child drowning deaths in the Victorian population in 2001-2016; investigate risk factors and direct antecedents to these deaths. METHODS Population-based retrospective case data were extracted from the National Coronial Information System for 16 years (January 2001-December 2016), and case-by-case analysis was conducted. Associated factors were determined using univariate and Poisson analyses. RESULTS 88 of 97 cases had information available for analysis, pools were the most frequent location (30%); 70% of all cases occurred between 08:00 and 17:00; most victims were not deliberately in the body of the water (73%), for example, the pool. Supervision lapses included carers leaving the room when the child was in the bath (16/18), siblings left to supervise the child in private pools (7/23), inadequate pool fences (8/23) or faulty/open gates (4/23), or neighbours' pool spa (4/23). Delays in finding the child occurred when searches occurred elsewhere, before the body of water (21/88) and when carers were asleep (5/88). Fourteen of the 88 children had an intellectual disability or predisposing medical condition. The grouped Poisson analysis demonstrated that age 0-4 years, male gender and rural place of residence were significant. A downward trend in drowning rate continued in this period. DISCUSSION AND CONCLUSIONS A case-by-case analysis of a drowned population of children identified details of risk factors and antecedents not previously described. Missing data on antecedents were common, likely resulting in undercounting. Further enhancements to systematic data collection are needed. The results support a systems approach to drowning prevention.
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Affiliation(s)
- Susan Soon Mee Chang
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Joan Ozanne-Smith
- Injury Prevention Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
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25
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Peden AE, Franklin RC, Pearn JH. The prevention of child drowning: the causal factors and social determinants impacting fatalities in portable pools. Health Promot J Austr 2019; 31:184-191. [PMID: 31369689 DOI: 10.1002/hpja.282] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 07/28/2019] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED There is a scarcity of research into portable pool drowning and its prevention. This total population study examines fatal drowning among children under five in portable pools in Australia. METHODS All child drowning deaths in portable pools for the period 1 July 2002 to 30 June 2018 were identified. A portable pool was defined as any structure used for swimming and wading which, when emptied, can be moved. RESULTS Twenty-three children (aged 0-17 years) drowned in portable pools. The drowning rate for children less than 5 years of age was 0.09 per 100 000 population. The peak age of death was 12-23 months (RR = 2.99; CI: 1.09-8.23), with the majority (n = 20 deaths) aged 16-31 months. Ninety per cent followed a fall into water. None were supervised. Children commonly resided in areas classified as socially and economically disadvantaged (85%; n = 17). Drowning rates in very remote areas were 15 times greater (RR = 15.41; CI: 0.03-7579.65) than city children. Eleven (55%) drowning deaths occurred in pools with a depth >300 mm, of which 10 (91%) were known to be unfenced. CONCLUSIONS Social determinants impact child drowning in portables pools, which can occur quickly and in just 150 mm of water. Active supervision and a regulation-compliant barrier are effective prevention stratagems, factors which were absent from the deaths in this study. SO WHAT?: Portable pool drowning disproportionately impacts those aged 16-31 months who reside in very remote areas and areas classified as having high socio-economic disadvantage. Education for these groups on fencing and supervision of children must be provided.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Sydney, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Sydney, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - John H Pearn
- Royal Life Saving Society - Australia, Sydney, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Senior Paediatrician, Queensland Children's Hospital, South Brisbane, QLD, Australia
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Franklin RC, Peden AE, Brander RW, Leggat PA. Who rescues who? Understanding aquatic rescues in Australia using coronial data and a survey. Aust N Z J Public Health 2019; 43:477-483. [PMID: 31180612 DOI: 10.1111/1753-6405.12900] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/01/2019] [Accepted: 03/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To examine fatal drowning associated with aquatic rescues and prior self-reported experience of undertaking an aquatic rescue in Australia. METHODS Previous aquatic rescue experience was sourced through the 2013 Queensland Computer Assisted Telephone Instrument Survey and compared to data on rescue-related fatal unintentional drowning between 1 January 2006 and 31 December 2015. RESULTS Twenty-three per cent (n=294/1291) of survey respondents had previously performed an aquatic rescue. Males (X2 =35.2; p<0.001) were more likely to have performed a rescue; commonly at a beach/ocean/harbour location (X2 =13.5; p<0.001). Females were more likely to have rescued a child (0-4 years of age) (X2 =29.2; p<0.001) from a swimming pool (X2 =34.3; p<0.001). Fifty-one people drowned while performing an aquatic rescue (Males=82.4%; 25-44 years of age=53.0%; beaches=54.9%). CONCLUSIONS Drownings are prevented by bystanders; this is not without risk to the rescuer. Most people perform only one rescue in their life, often at a younger age, on an altruistic basis, of family members or young children. Community-wide rescue skills, taught at a young age, with consideration for coastal, inland and swimming pool environments, may prevent drowning. Implications for public health: There is a need to train people early in their life on how to undertake a safe rescue and provide resuscitation, including promoting regular updates, in particular if supervising children.
