Children's Drowning Injuries, Deaths Decline: Study

Youngest children at risk in bathtubs, older boys at most risk from swimming

By Ellin Holohan
HealthDay Reporter

MONDAY, Jan. 16 (HealthDay News) -- More than 1,000 children die from drowning in the United States each year and another 5,000 are injured, but these casualties have declined dramatically since the early 1990s, a new study shows.

The number of children who died annually from drowning after being admitted to a hospital declined 42 percent between 1993 and 2008. Total trips to the hospital after drowning-related incidents declined by 51 percent among children during that time, researchers found.

"There have been efforts at education from a variety of groups," said study author Stephen Bowman, an assistant professor at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore. "One would think that those messages are getting across."

"We need to keep up our diligence to continue to reduce drowning-related deaths and injuries," he added.

The study, published online and in the February issue of Pediatrics, used the National Inpatient Sample, a vast database compiled by a consortium of about 1,000 hospitals.

Drowning injuries are the second leading cause of accidental trauma in children in the United States. Only car accidents injure more children, Bowman said. Nonfatal drowning often results in brain damage and long-term disability, according to the study.

Breaking down different levels of risk, the study found that children less than 4 years old are most likely to die in drowning incidents, usually in bathtubs or after falling into water. Older children are more likely to drown while swimming, according to research cited in the study, with the risk rising in warmer regions of the South and West that have longer swimming seasons.

Boys, meanwhile, are four to six times more likely than girls to suffer a drowning injury, possibly because they drink alcohol while swimming or overestimate their swimming skills, according to study background information, and between 30 and 50 percent of teen and adult drownings are caused, at least partly, by drinking.

The study found a 40 percent drop in hospital visits following bathtub-related drownings among children under 4 years old and a 50 percent decline in swimming-related hospital trips for children ages 10 to 14. In warmer parts of the country, drowning injuries declined by almost 50 percent during the study period.

"We wanted to create some benchmarks," so that various states and regions could measure their progress against national trends, Bowman said.

While the number of drowning deaths and injuries has dropped, the cost of medical treatment has remained about the same because expenses per case have grown, Bowman said.

"The relative cost per drowning case has risen dramatically and offsets the reduction in hospitalizations," Bowman said.

In 2000, costs associated with such injuries exceeded $5.3 billion, including $2.6 billion for children up to 14 years old, the study said.

The reason for the decline in drowning cases among the youngest children may be "targeted injury-prevention efforts" aimed at parents and caregivers of young children, the study said.

For children of all ages, other factors in reduced drowning rates include education, public health initiatives and safety legislation, according to the head of an organization devoted to preventing accidental childhood injury and death.

Kate Carr, chief executive officer of Safe Kids Worldwide, cited federal legislation passed in 2007 requiring pool and hot tub drains to have covers and calling for other safety measure to be taken by states. The law followed the drowning death of a child whose mother was unable to free her from the suction of a hot-tub drain.

"You can see that it is working. It is not the only thing, but it is one thing that has worked," Carr said.

The study is important, she said, because it helps safety organizations target their efforts at regions where more drownings occur. It "allows us to celebrate the progress that has been made," but more efforts are needed because "one death is one too many," she said.

More information

To learn more about drowning prevention, visit Safe Kids USA.

SOURCES: Stephen M. Bowman, Ph.D., assistant professor, Bloomberg School of Public Health, Johns Hopkins University, Baltimore; Kate Carr, chief executive officer, Safe Kids Worldwide, Washington, D.C.; February 2012 Pediatrics

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