title: Association between swimming lessons and drowning in childhood: a case-control study.
abstract: OBJECTIVE
  To estimate the association between swimming lessons and the risk of drowning among children aged 1 to 19 years.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Cases were identified from medical examiners'/coroners' offices between mid-2003 and mid-2005. Jurisdictions included the states of Maryland and North Carolina, 14 districts (33 counties) in Florida, 3 counties in California, 1 county in Texas, and 1 county in New York.
  
  
  METHODS
  Cases were children and adolescents aged 1 to 19 years who died of unintentional drowning. Interviews were conducted with 88 families of children who drowned and 213 matched controls. Main Exposure Swimming lessons. Main Outcome Measure Death due to unintentional drowning. Drownings that were intentional, of undetermined intent, or that occurred under conditions in which swimming ability was unlikely to impact risk (eg, in ice water or bathtubs) were excluded.
  
  
  RESULTS
  Of the 61 cases in the 1- to 4-year age group, 2 (3%) had participated in formal swimming lessons vs 35 of 134 matched controls (26%) (adjusted odds ratio [OR], 0.12; 95% confidence interval [CI], 0.01-0.97). Among the 27 cases aged 5 to 19 years, 7 (27%) had ever taken formal swimming lessons vs 42 of 79 matched controls (53%) (adjusted OR, 0.36; 95% CI, 0.09-1.51). In adjusted analyses, there was no statistically significant association between informal instruction and drowning risk.
  
  
  CONCLUSIONS
  Participation in formal swimming lessons was associated with an 88% reduction in the risk of drowning in the 1- to 4-year-old children, although our estimates were imprecise and 95% CIs included risk reductions ranging from 3% to 99%.
authors.affiliation: National Institute of Child Health and Human Development, Bethesda, MD 20892, USA. brennerr@mail.nih.gov
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Brenner
authors.forename: Gitanjali Saluja
authors.initials: GS
authors.lastname: Taneja
authors.forename: Denise L
authors.initials: DL
authors.lastname: Haynie
authors.forename: Ann C
authors.initials: AC
authors.lastname: Trumble
authors.forename: Cong
authors.initials: C
authors.lastname: Qian
authors.forename: Ron M
authors.initials: RM
authors.lastname: Klinger
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D004332:Drowning / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018570:Risk Assessment; D013550:Swimming / Q000193:education*; D014481:United States / Q000453:epidemiology; D055815:Young Adult