Measuring Australian Children’s Water Safety Knowledge: The National Water Safety Quiz

Water safety knowledge levels of Australian children are poorly understood. Royal Life Saving developed an online National Water Safety Quiz (NWSQ) as an interactive means of determining water safety knowledge amongst Australian primary school children (ages 5 to 12 years). Over a period of 8 months, a total of 4,215 children participated in the NWSQ. The NWSQ identified areas of water safety where knowledge was poor including the topics of CPR, swimming, and river safety. Children achieved a better result as they aged. Females out-performed males overall and specifically from ages 10-12 years. Children from independent schools performed better. This research is the first of its kind to measure water safety knowledge at a population level for primary school children, using an online web-based tool. Understanding children’s water safety knowledge is important as it enables the tailoring, delivery and evaluation of programs which help to reduce the burden of drowning

Drowning prevention strategies in Asia

The International Lifesaving Federation (ILS) recognises that the Asia Pacific region presents substantial challenges in the global effort to reduce the alarming death by drowning statistics in the region. The main exception to this situation is that Australia has a world-renowned history in lifesaving, dating back to the 19th century with the establishment of the Royal Life Saving Society (RLSSA) in comparison to the majority of the other countries in the region. Over the last decade some initiatives have seen the establishment of SwimSafe Vietnam, the Thailand Life Saving Society, the Philippine Lifesaving Society and the International Centre for Drowning Research in Bangladesh being formed. The Royal Life Saving Society has responded to the situation through a number of initiatives designed to assist the region develop sustainable solutions to the crisis and this paper will outline how these partnerships have developed. The presentation will provide an overview of a number of strategies, their development, management and more importantly the sustainability for the people of the countries that have been actively engaged in the drowning prevention efforts. In many applications it reflects the desire to encourage shared learning, knowledge and problem solving to achieve common goals between organisations in the region

Understanding the full burden of drowning: a retrospective, cross-sectional analysis of fatal and non-fatal drowning in Australia

Objectives: The epidemiology of fatal drowning is increasingly understood. By contrast, there is relatively little population-level research on non-fatal drowning. This study compares data on fatal and non-fatal drowning in Australia, identifying differences in outcomes to guide identification of the best practice in minimising the lethality of exposure to drowning. Design: A subset of data on fatal unintentional drowning from the Royal Life Saving National Fatal Drowning Database was compared on a like-for-like basis to data on hospital separations sourced from the Australian Institute of Health and Welfare's National Hospital Morbidity Database for the 13-year period 1 July 2002 to 30 June 2015. A restrictive definition was applied to the fatal drowning data to estimate the effect of the more narrow inclusion criteria for the non-fatal data (International Classification of Diseases (ICD) codes W65-74 and first reported cause only). Incidence and ratios of fatal to non-fatal drowning with univariate and X 2 analysis are reported and used to calculate case-fatality rates. ' Setting: Australia, 1 July 2002 to 30 June 2015. Participants: Unintentional fatal drowning cases and cases of non-fatal drowning resulting in hospital separation. Results: 2272 fatalities and 6158 hospital separations occurred during the study period, a ratio of 1:2.71. Children 0-4 years (1:7.63) and swimming pools (1:4.35) recorded high fatal to non-fatal ratios, whereas drownings among people aged 65-74 years (1:0.92), 75+ years (1:0.87) and incidents in natural waterways (1:0.94) were more likely to be fatal. Conclusions: This study highlights the extent of the drowning burden when non-fatal incidents are considered, although coding limitations remain. Documenting the full burden of drowning is vital to ensuring that the issue is fully understood and its prevention adequately resourced. Further research examining the severity of non-fatal drowning cases requiring hospitalisation and tracking outcomes of those discharged will provide a more complete picture

Fatal, unintentional drowning in older people: an assessment of the role of preexisting medical conditions

Background: The number of older people (aged 65 y and over) is increasing in Australia and chronic medical conditions are common. Aquatic activities provide physical and social benefits; however, understanding the risks related to aquatic activity is important for ongoing health and wellbeing. We explore the impact of preexisting medical conditions on unintentional fatal drowning among older people in Australia. Methods: Using coronial, forensic, and medical histories from the Australian National Coronial Information System, all cases of unintentional death by drowning (or where drowning was a factor) among older people in Australia between July 1, 2002 and June 30, 2012 were investigated. Preexisting medical conditions were reviewed to determine whether they were contributory to drowning. Results: Of the 506 older people who drowned, 69.0% had a preexisting medical condition. The leading contributory medical condition was cardiovascular disease, followed by dementia, depression, epilepsy, and Parkinson disease. All conditions except cardiovascular disease and depression were overrepresented compared with the proportion of the disease in the population. Falling into water was the most common activity immediately before drowning, especially among those with dementia, whereas those with cardiovascular disease were most likely to drown while swimming. Conclusions: Preexisting medical conditions contribute to drowning in older people but with unequal contributions. With the prevalence of medical conditions expected to increase as the population ages, targeted education for older people will be important. Risk management will enable older people to safely participate in aquatic activities

