Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review

Peden, Amy E.; Demant, Daniel; Hagger, Martin S.; Hamilton, Kyra

doi:10.1371/journal.pone.0196421

Cited by 29 publications

(36 citation statements)

References 48 publications

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“…Further data from our study suggest that available life jackets are considered unaffordable (ranging from ~US$15 to 150); the cheapest (non-ISO-conforming buoyancy vests) are seen by fishers as uncomfortable and ineffective (data not shown). A recent systematic review reported comfort, accessibility and ownership, and confidence in life jackets as key factors related to life jacket use 23. Male gender and adult age were associated with non-use of life jackets.…”

Section: Discussionmentioning

confidence: 99%

Drowning among fishing communities on the Tanzanian shore of lake Victoria: a mixed-methods study to examine incidence, risk factors and socioeconomic impact

et al. 2019

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ObjectivesTo estimate the incidence of unintentional fatal drowning and describe associated risk factors among Lake Victoria fishing communities, and to assess perceived social, financial and other impacts among families and colleagues of persons who drowned.DesignA retrospective, observational mixed-methods study, conducted between September 2017 and February 2018.SettingEight Tanzanian fishing communities on Lake Victoria.ParticipantsPersons who drowned in the preceding 24 months were identified using an extensive community networking approach. Adult family members, colleagues or community members familiar with the habits and behaviours of people who drowned and/or circumstances of drowning incidents participated in surveys (n=44) and in-depth interviews (n=22).Main outcome measuresPooled drowning incidence, with sensitivity analyses allowing for uncertainties in population estimates. Risk factors were identified through the evaluation of behavioural characteristics of persons who drowned and circumstances of drowning incidents. Perceived socioeconomic impacts were assessed through semi-structured interviews with their family members and colleagues.ResultsThe estimated drowning incidence was 217/100 000 person-years (95% CI 118 to 425/100 000). Of 86 victims identified, 70 (81%) were fishermen (79% aged 18–40 years; all men) and 9 were children (all ≤10 years). All deaths occurred in the lake. Most adults (65/77; 84%) were fishing from a boat when they drowned; 57/77 (74%) died in the evening (from ~5 pm) or at night. Six children (67%) drowned while swimming/playing at the lakeshore unsupervised. Few victims (2/86; 2%) were wearing a life jacket at the time of death. Reported socioeconomic impacts of these deaths ranged from income loss to family break-up.ConclusionsDrowning is a significant risk in Tanzanian lakeside fishing communities, with estimated mortality exceeding national incidence rates of fatal malaria, tuberculosis or HIV, but preventative strategies appear uncommon. Socioeconomic impact at the family level may be substantial. Intervention strategies are required to reduce the drowning burden among this neglected at-risk population.

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Section: Discussionmentioning

confidence: 99%

Drowning among fishing communities on the Tanzanian shore of lake Victoria: a mixed-methods study to examine incidence, risk factors and socioeconomic impact

et al. 2019

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“…In Australia, between 2002/03 and 2011/12, an average of 289 people died in Australia due to unintentional drowning [11]. Common fatal drowning scenarios in Australia include young children drowning unsupervised in bathtubs [17] and swimming pools [15] and adult males drowning in natural waterways such as beaches, oceans and in rivers [16] due to alcohol, pre-existing medical conditions [18] and not wearing a lifejacket [19]. Rivers are the leading location for drowning in Australia [11] with leading activities being undertaken prior to drowning including accidental falls into water (21.3%), non-aquatic transport incidents (commonly driving a motor vehicle into floodwaters) (18.2%) and swimming (16.2%).…”

Section: Introductionmentioning

confidence: 99%

Breathalysing and surveying river users in Australia to understand alcohol consumption and attitudes toward drowning risk

