A total population study of childhood fresh water drowning accidents (fatalities) for the 15 year period, 1967–1981, is reported. These data are from the ongoing Brisbane Drowning Study which has now also analysed 255 fresh water child immersions (both fatalities and near-fatalities) over the eleven year period, 1978–1981, and as such forms a consecutive unselected series for over one decade. The annual fatality (drowning) rate is 3.53 per 100,000. Details of immersion accidents by site, sex and by outcome (survivors versus fatalities) are presented. An analysis of secular trends revealed that one epidemic peak of child drownings in swimming pools and domestic baths (noted in the mid 1970s in Australia and other countries) is now passed. Evidence is presented to suggest that a vigorous education, and public awareness campaign can reduce the incidence of serious child immersion accidents by one-third. Such a campaign may have influence on all types of childhood household drownings (pools, baths, garden ponds), irrespective of site. Survival rates for unsupervised children who lose consciousness in fresh water are site-dependent, only 21% of such potential victims surviving after losing consciousness in rivers and creeks, compared with the survival rate of 65% for those in potential drowning incidents in their own backyard. Violent death continues to account for more than half of all deaths in childhood up to the age of 14 years [Gratz, 1979; Mayer, Walker and Johnson et al., 1981]. Secular trends and accidental child drownings are of great current interest in a number of affluent Western countries including the United States [Pearn, Wong and Brown, et al., 1979], Canada [Fleetham and Hunt, 1978] and Australia [Pearn and Nixon, 1979, Plueckhahn, 1979]. It was demonstrated in 1976 that child fresh water drowning rates were increasing rapidly [Pearn, Nixon and Wilkey, 1976]. Concern that such accidents had become the major cause of death in Australian preschool children [Pearn and Nixon, 1977c], led to the implementation of a vigorous preventive campaign [Nixon, Pearn and Wells, 1980] to correct this grave situation. Similar themes have occurred in New Zealand, in South Africa and in North America. In 1976, new safety legislation based partly on a Canberra model [Pearn and Thompson, 1977], and similar to that already implemented in North Queensland [Milliner, Pearn and Guard, 1980] was introduced in several Australian states. Coincident with this, vigorous public awareness campaigns were undertaken throughout the country [Nixon, et al., 1980]. Age-specific and site-specific risks were defined [Pearn, Nixon and Wilkey, 1976], thus providing baseline data against which improvement trends might be measured. In many countries, the United Kingdom included, controversy continues about the relative preventive role of education [Pearn, 1981], of design improvement, and of safety legislation. In some major types of childhood accidents, poisonings for example, much available evidence has indicated that little practical effect might be expected from purely educational campaigns [Dershewitz and Williamson, 1977], unless these are specifically directed at an accurately pinpointed target population. In the specific context of child drowning, one study at least has indicated that public awareness campaigns might reduce child drownings [Lawson and Oliver, 1978]. Unlike many other regions throughout Australia, but similar to the situation in the United Kingdom [Barry and Little, 1982], no safety legislation was introduced into the surveillance region of the Brisbane Drowning Study [Pearn et al., 1976; Pearn et al., 1977c], during the five years after publication of the initial findings [Pearn et al., 1976] which pointed out the high degree of risk to preschool children. This unfortunate circumstance nevertheless had one benefit in that it has enabled us to analyse the “pure” role of public education as a preventive tool, in one type of fatal child trauma. We report here a full analysis of child drowning tends over 15 years. With these data, both drowning and near-drowning rates and trends for children over a full decade are now available for the first time.