Using a retrospective cross-sectional study to analyse unintentional fatal drowning in Australia: ICD-10 coding-based methodologies verses actual deaths

Objectives: Fatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths. Design: An analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007-2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society-Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD. Setting: Australia, 2007-2011. Participants: Unintentional fatal drowning cases. Results: The Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0-17 years) were closely aligned (73.9%); however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level. Conclusion: Defining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention

Learning to Swim: What Influences Success?

Swimming and water safety skills are important life skills, particularly in Australia, where aquatic activities are regularly enjoyed. Little research has been undertaken exploring children’s swimming and water safety skills, what level they can achieve, and what factors impact their ability to learn these skills. This study explores children aged 5-12 years who participated in the Australian Capital Territory Primary Schools Swim and Survive Program, 2009-2011. Children who were more likely to achieve higher levels were older, were female, attended private school, swam at least once a fortnight, had a swimming pool at home, or visited a public swimming pool. Those who were less likely were Aboriginal or Torres Strait Islander, had a negative experience, and swam less than once a fortnight

World Conference on Drowning Prevention 2019, Durban, South Africa

No Abstract

A framework for prevention

The prevention of drowning is not a new issue nor is it an issue to be taken lightly. With estimates of between 400,000 and 1.2 million people drowning worldwide per annum, there is an imperative for preventative action [1, 2]. This chapter outlines a range of frameworks for drowning prevention and explores their application

Mapping Trends in Drowning Research: A Bibliometric Analysis 1995–2020

Drowning is public health issue requiring global, national and community responses. The multisectoral nature of drowning prevention reinforces the need for multidisciplinary research, which can play a key role in identifying patterns, factors and interventions and contributes to evidence-informed prevention. This study presents a biometric analysis of drowning research published in 1995–2020 and identifies temporal trends in research themes, journals, countries and authorship to assist in the planning of future research. This study identified 935 studies, representing authors from 80 countries. Publications grew 103-fold, and 41.2% (n = 385) were published since 2014. The top 20 journals are all injury prevention, public health, or medical journals. The top 5 accounted for 24.5% (n = 229) of total publications (TP). Research from the United States (TP = 313, 25.0%) and Australia (TP = 192, 15.3%) dominates the field. Growth is highest in low–middle-income countries (LMICs) including China (TP = 54, 4.3%, 32-fold), India (TP = 30, 2.4%, 17-fold) and Bangladesh (TP = 47, 3.7%, 7-fold). The study identifies significant growth in epidemiologic studies reporting burden and risk factors. Research in LMICs is increasing but lags relative to the burden. The role of multilateral and nongovernment organisations in evidence generation is evident and needs investigation, as do gaps in evidence for interventions and partnerships to progress the drowning prevention field

Identifying strategic priorities for advancing global drowning prevention: a Delphi method

Introduction The burden of drowning is gaining prominence on the global agenda. Two United Nations system resolutions in 3 years reflect rising political support, but priorities remain undefined, and the issue lacks a global strategy. We aimed to identify strategic priorities for advancing global drowning prevention using a modified Delphi method.Methods An advisory group was formed, and participants recruited with diverse expertise and backgrounds. We used document review, and data extracted from global health partnerships to identify strategic domains and draft priorities for global drowning prevention. Participants rated the priorities in two Delphi rounds, guided by relevance, feasibility and impact on equity, and where consensus was ≥70% of participants rating the priority as critical.Results We recruited 134 participants from research (40.2%), policy (26.9%), technical (25.4%) and community (7.5%) backgrounds, with 38.1% representing low- and middle-income countries. We drafted 75 priorities. Following two Delphi rounds, 50 priorities were selected across the seven domains of research and further contextualisation, best practice guidance, capacity building, engagement with other health and sustainable development agendas, high-level political advocacy, multisectoral action and strengthening inclusive global governance. Participants scored priorities based on relevance (43.2%), feasibility (29.4%) and impact on equity (27.4%).Conclusion Our study identifies global priorities for drowning prevention and provides evidence for advocacy of drowning prevention in all pertinent policies, and in all relevant agendas. The priorities can be applied by funders to guide investment, by researchers to frame study questions, by policymakers to contrast views of expert groups and by national coalitions to anchor national drowning prevention plans. We identify agendas including disaster risk reduction, sustainable development, child and adolescent health, and climate resilience, where drowning prevention might offer co-benefits. Finally, our findings offer a strategic blueprint as the field looks to accelerate action, and develop a global strategy for drowning prevention