Exploring the burden of fatal drowning and data characteristics in three high income countries: Australia, Canada and New Zealand

Abstract

Background Drowning is a leading and preventable cause of death that has suffered an attention deficit. Improving drowning data in countries would assist the understanding of the full extent and circumstances of drowning, to target interventions and evaluate their effectiveness. The World Health Organization identifies data collection as a key strategy underpinning effective interventions. This study compares unintentional fatal drowning data collection, management and comparison using the databases of Australia, Canada and New Zealand. Methods Cases of fatal unintentional drowning between 1-January-2005 and 31–December-2014 were extracted. Cases were combined into a single dataset and univariate and chi square analysis ( p < 0.01) were undertaken. Location and activity variables were mapped and combined. Variables consistently collected across the three countries were compared to the ILCOR Drowning Data Guideline. The authors also recommend variables for a minimum core dataset. Results Of 55 total variables, 19 were consistent and 13 could be compared across the three databases. When mapped against the ILCOR Drowning Data Guideline, six variables were consistently collected by all countries, with five compared within this study. The authors recommend a minimum core dataset of 11 variables including age, sex, location, activity, date of incident, and alcohol and drug involvement). There were 8176 drowning deaths (Australia 34.1%, Canada 55.9%, New Zealand 9.9%). All countries achieved reductions in crude drowning rates (Australia − 10.2%, Canada − 20.4%, New Zealand − 24.7%). Location and activity prior to drowning differed significantly across the three countries. Beaches (X 2 = 1151.0; p < 0.001) and ocean/harbour locations (X 2 = 300.5;p < 0.001) were common in Australia and New Zealand, while lakes/ponds (X 2 = 826.5; p < 0.001) and bathtubs (X 2 = 27.7;p < 0.001) were common drowning locations in Canada. Boating prior to drowning was common in Canada (X 2 = 66.3;p < 0.001). Conclusions The comparison of data across the three countries was complex. Work was required to merge categories within the 20% of variables collected that were comparable, thus reducing the fidelity of data available. Data sources, collection and coding varied by country, with the widest diversity seen in location and activity variables. This study highlights the need for universally agreed and consistently applied categories and definitions to allow for global comparisons and proposes a core minimum dataset.

The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study

“…There were approximately 295 210 (UI: 284 493 to 3 06 187) unintentional drowning deaths in 2017, an almost 50% reduction (44.5%) in unintentional drowning deaths over the last 28 years. This study explored changes between 1990 and 2017 in unintentional drowning mortality across the globe, and while there has been an expected reduction in unintentional drowning mortality, as has been seen in other studies, 7 24 the reduction was not uniform. Countries from middle SDI groupings had the greatest reduction (54.0%), again indicating that urbanisation and development are possible drivers of the decrease in drowning deaths; however, other drivers, such as greater investment in water safety, government recognition of the issue, changing social norms or coding frameworks, could be contributing.…”

“…Unintentional drowning is preventable and is linked to exposure 6 25–27. Increasing economic prosperity and urbanisation has brought about safer domestic and work-related conditions, with increasing exposure around recreational use of water 7 16 28–30. Children, with their natural curiosity, evolving cognition and lack of swimming skills, remain over-represented in unintentional drowning statistics.…”

“…Drowning disproportionately impacts those from low- and middle-income countries (LMICs), males and children 5 6. Having accurate and timely data to aid in the allocation of public health resources and the monitoring of interventions is important for continued implementation of drowning prevention programs 3 7…”

The Visible Behaviour of Drowning Persons: A Pilot Observational Study Using Analytic Software and a Nominal Group Technique

“…Videos recorded by CCTV cameras were overrepresented (71%), and therefore the majority of the recorded drownings occurred in swimming pools. In some countries, home and backyard pools drownings occur frequently [ 47 , 48 ]. However, in most countries, pool drownings are responsible for a minority of fatal and non-fatal drownings [ 31 , 38 , 48 , 49 ].…”

Exploring Flood-Related Unintentional Fatal Drowning of Children and Adolescents Aged 0–19 Years in Australia

“…It may be that not all flood-related drowning cases among children during the study period have been identified. Using only one country's data to explore this issue limits applicability and therefore international collaboration on this topic would be of value [55]. While outside the scope of this study, it may be that over the 16-year period of data analyzed, preventative measures to address flood-related drowning may have been recommended by a coroner or implemented.…”