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Affiliation(s)
- Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland.,Royal Life Saving Society - Australia, Sydney, New South Wales
| | - Amy E Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland.,Royal Life Saving Society - Australia, Sydney, New South Wales
| | - Robert W Brander
- School of Biological, Earth and Environmental Sciences, UNSW, New South Wales
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland.,School of Nursing and Midwifery, Faculty of Health Sciences, Flinders University, Adelaide, South Australia
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Peden AE, Barnsley PD, Queiroga AC. The association between school holidays and unintentional fatal drowning among children and adolescents aged 5-17 years. J Paediatr Child Health 2019; 55:533-538. [PMID: 30298959 DOI: 10.1111/jpc.14235] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
AIM Children aged 5-17 years in Australia have one of the lowest unintentional fatal drowning rates. One possible explanation is the protective effect of formal schooling, reducing leisure time for exposure to water hazards. We examine differences in frequency and circumstances of drowning deaths in this age group between school holidays and school days in Australia. METHODS A total population survey (2005-2014) of unintentional fatal drownings was extracted from the (Australian) Royal Life Saving National Fatal Drowning Database. Date of drowning incident and state of residence were used to determine if the drowning occurred during school days or school holidays (including public holidays). RESULTS A total of 188 5-17 year-olds drowned during the study period. We found a statistically significant difference between drowning incidence during school holidays and school days, with relative risk (RR) of drowning on a holiday 2.40 times higher (confidence interval (CI): 1.82-3.18) than on a school day. This risk was similar for males (RR = 2.41; CI: 1.75-3.33) and females (RR = 2.38; CI: 1.33-4.27) but differs between children 5-9 years (RR = 3.05; CI: 1.98-4.72) and adolescents 10-17 years of age (RR = 2.02; CI: 1.38-2.93). CONCLUSIONS Drowning rates among 5-17 year-olds are more than twice as high during holidays than on school days. Impact of school holidays was the strongest among younger children, visitors to the drowning location and in pools and inland waterways. Results were robust to alternative specifications excluding weekends and treating them as holidays. Prevention strategies may include counselling parents and care providers of the increased risk ahead of school holidays, education on drowning risk in the school curriculum and extra holidays for parents and care givers.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Paul D Barnsley
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia
| | - Ana C Queiroga
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.,EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
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Peden AE, Franklin RC, Leggat PA. Developing drowning prevention strategies for rivers through the use of a modified Delphi process. Inj Prev 2019; 26:240-247. [PMID: 30928913 PMCID: PMC7279562 DOI: 10.1136/injuryprev-2019-043156] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 11/17/2022]
Abstract
Introduction Internationally, rivers are a leading drowning location, yet little evidence exists evaluating river drowning prevention strategies. This study aims to use expert opinion to identify strategies more likely to be effective. Methods Using a modified Delphi process, a virtual panel of 30 experts from 12 countries considered, grouped and prioritised strategies for river drowning prevention. Proposed strategies were assessed against known evidence and suitability in high-income countries (HICs) as well as low-income and middle-income countries (LMICs) using expert opinion. The final phase consolidated a list of strategies whose effectiveness was assessed against 10 evidence-based river drowning scenarios. Results An initial list of 424 prevention strategies was refined to 22. After being assessed against the 10 scenarios, a final list of 13 strategies was derived. Strategies addressed alcohol consumption around rivers, flood mitigation, improving child supervision, learning to swim, increased lifejacket wear and achieving community-wide resuscitation skills. Discussion While all 13 strategies were assessed as being effective in both LMICs and HICs by at least 60% of the respondents, further work is required to define river drowning at a country level and therefore allow for effective solutions to be developed, particularly in LMICs. No strategy will be effective in isolation and must be implemented alongside policy and behaviour change, public awareness and education. Evaluation should be incorporated as part of any future implementation of strategies. Conclusion This Delphi process identified 13 drowning prevention strategies for rivers. Further research is required to validate the efficacy of these findings through implementation and evaluation.
