Ten-year study of pediatric drownings and near-drownings in King County, Washington: lessons in injury prevention.
The factors associated with submersion events among less than 20-year-old persons that occurred in King County from 1974 to 1983 were studied to focus prevention efforts. Near-drowning (n = 103) and drowning (n = 96) victims were identified from medical examiners' reports, paramedics' reports, and hospital discharge registers. Annual incidence was 5.5; the mortality rate was 2.6 per 100,000 children. Although preschool-aged children had the largest incidence (12.8), followed by older adolescents (4.9), adolescents had the largest case fatality rate, 77%. Lake and river victims had the largest incidence, mortality, and case fatality rate; swimming pools, the smallest case fatality rate (25%). A total of 89% of all victims had absent or no supervision; victims supervised by lifeguards had a 42% case fatality rate. Prior seizures were part of the history of 7.5% of all victims; 25% of fatal submersions by adolescents were associated with alcohol. Bathtub submersions were associated with child abuse in three of 16 preschool-aged children and epilepsy in four of five older children. Certain age groups and sites combined had the greatest incidence: preschool-aged children in swimming pools, infants in bathtubs, teenagers in lakes and rivers. Incidence decreased in public and semipublic pools coincident with fencing regulations. These findings suggest prevention strategies: extending fencing requirements to private pools, discouraging alcohol consumption during water sports, changing bathing practices of epileptics, and improving lifeguard efficacy.
Quan
L
L
Department of Pediatrics, University of Washington School of Medicine, Seattle.
Gore
E J
EJ
Wentz
K
K
Allen
J
J
Novack
A H
AH
D000293:Adolescent; D000367:Age Factors; D001494:Baths; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005618:Fresh Water; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D013551:Swimming Pools; D014861:Washington