Injury Prevention: Drowning
Drownings in the United States
More than 100 million Americans each year participate in
water-related activities. In 1994, almost 4,000 persons drowned and drownings ranged 7th
among all injury deaths after motor vehicle-related causes, suicide, homicide, poisonings,
and falls. Drowning is defined as immediate and delayed death caused by immersion in water
or fluid. Near-drowning is immersion that does not result in death and breathing is
re-established.In 1992, the U.S. Coast Guard received reports of 6,000 crashes
involving recreational boating—including 3,700 injuries and 816 deaths. Alcohol use
is involved in 50% or more of all injury-related deaths including those involving water
recreation. Also, alcohol is considered a major contributing factor in 40-50% of drownings
among adolescent boys.
Federal and state governments as well as community organizations, may take measures to
prevent alcohol-related drownings and injuries involving water recreation. Such measures
may include mandating and enforcing a legal limit of blood alcohol concentration (BAC)
during boating and other water recreation: airing public service announcements warning
about the dangers of combining alcohol use with water recreation; eliminating
advertisements that encourage alcohol use during boating; restricting the sale of alcohol
at water recreation facilities; and passing and enforcing federal and state legislation
restricting water-recreation activities during alcohol consumption.
Most deaths involving diving occur during June, July, and August and among persons age
15-39 years, with the largest proportion (14.8%) occurring among persons age 30-39 years.
Many diving-related injuries result in spinal cord injury, which is a major public health
problem and costs society as much as $6.2 billion annually. The major causes of spinal
cord injury are motor-vehicle crashes, gun shot wounds, sports related injuries and
diving. Alcohol use appears to be a contributing factor in many injuries and deaths
involving diving.
States with the highest drowning rates*
The national rate (deaths per 100,000 population) for drownings is 1.52,
representing 3,942 drownings. The ten states with the highest rates are Alaska (8.32;
n-53), Hawaii (3.46; n-46), Louisiana (2.72; n-113), Mississippi (2.72; n-68), Montana
(2.71; n-22), Florida (2.69; n-383) Idaho (2.59; n-26), Oregon (2.58; n-76), Nevada (2.41;
n-34), and South Carolina (2.36; n-85).
*Ranking based on age-adjusted rate: E830, E832, E910
For more information, write or call the National Center for
Injury Prevention and Control - (770) 488-4652,
National Center for Injury Prevention and Control, Division of
Unintentional Prevention, Mailstop K60 , 4770 Buford Highway NE, Atlanta, GA 30341-3724
Who are the victims?
Children: Injuries are the leading cause of death for persons age 1-19 years, accounting
for almost half of all deaths in this age group. After motor vehicle related deaths,
drowning is the second leading cause of injury death for children (age 1-19 years)
accounting for 1,430 deaths in 1992. For children age 0-4 years, drowning is the third
leading cause of death.
In 1993, drowning rates for every age were almost four times greater for males than for
females. Drowning rates overall among blacks were twice those of whites; however, this was
not true for all age groups. For example, among persons age 1-4 years, the drowning rate
among whites was twice the rate among blacks: this was largely because of drownings in
residential swimming pools. For children age 5-19 years, the drowning rate among blacks
was 2 to 4 times the rate among whites.
Where drownings occur
Swimming pools: According to the U.S. Consumer Product Safety Commission (CPSC), each
year emergency departments report about 500 drownings and 3,000 near drownings among
children under age 5 years in residential swimming pools. About 60-90% of drownings among
persons age 0-4 years occur in residential pools and more than half of these drownings
occur at the child’s own home. According to CPSC, in-ground pools without complete
fencing are 60% more likely to involve drowning than are pools with fencing.
Oceans, lakes, and rivers: Swimming and other activities in oceans, lakes, and rivers
must be done with extreme caution, even with lifeguards present. Swimmers should restrict
their activities to designated swimming areas, usually marked by buoys. Open water areas
usually have limited visibility, and conditions can change from hour to hour in some
waters. Swimmers and even persons wading at the shore should watch for dangerous waves for
indications of rip currents, which include water that is discolored and unusually choppy
as well as debris and foam moving seaward. River currents also are often unpredictable and
move rapidly, and can change direction abruptly. Any water
current can move even expert swimmers far from the shore or beach area.
