The Demographics of US Drowning & Data on Guarded Pool Deaths Julie Gilchrist, M.D.

Transcription

1 The Demographics of US Drowning & Data on Guarded Pool Deaths Julie Gilchrist, M.D. Dr. Julie Gilchrist is a Pediatrician and Medical Epidemiologist with the National Center for Injury Prevention and Control (NCIPC) at the CDC. She graduated from Rice University with degrees in Human Physiology and Sports Medicine before attending U.T. Southwestern Medical School in Dallas, TX. She completed a pediatrics residency at the University of Pennsylvania s Children s Hospital of Philadelphia and an epidemiology fellowship at CDC. She has been at CDC since In her current work at NCIPC, she is responsible for research and programs in drowning prevention and water safety promotion, and sports and recreation-related injury prevention, as well as other issues primarily affecting children: choking, suffocation, ingestions, dog bites, playground injuries, etc. She facilitated the development of CDC s research agenda for prevention of injuries in sports, recreation, and exercise and has been recognized for her efforts to establish a sports injury prevention program at CDC. As of 2010, she has authored/coauthored more than 54 journal articles and 5 book chapters and is an invited speaker both nationally and internationally. She has earned numerous awards for her efforts and accomplishments in research, communication, and disaster response. Abstract This presentation will have two sections. In the first, the presenter will describe the epidemiology of the 3,500 drowning deaths in the U.S. by age, gender, race, and location. Opportunities for drowning prevention will be discussed. In the second section, the findings of an examination of deaths occurring in guarded swimming pools will be presented. The data come from a search of news records regarding deaths in pools monitored by lifeguards from 2000 through A total of 140 deaths from 37 states were identified. Of decedents, 78% were children and 66% were males. African Americans accounted for 44% of deaths among those of known race. Three quarters occurred during May through August; 61% occurred in outdoor pools. Sites for fatal incidents included municipal pools (38%), community organizations (15%), and schools (14%). Of reports which included the information, decedents were initially identified in the pool twice as often by non-lifeguards (eg, other swimmers or bystanders) as by lifeguards. Deaths in pools with lifeguards are uncommon, but do occur. Groups most affected include children, males, and African Americans. While lifeguards provide an important layer of protection at swimming pools, they alone cannot prevent all drowning. Additional safety measures are needed. National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

2 Drowning in the US & Deaths in Guarded Pools Julie Gilchrist, MD National Center for Injury Prevention & Control Centers for Disease Control & Prevention October Leading Causes of Death, Leading Causes of Death, Ages 1-44 Years National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

3 Drowning 5 th leading cause of unintentional injury death among all ages 3 rd leading cause among those 1-44 years 3500 deaths per year 6200 ED visits per year 2800 hospitalized $5.3 Billion in medical and productivity costs Leading Causes of Unintentional Injury Death Among Children Age Group in Years Less Than 1 1 to 4 5 to 9 10 to 14 (n=5,883) (n=10,203) (n=7,144) (n=9,088) Suffocation Drowning MVT - Occupant MVT - Occupant 66% 27% 22% 26% MVT - Occupant Pedestrian MVT - Unspecified MVT - Unspecified 8% 15% 15% 15% Drowning Fires/Burns Pedestrian Pedestrian 7% 14% 14% 12% MVT - Unspecified MVT - Occupant Fires/Burns Drowning 5% 13% 13% 10% Other Injuries MVT - Unspecified Drowning MVT - Other 5% 9% 13% 9% CDC Childhood Injury Report, Drowning by Age Group & Race/Ethnicity Rate (per 100,000) black white hispanic Age group (years) Vital Statistics V90, V92, W65-W74, National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

4 Drowning by Age Group & Race/Ethnicity Rate (per 100,000) black white hispanic Age group (years) Vital Statistics V90, V92, W65-W74, Pool Drowning by Age Group & Race/Ethnicity Rate (per 100,000) Black White Hispanic Age group (years) Vital Statistics W67-W68, Pool Drowning Among 5-19 y.o. by Race/Ethnicity Rate (per 100,000) Black White Hisp Race or Ethnicity Vital Statistics W67-W68, National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

