Drowning: Global Burden, Risk Factors, and Prevention Strategies

Abstract

Drowning has been described as a major global public health problem and has recently been acknowledged by a United Nations Declaration on Global Drowning Prevention. While drowning impacts countries of all income levels, the burden is overwhelmingly borne by low- and middle-income countries (LMICs) who account for 90% of the global death toll. In addition, there is scarce data collection on drowning in LMICs, so the magnitude of drowning may be far greater than is represented. A range of factors including sex, age, education, income, access to water, a lack of swimming skills, certain occupations like commercial fishing, geographically isolated and flood-prone locations, preexisting medical conditions, and unsafe water transport systems, influence the risk of drowning. Some behavioral factors, such as alcohol or drug consumption, not wearing life jackets, and engaging in risky behaviors such as swimming or boating alone, increase drowning risk. Geopolitical factors such as migration and armed conflict can also impact drowning risk. There is a growing body of evidence on drowning prevention strategies. These include pre-event interventions such as pool fencing, enhancing community education and awareness, providing swimming lessons, use of lifejackets, close supervision of children by adults, and boating regulations. Interventions to reduce harm from drowning include appropriate training for recognition of a drowning event, rescue, and resuscitation. An active and/or passive surveillance system for drowning, focusing on individual settings and targeting populations at risk, is required. Drowning requires coordinated multisectoral action to provide effective prevention, rescue, and treatment. Therefore, all countries should aim to develop a national water safety plan, as recommended in the WHO Global Report on Drowning. Further research is required on the epidemiology and treatment of drowning in LMICs as well as non-fatal and intentional drowning in both high-income countries (HICs) and LMICs. Effective and context-specific implementation of drowning prevention strategies, including pilot testing, scale up and evaluation, are likely to help reduce the burden of both fatal and non-fatal drowning in all countries.

The Risks of Using Chatgpt to Obtain Common Safety-Related Information and Advice

“…This may explain why the information provided on child drowning was generally sound but limited to risk reduction measures in a high income and domestic context. This finding strengthens calls for further research on child drowning in low-and middle-income countries and on open water drowning risk (Rahman et al, 2023). The drowning prevention community must also improve recognition of drowning as a risk during times of flood, particularly for children and in the context of a changing climate (Peden and Franklin, 2019).…”

“…This likely reflects the high-income bias in the literature on child drowning that ChatGPT has at its disposal to formulate responses from. This adds further weight to the pre-existing call for further drowning prevention research from low-and middle-income countries (Rahman et al, 2023).…”

Change in global burden of unintentional drowning from 1990 to 2019 and its association with social determinants of health: findings from the Global Burden of Disease Study 2019

“…However, most of previous evidence focused on fatal drowning, and research on non-fatal drowning was scarce and it was also unknown on the contribution of social determinants to the reduction of global drowning burden. 16 17 WHO and several studies reported that this reduction might be related to rapid improvement in social determinants of health (SDH) such as income, educational attainment and living environment. 4 10 17–19 For instance, Nguyen et al 10 found that low socioeconomic status or low-income households were associated with increased drowning mortality, but this study only investigated the impact of a single SDH on the burden of drowning at family level.…”

“…However, most of previous evidence focused on fatal drowning, and research on non-fatal drowning was scarce and it was also unknown on the contribution of social determinants to the reduction of global drowning burden 16 17. WHO and several studies reported that this reduction might be related to rapid improvement in social determinants of health (SDH) such as income, educational attainment and living environment 4 10 17–19.…”

Evaluation of the First Lap learn to swim voucher programme: protocol

“…Swimming skills are an evidence-based component of drowning prevention 1. In Australia, children are expected to achieve the fundamental stage milestones of the National Swimming and Water Safety Benchmark by the age of 6 years 2.…”