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Abedin A, Zane DF, Lawson KA, Johnson MB. Disparities in unintentional drowning fatalities in Texas, USA, 1999-2020. Inj Prev 2024:ip-2024-045323. [PMID: 39002976 DOI: 10.1136/ip-2024-045323] [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: 03/25/2024] [Accepted: 06/28/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Drowning is the third-leading cause of unintentional injury death worldwide. Although the USA as a whole bears a heavy burden, with approximately 4000 drowning fatalities annually, Texas stands out as a high-risk state for drowning due to its large population, suitable climate for year-round aquatic activities and availability of water-related recreational opportunities. METHODS Using mortality data from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research online database, this retrospective, cross-sectional study overviews the magnitude and patterns of fatal unintentional drownings among Texans from 1999 to 2020. RESULTS Over the 22-year period, 7737 Texans died from unintentional drowning. An average of 352 drowning deaths occurred annually, with a rate of 1.4 deaths per 100 000 population. The highest proportion of unintentional drownings occurred in natural water settings (eg, lakes, ponds or rivers), accounting for 40% of fatal drownings. Children aged 1-4 years had the highest drowning death rate compared with all other age groups. Male Texans had a drowning death rate three times higher than that of female Texans. Black Texans had a higher drowning death rate than White Texans and Asian or Pacific Islander Texans. CONCLUSIONS Drowning remains a significant public health issue in Texas. Data on high-risk groups and settings should be used to strengthen drowning prevention efforts and policy initiatives and encourage more research to address the multifaceted factors contributing to drowning.
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Affiliation(s)
- Anushka Abedin
- School of Medicine, The University of Texas Health Science Center, Tyler, Texas, USA
| | - David F Zane
- Injury Epidemiologist (Ret.), Austin, Texas, USA
| | - Karla A Lawson
- Trauma and Injury Research Center, Dell Children's Medical Center, Austin, Texas, USA
- Department of Surgery and Perioperative Care, The University of Texas Dell Medical School, Austin, Texas, USA
| | - Molly B Johnson
- Trauma and Injury Research Center, Dell Children's Medical Center, Austin, Texas, USA
- Kinesiology Department, University of the Incarnate Word, San Antonio, TX, USA
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Agam A, Godler Y, Calif E. Child drowning mortality in Israel: Trends and measures for prevention. JOURNAL OF SAFETY RESEARCH 2024; 89:224-233. [PMID: 38858046 DOI: 10.1016/j.jsr.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/01/2023] [Accepted: 02/02/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION In this study, we use the media-based database of Beterem-Safe Kids Israel, to provide a 15-year review of unintentional fatal childhood drowning in Israel, between 2008 and 2022. METHOD It total, we identified 257 cases of child mortality due to drowning during this period. RESULTS Our results demonstrate a gradual rise in childhood mortality due to drowning, from 72 cases in 2008-2012, to 85 cases in 2013-2017, and to 100 cases in 2018-2022. Especially worth noting is the increase in childhood drowning in domestic swimming pools. We point to a link between low socioeconomic status and cases of drowning, showing that the risk of drowning extends beyond a mere matter of caregiver inattention. We recommend a series of regulatory and legislative steps to reduce fatal childhood drowning, including fencing built around domestic swimming pools, extending lifeguard activity hours, adding declared beaches, forming programs of safe behavior in water environments for adolescents, and establishing swimming lessons during the 2nd grade, for all populations. We further recommend that a special focus will be put in municipalities situated at the bottom of the socioeconomic index.
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Affiliation(s)
- Aviad Agam
- Beterem - Safe Kids Israel, HaSivim 30, Petah Tikva, Israel.
| | - Yigal Godler
- Beterem - Safe Kids Israel, HaSivim 30, Petah Tikva, Israel
| | - Elad Calif
- Beterem - Safe Kids Israel, HaSivim 30, Petah Tikva, Israel
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Jiang Z, Lin Z, Li Z, Yu M, He G, Hu J, Meng R, Hou Z, Zhu S, Zhou C, Xiao Y, Huang B, Xu X, Jin D, Qin M, Xu Y, Liu T, Ma W. Joint effects of heat-humidity compound events on drowning mortality in Southern China. Inj Prev 2024:ip-2023-045036. [PMID: 38443161 DOI: 10.1136/ip-2023-045036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Several previous studies have examined the association of ambient temperature with drowning. However, no study has investigated the effects of heat-humidity compound events on drowning mortality. METHODS The drowning mortality data and meteorological data during the five hottest months (May to September) were collected from 46 cities in Southern China (2013-2018 in Guangdong, Hunan and Zhejiang provinces). Distributed lag non-linear model was first conducted to examine the association between heat-humidity compound events and drowning mortality at city level. Then, meta-analysis was employed to pool the city-specific exposure-response associations. Finally, we analysed the additive interaction of heat and humidity on drowning mortality. RESULTS Compared with wet-non-hot days, dry-hot days had greater effects (excess rate (ER)=32.34%, 95% CI: 24.64 to 40.50) on drowning mortality than wet-hot days (ER=14.38%, 95%CI: 6.80 to 22.50). During dry-hot days, males (ER=42.40%, 95% CI: 31.92 to 53.72), adolescents aged 0-14 years (ER=45.00%, 95% CI: 21.98 to 72.35) and urban city (ER=36.91%, 95% CI: 23.87 to 51.32) showed higher drowning mortality risk than their counterparts. For wet-hot days, males, adolescents and urban city had higher ERs than their counterparts. Attributable fraction (AF) of drowning attributed to dry-hot days was 23.83% (95% CI: 21.67 to 26.99) which was significantly higher than that for wet-hot days (11.32%, 95% CI: 9.64 to 13.48%). We also observed that high temperature and low humidity had an additive interaction on drowning mortality. CONCLUSION We found that dry-hot days had greater drowning mortality risk and burden than wet-hot days, and high temperature and low humidity might have synergy on drowning mortality.
