Drowning in childhood and adolescence: a population-based study.

Wintemute, Garen J.; Kraus, Jess F.; Teret, Stephen P.; Wright, Michelle

doi:10.2105/ajph.77.7.830

Cited by 91 publications

(42 citation statements)

References 15 publications

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“…Although previous studies have addressed submersion events involving young children and aboveground pools, none has addressed the use of pool ladders by children to enter the pool. 2,5,6,[11][12][13]15,23,28,29 The CPSC recommends that steps and ladders leading from the ground to the pool be secured to block access and locked, or removed when the pool is not in use. 24,25,30,31 Yet, ladders supplied with inexpensive, portable, above-ground pools Ն36 in deep 20 generally cannot be locked to block access and are cumbersome to remove from the pool.…”

Section: Wading Pool Submersionsmentioning

confidence: 99%

“…An estimated 3000 children in this age group were treated annually in US hospital emergency departments for injuries associated with pool submersion from 2006 through 2008. 14 Private pools have been found to be the most frequent site of submersion injury for US children, 2,5,6,9,[11][12][13][14][15][16][17] and 54% of fatalities associated with pools reported to the US Consumer Product Safety Commission (CPSC) for children younger than 5 years during the period 2005 through 2007 occurred at the child's home. 18 Despite these statistics, many pool owners do not perceive their pool as a hazard for young children.…”

mentioning

confidence: 99%

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Pediatric Submersion Events in Portable Above-Ground Pools in the United States, 2001–2009

Shields

Pollack-Nelson²,

Smith

2011

Pediatrics

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OBJECTIVE: The goal of this study was to describe the epidemiology of pediatric submersion events occurring in portable pools in the United States. METHODS: A retrospective analysis of fatal and nonfatal submersion events involving children younger than 12 years in portable pools was conducted using injury and fatality data compiled by the US Consumer Product Safety Commission from 2001 through 2009. RESULTS: There were 209 fatal and 35 nonfatal submersion cases reported to the commission from 2001 through 2009. The majority (94%) involved children younger than 5 years, 56% involved boys, 73% occurred in the child's own yard, and 81% occurred during the summer months. The number of submersion events increased rapidly from 2001 to 2005 and then leveled off from 2005 to 2009. CONCLUSIONS: The use of portable pools in residential settings poses a significant risk of submersion-related morbidity and mortality to children, especially in the <5-year-old age group. No single strategy will prevent all submersion deaths and injuries; therefore, layers of protection are recommended. Industry is advised to engage in development of protective devices that are effective and affordable for portable pools, including isolation fencing, pool alarms, and safety covers. A strong and pervasive consumer education campaign is needed to make consumers aware of the dangers of portable pools, because these small, inexpensive, consumer-installed pools may not generate the same sense of risk as an in-ground pool.

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Section: Wading Pool Submersionsmentioning

confidence: 99%

mentioning

confidence: 99%

Pediatric Submersion Events in Portable Above-Ground Pools in the United States, 2001–2009

Shields

Pollack-Nelson²,

Smith

2011

Pediatrics

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“…[4][5][6] Residential swimming pools continue to be the most common place for immersion injuries, particularly in preschool children. 2,[6][7][8][9][10][11][12] The total annual economic losses due to swimming pool drowning and near drowning of young children in the United States are estimated to be between $450 and $650 million. 13 Adherence to safety precautions for residential swimming pools, such as four-sided fencing, is estimated to have prevented 50%-90% of swimming pool immersion injuries.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Near Drowning: The Experience of King Khalid University Hospital

