A Community-Based Approach to Preventing Childhood Drowning
Elizabeth Bennett, MPH, CHES, Linda Quan, MD and Kathy Williams, MS
The Drowning Problem
"A brief conversation on the phone was all it took for a 2-year old to slip away from his mother's watchful eye and fall into the backyard pool."
"A 4-year old child wandered away from a picnic gathering of friends and family. She was found at the bottom of a pond nearby."
"Throwing rocks in the river, an 8-year old slipped off the bank. It took over 20 minutes to find him. He survived for several years with 24-hour nursing care."
"On a dare, a 14-year old set off with a group of friends to swim to a floating raft out on the lake. He complained of being tired and the water was cold. Less than a minute later he slipped beneath the water. There was nothing his friends could do."
"What started out as a day of fishing turned deadly for a 17-year old when his small boat was swamped by a wave. The life vests were tucked under the seat, impossible to reach."
All of the above are true stories. They are typical situations where drownings occur among children and adolescents. Drowning is second only to motor vehicles as a cause of unintentional death among children in the United States, killing over 2,000 children each year. More children die from drowning than from house fires, bike crashes, poisoning or choking! Most other types of injury result in far more injuries than deaths. In other words, drowning is more deadly than motor vehicles, bicycles, and fire injuries. And for those children who are near drowning victims and survive, approximately 20% suffer from permanent neurological damage. Water is fun; but it's also deadly.
The national goal for Healthy People 2000 is to reduce drowning deaths for all ages to no more than 1.3 per 100,000 people, for children age 4 and younger a rate of no more than 2.3; and for males ages 15 to 34 years old, a rate of no more than 2.5. Several groups stand out because they have a high risk for drowning. Those at highest risk are males, children less than 5 years old, teens 15 to 19 years of age, (in certain parts of the country) African Americans, Native Americans and Hispanics.
Typical preventable causes of drowning include leaving young children unattended, inability to swim, lack of knowledge of water safety and water hazards, lack of life vests (also known as personal flotation devices, PFDs or life jackets) when boating or near open water, lack of lifeguards in designated swimming areas, use of alcohol and other drugs while boating or swimming, and boating under unsafe conditions.
The sites where children drown vary with age. For young children under 5 years of age, the most common site for drowning is swimming pools, followed by bathtubs and then open water such as lakes, rivers and ponds. For children ages 5 to 14, pools and swimming in open water are the leading sites. Boating and open water swimming are the leading circumstances in the 15 to 24-year age group.
Making A Difference
"An emergency medical technician (EMT) helped start a life vest loan program for children at several small boat rental sites on a lake. Three children survived their boat being swamped because they were wearing the loaner life vests."
"Trained as volunteer boating safety instructors, a retired couple teach over 6,000 school age children a year about boating safety and drowning prevention."
"An annual summer camp sponsored by the faith community encouraged members to donate outgrown life vests. They now have enough life vests to require all children to wear them both on docks as well as in boats."
"Small groups of volunteers working on water safety collected a variety of free water safety materials and compiled them in car or boat size litter bags for distribution with boat purchases and at the completion of swimming lessons at local pools."
These are just a few examples of how you can make a difference. Working with families is a great way to reach more than one child; besides, drowning is also a major cause of death among adults. The following are some specific suggestions:
Emphasize the importance of constant adult supervision
- Educate parents that most drownings occur during a brief lapse of supervision (less than 5 minutes) and that young children do not struggle in the water or call for help
- Educate families that school age siblings of young children are not capable of supervising their brothers or sisters in the bathtub, by a pool, or in a lake
- Encourage families to swim in lifeguarded areas whenever possible
- Work with your parks department or city government to be sure that lifeguards are available during high-use times at pools or lakes
- Assign responsible, sober adults to take turns being designated child-watchers at parties and gatherings
Increase the use of life vests on boats for children and teens; on docks and riverbanks for young and school age children; at beaches and swimming pools for young children and non-swimmers
- Set up life vest loan programs at community beaches or pools with sheriff marine patrols, at boat rental sites and summer camp programs. This will provide families low-cost access to life vests
- Provide families with an opportunity to select and try out life vests at health fairs, through loan programs and other water safety events. This will increase their familiarity and comfort level with life vests and make adults as well as children more likely to wear them
- Ask local retailers to sponsor a discount coupon program during the summer
- Organize a life vest exchange
- Educate families about the importance of owning life vests that fit — whether or not they have a boat. By increasing ownership of life vests, it is more likely that children and adults will wear them
- Encourage parents to wear life vests in small boats — children are more likely to wear a life vest in a boat if the adults are wearing one
- Support the passage of laws at the city, county and state levels requiring life jackets for children in boats
Teach children to swim
- Encourage or sponsor low cost or no cost swimming programs for low income and high risk groups (e.g. teenagers, Hispanics)
- Work with local and state school officials to build swimming lessons into required school activities
- Educate parents that knowing how to swim does not replace the need for life vests on boats and around deep or moving water
Increase the use of fences around high risk water sites
- Support and help in the passage of regulations at the city, county or state level requiring four sided fencing around backyard, apartment or condominium swimming pools or ponds
- Encourage the use of fencing at locations like popular fishing docks and irrigation canals located near residential areas
Teach families about drowning prevention and boating safety, including CPR
- Distribute materials and develop interactive exhibits at places where families go and where there are people to help reinforce the information, for example in doctor's offices and clinics, at health departments, community centers and swimming pool
- Sponsor a class or special event on drowning prevention
- Build water safety and boating safety education into already existing programs
- Promote education of older children about the need to wear life vests, drowning risks, the dangers of alcohol and other drug consumption, CPR and safe boat operation
- Encourage the media to include water safety tips and local contacts for classes and more information when they report on a drowning
- Include age appropriate drowning prevention recommendations as part of counseling families about injury prevention
Work with other groups who have an interest and expertise in water safety
- Work together with organizations already involved with drowning prevention
- Contact groups like: hospitals and health departments, city, county and state parks departments (ask if they have boating safety program office), community pools, emergency medical service (EMS) state offices or local providers, sheriff marine patrols, youth groups, your state chapter of associations for health professionals like the American Academy of Pediatrics, American Red Cross, YMCA, US Coast Guard Auxiliary and US Power Squadrons
For more information about the Washington State Drowning Prevention Project or Seattle Children's Stay on Top of It Campaign contact:
Elizabeth Bennett, MPH, CHES, External Affairs and Guest Services
Linda Quan, MD, Emergency Services
Seattle Children's Hospital
PO Box 5371, M1-9, Seattle, Washington 98105
Kathy Williams, MS, Injury Prevention Specialist
Department of Health Office of Emergency Medical and Trauma Prevention
PO Box 47853, Olympia, WA 98504-7853
Sources of information:
Healthy People 2000 National Health Promotion and Disease Prevention Objectives, Children's Hospital and Medical Center, Washington State Department of Health, Offices of Emergency Medical and Trauma Prevention, Health Promotion, and Statistics