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Affiliation(s)
- Zhiying Jiang
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Zhixing Li
- Department of Public Health, Jinan University, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Min Yu
- Division of NCD Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
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Waight E, McIntyre S, Woolfenden S, Watson L, Reid S, Scott H, Martin T, Webb A, Badawi N, Smithers‐Sheedy H. Temporal trends, clinical characteristics, and sociodemographic profile of post-neonatally acquired cerebral palsy in Australia, 1973-2012: A population-based observational study. Dev Med Child Neurol 2023; 65:107-116. [PMID: 35665921 PMCID: PMC10952665 DOI: 10.1111/dmcn.15293] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022]
Abstract
AIM To describe post-neonatally acquired (PNN) cerebral palsy (CP) in terms of temporal trends in prevalence, clinical and sociodemographic profiles, known causes and associations between causes, and sociodemographic variables. METHOD Numerator data, a count of children with PNN-CP confirmed at 5 years of age (n = 523), was drawn from two Australian state CP registers (birth years 1973-2012). Poisson regression was used to investigate temporal trends in the prevalence of PNN-CP by 5-year intervals, calculated per 10 000 live births. Using data from all state and territory Australian CP registers (n = 469), distributions of clinical characteristics, PNN-CP causes, and sociodemographic factors were tabulated (birth years 1995-2012). χ2 and logistic regression analyses were used to assess associations between sociodemographic profile, Australian reference data, and known causes. RESULTS A significant temporal decline in PNN-CP in Victoria (p = 0.047) and Western Australia (p = 0.033) was observed. The most common proximal causes of PNN-CP were cerebrovascular accidents (34%, n = 158), infection (25%, n = 117), and non-accidental injuries (12%, n = 58). Children born to teenage mothers, Aboriginal and/or Torres Strait Islander mothers, or children born in remote areas were over-represented in this cohort compared with reference data (all p ≤ 0.001). Infectious causes were strongly associated with teenage motherhood (odds ratio 3.0 [95% confidence interval 1.1-8.2], p = 0.028) and remote living (odds ratio 4.5 [95% confidence interval 2.0-10.2], p < 0.001). INTERPRETATION Although prevalence of PNN-CP has declined, the over-representation of priority populations, and the relative severity of a condition that is largely preventable, suggest the need for more specific primary preventive measures and support. WHAT THIS PAPER ADDS Prevalence of post-neonatally acquired (PNN) cerebral palsy (CP) in Australia significantly declined between 1973 and 2012. Cerebrovascular accidents are the most common proximal cause of PNN-CP. Children born in remote areas are at greater risk of PNN-CP.
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Affiliation(s)
- Emma Waight
- Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent HealthThe University of SydneyCamperdownNSWAustralia
| | - Sarah McIntyre
- Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent HealthThe University of SydneyCamperdownNSWAustralia
| | - Susan Woolfenden
- Faculty of Medicine, School of Women's and Children's HealthUniversity of New South WalesSydneyNSWAustralia
| | - Linda Watson
- Western Australian Register of Developmental AnomaliesPerthWAAustralia
| | - Susan Reid
- Murdoch Children's Research Institute and Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia
| | - Heather Scott
- Women's and Children's Health NetworkAdelaideSAAustralia
| | - Tanya Martin
- School of Nursing and MidwiferyThe University of SydneyCamperdownNSWAustralia
| | - Annabel Webb
- Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent HealthThe University of SydneyCamperdownNSWAustralia
| | - Nadia Badawi
- Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent HealthThe University of SydneyCamperdownNSWAustralia
- Grace Centre for Newborn Care, The Children's Hospital at Westmead, Specialty of Child & Adolescent HealthThe University of SydneyWestmeadNSWAustralia
| | - Hayley Smithers‐Sheedy
- Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent HealthThe University of SydneyCamperdownNSWAustralia
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Peden AE, Daw S, Lawes JC. Preliminary evaluation of the impact of mandatory life jacket laws at declared high-risk rock platforms on unintentional rock fishing drowning deaths. Inj Prev 2022; 28:560-563. [DOI: 10.1136/ip-2022-044724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/04/2022] [Indexed: 11/05/2022]
Abstract
ObjectivesTo explore the impact of mandatory lifejacket wear legislation on unintentional rock fishing-related drowning fatalities at declared high-risk rock platforms in New South Wales (NSW; Australia).MethodsRock fishing-related drownings for the five years pre-legislation enactment (23 November 2011 to 22 November 2016) and five years post-legislation enactment (23 November 2016 to 22 November 2021) were compared. Google Earth was used to assess if drowning deaths occurred at declared areas under legislation. Binary logistic regression was used to analyse change in the number of deaths in declared areas pre-legislation/post-legislation.ResultsOver the 10 years, 80 rock fishing drowning deaths occurred in New South Wales; 23 in declared areas pre-legislation and 13 post-legislation (−43.5%). The odds of a rock fishing drowning death occurring in a declared area pre-legislation was 2.3 times higher (95% CI 0.942 to 5.752; p=0.067).ConclusionReductions in rock fishing deaths at declared areas were observed since the legislation’s introduction, but were not significant. Greater enforcement and extension to other high-risk platforms may reduce deaths further.