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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 Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
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Hamilton K, Keech JJ, Peden AE, Hagger MS. Protocol for developing a mental imagery intervention: a randomised controlled trial testing a novel implementation imagery e-health intervention to change driver behaviour during floods. BMJ Open 2019; 9:e025565. [PMID: 30782937 PMCID: PMC6398747 DOI: 10.1136/bmjopen-2018-025565] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/16/2018] [Accepted: 12/18/2018] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Drowning due to driving into floodwater accounts for a significant proportion of all deaths by drowning. Despite awareness campaigns such as 'If it's flooded, forget it', people continue to drive into floodwater. This causes loss of life, risk to rescuers and damage to vehicles. The aim of this study was to develop and evaluate an online e-health intervention to promote safe driving behaviour during flood events. METHODS AND ANALYSIS The study will use a 2×3 randomised controlled trial in which participants are randomised into one of two conditions: (1) education about the risks of driving into floodwater or (2) education about the risks of driving into floodwater plus a theory-based behaviour change intervention using planning and imagery exercises. The effect of the intervention on the primary outcome, intention to drive through floodwater and the secondary outcomes will be assessed using a series of mixed-model analysis of covariances. ETHICS AND DISSEMINATION The study has been approved by the Griffith University Human Research Ethics Committee. Participants will review a study information sheet and provide informed consent prior to commencing participation. Results will be disseminated through peer-reviewed publications, industry reports, media releases and at academic conferences. Deidentified data will be made publicly available following publication of the results. TRIAL REGISTRATION NUMBER ACTRN12618001212246.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
- School of Psychology, Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Western Australia, Australia
| | - Jacob J Keech
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - 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
| | - Martin S Hagger
- School of Psychology, Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Western Australia, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Characteristics of aquatic rescues undertaken by bystanders in Australia. PLoS One 2019; 14:e0212349. [PMID: 30763388 PMCID: PMC6375621 DOI: 10.1371/journal.pone.0212349] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/31/2019] [Indexed: 11/19/2022] Open
Abstract
An issue of growing importance within the field of drowning prevention is the undertaking of aquatic rescues by bystanders, who sometimes drown in the process. The main objectives of this study were to describe characteristics of bystanders making rescues in different Australian aquatic environments, identify the role of prior water safety training in conducting bystander rescues and provide insights into future public education strategies relating to bystander rescue scenarios. An online survey was disseminated via various social media platforms in 2017 and gathered a total of 243 complete responses. The majority of bystander rescues described took place in coastal waterways (76.5%; n = 186), particularly beaches (n = 67), followed by pools (17.3%; n = 42) and inland waterways (6.2%; n = 15). The majority of respondents were males (64.2%; n = 156) who rescued on average approximately twice as many people in their lifetime (6.5) than female respondents (3.6). Most rescues occurred more than 1 km from lifeguard/lifesaver services (67%; n = 163), but in the presence of others (94.2%; n = 229). The majority of bystander rescuers had water safety training (65.8%; n = 160), self-rated as strong swimmers (68.3%; n = 166), conducted the rescue without help from others (60%; n = 146), did not use a flotation device to assist (63%; n = 153), but were confident in their ability to make the rescue (76.5%; n = 186). However, most considered the situation to be very serious (58%; n = 141) and felt they had saved a life (70.1%; n = 172). With the exception of pools, most bystanders rescued strangers (76.1%; n = 185).While Australia clearly benefits from having a strong water safety culture, there is no clear consensus on the most appropriate actions bystanders should take when confronted with a potential aquatic rescue scenario. In particular, more research is needed to gather information regarding bystander rescues undertaken by those without prior water safety training.
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Abstract
Unintentional fatal drowning among older people is an issue as lifespans lengthen and older people embrace active retirement. While pre-existing medical conditions are a known risk factor for drowning among this age group, less is known about the role of alcohol and drugs. This 15-year (1 July 2002 to 30 June 2017) Australian study used coronial data to investigate the impact on older people (aged 65 years and older) of the obtundent effects of prescribed drugs which had been ingested by those with a positive blood alcohol concentration (BAC). Of the closed coronial cases with toxicological information (N = 471), one quarter (24.6%; N = 116) had consumed alcohol prior to drowning (one in seven BAC ≥ 0.05%), of which a third also had obtundent drugs present (33.6%; N = 39). Rivers/creeks/streams and swimming pools were the locations with the highest number of drowning deaths. Bathtubs (36.8%) and rivers/creeks/streams (17.9%) recorded the highest proportion of cases with victims having a BAC ≥ 0.05%. Bathtubs (13.2%), lakes (7.0%), and rivers/creeks/streams (6.8%) recorded the highest proportion of drowning cases with obtundent drug involvement. Obtundent drug involvement was significantly more likely for activities where the person who drowned was alone (i.e., unknown activity) (X2 = 6.8; p = 0.009). Common obtundent drugs included Diazepam, Tempazepam, and Codeine. Advocacy to prevent drowning in older people is a complex challenge, due to the myriad of locations where drowning occurs, the consumption of alcohol, and polypharmacy required for treating illness and maintaining good health.
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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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Barnsley PD, Peden AE, Scarr J. Calculating the economic burden of fatal drowning in Australia. JOURNAL OF SAFETY RESEARCH 2018; 67:57-63. [PMID: 30553430 DOI: 10.1016/j.jsr.2018.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 07/11/2018] [Accepted: 09/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Aquatic activities provide physical and social benefits, while the risk of drowning generates countervailing social costs. Drawing on estimates of fatal drowning gathered by Royal Life Saving Society - Australia, this paper outlines a method for estimating the economic burden attributable to fatal drowning. METHODS This study estimated the burden of fatal drowning by combining Value of a Statistical Life Year (VSLY), hospitalization, productivity and emergency services costs. All unintentional fatal drowning cases in Australia between 1-July-2002 and 30-June-2017 were included. Foregone life years from each drowning were estimated based on Australian life expectancies for the year of death. The societal value of these Years of Life Lost was calculated using the VSLY for Australia, adjusted to reflect income elasticity. Corrections to discounting of VSLY were applied. Estimates of productivity losses not captured in VSLY were produced using net national capital growth. Time spent in hospital was found using coronial data and existing estimates of search, ambulance and coronial costs were adapted and incorporated. RESULTS The study covers 4285 cases of unintentional fatal drowning over 15 years. Based on this sample and estimates for the VSLY ($203,000), the economic burden of fatal drowning for Australia over this 14 year period was $18.63 billion in 2017 Australian dollars, averaging $1.24 billion annually. CONCLUSIONS Fatal drowning represents a significant source of health burden in Australia, underlining the need for further preventative measures. PRACTICAL APPLICATIONS We provide an easily-understood estimate of the scale of Australia's fatal drowning problem, permitting comparison with other social problems. They can also be used in determining net benefits of proposed drowning prevention policies and to identify situations where burden of fatal drowning is disproportionate. Suggestions for improving the calculation of societal burden of illness can be incorporated in cost-benefit analyses in related fields of study.
