The prevention of child drowning: the causal factors and social determinants impacting fatalities in portable pools

Abstract

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. 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. Twenty-three children (aged 0-17years) drowned in portable pools. The drowning rate for children less than 5years of age was 0.09 per 100000 population. The peak age of death was 12-23months (RR=2.99; CI: 1.09-8.23), with the majority (n=20 deaths) aged 16-31months. 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 >300mm, of which 10 (91%) were known to be unfenced. Social determinants impact child drowning in portables pools, which can occur quickly and in just 150mm 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 16-31months 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.