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Burnay C, Anderson DI, Button C, Cordovil R, Peden AE. Infant Drowning Prevention: Insights from a New Ecological Psychology Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4567. [PMID: 35457435 PMCID: PMC9029552 DOI: 10.3390/ijerph19084567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 12/10/2022]
Abstract
Drowning causes significant mortality and morbidity globally, and infants (0-4 years of age) are disproportionately impacted. In a groundbreaking approach to pediatric drowning prevention, ecological psychology has been used to investigate the relationship between infants' perceptual-motor development and their behavior around bodies of water. In this review, we summarize recent research findings in the field of ecological psychology and apply these to the prevention of infant drowning. Studies have linked infants' avoidance of falls into the water with locomotor experience and type of accessway into bodies of water. Through crawling experience, infants learn to perceive the risk of falling into water and start adapting their behavior to avoid drop-offs leading into water. Infants tend to enter deep water more when the access is via a slope than via a drop-off. We propose that ecological psychology can enhance infant drowning prevention interventions. The aim is to create an additional layer of protection, the perceptual information layer, in addition to existing strategies, such as supervision and barriers. This new protective layer can be a powerful tool to further highlight the risk of entering the water and reduce infant drowning-related mortality and morbidity.
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Affiliation(s)
- Carolina Burnay
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9016, New Zealand;
| | - David I. Anderson
- Marian Wright Edelman Institute, San Francisco State University, San Francisco, CA 94132, USA;
| | - Chris Button
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9016, New Zealand;
| | - Rita Cordovil
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1495-751 Cruz Quebrada, Portugal;
| | - Amy E. Peden
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia;
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
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7
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Peden AE, Richardson K. Quantifying fatal and non-fatal drowning in children under five in Aotearoa, New Zealand. Aust N Z J Public Health 2021; 46:46-51. [PMID: 34529307 DOI: 10.1111/1753-6405.13157] [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: 04/01/2021] [Revised: 07/01/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To quantify unintentional drowning trends and risk factors for children under five years of age in Aotearoa, New Zealand. METHODS A population-based analyses of fatal and non-fatal (hospitalisations and Accident Compensation Corporation [ACC] claims) unintentional drowning of children 0-4 years of age between 2005 and 2019 was conducted using DrownBase™ data. Analyses comprises calculation of linear temporal trends, crude drowning rates per 100,000 and relative risk (95% confidence interval) and ratios of fatal to non-fatal drowning. RESULTS 557 incidents (16.0% fatal) were recorded. Fatalities declined (y=-0.0769x+2.5678;R2=0.01509), while hospitalisations increased (y=0.1418x+9.1093;R2=0.0979). Males were overrepresented. One year-olds recorded the highest rates (fatal=4.39/100,000) and (non-fatal=2.14/100,000). 'Other' ethnicity (8.77/100,000) and Māori (2.49/100,000) children recorded the highest fatal drowning rates. Home pools were the leading fatal location, while domestic environments attracted the highest hospitalisation rate. For every one fatal drowning there were 6.9 hospitalisations and 74.7 ACC claims. CONCLUSIONS Drowning among young children represents a preventable cause of injury-related harm. While fatalities are declining, non-fatal drowning is increasing. Implications for public health: Strategies to prevent drowning among young children are well understood, particularly restricting water access and active adult supervision. Further investment in effective prevention strategies for young children will deliver significant social, economic and health system savings.
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Affiliation(s)
- Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales.,Royal Life Saving Society - Australia, Sydney, New South Wales
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8
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Theodorou CM, Rajasekar G, McFadden NR, Brown EG, Nuño M. Epidemiology of paediatric drowning hospitalisations in the USA: a population-based study. Inj Prev 2021; 28:148-155. [PMID: 34462333 DOI: 10.1136/injuryprev-2021-044257] [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: 04/21/2021] [Accepted: 08/17/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Drowning is a leading cause of death in children ≤5 years old. Detailed data on the epidemiology of drowning in this high-risk population can inform preventative efforts. We aimed to study trends in incidence and case fatality rates (CFR) in the USA among young children hospitalised after drowning. METHODS Children ≤5 years old hospitalised in the USA after drowning were identified from the Kids Inpatient Database 2000-2016. Incidence and CFRs by calendar year, age, sex, race/ethnicity and hospital region were calculated. Trends over time were evaluated. Factors associated with fatal drowning were assessed. RESULTS Among 30 560 804 hospitalised children ≤5 years old, 9261 drowning cases were included. Patients were more commonly male (62.3%) and white (47.4%). Two years old had the highest incidence of hospitalisation after drowning, regardless of race/ethnicity, sex and region. Overall drowning hospitalisations decreased by 49% from 2000 to 2016 (8.38-4.25 cases per 100 000 children). The mortality rate was 11.4% (n=1060), and most occurred in children ≤3 years old (83.0%). Overall case fatality decreased between 2000 and 2016 (risk ratio (RR) 0.44, 95% CI 0.25 to 0.56). The lowest reduction in incidence and case fatality was observed among Black children (Incidence RR 0.92, 95% CI 0.75 to 1.13; case fatality RR 0.80, 95% CI 0.41 to 1.58). CONCLUSIONS Hospitalisations and CFRs for drowning among children ≤5 years old have decreased from 2000 to 2016. Two years old are at the highest risk of both fatal and non-fatal drowning. Disparities exist for Black children in both the relative reduction in drowning hospitalisation incidence and case fatality. Interventions should focus on providing equitable preventative care measures to this population.
