Epidemiology

With increasing popularity of recreational activities involving water, submersion injury and its consequences have become a major public health problem in certain parts of the world. The impression that the paediatric age group is particularly at risk is confirmed by the fact that drowning is one of the three leading causes of accidental death in children. There are several published epidemiological surveys reporting incidences of drowning or submersion accidents in children requiring hospitalisation which vary from 20 per 100,000 of population in the USA (Wintemute, 1990), 6.2 per 100,000 in Australia (Pitt & Balanda, 1991) and 1.5 per 100,000 in the UK (Kemp & Sibert, 1992). In the USA alone there are 2000 deaths annually from drowning in children (Wintemute et al., 1987) and in a single year (1989) in England and Wales there were 306 submersion incidents involving admission to hospital in children less than 15 years of age, 149 of whom died (Kemp & Sibert, 1992). When age and sex are examined as factors there are obvious bimodal peaks, one at less than 5 years of age, which represents one-third of all drownings, and the second in the adolescent age group, with a preponderance of males in all age groups. The incidence of drowning also varies with geographical area, climate and socioeconomic conditions, as reflected in the number of private swimming pools and warmer climates, with their attendant increases in the length of the ‘swimming’ season (Wintemute et al., 1987).