Al-Mofadda

Nassar

Alturki

et al. 2001

Annals of Saudi Medicine

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Background:The purpose of the study was to evaluate the outcome of warm pediatric near drowning, and assess possible predictors of the outcome. Subjects and Methods: The study was performed at King Khalid University Hospital, Riyadh, Saudi Arabia. Twenty-eight cases of pediatric near drowning (one to 13 years of age) over a 10-year period ending June 1998, were reviewed retrospectively. Multiple variables during the prehospital and the hospital stages were evaluated to assess their effect on the outcome. Results: None of the patients' families had official training in cardiopulmonary resuscitation. Only one of the 21 private swimming pools had features compatible with swimming pool safely regulations. Eleven patients (39.3%) died in the pediatric intensive care, and 17 (60.7%) were discharged alive. Submersion time of >5 minutes and the emergency room documentation of absence of vital signs, Glasgow Coma Scale of ≤4, arterial pH of ≤7.0 and blood sugar of ≥10 mmol/L all predicted bad outcome, with a statistical significance (P< 0.05). Conclusion: This audit highlighted major concerns about our prehospital medical care, general population basic life support education and our society's adherence to swimming pool safety regulations. It demonstrated that hypothermia on arrival to the emergency department in warm near-drowning victims is likely to be associated with bad outcome. The audit results also agree with the opinion of not aggressively intervening or prolonging aggressive intervention in warm near-drowning cases presenting with bad prognostic outcome. Drowning is a preventable catastrophic accident. It is the fourth leading cause of death for children younger than 19 years of age, and the single leading cause of injury death for children under 5 years of age in the US.1,2 A rate of drowning of between 0.7 and 2.9 per 100,000 children younger than 19 years has been reported. 1,3 Roughly 80% of the children with near-drowning histories are admitted for at least one day, and 40%-50% of the cases die, with as many as 20% of the survivors suffering severe permanent disability. [4][5][6] Residential swimming pools continue to be the most common place for immersion injuries, particularly in preschool children. 2,[6][7][8][9][10][11][12] The total annual economic losses due to swimming pool drowning and near drowning of young children in the United States are estimated to be between $450 and $650 million. 13 Adherence to safety precautions for residential swimming pools, such as four-sided fencing, is estimated to have prevented 50%-90% of swimming pool immersion injuries. 4,[14][15][16][17][18] Near-drowning cases in Saudi Arabia do not get the deserved publicity from the media or from pediatricians. To the best of our knowledge, this is the first audit tackling the issue of neardrowning of children in Saudi Arabia. Subjects and MethodsA retrospective case review study was conducted to evaluate near-drowning cases managed at King Khalid University Hospital (KKUH) Pediatric Intensive Care Unit (PICU) in Riyadh, Saudi...

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“…Wintemute et al 41 found a strong positive temporal association between the number of pools in Sacramento County, Calif (1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984) and the pool-related drowning rate in children. We found that there was a positive dose-response association between pool density and drowning and that adjustment for pool density had a pronounced influence on the effect observed for race/ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Effects of pool-fencing ordinances and other factors on childhood drowning in Los Angeles County, 1990-1995

2000

Am J Public Health

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OBJECTIVES: This study estimated the effects of local pool-fencing ordinances and other factors on the rate of childhood drowning in Los Angeles County, California. METHODS: Stage 1 was a retrospective dynamic cohort study of all drownings among children younger than 10 years that occurred in residential swimming pools in Los Angeles County between 1990 and 1995. Stage 2 was a matched case-control study that compared pools in which childhood drownings occurred (cases) with randomly selected pools in which drownings did not occur (controls). RESULTS: The drowning rate was relatively high among toddlers (aged 1-4 years), boys, and African Americans and in areas with a high density of residential swimming pools. Pool-fencing ordinances were not associated with a reduced overall rate of childhood drowning. CONCLUSIONS: Local ordinances enacted in Los Angeles County before 1996 do not appear to have been effective in reducing the rate of childhood drowning in residential pools. Possible reasons for this ineffectiveness are insufficient building codes for isolating pools from homes, inadequate enforcement of the ordinances, and inadequate operation or maintenance of fencing equipment by pool owners.

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Drowning in childhood and adolescence: a population-based study.

Cited by 91 publications

References 15 publications

Pediatric Submersion Events in Portable Above-Ground Pools in the United States, 2001–2009

Pediatric Submersion Events in Portable Above-Ground Pools in the United States, 2001–2009

Pediatric Near Drowning: The Experience of King Khalid University Hospital

Effects of pool-fencing ordinances and other factors on childhood drowning in Los Angeles County, 1990-1995

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