How you can prevent drowning
Never swim alone or in unsupervised places. Young children who are swimming or just
playing in the water should always be accompanied by an adult and older children by a
buddy. Water wings are not advised for any age.
Learn to swim.
Always check the depth of water before entering. The American Red Cross recommends nine
feet of water as a minimum safe depth for diving and jumping.
Know the local weather conditions and forecasts before swimming or boating.
Use U.S. Coast Guard-approved personal flotation devices (life jackets) for all ages
when boating, regardless of the distance to be traveled, the size of the boat, or swimming
ability.
Never drink alcohol during or immediately before boating or other water recreation.
To prevent choking, never chew gum or eat while swimming, diving, or playing in the
water.
Watch children constantly—especially those who are very young! It takes only
seconds for children to get into trouble around water and to drown. Those supervising
young children should not talk on the phone, mow the lawn, read or play cards when
watching children who are in the bathtub, pool of any size, or the beach.
Keep small children away from all buckets. Five-gallon industrial containers appear to
be particularly hazardous, but caregivers should never leave a small child alone with any
large container of liquid, and all buckets should be emptied immediately when household
chores are completed.
Many states and communities mandate four-sided isolation pool fencing with self-closing
and self-latching gates that surround the pool and prevent direct access from the house
and yard.
CPR training for pool owners and water enthusiasts is recommended.
Telephones are recommended in the vicinity of residential pools.
All boaters should take a course in boating safety.
How to Plan for the Unexpected: Preventing Child Drownings
In parts of the nation's sunbelt, drowning has been the leading cause
of accidental death in the home of children under 5 years old. The information below can
help parents and caregivers provide young children with the protection they deserve.
Each year, nationwide, more than 300 children under 5 years old drown
in residential swimming pools, usually a pool owned by their family. In addition, more
than 2,000 children in that age group are treated in hospital emergency rooms for
submersion injures.
Medical costs for submersion victims during the initial hospitalization
alone can be quite high. Costs can range from an estimated $2,000 for a victim who
recovers fully to $80,000 for a victim with severe brain damage. Some severely brain
damaged victims have initial hospital stays in excess of 120 days and expenses in excess
of $150,000.
Many communities have enacted safety regulations governing residential
swimming pools — inground and aboveground. It's up to parents to comply with these
regulations. Apart from these laws, parents who own pools can take their own precautions
to reduce the chances of their youngsters accessing the family pool or spa without adult
supervision.
Facts and Figures
Following are just a few facts uncovered by the U.S.Consumer Product
Safety Commission (CPSC) in a comprehensive study of drowning and submersion incidents
involving children under five years old in Arizona, California, and Florida.
- Seventy-five percent of the submersion victims studied by CPSC were between 1 and 3
years old; 65 percent of this group were boys. Toddlers, in particular, often do something
unexpected because their capabilities change daily.
- At the time of the incidents, most victims were being supervised by one or both parents.
Forty-six percent of the victims were last seen in the house; 23 percent were last seen in
the yard or on the porch or patio; and 31 percent were in or around the pool before the
accident. In all, 69 percent of the children were not expected to be at or in the pool,
yet they were found in the water.
- Submersion incidents involving children usually happen in familiar surroundings.
Sixty-five percent of the incidents happened in a pool owned by the child's family and 33
percent of the incidents happened in a pool owned by friends or relatives.
- Pool submersions involving children happen quickly. A child can drown in the time it
takes to answer a phone. Seventy-seven percent of the victims had been missing from sight
for five minutes or less.
- Survival depends on rescuing the child quickly and restarting the breathing process,
even while the child is still in the water. Seconds count in preventing death or brain
damage.
- Child drowning is a silent death. There's no splashing to alert anyone that the child is
in trouble.
Barriers
Barriers are not childproof, but they provide layers of protection for
a child who strays from supervision. Barriers give parents additional time to locate a
child before the unexpected becomes a reality.
Barriers include a fence or wall, door alarms for the house, and a
power safety cover over the pool. Barriers also may be used to protect children from
accessing hot tubs and spas.