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Affiliation(s)
- Christina M Theodorou
- Division of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Ganesh Rajasekar
- Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Nikia R McFadden
- Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Erin G Brown
- Division of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Miriam Nuño
- Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA.,Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Sacramento, CA, USA
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Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, Yusuf S, Weiss J, Hoffman B. Prevention of Drowning. Pediatrics 2021; 148:peds.2021-052227. [PMID: 34253571 DOI: 10.1542/peds.2021-052227] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Drowning is a leading cause of injury-related death in children. In 2018, almost 900 US children younger than 20 years died of drowning. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in prevention of drowning.
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Affiliation(s)
- Sarah A Denny
- Nationwide Children's Hospital and College of Medicine, The Ohio State University, Columbus, Ohio;
| | - Linda Quan
- Pediatric Emergency Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | | | - Tracy McCallin
- Children's Hospital of San Antonio, San Antonio, Texas.,Baylor College of Medicine, Houston, Texas
| | - Rohit Shenoi
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Shabana Yusuf
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jeffrey Weiss
- Phoenix Children's Hospital Medicine, Phoenix Children's Hospital, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; and
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Peden AE, Franklin RC, Clemens T. Can child drowning be eradicated? A compelling case for continued investment in prevention. Acta Paediatr 2021; 110:2126-2133. [PMID: 33043488 DOI: 10.1111/apa.15618] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/27/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
AIM To explore temporal trends in fatal child drowning and benchmark progress across three high-income countries to provide prevention and future investment recommendations. METHODS A total population analysis of unintentional fatal drownings among 0- to 19-year-olds in Australia, Canada and New Zealand from 2005 to 2014 was undertaken. Univariate and chi-square analyses were conducted, age- and sex-specific crude rates calculated and linear trends explored. RESULTS A total of 1454 children drowned. Rates ranged from 0.92 (Canada) to 1.35 (New Zealand) per 100 000. Linear trends of crude drowning rates show both Australia (y = -0.041) and Canada (y = -0.048) reduced, with New Zealand (y = 0.005) reporting a slight rise, driven by increased drowning among females aged 15-19 years (+200.4%). Reductions of 48.8% in Australia, 51.1% in Canada and 30.4% in New Zealand were seen in drowning rates of 0- to 4-year-olds. First Nations children drowned in significantly higher proportions in New Zealand (X2 = 31.7; P < .001). CONCLUSION Continual investment in drowning prevention, particularly among 0- to 4-year-olds, is contributing to a reduction in drowning deaths; however, greater attention is needed on adolescents (particularly females) and First Nation's children. Lessons can be learned from each country's approach; however, further investment and evolution of prevention strategies will be needed to fully eradicate child drowning deaths.
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Affiliation(s)
- Amy E. Peden
- Royal Life Saving Society—Australia Broadway NSW Australia
- School of Population Health Faculty of Medicine UNSW Sydney Sydney 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
| | - Tessa Clemens
- Drowning Prevention Research Centre Canada Toronto ON Canada
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11
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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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12
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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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13
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Stephenson L, Stockham P, van den Heuvel C, Byard RW. Characteristics of drowning deaths in an inner city river. Leg Med (Tokyo) 2020; 47:101783. [PMID: 32919339 DOI: 10.1016/j.legalmed.2020.101783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/17/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
A study was undertaken of all drowning deaths that occurred over a 30-year period from 1988 to 2017 in the urban section of the River Torrens, Adelaide, South Australia, an augmented waterway that runs through the central business district. Autopsy records from Forensic Science South Australia (FSSA) were reviewed. There were 34 drownings (0-5 cases/yr) with 28 males and 6 females (M;F = 4.6:1), with an age range for males of 18-76yrs (mean 42.0; SD 18.0) and for females of 20-84yrs (mean 69.3; SD 24.5). There were 15 (44%) accidents, 11 (32%) suicides, 1 (3%) homicide and 7 (21%) undetermined. Of the 22 cases during or after 1994 with complete toxicology reports, 10 (45%) had a blood alcohol concentration (BAC) of greater than 0.05% (g/100 mL) with an illicit substance detected in 4 (18%) cases: (MDMA (3,4-methylenedioxymethamphetamine), methylamphetamine and THC (delta-9-tetrahydrocannabinol) acid). The presence of various therapeutic drugs was also detected in 10 cases (45%) including temazepam, fluoxetine, diazepam, olanzapine, amitriptyline, carbamazepine, codeine, citalopram and valproate. Although the numbers of cases were not high, the urban portion of the River Torrens had a much higher number of drowning events per kilometre compared to other inland waterways in South Australia such as the Murray River. This is most likely due to the vulnerability that exists for intoxicated individuals in the city from falls into the water and to the availability of the river as a means of suicide to members of the adjacent urban population.
