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May 25, 1994, Vol 271, No. 20 >
ARTICLE | May 25, 1994

Divergent Trends in Childhood Drowning Rates, 1971 Through 1988 FREE

Ruth A. Brenner, MD, MPH; Gordon S. Smith, MB, ChB, MPH; Mary D. Overpeck, DrPH, MPH
[+] Author Affiliations

Reprint requests to Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, 6100 Executive Blvd, Room 7B03, Bethesda, MD 20892 (Dr Brenner).


JAMA. 1994;271(20):1606-1608. doi:10.1001/jama.1994.03510440066035
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References

Objective.  —To examine national age-, race-, and sex-specific trends in unintentional drowning rates among US children aged 0 through 19 years.

Design.  —National mortality data published by the National Center for Health Statistics and population data from the US Bureau of the Census were used in calculating age-, race-, and sex-specific drowning rates for 1971 through 1988. Time trends were analyzed using Poisson regression techniques.

Setting.  —United States, 1971 through 1988.

Main Outcome Measure.  —Rates of death due to unintentional, non-boatrelated drowning.

Results.  —From 1971 through 1988, there were 45680 unintentional, non—boatrelated drowning deaths among 0- through 19-year-olds in the United States. Drowning rates declined sharply in older children (-5.8% per year in 10- through 14-year-olds and —5.4% per year in 15-through 19-year-olds), declined only slightly in toddlers (-1.6% per year in 1- and 2-year-olds), and actually increased in infants (+1.6% per year in those children younger than 1 year).

Conclusion.  —Drowning rates in toddlers have changed little over time despite the availability of effective prevention strategies such as pool fencing. In older children, drowning rates have declined dramatically despite the lack of clear preventive initiatives. Prevention interventions targeted specifically at the infant and toddler age groups should receive priority.(JAMA. 1994;271:1606-1608)

REFERENCES

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Baker SP, O'Neill B, Ginsburg MJ, Guohua L. The Injury Fact Book . New York, NY: Oxford University Press; 1992;:174-183.
2 +
US Public Health Service. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Dept of Health and Human Services, US Public Health Service; 1991;. DHHS publication PHS 91-50213.
3 +
National Center for Health Statistics, Fingerhut L.  Trends and current status in childhood mortality, United States, 1900-85. Vital Health Stat . 1989;; Series 3, No. (26) .
4 +
National Center for Health Statistics. Vital Statistics of the United States, II: Mortality, Part A, 1971-1988 . Washington, DC: US Dept of Health and Human Services; 1975-1991;.
5 +
World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Eight Revision Conference, 1965, and Adopted by the Nineteenth World Health Assembly . Geneva, Switzerland: World Health Organization; 1967;.
6 +
World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference, 1975 . Geneva, Switzerland: World Health Organization; 1977;.
7 +
US Bureau of the Census. Preliminary Estimates of the Population of the United States, by Age, Sex, and Race: 1970-1981 . Washington, DC: US Government Printing Office; 1989;. Current Population Reports, series P-25, No. 917.
8 +
US Bureau of the Census. Preliminary Estimates of the Population of the United States, by Age, Sex, and Race: 1980-1988 . Washington, DC: US Government Printing Office; 1989;. Current Population Reports, series P-25, No. 1045.
9 +
McCullaghP, Nelder JA. Generalized Linear Models . 2nd ed. New York, NY: Chapman and Hall; 1989;.
10 +
GulaidJA, Sattin RW.  Drownings in the United States, 1978-1984. MMWR Morb Mortal Wkly Rep . 1988;;37:27-33.
11 +
Quan L, Gore EJ, Wentz K, Allen J, Novack AH.  Ten-year study of pediatric drownings and neardrownings in King County, Washington: lessons in injury prevention. Pediatrics . 1989;;83:1035-1040.
12 +
Wintemute GJ.  Childhood drowning and neardrowning in the United States. AJDC . 1990;;144: 663-669.
13 +
National Center for Health Statistics. Vital Statistics of the United States, II: Mortality, Part A, 1987-1988 . Washington, DC: US Dept of Health and Human Services; 1990-1991;.
14 +
Dietz PE, Baker SP.  Drowning: epidemiology and prevention. Am J Public Health . 1974;;64:303-312.
15 +
Wintemute GJ, Kraus JF, Teret SP, Wright M.  Drowning in childhood and adolescence: a populationbased study. Am J Public Health . 1987;;77:830-832.
16 +
Howland J, Hingson R.  Alcohol as a risk factor for drownings: a review of the literature (1950-1985). Accid Anal Prev . 1988;;20:19-25.
17 +
Pearn JH, Wong RY, Brown J, Ching Y, Bart R, Hammar S.  Drowning and near-drowning involving children: a five year total population study from the city and county of Honolulu. Am J Public Health . 1979;;69:450-454.
18 +
O'Carroll PW, Alkon E, Weiss B.  Drowning mortality in Los Angeles County, 1976 to 1984. JAMA . 1988;;260:380-383.
19 +
Flood TJ, Aickin M, Englender SJ, et al.  Child drownings and near drownings associated with swimming pools—Maricopa County, Arizona, 1988 and 1989. MMWR Morb Mortal Wkly Rep . 1990;;39:441-442.
20 +
PearnJH, NixonJ, Wilkey I.  Freshwater drowning and near-drowning accidents involving children: a five year total population study. Med J Aust . 1976;;2:942-946.
21 +
Budnick LD, Ross DA.  Bathtub-related drownings in the United States, 1979-81. Am J Public Health . 1985;;75:630-633.
22 +
Mann NC, Weller SC, Rauchschwalbe R.  Bucket-related drownings in the United States, 1984 through 1990. Pediatrics . 1992;;89:1068-1071.
23 +
Jumbelic MI, Chambliss M.  Accidental toddler drowning in 5-gallon buckets. JAMA . 1990;;263:1952-1953.
24 +
Shinberger CS, Anderson CL, KrausJF.  Young children who drown in hot tubs, spas and whirlpools in California: a 26-year survey. Am J Public Health . 1990;;80:613-614.
25 +
Pitt WR, Balanda KP.  Childhood drowning and near drowning in Brisbane: the contribution of domestic pools. Med J Aust . 1991;;154:661-665.
26 +
Cass DT, Ross FI, Grattan-Smith TM.  Child drownings: a changing pattern. Med J Aust . 1991;; 154:163-165.
27 +
Pearn JH, Nixon J.  Swimming pool immersion accidents: an analysis from the Brisbane drowning study. Med J Aust . 1977;;1:432-437.
28 +
Pearn JH, Brown J, Wong R, Bart R.  Bathtub drownings: report of seven cases. Pediatrics . 1979;; 64:68-70.
29 +
Jenson LR, Williams SD, Thurman DJ, Keller PA.  Submersion injuries in children younger than 5 years in urban Utah. West J Med . 1992;;157:641-644.
30 +
Griest KJ, Zumwalt RE.  Child abuse by drowning. Pediatrics . 1989;;83:41-46.
31 +
Saunders E.  Neonaticides following 'secret' pregnancies: seven case reports. Public Health Rep . 1989;;104:368-372.
32 +
Feldman KW, Monastersky C, Feldman GK.  When is childhood drowning neglect? Child Abuse Negl . 1993;;17:329-336.