2018

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BackgroundLittle is known about people’s river usage, a leading drowning location. This study examines alcohol consumption patterns of river users and their attitudes to drowning risk.MethodsA convenience sample of adult (18+ years) river users were surveyed at four river locations. The survey covered eight domains: demographics; river attendance frequency; frequency of engaging in water activities; drinking patterns; alcohol and water safety knowledge; alcohol and water safety attitudes; alcohol consumption; and Blood Alcohol Concentration (BAC). For BAC, participants were asked to record time since their last alcoholic drink and were then breathalysed to record an estimate of their BAC. BAC was examined by BAC reading (negative, positive, ≥0.050%). Hazardous lifetime drinking levels were calculated and their impact on drowning risk evaluated. Univariate and chi square analysis (95% confidence interval) was conducted.ResultsSix hundred eighty four people participated (51.6% female; 49.0% aged 18–34 years). Sixteen percent (15.9%) had a positive BAC (Mean + BAC = 0.068%; SD ± 0.08; Range = 0.001–0.334%), with 7.2% ≥0.050% (Mean BAC ≥0.050% =0.132%; SD ± 0.06). Those significantly more likely to record a BAC ≥0.050% at the river were: aged 18–34 years, resided in inner regional and low socio-economic areas, visited the river in the afternoon, with friends, on days with higher maximum air temperatures, frequent river users (11+ times in the last 30 days) and those who spend longer in the water (301+ minutes). River users who recorded a BAC ≥0.050% were more likely to self-report engaging in risky activities (i.e. diving into water of unknown depth and jumping into the river from height). River users on Australia day (a national public holiday) were significantly more likely to drink heavily (Mean BAC ≥0.05% = 0.175%; SD ± 0.09).ConclusionsDespite males accounting for 85% of alcohol-related river drowning deaths, similar numbers of males and females were consuming alcohol at the river. This study has addressed a gap in knowledge by identifying river usage and alcohol consumption patterns among those at increased drowning risk. Implications for prevention include delivering alcohol-related river drowning prevention strategies to both males and females; at peak times including during hot weather, afternoons, public holidays and to river users who swim.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6256-1) contains supplementary material, which is available to authorized users.

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“…A barrier to use in LMICs, however, is access to low-cost lifejackets 4. Despite 57% of respondents to the Delphi process stating that the river drowning strategy of ‘ Wear a lifejacket ’ would be effective in both HICs and LMICs, there is a dearth of research from rivers and LMICs on the issue of lifejackets 35. Lifejackets must be seen as an active prevention strategy (to be worn whenever boating), rather than a reactive one (putting a lifejacket on once the boat has capsized) 36.…”

Section: Discussionmentioning

confidence: 99%

“…Lifejackets must be seen as an active prevention strategy (to be worn whenever boating), rather than a reactive one (putting a lifejacket on once the boat has capsized) 36. Although beyond the scope of this Delphi, the authors note that any river drowning prevention strategy focused on lifejackets must address the personal, social and environmental factors underpinning lifejacket wear behaviour,35 as well as suitability and availability of lifejackets in the particular country where they are proposed to be used.…”

Section: Discussionmentioning

confidence: 99%

Developing drowning prevention strategies for rivers through the use of a modified Delphi process

Peden¹,

Franklin

Leggat

2019

Inj Prev

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IntroductionInternationally, rivers are a leading drowning location, yet little evidence exists evaluating river drowning prevention strategies. This study aims to use expert opinion to identify strategies more likely to be effective.MethodsUsing a modified Delphi process, a virtual panel of 30 experts from 12 countries considered, grouped and prioritised strategies for river drowning prevention. Proposed strategies were assessed against known evidence and suitability in high-income countries (HICs) as well as low-income and middle-income countries (LMICs) using expert opinion. The final phase consolidated a list of strategies whose effectiveness was assessed against 10 evidence-based river drowning scenarios.ResultsAn initial list of 424 prevention strategies was refined to 22. After being assessed against the 10 scenarios, a final list of 13 strategies was derived. Strategies addressed alcohol consumption around rivers, flood mitigation, improving child supervision, learning to swim, increased lifejacket wear and achieving community-wide resuscitation skills.DiscussionWhile all 13 strategies were assessed as being effective in both LMICs and HICs by at least 60% of the respondents, further work is required to define river drowning at a country level and therefore allow for effective solutions to be developed, particularly in LMICs. No strategy will be effective in isolation and must be implemented alongside policy and behaviour change, public awareness and education. Evaluation should be incorporated as part of any future implementation of strategies.ConclusionThis Delphi process identified 13 drowning prevention strategies for rivers. Further research is required to validate the efficacy of these findings through implementation and evaluation.

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Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review

Cited by 29 publications

References 48 publications

Drowning among fishing communities on the Tanzanian shore of lake Victoria: a mixed-methods study to examine incidence, risk factors and socioeconomic impact

Drowning among fishing communities on the Tanzanian shore of lake Victoria: a mixed-methods study to examine incidence, risk factors and socioeconomic impact

Breathalysing and surveying river users in Australia to understand alcohol consumption and attitudes toward drowning risk

Developing drowning prevention strategies for rivers through the use of a modified Delphi process

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