1. DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine

2. Outline Definitions Statistics Risks Causes Prevention

3. Drowning: Definitions Drowning –A suffocation resulting in death < 24 hours of being submerged in water Near Drowning –An incident resulting in survival > 24 hours after being submerged in water

4. Drowning Statistics In 2000, there were 3482 unintentional drownings in the United States, an average of 9/day. –U.S. Centers for Disease Control and Prevention It is estimated that for each drowning death, there are 1 to 4 nonfatal submersions serious enough to result in hospitalization……..with at least half of survivors suffering significant neurologic impairment. –American Academy of Pediatrics

5. Drowning Statistics Drowning is the 2 nd leading cause of injury-related death among children < 15 years. –U.S. Centers for Disease Control and Prevention 19% drowning deaths involving children occur in public pools with certified lifeguards present. –Drowning Prevention Foundation

6. Why Should We Care? The State of Florida averages 400 deaths/yr California, Arizona & Florida –Leading cause of injury related death for children < 5 years Cost of Drowning & Near Drowning –$400,000,000/year

7. Who is Affected? Vulnerable Populations –Geography: Southern States –Gender: Males > 81% of drowning victims –Age: Children are the most vulnerable

8. Differences by Race Vulnerable Populations Race –Blacks: age adjusted drowning rate > 1.5 times –Difference dependent on age range: < 4 yrs: Whites have a higher rates > 4 yrs: Black children 2.5 times

9. Differences by Race Vulnerable Populations Race –American Indians & Alaska Native children 2x –Unlike white children, they tend to drown in natural bodies of water

10. "(She) was left unattended for about one or two minutes when she drowned Monday, police said." (AP) Jacksonville was the location of the tragedy, the victim aged 18 months, the setting a bathtub. But 15 times in 1998 similar stories were repeated in Lee County. Six (6) of the dead were < 18 years. Why do people drown?

11. Why to people Drown?

12. Why do people drown? Causes Access Ethanol –> 50% for Adolescents & Adults Adult Supervision –Children Lack of Education

13. Where: Bathtubs

14. Where: Buckets & Toilets

15. Where: Pools pool

16. Marine Waters

17. Where: Lakes & Other Water Bodies

18. Where: Recreational Water Activities

19. Where: Occupational Water Activities

20. Ethanol & Water Activities

21. Prevention f

22. Prevention: Pool Fencing

23. Prevention: Education & Warnings Buckets

24. Prevention: Education & Warnings

25. Prevention: Targeted Education

26. Prevention: Swimming & CPR

27. Conclusions Drowning is preventable –Warnings Supervision –Targeted Education Age etc Access –Intervention

28. Thank you Gina Mena (2001)