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Affiliation(s)
- Lilli Stephenson
- Forensic Science South Australia (FSSA) and the School of Medicine, The University of Adelaide, Adelaide, South Australia 5000, Australia
| | - Peter Stockham
- Forensic Science South Australia (FSSA) and the School of Medicine, The University of Adelaide, Adelaide, South Australia 5000, Australia
| | - Corinna van den Heuvel
- Forensic Science South Australia (FSSA) and the School of Medicine, The University of Adelaide, Adelaide, South Australia 5000, Australia
| | - Roger W Byard
- Forensic Science South Australia (FSSA) and the School of Medicine, The University of Adelaide, Adelaide, South Australia 5000, Australia.
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14
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Ma T, Peden AE, Peden M, Hyder AA, Jagnoor J, Duan L, Brown J, Passmore J, Clapham K, Tian M, Rahman AKMF, Ivers RQ. Out of the silos: embedding injury prevention into the Sustainable Development Goals. Inj Prev 2020; 27:166-171. [PMID: 32917743 DOI: 10.1136/injuryprev-2020-043850] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/09/2020] [Accepted: 08/14/2020] [Indexed: 12/25/2022]
Abstract
Globally, unintentional injuries contribute significantly to disability and death. Prevention efforts have traditionally focused on individual injury mechanisms and their specific risk factors, which has resulted in slow progress in reducing the burden. The Sustainable Development Goals (SDGs) represent a global agenda for promoting human prosperity while respecting planetary boundaries. While injury prevention is currently only recognised in the SDG agenda via two road safety targets, the relevance of the SDGs for injury prevention is much broader. In this State of the Art Review, we illustrate how unintentional injury prevention efforts can be advanced substantially within a broad range of SDG goals and advocate for the integration of safety considerations across all sectors and stakeholders. This review uncovers injury prevention opportunities within broader global priorities such as urbanisation, population shifts, water safeguarding and corporate social responsibility. We demonstrate the relevance of injury prevention efforts to the SDG agenda beyond the health goal (SDG 3) and the two specific road safety targets (SDG 3.6 and SDG 11.2), highlighting 13 additional SDGs of relevance. We argue that all involved in injury prevention are at a critical juncture where we can continue with the status quo and expect to see more of the same, or mobilise the global community in an 'Injury Prevention in All Policies' approach.
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Affiliation(s)
- Tracey Ma
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy E Peden
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Margaret Peden
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Imperial College London, London, UK
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Julie Brown
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Jonathon Passmore
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - A K M Fazlur Rahman
- The Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh.,Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Rebecca Q Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia .,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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15
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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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16
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Learning to Swim: An Exploration of Negative Prior Aquatic Experiences among Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103557. [PMID: 32438661 PMCID: PMC7277817 DOI: 10.3390/ijerph17103557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 11/16/2022]
Abstract
Learning to swim via a structured program is an important skill to develop aquatic competencies and prevent drowning. Fear of water can produce phobic behaviors counterproductive to the learning process. No research examines the influence of negative aquatic experiences on learning to swim. This study explored the influence of children’s negative prior aquatic experiences (NPAE) on learn-to-swim achievement via swim school data. Children’s enrolment records (5–12 years) in the Australian Capital Territory were analyzed via demographics, level achieved and NPAE. NPAE was recorded as yes/no, with free text thematically coded to 16 categories. Of 14,012 records analyzed (51% female; 64% aged 6–8 years), 535 (4%) reported a NPAE at enrolment. Males, children with a medical condition and attending public schools were significantly more likely (p = 0.001) to report a NPAE. Children reporting a NPAE achieved a lower average skill level at each year of age. The largest proportion (19%) of NPAE reported related to swimming lessons. NPAE have a detrimental influence on aquatic skill achievement. We recommend increased adult supervision to reduce likelihood of an NPAE occurring, while also encouraging swim instructors to consider NPAE when teaching swimming and develop procedures to ensure a NPAE does not occur during instruction.