Figures

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Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Baker SP, O'Neill B, Ginsburg MJ, Guohua L. The Injury Fact Book . New York, NY: Oxford University Press; 1992;:174-183.
2 +
US Public Health Service. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Dept of Health and Human Services, US Public Health Service; 1991;. DHHS publication PHS 91-50213.
3 +
National Center for Health Statistics, Fingerhut L.  Trends and current status in childhood mortality, United States, 1900-85. Vital Health Stat . 1989;; Series 3, No. (26) .
4 +
National Center for Health Statistics. Vital Statistics of the United States, II: Mortality, Part A, 1971-1988 . Washington, DC: US Dept of Health and Human Services; 1975-1991;.
5 +
World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Eight Revision Conference, 1965, and Adopted by the Nineteenth World Health Assembly . Geneva, Switzerland: World Health Organization; 1967;.
6 +
World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference, 1975 . Geneva, Switzerland: World Health Organization; 1977;.
7 +
US Bureau of the Census. Preliminary Estimates of the Population of the United States, by Age, Sex, and Race: 1970-1981 . Washington, DC: US Government Printing Office; 1989;. Current Population Reports, series P-25, No. 917.
8 +
US Bureau of the Census. Preliminary Estimates of the Population of the United States, by Age, Sex, and Race: 1980-1988 . Washington, DC: US Government Printing Office; 1989;. Current Population Reports, series P-25, No. 1045.
9 +
McCullaghP, Nelder JA. Generalized Linear Models . 2nd ed. New York, NY: Chapman and Hall; 1989;.
10 +
GulaidJA, Sattin RW.  Drownings in the United States, 1978-1984. MMWR Morb Mortal Wkly Rep . 1988;;37:27-33.
11 +
Quan L, Gore EJ, Wentz K, Allen J, Novack AH.  Ten-year study of pediatric drownings and neardrownings in King County, Washington: lessons in injury prevention. Pediatrics . 1989;;83:1035-1040.
12 +
Wintemute GJ.  Childhood drowning and neardrowning in the United States. AJDC . 1990;;144: 663-669.
13 +
National Center for Health Statistics. Vital Statistics of the United States, II: Mortality, Part A, 1987-1988 . Washington, DC: US Dept of Health and Human Services; 1990-1991;.
14 +
Dietz PE, Baker SP.  Drowning: epidemiology and prevention. