Abstract
The study assessed the utility of risk analysis for advancing knowledge on drowning risk factors. The setting was unintentional drowning of surf bathers in Australia. Bathers reported earlier exposure to selected risk factors (swimming ability, wave height associated with rip currents and surf bathing experience) and were observed for water exposure (in minutes). These data were then assembled in mathematical models. The analysis forecast relative drowning risk pertaining to risk markers representing selected surf bather subgroups (gender, age and water activity). Contextualized through previous study findings, comparison of results with a gold standard obtained from mortality data generated new surf bather drowning hypotheses suitable for future testing by rigorous analytical epidemiologic designs. The hypotheses were: (1) The male to female comparative surf bather drowning rate is explained primarily by differences in crude water exposure; (2) the association of cardio-vascular medical conditions with surf bather drowning is stronger for older surf bathers compared to younger surf bathers; and (3) other risk contributors to surf bather drowning are: Poorly calibrated perception of bathing ability (overconfidence) and use of alcohol. Nonetheless, drowning rates appear generally consistent with time exposure to water. The study findings may also support drowning prevention strategies targeting risk marker subgroups.
Highlights
IntroductionUnintentional drowning is a long-standing global health problem
Published: 17 December 2021Unintentional drowning is a long-standing global health problem
Australian surf subgroups drawn from disparity in bathing time weighted by exposure to bather subgroups drawn from disparity in bathing time weighted by exposure drowning to drownrisk factors
Summary
Unintentional drowning is a long-standing global health problem. Recent estimates suggest falling rates, though global fatalities remain substantial at around 300,000 persons in 2017 [1]. Factors contributing to unintentional drowning risk vary by person, circumstances and setting [2]. Effective drowning prevention strategies within and across settings will be supported through establishing relative risks of causal factors for specified locations. Most epidemiological studies of drowning remain descriptive, and though important for hypothesis generation, associations between exposure and injury remain unknown [3]. Risk analysis incorporating observed exposure measures is proposed here as a novel analytical method to identify drowning risk factors [4]. The method has the capacity to inform rigorous epidemiological studies on target variables and so capture design efficiencies
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