Characteristics of drowning victims in a surf environment: a 6-year retrospective study in southwestern France.

Bruno Simonnet,Éric Tellier,Cédric Gil-Jardiné,Marion Bailhache,Bruno Castelle,Louis-Rachid Salmi

doi:10.1186/s40621-019-0195-x

Abstract

BackgroundDrowning is the third cause of non-intentional injury death worldwide. Beaches of Gironde, in southwestern France, are exposed to strong environmental conditions, leading to rip currents and shore breaks. Bathing season usually lasts from April to October and is supervised from June till mid-September. The objective of this study was to study the characteristics of drowning victims along Gironde surf beaches and to identify peculiarities compared to national figures.MethodsAll calls originating from beaches to the emergency call center of Gironde from 2011 to 2016 were analyzed. Patient data, filled by a physician based on information given by pre-hospital care team (lifeguards, paramedics or emergency physicians), were extracted from the emergency call center database. We used Szpilman classification (0 = rescue to 6 = cardiac arrest) to assess severity. Rescues are patients without respiratory impairment who needed lifeguards or helicopter intervention. We compared our findings with national studies carried every three years (2012 and 2015).ResultsWe analyzed 5680 calls from beaches and included 4398, 576 of which were rescued from the water, including 352 without respiratory impairment (stage 0). Among drownings, 155 had cough only (stage 1), 26 pulmonary rales (stage 2), 9 pulmonary edema (stage 3) and 1 had pulmonary edema with hypotension (stage 4). Five rescued people were in respiratory arrest and 28 were in cardiac arrest. 77.5% were bathers, others were mainly surfers or body-boarders. Drowning victims median age was 24 (quartiles: 17–40), and sex-ratio was 1.44 Male/Female. Men were significantly older than women (34 vs. 26 years old), and severity from stage 1 to 4 was positively associated with age. Compared to national data, Gironde drownings had a higher proportion of 15–44 year-old victims, and the case-fatality was lower in Gironde (11.5%) than at the national level (27.4%, p < 0.001).ConclusionAlong Gironde coast, drowning is rarely severe, concerns mostly young men; the age distribution could explain the different case-fatality. Further study is needed to identify environmental predictors of drowning.

Highlights

Drowning is the third cause of non-intentional injury death worldwide
During 2015, this study reported 1266 drownings in France, including 637 (50.3%) on coasts (Lasbeur et al, 2016); data were similar in the 2012 report (Lasbeur & Thélot, 2013)
For calls secondary to rescue from water, age was missing in 170 files (29.5%), mostly for stages 0 (n = 164) and 1 (n = 6) patients

Summary

Introduction

Drowning is the third cause of non-intentional injury death worldwide. Drowning is defined in 2005 by the World Health Organization (WHO) as “the process of experiencing respiratory impairment from submersion/immersion in liquid” (van et al, 2005). It is the third leading cause of non-intentional injury death worldwide, representing in 2017 294,000 people according to the Global Burden of Disease data (Dicker et al, 2018). In France, every three years, a national study is conducted by the French national institute of public health (Santé Publique France), registering all cases of drowning leading to hospitalization or death, from June, 1st till September, 30th. On the beaches of Gironde, an area in Southwestern France, magnified in Figs. 1, 38 drownings resulting in 7 deaths were reported in the 2015 study

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