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Affiliation(s)
- Paul D Barnsley
- Royal Life Saving Society - Australia, Broadway, NSW, Australia
| | - Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Justin Scarr
- Royal Life Saving Society - Australia, Broadway, NSW, Australia
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Peden AE, Mahony AJ, Barnsley PD, Scarr J. Understanding the full burden of drowning: a retrospective, cross-sectional analysis of fatal and non-fatal drowning in Australia. BMJ Open 2018; 8:e024868. [PMID: 30473541 PMCID: PMC6254411 DOI: 10.1136/bmjopen-2018-024868] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The epidemiology of fatal drowning is increasingly understood. By contrast, there is relatively little population-level research on non-fatal drowning. This study compares data on fatal and non-fatal drowning in Australia, identifying differences in outcomes to guide identification of the best practice in minimising the lethality of exposure to drowning. DESIGN A subset of data on fatal unintentional drowning from the Royal Life Saving National Fatal Drowning Database was compared on a like-for-like basis to data on hospital separations sourced from the Australian Institute of Health and Welfare's National Hospital Morbidity Database for the 13-year period 1 July 2002 to 30 June 2015. A restrictive definition was applied to the fatal drowning data to estimate the effect of the more narrow inclusion criteria for the non-fatal data (International Classification of Diseases (ICD) codes W65-74 and first reported cause only). Incidence and ratios of fatal to non-fatal drowning with univariate and Χ2 analysis are reported and used to calculate case-fatality rates. SETTING Australia, 1 July 2002 to 30 June 2015. PARTICIPANTS Unintentional fatal drowning cases and cases of non-fatal drowning resulting in hospital separation. RESULTS 2272 fatalities and 6158 hospital separations occurred during the study period, a ratio of 1:2.71. Children 0-4 years (1:7.63) and swimming pools (1:4.35) recorded high fatal to non-fatal ratios, whereas drownings among people aged 65-74 years (1:0.92), 75+ years (1:0.87) and incidents in natural waterways (1:0.94) were more likely to be fatal. CONCLUSIONS This study highlights the extent of the drowning burden when non-fatal incidents are considered, although coding limitations remain. Documenting the full burden of drowning is vital to ensuring that the issue is fully understood and its prevention adequately resourced. Further research examining the severity of non-fatal drowning cases requiring hospitalisation and tracking outcomes of those discharged will provide a more complete picture.
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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
| | - Alison J Mahony
- Royal Life Saving Society-Australia, Broadway, New South Wales, Australia
| | - Paul D Barnsley
- Royal Life Saving Society-Australia, Broadway, New South Wales, Australia
| | - Justin Scarr
- Royal Life Saving Society-Australia, Broadway, New South Wales, Australia
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Pajunen T, Vuori E, Lunetta P. Epidemiology of alcohol-related unintentional drowning: is post-mortem ethanol production a real challenge? Inj Epidemiol 2018; 5:39. [PMID: 30382440 PMCID: PMC6211144 DOI: 10.1186/s40621-018-0169-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/17/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Post-mortem (PM) ethanol production may hamper the interpretation of blood alcohol concentration (BAC) in victims of drowning. Different exclusion criteria (e.g. cases with low BAC or with protracted interval between death and toxicological analysis) have been proposed with no factual figures to reduce the potential bias due to PM ethanol production when examining the prevalence rates for alcohol-related drowning. The aim of this study is to verify the extent to which PM alcohol production may affect the accuracy of studies on drowning and alcohol. FINDINGS Unintentional fatal drowning cases (n = 967) for which a full medico-legal autopsy and toxicological analysis was performed, in Finland, from 2000 to 2013, and relevant variables (demographic data of the victims, month of incident, PM submersion time, blood alcohol concentration, urine alcohol concentration (UAC), vitreous humour alcohol concentration (VAC) were available. Overall, out of 967 unintentional drownings, 623 (64.4%) were positive for alcohol (BAC > 0 mg/dL), 595 (61.5%) had a BAC ≥ 50 mg/dL, and 567 (58.6%) a BAC ≥ 100 mg/dL. Simultaneous measurements, in each victim, of BAC, UAC, and VAC revealed PM ethanol production in only 4 victims (BAC: 25 mg/dL - 48 mg/dL). These false positive cases represented 0.4% of drownings with BAC > 0 mg/dL and 14.3% of drownings with BAC > 0 mg/dL and < 50 mg/dL. CONCLUSIONS The present study suggests that PM ethanol production has a limited impact on research addressing the prevalence rate for alcohol-related drowning and that the use of too rigorous exclusion criteria, such as those previously recommended, may led to a significant underestimation of actual alcohol-positive drowning cases.
