Summer is a high-risk time of the year for drowning – and particularly so during a La Niña event, as we are now experiencing.
Some timely tips on drowning prevention are shared below by Dr Amy Peden, an injury prevention researcher and lecturer at the School of Population Health at UNSW.
The post is based upon her recent week of guest tweeting for Croakey’s rotated, curated Twitter account, @WePublicHealth, reflecting on #NationalWaterSafetyDay.
We welcome applications to guest tweet at @WePublicHealth during 2022. Contact @MelissaSweetDr.
Amy Peden tweets:
Drowning has been described as a global public health threat by the World Health Organization (WHO) and disproportionately impacts low and middle income countries, and children and young people less than 25 years of age.
Here’s the historic first global report on drowning. Drowning is estimated to claim the lives of 236,000 people worldwide (as per WHO); however, these estimates EXCLUDE drowning due to disaster (floods, tsunami etc) and transportation (ie ferries).
Here’s a blog that Professor Richard Franklin and I wrote in @IP_BMJ, the Injury Prevention journal, Global Drowning Prevention Day 2021: The start of a new era?
The historic first United Nations declaration on drowning proclaims July 25 as World Drowning Prevention Day.
This global advocacy event serves as an opportunity to highlight the tragic and profound impact of drowning on families and communities.
In Australia we observe #NationalWaterSafetyDay on December 1, the first day of summer.
The day has bipartisan political support and activities are led by national drowning prevention organisations: @RoyalLifeSaving and @SLSAustralia.
Such is my commitment to drowning prevention I’m off to take my children to swimming lessons this morning.
Terminology
Now to talk about the fatal and non-fatal drowning burden in Australia.
First things first, did you know that drowning isn’t always fatal?
You may die from drowning or you may survive, with or without persisting injury. Terms such as secondary, delayed or dry drowning are not appropriate, nor accurate. More info here.
Globally, it’s estimated that 236,000 people died from drowning in 2019. But we’ve already discussed the issues with the estimates. Did you know the global non-fatal drowning burden is very poorly understood? Interim guidance from the WHO aims to help this.
In Australia we are fortunate to have excellent data on fatal and non-fatal drowning to drive prevention thanks to the hard work of organisations such as the National Coronial Information System, @RoyalLifeSaving and @SLSAustralia.
On average, 273 people die from unintentional drowning each year in Australia. A further 534 are hospitalised due to non-fatal drowning.
You can find detailed analysis of the 2021 drowning statistics in the @royallifesaving National Drowning Report.
This doesn’t speak to the Emergency Department presentations, the ambulance attendances and rescues conducted each year. @SLSAustralia reported undertaking 8,064 rescues in 2021 & a further 1.75 million preventative actions. More here.
In addition to this, bystander rescuers save even more lives. Work done in Australia by @Dr_Rip_SOS and by @surfingmed colleagues in Europe show surfers play an important role in preventing drowning.
Respect the River
Next we’re going to take a location-based look at drowning and explore the leading location for drowning in Australia – our rivers, creeks and streams.
Did you know that rivers are the leading location for drowning in Australia?
@RoyalLifeSaving data shows on average, rivers claim the lives of 73 people per year, with 75 deaths in 2020/21. Wealth of information here.
Although a leading location, rivers have been neglected in drowning prevention efforts. My PhD with @Franklin_R_C and @leggat_peter tried to redress this. We found being male, alcohol consumption, rurality and flooding were key risk factors.
This work influenced @RoyalLifeSaving to undertake #RespectTheRiver – a national river drowning prevention program that continues to this day.
Some important river safety tips – wear a lifejacket, avoid alcohol around water, never swim alone, learn how to save a life with CPR and rescue skills.
To continue our discussion about inland drowning risk and look at the very topical issue of flooding given our predicted La Nina summer.
Flooding is a significant risk factor for fatal river drowning: water levels are higher, currents stronger, and conditions can change quickly including debris being washed downstream. Playing or swimming in floodwaters is dangerous and should be discouraged.
So too is driving into floodwaters. Research by colleagues @DrKyraHamilton and @jacobjkeech et al shows that drivers often feel pressure from other motorists or to get to their destination when they drive into floodwaters, increasing their drowning risk.
Climate impacts
Climate change is predicted to increase the frequency and severity of floods worldwide. In 2020, @CREDUCL reported 26 percent more storms, 23 percent more floods and 18 percent more flood deaths than the annual average.