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17
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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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18
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Franklin RC, Peden AE, Hamilton EB, Bisignano C, Castle CD, Dingels ZV, Hay SI, Liu Z, Mokdad AH, Roberts NLS, Sylte DO, Vos T, Abady GG, Abosetugn AE, Ahmed R, Alahdab F, Andrei CL, Antonio CAT, Arabloo J, Arba AAK, Badiye AD, Bakkannavar SM, Banach M, Banik PC, Banstola A, Barker-Collo SL, Barzegar A, Bayati M, Bhardwaj P, Bhaumik S, Bhutta ZA, Bijani A, Boloor A, Carvalho F, Chowdhury MAK, Chu DT, Colquhoun SM, Dagne H, Dagnew B, Dandona L, Dandona R, Daryani A, Dharmaratne SD, Dibaji Forooshani ZS, Do HT, Driscoll TR, Eagan AW, El-Khatib Z, Fernandes E, Filip I, Fischer F, Gebremichael B, Gupta G, Haagsma JA, Hassan S, Hendrie D, Hoang CL, Hole MK, Holla R, Hostiuc S, Househ M, Ilesanmi OS, Inbaraj LR, Irvani SSN, Islam MM, Ivers RQ, Jayatilleke AU, Joukar F, Kalhor R, Kanchan T, Kapoor N, Kasaeian A, Khan M, Khan EA, Khubchandani J, Krishan K, Kumar GA, Lauriola P, Lopez AD, Madadin M, Majdan M, Maled V, Manafi N, Manafi A, McKee M, Meles HG, Menezes RG, Meretoja TJ, Miller TR, Mithra P, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohebi F, Molokhia M, Mustafa G, Negoi I, Nguyen CT, Nguyen HLT, Olagunju AT, Olagunju TO, Padubidri JR, Pakshir K, Pathak A, Polinder S, Pribadi DRA, Rabiee N, Radfar A, Rana SM, Rickard J, Safari S, Salamati P, Samy AM, Sarker AR, Schwebel DC, Senthilkumaran S, Shaahmadi F, Shaikh MA, Shin JI, Singh PK, Soheili A, Stokes MA, Suleria HAR, Tarigan IU, Temsah MH, Tesfay BE, Valdez PR, Veisani Y, Ye P, Yonemoto N, Yu C, Yusefzadeh H, Zaman SB, Zhang ZJ, James SL. The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study. Inj Prev 2020; 26:i83-i95. [PMID: 32079663 PMCID: PMC7571364 DOI: 10.1136/injuryprev-2019-043484] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 12/21/2022]
Abstract
Background Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study’s objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. Methods Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. Results Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. Conclusions There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.
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Affiliation(s)
- Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia.,Royal Life Saving Society, Sydney, New South Wales, Australia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, New South Wales, Australia.,School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Gdiom Gebreheat Abady
- College of Medicine and Health Sciences, Department of Nursing, Adigrat University, Adigrat, Ethiopia
| | | | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines.,Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Shankar M Bakkannavar
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland.,Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Palash Chandra Banik
- Department of Non-Communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India.,Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Deemed University, Wardha, India
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, University of Toronto, Toronto, Ontario, Canada.,Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Archith Boloor
- Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.,Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Samantha M Colquhoun
- Research School of Population Health, Australian National University, Action, Australian Capital Territory, Australia
| | - Henok Dagne
- Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA.,Public Health Foundation of India, Gurugram, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Public Health Foundation of India, Gurugram, India
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts, USA.,Department of Social Services, Tufts Medical Center, Boston, Massachusetts, USA
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California, USA.,School of Health Sciences, A.T. Still University, Arizona, Missouri, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Shoaib Hassan
- Centre for International Health and Section for Ethics and Health Economics, University of Bergen, Bergen, Norway
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, Texas, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.,Qatar Foundation for Education, Science, and Community Development, Doha, Qatar
| | | | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka.,Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Qazvin, Iran.,Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maseer Khan
- Epidemiology Department, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,University of Melbourne, Melbourne, Victoria, Australia
| | - Mohammed Madadin
- Pathology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India.,Health University, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran.,Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ali Manafi
- Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,Pacific Institute for Research & Evaluation, Calverton, Maryland, USA
| | - Prasanna Mithra
- Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | | | | | - Farnam Mohebi
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan.,Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Ionut Negoi
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jagadish Rao Padubidri
- Department of Forensic Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Keyvan Pakshir
- Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashish Pathak
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, RD Gardi Medical College, Ujjain, India
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, Florida, USA.,College of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Saleem Muhammad Rana
- University Institute of Public Health, University of Lahore, Lahore, Pakistan.,Public Health Department, University of Health Sciences, Lahore, Pakistan
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, Minnesota, USA.,Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea.,Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | | | - Amin Soheili
- Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran.,Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Ingan Ukur Tarigan
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina.,Velez Sarsfield Hospital, Buenos Aires, Argentina
| | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Non-Communicable Disease Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China.,Global Health Institute, Wuhan University, Wuhan, China
| | - Hasan Yusefzadeh
- Department of Health Economics and Management, Urmia University of Medical Science, Urmia, Iran
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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19
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Chauvin M, Kosatsky T, Bilodeau-Bertrand M, Gamache P, Smargiassi A, Auger N. Hot weather and risk of drowning in children: Opportunity for prevention. Prev Med 2020; 130:105885. [PMID: 31705939 DOI: 10.1016/j.ypmed.2019.105885] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/13/2019] [Accepted: 11/05/2019] [Indexed: 01/02/2023]
Abstract
The link between outdoor temperature and risk of drowning in children is poorly understood. The objective of this study was to determine the association between elevated temperature and the chance of drowning in children and adolescents. We used a case-crossover study design to assess 807 fatal and nonfatal drowning-related hospitalisations among children aged 0 to 19 years in Quebec, Canada between 1989 and 2015. The primary exposure measure was maximum temperature the day of drowning. We estimated odds ratios and 95% confidence intervals (CI) for the association of temperature with drowning by age group (<2, 2-4, 5-9, 10-19 years), adjusted for precipitation, relative humidity, and holidays. Elevated temperature was associated with greater odds of drowning. Compared with 15 °C, a temperature of 30 °C was associated with 6 times the chance of drowning between 0 and 19 years of age (95% CI 4.40-8.16). The association was not modified by characteristics such as age or location of drowning. Relative to 15 °C, a temperature of 30 °C was associated with 3.75 times the odds of drowning in pools (95% CI 1.85-7.63) and 12.44 times the odds of drowning in other bodies of water (95% CI 3.53-43.81). Associations persisted even after implementation of a policy to restrict access to private pools in 2010. These findings suggest that hot weather is strongly associated with the risk of drowning in children aged 0 to 19 years. Interventions to prevent drowning in children should be enhanced during hot days, and not only around pools.