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Affiliation(s)
- Tuulia Pajunen
- Department of Biomedicine, Pathology and Forensic Medicine, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Erkki Vuori
- Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, 00500 Helsinki, Finland
| | - Philippe Lunetta
- Department of Biomedicine, Pathology and Forensic Medicine, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
- Department of Forensic Medicine, University of Oulu, 90014 Oulu, Finland
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A Retrospective, Cross-Sectional Cohort Study Examining the Risk of Unintentional Fatal Drowning during Public Holidays in Australia. SAFETY 2018. [DOI: 10.3390/safety4040042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Australia’s celebration of its public holidays often involves aquatic recreation, frequently mixed with consumption of alcohol, both of which are risk factors for drowning. This study examines how the demographics and circumstances of public holiday drownings compare to the average day drownings. A total population survey (1 July 2002 to 30 June 2017) of unintentional fatal drownings in Australia were extracted from the Royal Life Saving National Fatal Drowning Database. Date of drowning and state/territory of residence were used to determine if the drowning occurred on a public holiday in the person’s place of residence. 4175 persons drowned during the study period. There was a statistically significant difference between the incidence of fatal drowning on public holidays and the other days, with fatal drowning 1.73 times more likely to occur on public holidays (CI: 1.57–1.89). The increased risk of drowning on public holidays should inform the timing and the content of drowning prevention campaigns and strategies.
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Peden AE, Franklin RC, Leggat PA. Cardiopulmonary resuscitation and first-aid training of river users in Australia: A strategy for reducing drowning. Health Promot J Austr 2018; 30:258-262. [PMID: 30134008 DOI: 10.1002/hpja.195] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/19/2018] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Rivers are a leading location for fatal drowning worldwide, often geographically isolated from timely medical assistance. Cardiopulmonary resuscitation (CPR) benefits drowning victims and those who suffer cardiac arrests. This study explored CPR and first-aid training of river users in Australia. METHODS Adult river users (18+ years) were surveyed at four high-risk river drowning sites. Respondents were asked the last time they undertook CPR (responses converted into: "CPR ever undertaken"-yes/no; and "CPR training current"-yes/no (training undertaken ≤12 months ago). Responses were explored by demographics and social determinants of health. RESULTS Of those surveyed (N = 688), 98.4% responded regarding CPR. Seventy-five percent (74.9%) had undertaken CPR training previously. Females and 35- to 44-year-olds were more likely to have undertaken training (P < 0.05). Males and older people (65+ years) were less likely to hold a current qualification (P < 0.05). Major city residents reported a longer mean time (5.4 years) since last trained than remote and very remote locations (2.0 years). People in low socio-economic areas had a shorter time since qualification current (5.8 years) than those in areas deemed high (7.2 years). CONCLUSION Current CPR qualifications are important, particularly among those visiting high-risk river drowning locations. System-level, upstream strategies that should be explored include compulsory CPR training in secondary schools and linking CPR updates to motor vehicle licence renewals. SO WHAT?: Cardiopulmonary resuscitation is a vital component of multifaceted river drowning prevention. Social determinants of health, such as socio-economic disadvantage and geographical isolation, were not barriers to participation or currency of qualification.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Reijnen G, van de Westeringh M, Buster M, Vos P, Reijnders U. Epidemiological aspects of drowning and non-fatal drowning in the waters of Amsterdam. J Forensic Leg Med 2018; 58:78-81. [DOI: 10.1016/j.jflm.2018.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/24/2018] [Accepted: 04/28/2018] [Indexed: 12/26/2022]
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Keech JJ, Smith SR, Peden AE, Hagger MS, Hamilton K. The lived experience of rescuing people who have driven into floodwater: Understanding challenges and identifying areas for providing support. Health Promot J Austr 2018; 30:252-257. [PMID: 29893063 DOI: 10.1002/hpja.181] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 06/08/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Drowning is a major public health issue, with risk increasing during times of flood. Driving into floodwater is a major risk factor for flood-related drowning and injury, and despite widespread public health campaigns, many people continue to undertake this risky behaviour and require rescue. PURPOSE We aimed to identify key challenges faced by emergency services personnel when rescuing those who have driven into floodwater, and to identify strategies for supporting rescuers in this important role. METHODS Australian flood rescue operators (N = 8) who had previously rescued a driver who had driven into floodwater participated in semi-structured interviews. Data were analysed using thematic analysis. RESULTS Four challenges emerged from their experiences: involvement of untrained personnel; varying information provided by emergency telephone operators; behaviour of drivers complicating the rescue; people sightseeing floods or flood rescues or ignoring closed roads providing rescuers with sources of distraction and frustration. CONCLUSIONS We propose five strategies for translating these results into practice, including: training and protocol development for (i) emergency personnel and (ii) telephone operators; (iii) training for rescuers regarding non-compliant rescuees; (iv) educating the public and (v) increasing compliance with closed roads. Current findings provide valuable insights into how rescuers can be supported in performing their roles, and implementation of these strategies has the potential to reduce fatalities occurring due to attempting to drive through floodwater. SO WHAT?: The strategies presented have the potential to reduce the frequency and improve the outcomes of floodwater rescues, aiding in the prevention of injury and death.