Beyond flooding, climate change also brings with it extremes in temperatures increasing drowning risk not only in summer, but also in the cooler seasons as this study out of Canada shows.
Looking forward, it’s vital that we continue the work on the intersections between climate, disaster, and drowning prevention in 2022.
Older swimmers
Next we focus on drowning among older people. Did you know, according to @RoyalLifeSaving data, 69 people aged 65+ years drowned in Australia in 2020/21?
Drowning among older people has been described as a hidden epidemic with increasing drowning rates among 65+ year olds in Australia and Canada. With an aging population globally, this neglected age group is cause for concern.
Pre-existing medical conditions have been identified as a risk factor for drowning among older people in Australia. Common conditions identified included cardiovascular disease, dementia, depression, epilepsy and Parkinson’s Disease. More here.
The @royallifesaving #SwimReady campaign encourages people with medical conditions to consult their doctor before enjoying the health benefits of swimming. This includes being mindful of possible side effects any medications being taken can have when exercising.
The #GreyMedallion program also helps adults develop essential lifesaving and water safety skills to enjoy the water safely.
In the coastal environment, @SLSAustralia #SilverSalties program provides physical activity and social connectedness for older Australians with the aim of reducing drowning
Also check out this fascinating qualitative study from @MegAbercrombyand @deep_curtin colleagues around older Australians water safety attitudes and practices in Western Australia @HealthProm_J_Au.
Despite an aging population and increasing drowning rates among this age group, little work has been done globally to reduce #drowning risk among this cohort.
Swimming pools
Next we’re going to take a look at swimming pools – both home pools and public pools. According to @RoyalLifeSaving, 30 people died from unintentional drowning in swimming pools in Australia in 2020/21.
Home swimming pools are a high-risk location for drowning for children under five. Thirty-two percent of child drownings in 2020/21 occurred in home swimming pools. Active adult supervision is a key strategy to reduce child drowning risk.
Restricting access to water through correctly installed and regularly maintained pool fencing reduces child drowning risk in home pools, our study out of Queensland shows.
Let’s also not forget about portable pools. These also pose a drowning risk, disproportionately impacting children from rural and remote areas and low socio economic areas.
Portable pools also require active adult supervision and a barrier if deeper than 30cm in most states and territories.
Public pools and aquatic centres are also part of the drowning prevention picture. They provide safe places to learn to swim and to swim for fitness. The social and economic benefits of such facilities are huge and should be supported.
So seek out your local pool – it’s the safest place to swim this summer thanks to the lifeguards.
Next to coastal drowning. A lot of work has been done on coastal drowning prevention but gaps remain as this literature review by @UNSW_BSRG colleagues shows.
Top tips for keeping safe at the beach?
- Always swim between the flags, at patrolled beaches during patrol times.
- Avoid alcohol or drugs before getting in the water.
- Supervise young children.
- Take a second to assess conditions before you get in.
Making progress?
Now to wrap things up and look at progress to date in reducing drowning in Australia. We are fortunate enough to have a sector that aligns activities to the Australian Water Safety Strategy – which we’ve had in various iterations since 2004.
In fact, the Australian Water Safety Strategy has been identified as a drowning prevention exemplar by the WHO in its Implementation Guide for drowning prevention. More here.
Myself and colleagues @JustinScarr and Alison Mahony explored progress in reducing drowning deaths against the goals of the Australian Water Safety Strategy in @anzjph.
We found fatal drowning rates decline by 28 percent with the biggest reductions in drowning among under fives (-63%) and 5-14 year olds (-56%). This is due to a range of measures including pool fencing legislation and enforcement, CPR and increased awareness of the need for supervision.
However, drowning rates among 75+ year olds (-11%) and adolescents 15-24 years (-14%) have been the most resistant to change.
All locations declined – aside from rocks (+46%) highlighting the dangers of rock fishing and slips and falls.
We can all work together to reduce drowning over summer. The usual warnings apply, wear lifejackets, swim between the flags, supervise children.
Considering La Nina – avoiding entering floodwaters at all costs must absolutely be front of mind. I wish everyone a water safe summer.
Follow on Twitter: @dramyepeden
See the Croakey stories contributed by @WePublicHealth guest tweeters in 2021.
