Drowning deaths in people with epilepsy.
OBJECTIVE
To determine the demographic characteristics and risk factors associated with death from drowning among people with epilepsy.


METHODS
Retrospective review of medical examiner's investigations into deaths from drowning from Jan. 1, 1981, to Dec. 31, 1990.


METHODS
Alberta.


METHODS
Personal data, medical history, circumstances surrounding the death, autopsy findings and results of postmortem toxicologic analyses.


RESULTS
Of 482 deaths from drowning in Alberta during the study period, 25 (5%) were considered by the medical examiner's office to be directly related to seizures. Fifteen (60%) of the 25 deaths occurred while the person was taking a bath, unsupervised. Only one person (4%) died while taking a shower. The remaining deaths occurred on a river or lake (16%), in a private pool (8%), in a public pool (8%) and in a jacuzzi (4%). Two people fell out of moving boats while having a seizure; neither had been wearing a personal flotation device. Nineteen (83%) of 23 people who had been receiving anticonvulsant drug therapy had undetectable or subtherapeutic levels of one or more of the drugs at autopsy. Ethanol was not a factor in any of the deaths.


CONCLUSIONS
Seizure-related drownings represent a small but potentially preventable proportion of all drownings. Enhanced seizure control and compliance with anticonvulsant drug therapy may prevent some of these deaths. In addition, all people with epilepsy, regardless of the level of control of their condition, should be encouraged to take showers while sitting instead of baths. The presence of people in the same house who are not directly supervising the person in the bathroom does not protect against drowning. Personal flotation devices should be worn at all times during boating activities.
Ryan
C A
CA
Department of Pediatrics, University of Alberta Hospitals, University of Alberta, Edmonton.
Dowling
G
G
D000061:Accidents, Home / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000416:Alberta / Q000453:epidemiology; D000927:Anticonvulsants / Q000097:blood; D001494:Baths; D004332:Drowning / Q000401:mortality*; D004827:Epilepsy / Q000453:epidemiology*; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013550:Swimming
D000927:Anticonvulsants; D000431:Ethanol