DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine

DROWNING & PREVENTION

Lora E Fleming MD PhD MPH MSc

University of Miami School of Medicine

Outline

• Definitions• Statistics• Risks• Causes• Prevention

Drowning: Definitions

• Drowning– A suffocation resulting in death < 24 hours of

being submerged in water

• Near Drowning– An incident resulting in survival > 24 hours

after being submerged in water

Drowning Statistics

• In 2000, there were 3482 unintentional drownings in the United States, an average of 9/day.– U.S. Centers for Disease Control and Prevention

 • It is estimated that for each drowning death, there are

1 to 4 nonfatal submersions serious enough to result in hospitalization……..with at least half of survivors suffering significant neurologic impairment.– American Academy of Pediatrics

Drowning Statistics

• Drowning is the 2nd leading cause of injury-related death among children < 15 years.– U.S. Centers for Disease Control and

Prevention

• 19% drowning deaths involving children occur in public pools with certified lifeguards present. – Drowning Prevention Foundation

Why Should We Care?

• The State of Florida averages 400 deaths/yr

• California, Arizona & Florida

– Leading cause of injury related death for children < 5 years

• Cost of Drowning & Near Drowning

– $400,000,000/year

Who is Affected?

Vulnerable Populations

– Geography: Southern States

– Gender: Males > 81% of drowning victims

– Age: Children are the most vulnerable

Differences by Race

Vulnerable Populations

• Race

– Blacks: age adjusted drowning rate > 1.5 times

– Difference dependent on age range:

< 4 yrs: Whites have a higher rates

> 4 yrs: Black children 2.5 times

Differences by Race

Vulnerable Populations

• Race

– American Indians & Alaska Native children 2x

– Unlike white children, they tend to drown in natural bodies of water

"(She) was left unattended for about one or two minutes when she drowned Monday, police

said." (AP)

Jacksonville was the location of the tragedy, the victim aged 18 months, the setting a bathtub.

But 15 times in 1998 similar stories were repeated in Lee County. Six (6) of the dead

were < 18 years.

Why do people drown?

Why to people Drown?

Why do people drown?

Causes• Access• Ethanol

– > 50% for Adolescents & Adults• Adult Supervision

– Children• Lack of Education

Where: Bathtubs

Where: Buckets & Toilets

Where: Pools

pool

Marine Waters

Where: Lakes & Other Water Bodies

Where: Recreational Water Activities

Where: Occupational Water Activities

Ethanol & Water Activities

Prevention

f

Prevention: Pool Fencing

Prevention: Education & Warnings

Buckets

Prevention: Education & Warnings

Prevention: Targeted Education

Prevention: Swimming & CPR

Conclusions

Drowning is preventable– Warnings

• Supervision

– Targeted Education• Age etc

• Access

– Intervention

Thank you

Gina Mena (2001)