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Affiliation(s)
- Jacob J Keech
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Stephanie R Smith
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Martin S Hagger
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.,Health Psychology and Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, WA, Australia.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.,Health Psychology and Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, WA, Australia
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Peden AE, Franklin RC, Leggat P. The Flood-Related Behaviour of River Users in Australia. PLOS CURRENTS 2018; 10:ecurrents.dis.89e243413a0625941387c8b9637e291b. [PMID: 30022793 PMCID: PMC6028280 DOI: 10.1371/currents.dis.89e243413a0625941387c8b9637e291b] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Flooding is a common natural disaster affecting 77.8 million people and claiming the lives of 4,731 people globally in 2016. During times of flood, drowning is a leading cause of death. Flooding is a known risk factor for river drowning in Australia. With little known about river usage in Australia, this study aimed to examine the links between person demographics and self-reported participation in two flood-related behaviours, driving through floodwaters and swimming in a flooded river. METHODS A self-reported questionnaire was administered to adult river users at four high-risk river drowning locations; Alligator Creek, Townsville, Queensland; Murrumbidgee River, Wagga Wagga, New South Wales; Murray River, Albury, New South Wales; and Hawkesbury River, Windsor, New South Wales. Univariate and chi square analysis was undertaken with a 95% confidence interval (p<0.05). All river users surveyed, were also breathalysed to record an estimate of their blood alcohol content (BAC) on their expired breath. Results: 688 river users responded to the questionnaire; 676 (98.3%) answered the driving question and 674 (98.0%) answered the swimming in floodwaters questions. Of the respondents, 35.7% stated they had driven through floodwater and 18.7% had swum in a flooded river. Males were more likely (p<0.001) to report having undertaken both activities. Australian-born respondents were more likely to report having driven through floodwaters (p=0.006). Those aged 18-24 years old and those residing in outer regional areas were more likely (p<0.001) to have swum in a flooded river. Those who self-reported participating in both driving through floodwaters (p=0.001) and swimming in a flooded river (p<0.001) were significantly more likely to record contributory levels of alcohol (i.e. a BAC ≥0.05%) when breathalysed at the river. DISCUSSION Ensuring the safe movement of people during floods is difficult, particularly for those living in regional Australia, due in part to long distances travelled and reduced investment in infrastructure such as bridges. With males and females equally exposed, more effective prevention strategies must target both sexes and may include improved education on when it is safe to drive through (low depth, still water, stable road base) and when it is not (e.g. deep water, moving water and unstable road base). This study identified one in five respondents had swum in a flooded river, most commonly young people aged 18-24 years, with participants signficantly more likely to have recorded contributory levels of alcohol when breathalysed. Further research should examine the reasons behind participation in this behaviour, including the role of alcohol. CONCLUSION Preventing drowning in floodwaters is an international challenge, made more difficult by people driving through or swimming in floodwaters. Strategies for driving through floodwaters should educate both males and females on when it is safe to drive through floodwaters and when it is not. Further research is required to improve knowledge of the poorly understood behaviour of swimming in flooded rivers.
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Affiliation(s)
- Amy E Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Royal Life Saving Society - Australia, Broadway, New South Wales, Australia
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Peter Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Faculty of Health Sciences, Flinders University, Adelaide, South Australia, Australia
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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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Sedain B, Pant PR. Status of drowning in Nepal: A study of central police data. F1000Res 2018; 7:576. [PMID: 30467520 PMCID: PMC6113885 DOI: 10.12688/f1000research.14563.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 09/29/2023] Open
Abstract
Background: Drowning is a serious and mostly preventable injury-related cause of death. Low-and-middle income countries represent 90% of total drowning deaths worldwide. There is lack of epidemiological studies of drowning in Nepal. The aim of this paper is to describe the status of drowning in Nepal. Methods: Cases of drowning, occurring between January 2013 and December 2015 were extracted from the Daily Incident Recording System of Nepal Police. Variables on age, sex of the deceased, types of water bodies, places, season when drowning occurred and activities of deceased were extracted and descriptive analysis was done. Results: A total of 1,507 drowning cases were recorded over a 3 year period. The rate of drowning was 1.9 per 100,000 (2.95 for males and 0.92 for females). Majority of drowning occurred among males (76%) and more than half were (53%) under 20 years of age. Mostly drowning occurred in rivers (natural water bodies). The findings provide strong indication that drowning occurs throughout the year in Nepal. Children were highly vulnerable to drowning. The magnitude of drowning was found to be lower than estimated by global burden of disease (GBD) study. Conclusion: The burden of drowning in Nepal is considerable, but mostly unknown to the public. Despite only having access to a limited data source, this study provides useful evidence that comprehensive research in Nepal is needed urgently.
