title: Sudden Death Phenomenon While Bathing in Japan　- Mortality Data.
abstract: Bath-related sudden cardiac arrest frequently occurs in Japan, but the mortality data have not been sufficiently reported.
  
  
  
  This prospective cross-sectional observational study was conducted in the Tokyo Metropolis, Saga Prefecture and Yamagata Prefecture between October 2012 and March 2013 (i.e., in winter). We investigated the data for all occurrences in these areas for which the emergency medical system needed to be activated because of an accident or acute illness related to bathing. Emergency personnel enrolled the event when activation of the emergency medical system was related to bathing. Of the 4,599 registered bath-related events, 1,527 (33%) were identified as bath-related cardiac arrest events. Crude mortality (no. deaths per 100,000) during the observational period was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga. According to the mortality data for age and sex, the estimated number of bath-related deaths nationwide was 13,369 in winter, for the 6 months from October (95% CI: 10,862-16,887). Most cardiac arrest events occurred in tubs filled with water with the face submerged in the water. This suggests that drowning plays a crucial role in the etiology of such phenomena.
  
  
  
  The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October. Crude mortality during the winter season was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga.
authors.affiliation: Department of Emergency and Critical Care Medicine, Keio University School of Medicine.
authors.forename: Masaru
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Ohta Nishinouchi Hospital.
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.affiliation: Faculty of Science and Technology, Keio University.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ikaga
authors.affiliation: Department of Emergency and Critical Care Medicine, Keio University School of Medicine.
authors.forename: Shingo
authors.initials: S
authors.lastname: Hori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001494:Baths / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003645:Death, Sudden / Q000453:epidemiology* / Q000517:prevention & control*; D003695:Delivery of Health Care / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012621:Seasons
keywords: Aging; Bathing; Cardiac arrest; Epidemiology; Mortality