Water incident related hospital activity across England between 1997/8 and 2003/4: a retrospective descriptive study.
BACKGROUND
No one has ever reported or investigated the number of people who have been admitted to hospital for a water related incident. The purpose of this paper is to examine, the hospital activity resulting from such incidents including to length of stay, gender, age and cause.


METHODS
The data was extracted from the Hospital Episode Statistics (HES) for episodes with a mention of ICD 10 (V90-94, W15-16, W65-74, X38, X92, Y21) for the years 1997/8 to 2003/4. Population based rates and relative risk were calculated using the most recent Census data for England (2001).


RESULTS
The 6,793 episodes resulted in a total of 32,520 bed days with an average of length of stay of 5.0 days. Males made up 73.7% (n = 5,006) of episodes and females 26.1% (n = 1,787). Annual trends peaked in 1999-2000 at a rate of 2.4 per 100,000 and have fluctuated on alternate years there after. In terms of relative risk males are at a 2.3 to 3.0 increased annual risk of being admitted compared to females, relating to a water event. The highest annual rates were observed within the 0 - 14 age group, ranging from 3.1 to 4.2 episodes per 100,000.


CONCLUSIONS
Based on these findings, for every one drowning that occurs per year there are three hospital episodes. Each of the age groups identified within the study reported an increase in hospital episodes between 2002 - 2003 and 2003 - 2004, when considering the fatality information available it would appear that although fatalities are decreasing in the similar time period, hospital episodes are increasing. For the 0-14 age group, the cause of the injury had changed over the years, moving away from bath tub and swimming pool, to watercraft incidents (V91 - 93). For the 15 - 59 age group there had been a decline in the frequency of watercraft and water transport episodes, however, an increase in diving and jumping injury and incidents. In the over 60 age group water transport episodes remained the most frequent, with swimming pool related episodes declining and other specified drowning and submersion increasing. More work needs to be undertaken in regard to who is admitted to hospital, when where, and how to fill gaps in knowledge and highlight information that is critical to prevention strategies.
Henderson
Holly
H
Research Consultant, Gateshill, Middle Road, Lychett Maltravers, Poole, Dorset, BH16 6HJ, UK. hehenderson@mac.com
Wilson
Richard C
RC
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001265:Athletic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004242:Diving / Q000293:injuries*; D004332:Drowning / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D017050:Episode of Care; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D013550:Swimming / Q000293:injuries*; D014872:Water Movements