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Affiliation(s)
- Bhagabati Sedain
- Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Puspa Raj Pant
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
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Abstract
Background: Drowning is a serious and mostly preventable injury-related cause of death. Low-and-middle income countries represent over 90% of total drowning deaths worldwide. There is lack of epidemiological studies of drowning in Nepal. The aim of this paper is to describe the status of drowning in Nepal. Methods: Cases of drowning, occurring between 1 January 2013 and 31 December 2015 were extracted from the Daily Incident Recording System of Nepal Police. Drowning cases were extracted and analysed regardless of their intent. Variables on age, sex of the deceased, types of water bodies, geographical locations, season when drowning occurred and activities of deceased were extracted and descriptive analysis was conducted. Results: A total of 1,507 drowning cases were recorded over a 3 year period. The rate of drowning was 1.9 per 100,000 (2.95 for males and 0.92 for females). Majority of drowning occurred among males (76%) and more than half were (53%) under 20 years of age. Mostly drowning occurred in rivers (natural water bodies). The findings provide strong indication that drowning occurs throughout the year in Nepal. Children were highly vulnerable to drowning. The magnitude of drowning was found to be lower than estimated by global burden of disease (GBD) study. Conclusion: The burden of drowning in Nepal is considerable, but mostly unknown to the public. Despite only having access to a limited data source, this study provides useful evidence that comprehensive research in Nepal is needed urgently.
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Affiliation(s)
- Bhagabati Sedain
- Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Puspa Raj Pant
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
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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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Wang L, Cheng X, Yin P, Cheng P, Liu Y, Schwebel DC, Liu J, Qi J, Zhou M, Hu G. Unintentional drowning mortality in China, 2006-2013. Inj Prev 2018; 25:47-51. [PMID: 29691315 PMCID: PMC6388908 DOI: 10.1136/injuryprev-2017-042713] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/28/2018] [Accepted: 04/06/2018] [Indexed: 11/23/2022]
Abstract
Background Epidemiological characteristics and recent trends in unintentional drowning at the national level in China are unreported. Methods Using data from the Disease Surveillance Points system, the overall, sex-, location-, age- and cause-specific age-standardised mortality from unintentional drowning in China were calculated and compared. Linear regression was used to examine the significance of mortality trend changes over time. Results The average mortality was 4.05 per 100 000 persons between 2006 and 2013. Men and rural residents had much higher drowning mortality rates than women and urban residents at all time points. Drowning following a fall into natural water was the most common mechanism (46% of all drowning deaths). The overall drowning mortality rate remained stable for all subgroups except for distinct decreases in urban residents, children aged 5–9 years, and other specified and unspecified drowning (−10%, −36% and −25%, respectively). Conclusions The overall drowning mortality rate remained high and stable in China between 2006 and 2013. Effective prevention measures like removing or covering water hazards, wearing personal floatation devices, supervision of children, and teaching survival swimming and resuscitation skills should be implemented nationwide.
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Affiliation(s)
- Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention, Beijing, China
| | - Xunjie Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention, Beijing, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention, Beijing, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention, Beijing, China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention, Beijing, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Abstract
OBJECTIVE This paper aims to quantify the population-level associations between child injury deaths and adult (aged 15+ years) per capita alcohol consumption (PCC) and between child injury deaths and the impact of major alcohol and safety policy changes in Australia. METHODS All child deaths due to external causes during 1910-2013, and child deaths due specifically to road crashes, assaults, suicide and other external causes, were obtained from the Australian Institute of Health and Welfare. Child (0-14 year) mortality rates were analysed in relation to PCC using an Autoregressive Integrated Moving Average model. RESULTS A positive association between PCC and overall child external mortality was identified. The estimated coefficient was 0.326 (p = .002), indicating that a 10% decrease in PCC was associated with a 3.3% reduction in child injury mortality. A positive association was identified for road traffic and other child injury mortality, but not assault injuries. The introduction of compulsory seatbelt legislation in combination with random breath testing was associated with a reduction in overall injury and road traffic child mortality. Decreasing the legal drinking age was associated with an increase in the rate of other external-cause child mortality. CONCLUSION Reducing PCC in Australia is likely to result in a small but significant reduction in the injury mortality rate of children aged 0-14 years.
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Affiliation(s)
- Anne-Marie Laslett
- National Drug Research Institute, Curtin University, Bentley, Perth, 6002, Australia; Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, 3086, Australia; School of Population and Global Health, University of Melbourne, 3000, Australia.