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Affiliation(s)
- Marine Chauvin
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375, Côte-Ste-Catherine Road, Montreal, Quebec H3T 1A8, Canada; Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec H2P 1E2, Canada
| | - Tom Kosatsky
- National Collaborating Centre for Environmental Health, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada
| | | | - Philippe Gamache
- Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec H2P 1E2, Canada
| | - Audrey Smargiassi
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375, Côte-Ste-Catherine Road, Montreal, Quebec H3T 1A8, Canada; Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec H2P 1E2, Canada
| | - Nathalie Auger
- Institut national de santé publique du Québec, 190 Cremazie Blvd E., Montreal, Quebec H2P 1E2, Canada; University of Montreal Hospital Research Centre, Department of Social and Preventive Medicine, University of Montreal, 900 Saint Denis St, Montreal, Quebec H2X 0A9, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue W, Quebec H3A 1A2, Canada.
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20
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Hamilton K, Peden AE, Smith S, Hagger MS. Predicting pool safety habits and intentions of Australian parents and carers for their young children. JOURNAL OF SAFETY RESEARCH 2019; 71:285-294. [PMID: 31862040 DOI: 10.1016/j.jsr.2019.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 08/08/2019] [Accepted: 09/28/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Children under five years are most at risk of experiencing fatal and nonfatal drowning. The highest proportion of drowning incidents occur in private swimming pools. Lapses in adult supervision and failures in pool barriers are leading contributory factors for pool drowning in this age group. METHODS We investigated the role of the theory of planned behavior social cognitions (attitude, subjective norm, and perceived behavioral control) as well as perceived barriers, planning, role construction, and anticipated regret on parents' and carers' intentions and habits toward two pool safety behaviors: restricting access and supervising children around private swimming pools. The study adopted a cross-sectional correlational design. Participants (N = 509) comprised Australian parents or caregivers with children aged under five years and access to a swimming pool at their residence. Participants completed a battery of self-report measures of social cognitive variables with respect to the swimming pool safety behaviors for their children. RESULTS Path analytic models controlling for past behavior indicated that subjective norm, planning, anticipated regret, and role construction were important predictors of habit, and subjective norm was a consistent predictor of intentions, for both behaviors. Planning predicted intentions in the restricting access sample, while attitudes, barriers, and role construction also predicted intentions in the supervising sample. Both models controlled for past behavior. CONCLUSION Current findings indicate the importance of psychological factors for restricting access and supervising behaviors, with normative factors prominent for both reasoned (intentions) and non-conscious (habits) behavioral antecedents. It seems factors guiding restricting access, which likely require regular enactment of routine behaviors (e.g., ensuring gate is not propped open, pool fence meets standards), may be governed by more habitual than intentional processes.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Health Psychology and Behavioural Medicine Research Group, School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Amy E Peden
- Royal Life Saving Society - Australia, Sydney, Australia; School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stephanie Smith
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Martin S Hagger
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Psychological Sciences, University of California, Merced, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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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: 16] [Impact Index Per Article: 3.2] [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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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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23
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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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24
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Exploring Flood-Related Unintentional Fatal Drowning of Children and Adolescents Aged 0–19 Years in Australia. SAFETY 2019. [DOI: 10.3390/safety5030046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Disasters, such as flooding, are predicted to increase. Drowning is one of the leading causes of death during times of flood. This study examined the little explored topic of child drowning during floods, with the aim of identifying risk factors to inform prevention strategies. A retrospective, total population examination of cases of children and adolescents aged 0–19 years who died from unintentional flood-related drowning in Australia for the 16-year period 1 July 2002 to 30 June 2018 was undertaken. Univariate and chi-square analysis was conducted, with Fisher’s exact test used for cell counts <5. Across the study period, 44 flood-related drowning deaths occurred among children and adolescents (63.6% male; 34.1% aged 10–14 years). Almost all (84.1%) occurred in rivers, creeks, or streams in flood, with the remaining incidents occurring in storm water drains (n = 7). Leading activities immediately prior to drowning were non-aquatic transport (40.9%), swimming in floodwaters (25.0%), and falls into floodwaters (15.9%). Flood-related fatal drowning among children and adolescents is rare (0.05 per 100,000 population), however flood-drowning risk increases as remoteness increases, with children and adolescents drowning in floodwaters in very remote areas at a rate 57 times that of major cities. All drownings are preventable, and this study has identified key causal factors that must be considered in advocacy and prevention efforts. These include: the importance of adult supervision, avoiding flooded waterways when driving or for recreational purposes, and the increased risks for those residing in geographically isolated and socially disadvantaged areas. Findings must be considered when developing interventions and advocacy for the purposes of the reduction of child and adolescent drowning during times of flood.
