Drowning fatalities in childhood: the role of pre-existing medical conditions

• Published in: Archives of disease in childhood Vol. 102; no. 10; pp. 888 - 893
• Main Authors: Franklin, Richard C, Pearn, John H, Peden, Amy E
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.10.2017
• Subjects: Adolescent; Age Groups; Asthma; Australia - epidemiology; Autism; Child; Child Mortality; Child, Preschool; Children; Children & youth; Children with disabilities; Cross-Sectional Studies; Data Analysis; Death; Disabilities; Disability; Drowning; Drowning - epidemiology; Drowning - mortality; Drownings; Epilepsy; Ethics; Female; Forensic science; Humans; Infant; Information systems; Intellectual disabilities; Male; Medical Audit; Mortality; Murders & murder attempts; Persuasive Discourse; Physical Disabilities; Physicians; Population; Population studies; Public health; Risk Factors; Supervision; Victims of Crime; Water; Australia; epilepsy; cardio-pulmonary resuscitation; children; supervision; drowning; injury prevention; autism; water safety
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2017-312684

ObjectivesThis study is an analysis of the contribution of pre-existing medical conditions to unintentional fatal child (0–14 years) drowning and a of critique prevention stratagems, with an exploration of issues of equity in recreation.DesignThis study is a total population, cross-sectional audit of all demographic, forensic and on-site situational details surrounding unintentional fatal drowning of children 0–14 years in Australia for the period of 1 July 2002 to 30 June 2012. Data were sourced from the National (Australia) Coronial Information System. Age-specific disease patterns in the general population were obtained from the Australian Institute of Health and Welfare.ResultsFour hundred and sixty-eight children drowned during the study period. Fifty-three (11.3%) had a pre-existing medical condition, of whom 19 suffered from epilepsy, 13 from autism and 5 with non-specific intellectual disabilities. Epilepsy is a risk factor in childhood drowning deaths, with a prevalence of 4.1% of drowning fatalities, compared with 0.7%–1.7% among the general 0–14 years population (relative risk: 2.4–5.8). Epilepsy was deemed to be contributory in 16 of 19 cases (84.2% of epilepsy cases) with a median age of 8 years. Asthma and intellectual disabilities were under-represented in the drowning cohort.ConclusionExcept for epilepsy, this research has indicated that the risks of drowning while undertaking aquatic activities are not increased in children with pre-existing medical conditions. Children with pre-existing medical conditions can enjoy aquatic activities when appropriately supervised.