Child Drowning in Australia Meeting the Drowning Challenge? Dr Richard Franklin National Manager for Research and Health Promotion Royal Life Saving Society Australia 1976...Drowning and near-drowning accidents involving children have become an unfortunate part of modern day living... Pearn and Nixon 1976 Pearn and Nixon (1976) Freshwater Drowning and Near-drowning accidents involving children: A five year total population study. MJA 2: 942-946 1
The Joys of Water Fun Cooling Skill development Exercise Fitness Transport Work Proposed drowning prevention strategies Recommended Pool Fencing Unproven Decrease boating while intoxicated Increase awareness of risks Inspect swimming areas Isolate unsafe areas Pool Covers Promote boating safety education Rescue equipment Promising Community CPR Knowledge Increase Adult Supervision Increase Life guard Presence Pool Alarms and Other Monitoring Devices Use of PFD s Swimming lessons Ineffective Change Child Behaviour Source: Harborview Injury Prevention and Research Centre http://depts.washington.edu/cdreview/main.php 2
Methods Source: National Coroners Information System (NCIS) Period: 1 July 2002 to 30 June 2007 Excluded: Natural causes, shark attacks, crocodile attacks, marine stinger deaths, suicide, homicide Check: Matched to RLSSA drowning report and data from Queensland Coroner Limitations: Case closure, case ascertainment 5 of Drowning Deaths 1441 Deaths 76% Males 12% Less than 5 29% Greater than 55 5-14 (59% Males) 350 300 250 200 150 100 50 0 250 200 150 100 2002-2003 2003-2004 2004-2005 2005-2006 2006-2007 Female Male Unknown 50% reduction 133 Deaths in 2020 50 0 0-4 5-14 15-24 25-34 Female 35-44 Male 45-54 55-64 65+ 3
Children 0-4 Av 34 Deaths per annum 33 death in 2006-2007 50% Reduction 17 in 2020 24 Continue the same reduction 10) 44% - Swimming Pools 2 were in public pools 16% - Bathtub 15% - Lake/Dam/Lagoon 45 40 35 30 25 20 15 10 5 0 Other 9% 26 24 13 12 12 10 2002-2003 2003-2004 2004-2005 2005-2006 2006-2007 Unknown 3% Bathtub 17% Female Male 26 13 River 9% Swimming Pool 47% 17 16 Lake / Dam / Lagoon 15% Key Prevention Strategies Activity Swimming/ Leisure Activity Restricting (Pool Fencing - 69) 28-41% Safe Play Area (36 Cases) -21% Bath(-2%) Supervision (32 Cases) 19% reduction CPR River Lake/ Dam/ Lagoon Pool Bath Other Unknown Total 1 6 7 Fall 12 24 69 4 15 124 Bathing 25 25 Other 3 1 4 Unknown 4 5 9 Total 15 25 79 29 15 6 169 4
Restricting Access 2 Styles Barrier around the water (e.g. Pool fencing) Barrier around the child Most pools have barriers weakest point the gate Supervision What is Supervision? Until recently there were a range of interpretations of what was supervision Recently work from the US has provided us with a better understanding of the elements that make up supervision Saluja, G., Brenner, R., Morrongiello, B. A., Haynie, D., Rivera, M., & Cheng, T. L. (2004). The role of supervision in child injury risk: definition, conceptual and measurement issues. Injury Control and Safety Promotion, 11(1), 17-22. Morrongiello, B. A., Klemencic, N., & Corbett, M. (2008). Interactions Between Child Behaviour Patterns and Parent Supervision: Implications for Children's Risk of Unintentional Injury. Child Development, 79(3), 627-638. 5
Key elements of supervision Proximity Always be within arms reach of your child Attention Always keep your attention on your child, this is not an occasional glance while reading a magazine Continuity Check children on a regular basis Never leave their presence if they are under 5 Prepare Ensure you are ready to supervise CPR Message is clear and simple Have a go Blow and push Constant reminder Last resort Trainee Paramedics Marchant, J., Cheng, N. G., Lam, L. T., Fahy, F. S., Sounndapound, S. V., Cass, D. T., et al. (2008). Bystander basic life support: an important link in the chain of survival for children suffering a drowning or near-drowning episode. Medical Journal of Australia(188), 484-485. 6
Potential Impact Very Good Could exceed 50% by 2020 if: Increase in supervision Improvement in home pool fencing Increase in safe play areas Improvement in CPR skills Best Case approximately 75% Worst case due to increase in age of pool fencing, poor supervision, current number of safe play areas and decrease in CPR there could be an increase 7
What can we conclude? It may be possible to reduce by 50% up to 75%, however: current activities need to be maintained Some new programs are required Monitoring and Evaluation of existing programs More information required The Challenges of preventing child drowning deaths Dr Richard Franklin National Manager for Research and Health Promotion Royal Life Saving Society Australia rfranklin@rlssa.org.au 8