Reducing Drownings Through Epidemiology & Interventions

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1 Eric J. Wiegert, MPH New York State Department of Health Bureau of Community Environmental Health & Food Protection Disclaimer: The findings, conclusions and opinions in this presentation are those of the author(s) and do not necessarily represent the views of the New York State Department of Health. Reducing Drownings Through Epidemiology & Interventions

2 2 Overview Background Process Findings Prevention Questions/Discussion

3 Background 3

4 NYS Drowning Risk 4

5 Drownings at Regulated Beaches and Pools 5 Drownings = Preventable Accident 1980 s-doh established policy to investigate & report on drownings Applicable to public bathing beaches and swimming pools Regulated under State Sanitary Code 1,500 beaches 7,500 swimming pools Regulations applied by 46 Local Health Departments Facility Design Approval Operational Inspections Required incident reporting

6 Process 6

7 Process-Overview 7 Investigate/Collect Data Analyze/Develop Interventions Prevent Drownings

8 Epidemiological Model Applied to Drowning 8 Agent

9 Haddon Matrix 9 Host Agent Environment

10 Investigation 10 Investigate/Collect Data Analyze/Develop Interventions Prevent Drownings

11 Drowning Investigation Investigation Data Facility/Environmental 11 Supervision: Quantity/Quality Emergency Response Interview: Witnesses/Supervisory Staff/Victim Contacts Records/Reports

12 Investigation Tools Data collection: 12 Investigation tools developed/provided to field offices Data categories: environmental, supervision, victim, etc. Balance between quantitative and qualitative

13 13 Findings Investigate/Collect Data Analyze/Develop Interventions Prevent Drownings

14 Number of Drownings Drownings at NYS Regulated Bathing Facilities Pool n = 85 Beach n = 86 N = 185 Annual Mean: '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 ' Pool Beach Cumulative Mean

15 Fatal Drownings at NYS Bathing Facilities Hotels/ Campgrounds 10 Beaches N = 97 Pools N = 98 Children's Camps 4 State Parks 24 State Parks 3 Children's Camps 9 Hotels/ Campgrounds 27 Part 6 59 Part 6* 59 * Includes: 7 Spas, 5 Phys Ed Classes, 1 Wave Pool, 1 Aquatic Theme Park

16 Fatal Drownings NYS Regulated Bathing Facilities: Age and Sex of Victim n = 38 n = 157 N = >66 Female Male

17 17 Number of Drowning Victims and Average Age over Time 70 Number of Victims Linear (Number of Victims) Average Age of Victim Linear (Average Age of Victim) Total victims = 195 Year

18 Depth (feet) 18 Water Depth at Location of Submersion Unknown > > > >15 3 Pool n = 98 Beach n = 97 N= Number of Drownings

19 19 Contributing Factors * : Environment Victim 46 7 Glare (Outdoor AND Indoor) (26%) 12 Water Clarity Supervision Environment 38 (22%) 1 7 Excessive Spa Immersion Cold Water Strong Current 90 4 Bottom Conditions (52%) 6 Excessive Depth * 174 Contributing Factors Identified in 112 Drownings,

20 Contributing Factors * : Supervision Environment 38 (22%) Victim 46 (26%) Supervision 90 (52%) Absence of Supervision (Lifeguard or other acceptable level)) Inadequate Number of Qualified Lifeguards Lifeguard Positioning Improper Procedure Lifeguards Distracted / No Victim Recognition Buddy System Lacking or Improper Adult Supervision Lacking / Insufficient (parent/ guardian/ counselor) * 174 Contributing Factors Identified in 112 Drownings,

21 21 Contributing Factors * : Victim Hyperventilation Supervision 90 (52%) Victim Drugs, Alcohol, Medication Developmental Disability (26%) 13 Seizure Disorder Environment 38 (22%) 9 Other Medical 1 Diabetes, 7 Cardiac 1 Unknown event * 174 Contributing Factors Identified in 112 Drownings,

22 22 Don t Blame the Victim

23 23 Prevention Investigate/Collect Data Analyze/Develop Interventions Prevent Drownings

24 24 Prevention: Pre-event Patron Surveillance & Supervision Design Capacity Lifeguard Training Including instinctive drowning response Quantity & Positioning of Lifeguards Limit Duties

25 25 Prevention: Pre-event Patron Surveillance & Supervision Risk management plan ( Written Safety Plan ) Provides site specific details for drowning and injury prevention Completed by facility managers Reviewed/approved by local health departments NYSDOH developed template for operators Content based on known contributing factors

26 Prevention: Post-event 26 Incident Response Training Communication Treatment

27 The Future 27 Seeking greater precision and resolution of data: Additional multi-variable analysis Updated field investigation tools Future interventions?

28 28 Thank You! Eric J. Wiegert, MPH Acknowledgements: Douglas C. Sackett Timothy Shay Amanda Tarrier, MPH Francesco Pia, PhD Darwin Delappa Richard Alden NYS Local Health Departments & Regional Offices

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