Abstract
ObjectiveTo redress the lack of Queensland population incidence mortality and morbidity data associated with drowning in those aged 0-19yrs, and to understand survival and patient care.Design, Setting and ParticipantsRetrospective population-based study used data linkage to capture both fatal and non-fatal drowning cases (N = 1299) among children aged 0-19years in Queensland, from 2002-2008 inclusive. Patient data were accessed from pre-hospital, emergency department, hospital admission and death data, and linked manually to collate data across the continuum of care.Main Outcome MeasuresIncidence rates were calculated separately by age group and gender for events resulting in death, hospital admission, and non-admission. Trends over time were analysed.ResultsDrowning death to survival ratio was 1:10, and two out of three of those who survived were admitted to hospital. Incidence rates for fatal and non-fatal drowning increased over time, primarily due to an increase in non-fatal drowning. There were non-significant reductions in fatal and admission rates. Rates for non-fatal drowning that did not result in hospitalisation more than doubled over the seven years. Children aged 5-9yrs and 10-14yrs incurred the lowest incidence rates 6.38 and 4.62 (expressed as per 100,000), and the highest rates were among children aged 0-4yrs (all drowning events 43.90; fatal 4.04; non-fatal 39.85–comprising admission 26.69 and non-admission 13.16). Males were over-represented in all age groups except 10-14yrs. Total male drowning events increased 44% over the seven years (P<0.001).ConclusionThis state-wide data collection has revealed previously unknown incidence and survival ratios. Increased trends in drowning survival rates may be viewed as both positive and challenging for drowning prevention and the health system. Males are over-represented, and although infants and toddlers did not have increased fatality rates, they had the greatest drowning burden demonstrating the need for continued drowning prevention efforts.
Highlights
Drowning is preventable, yet in most countries drowning ranks among the top three causes of injury death.[1,2] The estimated drowning global mortality rate of 6.8/100,000 translates to approximately 400,000 deaths annually.[3]
Incidence rates for fatal and non-fatal drowning increased over time, primarily due to an increase in non-fatal drowning
Children aged 5-9yrs and 10-14yrs incurred the lowest incidence rates 6.38 and 4.62, and the highest rates were among children aged 0-4yrs
Summary
Drowning is preventable, yet in most countries drowning ranks among the top three causes of injury death.[1,2] The estimated drowning global mortality rate of 6.8/100,000 translates to approximately 400,000 deaths annually.[3]. Drowning is an injury with particular etiological patterns that change according to age group, aquatic setting and activity.[4] Many studies focus on either mortality or hospital admissions, with very few publishing combined figures. Reporting across these various categories makes a uniform measure of drowning difficult to define, and it is difficult to compare findings across studies or conduct meta-analyses in order to implement preventative strategies. The rates for the most vulnerable children aged 1–4yrs varied from 2.0–10.2/ 100,000.[6]
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