Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs – a retrospective study, 1992–2009

Abstract

BackgroundDrowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.MethodsDuring an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.ResultsDuring the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (≤18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688 /4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.ConclusionPresence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

Retrospective Autopsy-Based Analysis of Fatal Drowning in Fiji from 2011 to 2014

“…In this study males dominate accounting for 72.3% of fatal drowning that are similar to other studies where males account for more than 70% [16,17].…”

“…The greatest efforts must be driven towards making individuals skilled in water activities such as swimming; and use of peer groups, safety groups while conducting water activities. Accidents formed 8.3% of the fatal drowning and alcohol is another important factor in fatal drowning though in this study it constitutes 1.5% of the fatal drowning as compared to 44% in another study [17].…”

The Evaluation of the Corpses Pulled Out of Water in Province of Muğla

“…İsveç'te yapılan ça-lışmada, bireylerin %38'inde alkol, %40'ında psikoaktif madde saptandığı, madde olarak en çok benzodiazepin (%21) bulunduğu bildirilmiştir. 15 Yapılan diğer çalışmalarda da boğulma vakalarında etil alkolün önemli bir risk faktörü olduğu vurgulanmıştır. [4][5][6][7][8][9] Yüzme bilmek boğulmaya karşı tamamen koruyu faktör olmamaktadır.…”

La asociación entre la exposición a la violencia, alcohol y drogas en el perfil psicosocial de adolescentes México-Americanos de bajos recursos

“…Evidence suggests that engagement in heavy drinking during adolescence has profound consequences for brain development, mainly associated with neurocognitive dysfunction (Colby et al, 2012;Elofson, Gongvatana, & Carey, 2013;Squeglia, Schweinsburg, Pulido, & Tapert, 2011). A variety of other adverse health outcomes are also related to drinking during adolescence, including engagement in high risk behaviors such as drunk driving (Dhami, Mandel, & Garcia-Retamero, 2011;Kuntsche & Muller, 2012), substance-abuse (Ahlm, Saveman, & Bjornstig, 2013;Hensing, 2012;Huang, Lin, Lee, & Guo, 2013), physical fighting (Fraga, Ramos, Dias, & Barros, 2011;Rudatsikira, Siziya, Kazembe, & Muula, 2007), and/or unsafe sexual behaviors (Hipwell, Stepp, Chung, Durand, & Keenan, 2012;Imaledo, Peter-Kio, & Asuquo, 2012;Jackson, Sweeting, & Haw, 2012). Alcohol exposure at an early age also makes adolescents vulnerable to interpersonal violence, both as victims and perpetrators, suggesting it plays a role in recurring cycles of violence (Cui, Ueno, Gordon, & Fincham, 2013;Haynie et al, 2013;Reed et al, 2013;Thornberry & Henry, 2013; P. W. Wang et al, 2013).…”