Drowning

What's the Problem?

Each year, about 4,000 people drown in the United States; drowning kills more children 1-4 years of age than anything else except birth defects. Among children 1-14, drowning is the second leading cause of unintentional injury death (after motor vehicle crashes). More than half of those who are treated in an emergency department for drowning require hospitalization or transfer for further care (compared with about 6% of all unintentional injuries). A person who survives drowning may suffer lasting consequences like brain damage.

Who's at Risk?

• Children and young adults: Drowning rates are highest mainly for children under 5 years of age and persons 15-24 years of age. How children drown tends to vary by age. For example, children under age one most often drown in bathtubs, buckets, and toilets. Children 1-4 most often drown in swimming pools, hot tubs, and spas. Older children, teens and young adults typically drown in natural water settings, such as lakes and rivers.
• Males: Nearly 80% of people who die from drowning are male.
• Minorities: Between 2005 and 2009, the fatal unintentional drowning rate for African Americans was significantly higher than that of whites across all ages. The disparity is increases among children 5-14 years old. The fatal drowning rate of African American children ages 5 to 14 is almost three times that of white children in the same age range. The disparity is most pronounced when looking at drowning that happens in swimming pools; African American children 5-19 drown in swimming pools at rates 5.5 times higher than those of whites. This disparity is greatest among those 11-12 years where African Americans drown in swimming pools at rates 10 times those of whites. These disparities might be associated with lack of basic swim skill in some minority populations.

In addition, alcohol use can increase the risk of drowning. Among adolescents and adults, alcohol use is involved in up to 70% of deaths that occur during water recreation, almost a quarter of ED visits for drowning, and about one in five reported boating deaths.

Can It Be Prevented?

Definitely. Tips to help people stay safe in the water:

• Closely supervise children around water. Adults often expect children to splash and show obvious signs of distress when they are having trouble in the water. However, drowning victims, especially children, rarely are able to call for help or wave their arms, and thus usually drown silently.
• Avoid alcohol while supervising children or before swimming, boating, or water skiing. Alcohol influences balance, coordination, and judgment, and its effects are heightened by sun exposure and heat.
• Learn to swim; make sure children can swim and float. Swimming is more than a recreational activity; it is a potentially life-saving skill.
• Learn CPR (cardio-pulmonary resuscitation). In the time it takes for paramedics to arrive, CPR skills performed by a bystander could save someone’s life.
• Install four-sided fencing around a swimming pool.
• Always wear appropriately fitted life jackets when boating.

Tips for Scripts

• INFORM viewers that alcohol use can increase the risk of drowning. This message is particularly important for adolescent males and their parents.
• EDUCATE viewers about the risk of children getting into distress quickly and quietly in the water. Childhood fatal and nonfatal drownings often occur when a child is left alone, even for a few seconds. Most children who drown in pools were last seen inside the home, had been out of sight less than five minutes, and were in the care of one or both parents at the time. Children may drown with adults or other swimmers around them that aren’t watching or don’t understand what is happening.
• REMIND viewers of the importance of wearing life jackets on boats.
• ENCOURAGE parents to closely supervise young children as they bathe.
• ADVISE viewers about the effectiveness of four-sided fencing around a swimming pool as a prevention method.
• ALERT parents about the importance of basic swim skills (e.g., float, don’t panic, control breathing, traverse a distance). Everyone needs to know how to survive in the water. 

Case Examples

1. Parents with two young children, 4-year old Jim and 3-year old Amy, visit friends who have an in-ground pool in their back yard. The friends' three children are already in the water, and Jim and Amy jump in and start playing with the others. The two fathers drink beer and fire up the grill. Their backs are to the nearby pool, but they occasionally glance over at the kids. The two mothers head inside the house to prepare the rest of the meal, asking the men to keep an eye on the kids. Tired of the game, Jim climbs out of the water, walks over to the pool's deeper end, and jumps in. Only Amy notices him do this, and sees that he does not come back up, but does not really understand that this is serious. After a moment, she walks over to her dad, tugs on his pants, and says softly, "Jim is under."
2. Six college students head to the beach for an afternoon of eating, drinking, swimming, and body surfing. Four drink beer and wine, and the two others drink soda and water. Late in the day, one guy who has had a couple of beers says it's time to get back out there in the waves. One of the young women who has not been drinking catches up with him as he's wading into the water. "Hang on, Dan. You've been drinking. No more swimming for you, sweetie." "No way," he says. "I've been swimming at this beach since I was a kid. I've only had a couple beers, I'm good." The young woman says, "No, buddy. My cousin Robert was out here two years ago with his friends, and he spent the day partying just like we have. The water was calm, and they all decided to go for a last swim. Robert floated out away from the others, then disappeared. He was a great swimmer, he taught me to swim. But he'd had about as much to drink as you. The jerk threw up, and he swallowed a lot of water, and he drowned. You can't get out there if you've been drinking."