title: Unintentional drowning in Finland 1970-2000: a population-based study.
abstract: BACKGROUND
  While standard data on drowning reported by the World Health Organization (WHO) fails to provide a reliable picture of the burden of drowning in Finland, they suggest that the rates are much higher than those of other industrialized countries.
  
  
  OBJECTIVE
  To determine the true burden of drowning in Finland and factors related to its high rates.
  
  
  METHODS
  Descriptive, retrospective, population-based analysis of all deaths by drowning, among residents of all ages.
  
  
  METHODS
  Finland, 1970-2000.
  
  
  METHODS
  Mortality and population data furnished by Statistics Finland (SF) were used to determine age- and sex-specific drowning mortality rates using both nature- and cause-of-injury codes. Individual-level data from the death certificates were analysed and cross-linked to a nationwide postmortem toxicology database.
  
  
  RESULTS
  From 1970 to 2000, 9279 unintentional drownings occurred (mean: 299.3/year SD 84.3, rate 6.1/100 000/year; M:F ratio = 8.6:1), accounting for 11.7% of all unintentional injury deaths. Drowning rates overall have decreased from 9.9/100 000/year in 1970-1972, to 4.5 in 1998-2000 (-2.7%/year; 95% CL: -3.0; -2.5). The most frequent activities related to drowning included boating (29.8%), falling (26.1%), swimming (25.0%), and activities on ice (12.4%). In non-boating-related drownings, 74.5% of males and 67.4% of females tested had a blood alcohol concentration (BAC) >/=50 mg/dl, while in boating-related drownings, the respective values were 78.1% and 71.4%.
  
  
  CONCLUSIONS
  WHO statistics underestimate the true burden of drowning in Finland by up to 40-50%. Drowning rates and alcohol involvement in drowning are much higher than in other comparable developed countries. Broad-based countermeasures to reduce alcohol use in water activities are needed as part of any strategy to reduce drowning rates.
authors.affiliation: Department of Forensic Medicine, PO Box 40 (Kytösuontie 11), University of Helsinki, 00300 Helsinki, Finland. philippe.lunetta@helsinki.fi
authors.forename: Philippe
authors.initials: P
authors.lastname: Lunetta
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Smith
authors.forename: Antti
authors.initials: A
authors.lastname: Penttilä
authors.forename: Antti
authors.initials: A
authors.lastname: Sajantila
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology* / Q000209:etiology; D000431:Ethanol / Q000097:blood; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D000431:Ethanol