Sudden Death Phenomenon While Bathing in Japan　― Mortality Data ―

Abstract

Background: Bath-related sudden cardiac arrest frequently occurs in Japan, but the mortality data have not been sufficiently reported. Methods and Results:This prospective cross-sectional observational study was conducted in the Tokyo Metropolis, Saga Prefecture and Yamagata Prefecture between October 2012 and March 2013 (i.e., in winter). We investigated the data for all occurrences in these areas for which the emergency medical system needed to be activated because of an accident or acute illness related to bathing. Emergency personnel enrolled the event when activation of the emergency medical system was related to bathing. Of the 4,599 registered bath-related events, 1,527 (33%) were identified as bath-related cardiac arrest events. Crude mortality (no. deaths per 100,000) during the observational period was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga. According to the mortality data for age and sex, the estimated number of bath-related deaths nationwide was 13,369 in winter, for the 6 months from October (95% CI: 10,862-16,887). Most cardiac arrest events occurred in tubs filled with water with the face submerged in the water. This suggests that drowning plays a crucial role in the etiology of such phenomena. Conclusions:The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October. Crude mortality during the winter season was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga.

Association Between Bathing and Sudden Death

“…It suggests that drowning plays a crucial role in the etiology of bathing-related cardiac arrests. 12 The drowning is an important cause of OHCA.…”

Relationship between Bath-related Deaths and Low Air Temperature

“…This phenomenon is unique to Japan and is not seen in other developed countries, including the US, UK, Germany, and France ( 9 ). Few previous studies have reported the actual death toll ( 6 , 11 , 12 ). We recently conducted broad surveillance programs in three areas - Tokyo Metropolis, Saga Prefecture, and Yamagata Prefecture - and revealed the nationwide occurrence of an estimated 19,000 deaths annually ( 11 ).…”

“…Few previous studies have reported the actual death toll ( 6 , 11 , 12 ). We recently conducted broad surveillance programs in three areas - Tokyo Metropolis, Saga Prefecture, and Yamagata Prefecture - and revealed the nationwide occurrence of an estimated 19,000 deaths annually ( 11 ). This sudden death phenomenon is rapidly increasing, since the elderly population (≥65 years of age) of Japan is now growing.…”

“…This sudden death phenomenon is rapidly increasing, since the elderly population (≥65 years of age) of Japan is now growing. Because of this phenomenon, the annual number of deaths nationwide is expected to increase to 25,000 by 2025 and to over 27,000 by 2035 ( 11 ). We may therefore soon face over 20,000 annual deaths unless an effective means of prevention is established.…”

Tub bathing and heart disease

“…Sudden death associated with hot bathing is a frequent occurrence in Japan,1 with estimates of the annual number of deaths of 19 000 2. In 2012, it was reported in the The Daily Telegraph 3 that Japan’s health ministry was to launch an investigation into bath-time deaths because of the large number of fatalities—said to be three times as many as those who died in car accidents.…”