5 Rate (per 100,000) Pool Drowning by Age Group & Gender female male Age group (years) Vital Statistics W67-W68, Pool Drowning by Gender Rate (per 100,000) Female Male Vital Statistics W67-W68, Pool Drowning by Location Drowning rates in South and West are 3 times those of Northest and Midwest The more urban, the higher the rates Significantly higher in Large Metro Areas National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

6 Disposition of Nonfatal Drowning Among 0-14 years Disposition Treated and Released Hospitalized or Transferred Annual Estimate Percent All Unintentional Injury National Electronic Injury Surveillance System - All Injury Program ( ) Prevention of Drowning Managing access to water settings Keeping participants safer in the water Improving outcomes in an emergency Current Swimming Ability Adults self-reported inability to swim % Men %Women %Total Caucasian African Am Asian Hispanic Total % of minority children have limited swimming ability; strongly related to parental ability Gilchrist et al. PHR 2000; Irwin et al. USA Swimming National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

7 Improving Swimming Ability: Access Creating opportunities Access to appropriate supervised aquatic environments Access to training/lessons Improving Swimming Ability: Education and Training Increasing participation Desirability compared to other activities Understanding that it is a life-saving skill Role models Benefits of Learning to Swim Exceptional recreational physical activity Bonding experience Mental, physical and emotional development Potentially life-saving skill Early participation does not increase drowning risks* Opportunity for education of parents and children *Brenner RA et al. Arch Peds Adol Med 2009 National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

8 Deaths in Lifeguarded Pools Case series: US, All deaths not just drowning Guarded swimming pools Case finding: Lexis-Nexus, ProQuest Additional details: death certificates, follow up phone calls, internet Pelletier AR Injury Prevention 2011 Results 140 fatalities identified 78% were < 18 years old 66% were male Disproportionately black (44%) Gender & Age Group Fatalities Percentage % of US pop Sex Male Female Age Group >= National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

9 Race & Ethnicity Fatalities Percentage % of US pop Race White Black Asian Unknown Ethnicity Hispanic Non-Hispanic Unknown Time & Place 37 states PA (14) CA, MD, OH (9) MI, NY (8) FL, TX (7) 74% May through August 61% outdoor pools Most on Wed (26), Least on Sun (13) Sites of Pools 38% municipal 15% community organizations 14% school 12% club 6% apartment 5% summer camp 5% water park 4% other National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

10 Causes of Death 122 of 140 included official cause of death 98% (all but 3) due to drowning 73 & 80 year old males: heart disease 13 year old male: undetermined cause Contributing factors Disabilities (8): 1 physical, 3 mental, 4 both Heart disease (7) History of seizures (7) Alcohol intoxication (1) Other Characteristics Timing of death 75% died on the same day 11% died the following day 14% died 2-27 days after the incident 89% underwent autopsy (n=99) 2 with trauma: 19yoM injury on neck, 8yoF bruise on scalp Other Characteristics Breath holding (8): 7 between years 2 were off duty lifeguards Lifejacket (1): 3 yo trapped under inflatable raft shared with sister in 50m outdoor pool with 100 swimmers and 11 guards National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

11 Lifeguards & Swimmers Median guards on duty: 2 (range 1-50) Data available (n=106) Number people in pool: 30 (range ) Data available (n=57) Swimmer-LG ratio: 13:1 (range 1:2-75:1) Data available (n=51) First identified by: LG: 22% Non-LG: 44% Unknown: 34% Groups at Risk Similar demographics to other drowning: Children, males, blacks Children: lack of supervision Males: more exposure, alcohol, risk taking Blacks: swimming ability Indoor vs. Outdoor Pools Over 60% outdoor Increased exposure in summer months Seasonal pools -- inexperienced staff Summer patrons -- limited ability Environmental factors overcrowding, glare, heat National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)

12 Lifeguards Enhance water safety Provide parents false sense of security Parents may relinquish responsibility LG are only one layer of protection Limitations Underestimate Other studies suggest 52-72% LG information not available Location, experience, certification Circumstances mission: pool depth, clarity Survivors not included: Underestimates burden of submersions Underestimates value of LG Conclusions Deaths in LG pools uncommon LG are a layer of protection LG are specifically trained in response Swim with a buddy National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO (719)