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25
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Peden AE, Franklin RC, Clemens T. Exploring the burden of fatal drowning and data characteristics in three high income countries: Australia, Canada and New Zealand. BMC Public Health 2019; 19:794. [PMID: 31226973 PMCID: PMC6588923 DOI: 10.1186/s12889-019-7152-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/11/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Drowning is a leading and preventable cause of death that has suffered an attention deficit. Improving drowning data in countries would assist the understanding of the full extent and circumstances of drowning, to target interventions and evaluate their effectiveness. The World Health Organization identifies data collection as a key strategy underpinning effective interventions. This study compares unintentional fatal drowning data collection, management and comparison using the databases of Australia, Canada and New Zealand. METHODS Cases of fatal unintentional drowning between 1-January-2005 and 31-December-2014 were extracted. Cases were combined into a single dataset and univariate and chi square analysis (p < 0.01) were undertaken. Location and activity variables were mapped and combined. Variables consistently collected across the three countries were compared to the ILCOR Drowning Data Guideline. The authors also recommend variables for a minimum core dataset. RESULTS Of 55 total variables, 19 were consistent and 13 could be compared across the three databases. When mapped against the ILCOR Drowning Data Guideline, six variables were consistently collected by all countries, with five compared within this study. The authors recommend a minimum core dataset of 11 variables including age, sex, location, activity, date of incident, and alcohol and drug involvement). There were 8176 drowning deaths (Australia 34.1%, Canada 55.9%, New Zealand 9.9%). All countries achieved reductions in crude drowning rates (Australia - 10.2%, Canada - 20.4%, New Zealand - 24.7%). Location and activity prior to drowning differed significantly across the three countries. Beaches (X2 = 1151.0;p < 0.001) and ocean/harbour locations (X2 = 300.5;p < 0.001) were common in Australia and New Zealand, while lakes/ponds (X2 = 826.5;p < 0.001) and bathtubs (X2 = 27.7;p < 0.001) were common drowning locations in Canada. Boating prior to drowning was common in Canada (X2 = 66.3;p < 0.001). CONCLUSIONS The comparison of data across the three countries was complex. Work was required to merge categories within the 20% of variables collected that were comparable, thus reducing the fidelity of data available. Data sources, collection and coding varied by country, with the widest diversity seen in location and activity variables. This study highlights the need for universally agreed and consistently applied categories and definitions to allow for global comparisons and proposes a core minimum dataset.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, PO Box 558, 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, PO Box 558, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Tessa Clemens
- Drowning Prevention Research Centre Canada, Toronto, Canada
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26
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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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27
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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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28
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Cenderadewi M, Franklin RC, Peden AE, Devine S. Pattern of intentional drowning mortality: a total population retrospective cohort study in Australia, 2006-2014. BMC Public Health 2019; 19:207. [PMID: 30782167 PMCID: PMC6381671 DOI: 10.1186/s12889-019-6476-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 01/24/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While a downward trend in unintentional drowning deaths in Australia has been observed, little is known about intentional drowning mortality. Limited information on intentional drowning death impedes the planning, implementation, and evaluation of prevention strategies. This study aims to describe rates of intentional fatal drowning in Australia and compare these to other categories of drowning. METHODS Data were sourced from the Australian Bureau of Statistics (ABS) over a 9-year period (2006-2014). Rates and trends of intentional drowning were compared with unintentional, water-transport related and undetermined intent drowning. Rates of intentional drowning deaths across gender, age groups, states/territories, remoteness of residence and First Peoples of Australia were calculated. Relative risk (RR) (95% confidence interval [CI]) was calculated, and chi-square tests of independence were performed (p < 0.05). RESULTS The crude mortality rate for intentional drowning deaths in Australia over the study period was 0.23/100000, lower than unintentional drowning (0.89/100000). Males were 1.6 (CI: 1.4-2.0) times more likely than females to intentionally drown, however females made up a significantly larger proportion of intentional drowning deaths (38.2%) compared to unintentional deaths (22.4%) (χ2 = 47.3; df = 1; p < 0.05). A significant linear association between age group and intentional drowning was observed (χ2 = 131.3; p < 0.05), with individuals aged 75 years and over 32.6 times more likely to intentionally drown. Non-Indigenous peoples were 4.1 times more likely to intentionally drown in comparison to First Peoples of Australia. Residents of Inner Regional, Outer Regional, and Major Cities were 4.2 times (CI: 0.6-30.0), 4.1 times (CI: 0.6-29.9), and 4.0 times (CI: 0.6-28.6) more likely to intentionally drown, respectively, compared with residents of Very Remote areas. CONCLUSIONS This study adds to the limited evidence currently available about intentional drowning rates and trends in Australia. Being male, of older age groups, non-Indigenous, residing in Inner and Outer Regional areas, and Major Cities were risk factors for intentional drowning deaths. Improving data collection systems and furthering understanding of the risk factors of intentional drowning, as well as the development, implementation, and evaluation of prevention programmes, are required to reduce the risk of intentional drowning death in Australia.
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Affiliation(s)
- Muthia Cenderadewi
- 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
- Royal Life Saving Society – Australia, Sydney, 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, Sydney, NSW 2007 Australia
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811 Australia
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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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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: 43] [Impact Index Per Article: 7.2] [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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