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, 3086, Australia; School of Population and Global Health, University of Melbourne, 3000, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Bentley, Perth, 6002, Australia
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Peden AE, Franklin RC, Pearn JH. Unintentional fatal child drowning in the bath: A 12-year Australian review (2002-2014). J Paediatr Child Health 2018; 54:153-159. [PMID: 29417672 DOI: 10.1111/jpc.13688] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 06/19/2017] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Abstract
AIM To establish the prevalence of unintentional fatal drowning in baths involving children <18 years in Australia and to identify causal factors to underpin prevention. METHODS We report a total population study of all childhood (0-17 years) unintentional drowning fatalities in baths (bathtubs, spa baths and showers) in Australia between 1 July 2002 and 30 June 2014. Demographic, forensic and aetiological data (including co-bathing, use of bath aids, supervision and enactment of cardiopulmonary resuscitation) were documented for each victim. RESULTS Seventy-eight children were identified; two thirds (66.7%) were under 2 years old, of which 43.6% were aged less than 1 year (1.0/100 000/annum) and 23.1% 1-2 years (0.27/100 000/annum). Nine older children (10-17 years) also drowned. Common causes included: infants and children unable to hold their head out of water while unsupervised and associated pre-existing medical conditions, including epilepsy. All children who drowned were left without adult supervision. No child drowned in a bath with water deeper than 40 cm (M = 19.4 cm). Custodian-reported 'time left unsupervised' ranged from 30 s to 60 min. Children with pre-existing medical conditions were, on average, older (9.9 years; confidence interval: 7.9-11.9) and left unsupervised for longer (M = 15.4 min; confidence interval: 3.8-27.1) than those without. CONCLUSIONS On average, 6.5 children drown every year in baths in Australia. Children aged younger than 1 year are most affected, with both genders equally represented. Infants and toddlers left unsupervised, false confidence in the preventive role of bath aids, unrealistic expectations in the supervisory capabilities of co-bathing children and epilepsy remain threats to children in the bath.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Sydney, 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, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - John H Pearn
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,Department of Paediatrics and Child Health, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
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Peden AE, Franklin RC, Leggat P. Preventing river drowning deaths: Lessons from coronial recommendations. Health Promot J Austr 2018; 29:144-152. [PMID: 30159988 DOI: 10.1002/hpja.24] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 11/14/2017] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Coronial data provide rich information on drowning causal factors. Coroners may make recommendations to prevent future drowning events. Rivers are the leading drowning location in Australia. This study examines coronial recommendations associated with unintentional fatal drowning in Australian rivers from an injury prevention perspective. METHODS All river drowning cases in Australia between 1 July 2002 and 30 June 2012 were extracted from the National Coronial Information System (NCIS). Recommendations were thematically analysed. Using a deductive process, each unique recommendation was coded to a category aligned to the Hierarchy of Control's 6 levels. An inductive process was used for those not categorised. Recommendations were also coded against a modified SMART principle. RESULTS Of the 730 river drownings, 58 cases (7.9%) resulted in 71 unique recommendations. Victorian cases (X2 = 32.1; P < 0.01) and multiple fatality events (X2 = 41.9; P < 0.01) were more likely to have recommendations. Common categories of recommendations were administrative (39.4%) and signage-related (18.3%). Recommendations were often low on the Hierarchy; namely administrative (67.6%) and behaviour (19.1%). Half (50.7%) satisfied four of six modified SMART principle components. CONCLUSION Coronial recommendations associated with river drowning in Australia are reasonably rare. Recommendations provide opportunities for organisations to enact change, however, they could be strengthened with a specified time period and higher order control strategies recommended. SO WHAT?: SMART coronial recommendations may be more successful in achieving the behavioural, social and societal change required to prevent future river drownings. The recommendations examined in this study can be used as a benchmark for what could be considered appropriate safety actions.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Peter Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Research School of Population Health, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
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Peden AE, Franklin RC, Mahony AJ, Scarr J, Barnsley PD. Using a retrospective cross-sectional study to analyse unintentional fatal drowning in Australia: ICD-10 coding-based methodologies verses actual deaths. BMJ Open 2017; 7:e019407. [PMID: 29273670 PMCID: PMC5778319 DOI: 10.1136/bmjopen-2017-019407] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Fatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths. DESIGN An analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007-2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society-Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD. SETTING Australia, 2007-2011. PARTICIPANTS Unintentional fatal drowning cases. RESULTS The Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0-17 years) were closely aligned (73.9%); however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level. CONCLUSION Defining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | | | - Justin Scarr
- Royal Life Saving Society - Australia, Broadway, Australia
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Franklin RC, Peden AE. Improving Pool Fencing Legislation in Queensland, Australia: Attitudes and Impact on Child Drowning Fatalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1450. [PMID: 29186787 PMCID: PMC5750869 DOI: 10.3390/ijerph14121450] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/16/2022]
Abstract
Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes and examines child (<5 years) drowning deaths in pools. Data from the 2011 Queensland Computer-Assisted Telephone Interviewing (CATI) Social Survey include results from questions related to pool ownership and pool fencing legislation. Fatal child drowning cases between 1 January 2005 and 31 December 2015 were sourced from coronial data. Of the 1263 respondents, 26/100 households had a pool. A total of 58% believed tightening legislation would be effective in reducing child drowning deaths. Pool owners were more likely to doubt the effectiveness of legislation (p < 0.001) when compared to non-pool owners. Perceptions of effectiveness did not differ by presence of children under the age of five. There were 46 children who drowned in Queensland home pools (7.8/100,000 pools with children residing in the residence/annum) between 2005 and 2015. While pool owners were less likely to think that tightening the legislation would be effective, the number of children drowning in home swimming pools declined over the study period. Drowning prevention agencies have more work to do to ensure that the most vulnerable (young children in houses with swimming pools) are protected.
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Affiliation(s)
- Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Royal Life Saving Society—Australia, Broadway, NSW 2007, Australia;
| | - Amy E. Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Royal Life Saving Society—Australia, Broadway, NSW 2007, Australia;
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