Preventing river drowning deaths: Lessons from coronial recommendations

2019

Safety

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Disasters, such as flooding, are predicted to increase. Drowning is one of the leading causes of death during times of flood. This study examined the little explored topic of child drowning during floods, with the aim of identifying risk factors to inform prevention strategies. A retrospective, total population examination of cases of children and adolescents aged 0–19 years who died from unintentional flood-related drowning in Australia for the 16-year period 1 July 2002 to 30 June 2018 was undertaken. Univariate and chi-square analysis was conducted, with Fisher’s exact test used for cell counts <5. Across the study period, 44 flood-related drowning deaths occurred among children and adolescents (63.6% male; 34.1% aged 10–14 years). Almost all (84.1%) occurred in rivers, creeks, or streams in flood, with the remaining incidents occurring in storm water drains (n = 7). Leading activities immediately prior to drowning were non-aquatic transport (40.9%), swimming in floodwaters (25.0%), and falls into floodwaters (15.9%). Flood-related fatal drowning among children and adolescents is rare (0.05 per 100,000 population), however flood-drowning risk increases as remoteness increases, with children and adolescents drowning in floodwaters in very remote areas at a rate 57 times that of major cities. All drownings are preventable, and this study has identified key causal factors that must be considered in advocacy and prevention efforts. These include: the importance of adult supervision, avoiding flooded waterways when driving or for recreational purposes, and the increased risks for those residing in geographically isolated and socially disadvantaged areas. Findings must be considered when developing interventions and advocacy for the purposes of the reduction of child and adolescent drowning during times of flood.

Section: Methodsmentioning

confidence: 99%

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

2019

Safety

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“…22 The risk of untrained rescuers has been Who rescues who? Understanding aquatic rescues in Australia using coronial data and a survey Richard C. Franklin, 1,2 Amy E. Peden, 1,2 Robert W. Brander, 3 Peter A. Leggat 1,4 identified, 23 with bystanders trained in safe rescue and resuscitation identified as being less likely to place themselves at risk of drowning. 12 Tragically, every year there are cases of AVIR syndrome, 9,10 a global phenomenon recognised in studies from mainland China, 24 New Zealand, 11 Turkey, 25 the Netherlands 26 and Brazil.…”

mentioning

confidence: 99%

Who rescues who? Understanding aquatic rescues in Australia using coronial data and a survey

Australian and New Zealand Journal of Public Health

Brander

et al. 2019

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Objective: To examine fatal drowning associated with aquatic rescues and prior self‐reported experience of undertaking an aquatic rescue in Australia. Methods: Previous aquatic rescue experience was sourced through the 2013 Queensland Computer Assisted Telephone Instrument Survey and compared to data on rescue‐related fatal unintentional drowning between 1 January 2006 and 31 December 2015. Results: Twenty‐three per cent (n=294/1291) of survey respondents had previously performed an aquatic rescue. Males (X2=35.2; p<0.001) were more likely to have performed a rescue; commonly at a beach/ocean/harbour location (X2=13.5; p<0.001). Females were more likely to have rescued a child (0‐4 years of age) (X2=29.2; p<0.001) from a swimming pool (X2=34.3; p<0.001). Fifty‐one people drowned while performing an aquatic rescue (Males=82.4%; 25–44 years of age=53.0%; beaches=54.9%). Conclusions: Drownings are prevented by bystanders; this is not without risk to the rescuer. Most people perform only one rescue in their life, often at a younger age, on an altruistic basis, of family members or young children. Community‐wide rescue skills, taught at a young age, with consideration for coastal, inland and swimming pool environments, may prevent drowning. Implications for public health: There is a need to train people early in their life on how to undertake a safe rescue and provide resuscitation, including promoting regular updates, in particular if supervising children.

“…Once determined, a coroner's report is completed and the case is closed on the NCIS. Cases may go to coronial inquest where recommendations are made to prevent future loss of life in similar circumstances [21]. Cases which remain open at time of analysis, do not have autopsy, toxicology, and police reports available, therefore limiting available data on alcohol and drug involvement and presence of pre-existing medical conditions.…”

Section: Methodsmentioning

confidence: 99%

The Influence of Alcohol and Drugs on Drowning among Victims of Senior Years

Pearn

2019

Safety

Unintentional fatal drowning among older people is an issue as lifespans lengthen and older people embrace active retirement. While pre-existing medical conditions are a known risk factor for drowning among this age group, less is known about the role of alcohol and drugs. This 15-year (1 July 2002 to 30 June 2017) Australian study used coronial data to investigate the impact on older people (aged 65 years and older) of the obtundent effects of prescribed drugs which had been ingested by those with a positive blood alcohol concentration (BAC). Of the closed coronial cases with toxicological information (N = 471), one quarter (24.6%; N = 116) had consumed alcohol prior to drowning (one in seven BAC ≥ 0.05%), of which a third also had obtundent drugs present (33.6%; N = 39). Rivers/creeks/streams and swimming pools were the locations with the highest number of drowning deaths. Bathtubs (36.8%) and rivers/creeks/streams (17.9%) recorded the highest proportion of cases with victims having a BAC ≥ 0.05%. Bathtubs (13.2%), lakes (7.0%), and rivers/creeks/streams (6.8%) recorded the highest proportion of drowning cases with obtundent drug involvement. Obtundent drug involvement was significantly more likely for activities where the person who drowned was alone (i.e., unknown activity) (X2 = 6.8; p = 0.009). Common obtundent drugs included Diazepam, Tempazepam, and Codeine. Advocacy to prevent drowning in older people is a complex challenge, due to the myriad of locations where drowning occurs, the consumption of alcohol, and polypharmacy required for treating illness and maintaining good health.