The weak link in the strongest and highest fence
is a gate that fails to close and latch completely. For a gate to close completely every
time, it must be in proper working order.
Door Alarms
If the house forms one side of the barrier, then doors leading from the
house to the pool should be protected with alarms that produce an audible sound when a
door is unexpectedly opened.
Install an alarm that can be temporarily turned off by an adult for a
single opening of the door by using a keypad or switch that is out of a child's reach.
Battery and electrically powered alarms are available. The keypad
switch can be used by adults who wish to pass through the door without setting off the
alarm. It should be placed high on all doors leading from the house to the pool.
Affordable and easily installed alarms are available. An alarm signal immediately tells a
parent that a door has been opened.
Power Safety Covers
Power safety covers over the pool may be used as
an alternative to door alarms. A power safety cover should meet the requirements of the
ASTM pool cover standard which addresses labeling requirements and performance. ASTM
requires that a cover withstand the weight of two adults and a child to allow a rescue
should an individual fall onto the cover. The standard also requires quick removal of
water from the cover. A young child can drown in just inches of water.
A power safety cover is a motor powered barrier that can be placed over
the water area. Motor-driven covers easily open and close over the pool. When the power
safety cover is properly in place over the pool, it provides a high level of safety for
children under five years old by inhibiting their access to the water.
Above-ground Pools
Steps and ladders leading from the ground to the pool should be secured
and locked, or removed when the pool is not in use.
Rules for Pools
- Instruct babysitters about potential pool hazards to young children and about the use of
protective devices, such as door alarms and latches. Emphasize the need for constant
supervision.
- Never leave a child unsupervised near a pool. During social gatherings at or near a
pool, appoint a "designated watcher" to protect young children from pool
accidents. Adults may take turns being the "watcher." When adults become
preoccupied, children are at risk.
- If a child is missing, check the pool first. Seconds count in preventing death or
disability. Go to the edge of the pool and scan the entire pool, bottom and surface, as
well as the pool area.
- Do not allow a young child in the pool without an adult.
- Do not consider young children to be drownproof because they have had swimming lessons.
Children must be watched closely while swimming.
- Do not use flotation devices as a substitute for supervision.
- Learn CPR (cardiopulmonary resuscitation). Babysitters and other caretakers, such as
grandparents and older siblings, should also know CPR.
- Keep rescue equipment by the pool. Be sure a telephone is poolside with emergency
numbers posted nearby.
- Remove toys from in and around the pool when it is not in use. Toys can attract young
children to the pool.
- Never prop open the gate to a pool barrier.
NOTE: To obtain detailed barrier recommendations, write CPSC,
Pool Barriers, Office of Information & Public Affairs, Washington, DC 20207.
Prevent Child Drownings in the Home
The U.S. Consumer Product Safety Commission (CPSC) warns that young
children can drown in very small amounts of water. CPSC has reports of more than 300
children since 1973 who have drowned in bathtubs, basins, showers, and jetted bathtubs in
as little as two inches of water; 49 children who drowned in toilet bowls, usually after
falling in head first; and 30 children who drowned in diaper pails. More than 200 children
have drowned in 5-gallon buckets since 1984.
The Commission offers these safety tips to help prevent child drownings
in the home:
- Keep young children out of the bathroom unless you are watching them closely.
- Empty 5-gallon buckets after each use. Do not leave even a few inches of liquid in the
bucket because a young child could topple into the bucket and drown. Do not allow
unattended toddlers around buckets while the buckets are in use.
- Do not rely on baby bathtub "supporting ring" devices to keep baby safe in the
tub. Never leave a baby alone in these bath support rings. Even turning away to answer the
doorbell or telephone can result in drowning or submersion of the baby.
Facts
Toilets - 49 children drowned since 1973
Bathtubs, Basins, Showers and Jetted Bathtubs - more than 300 children have drowned
since 1973
5-Gallon Buckets - more than 200 children have drowned since 1984
Baby Bathtub "Supporting Ring" Devices - 8 children have drowned since 1983
Diaper Pails - 30 children have drowned since 1977
For more information contact: U.S. Consumer Product Safety Commission,
Washington, DC 20207, (301) 504-0580
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