title: Drowning mortality and morbidity rates in children and adolescents 0-19 yrs: a population-based study in Queensland, Australia.
abstract: OBJECTIVE
  To redress the lack of Queensland population incidence mortality and morbidity data associated with drowning in those aged 0-19 yrs, and to understand survival and patient care.
  
  
  METHODS
  Retrospective population-based study used data linkage to capture both fatal and non-fatal drowning cases (N = 1299) among children aged 0-19 years in Queensland, from 2002-2008 inclusive. Patient data were accessed from pre-hospital, emergency department, hospital admission and death data, and linked manually to collate data across the continuum of care.
  
  
  METHODS
  Incidence rates were calculated separately by age group and gender for events resulting in death, hospital admission, and non-admission. Trends over time were analysed.
  
  
  RESULTS
  Drowning death to survival ratio was 1:10, and two out of three of those who survived were admitted to hospital. Incidence rates for fatal and non-fatal drowning increased over time, primarily due to an increase in non-fatal drowning. There were non-significant reductions in fatal and admission rates. Rates for non-fatal drowning that did not result in hospitalisation more than doubled over the seven years. Children aged 5-9 yrs and 10-14 yrs incurred the lowest incidence rates 6.38 and 4.62 (expressed as per 100,000), and the highest rates were among children aged 0-4 yrs (all drowning events 43.90; fatal 4.04; non-fatal 39.85-comprising admission 26.69 and non-admission 13.16). Males were over-represented in all age groups except 10-14 yrs. Total male drowning events increased 44% over the seven years (P<0.001).
  
  
  CONCLUSIONS
  This state-wide data collection has revealed previously unknown incidence and survival ratios. Increased trends in drowning survival rates may be viewed as both positive and challenging for drowning prevention and the health system. Males are over-represented, and although infants and toddlers did not have increased fatality rates, they had the greatest drowning burden demonstrating the need for continued drowning prevention efforts.
authors.affiliation: Centre for Children's Burns & Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia; Paediatric Burns and Trauma Network, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Belinda A
authors.initials: BA
authors.lastname: Wallis
authors.affiliation: Centre for Children's Burns & Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
authors.forename: Kerrianne
authors.initials: K
authors.lastname: Watt
authors.affiliation: Centre for Children's Burns & Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia; Royal Life Saving Society Australia, Sydney, Australia.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Franklin
authors.affiliation: Centre for Children's Burns & Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia.
authors.forename: James W
authors.initials: JW
authors.lastname: Nixon
authors.affiliation: Centre for Children's Burns & Trauma Research, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia; Paediatric Burns and Trauma Network, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Roy M
authors.initials: RM
authors.lastname: Kimble
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D009026:Mortality; D011159:Population Surveillance; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult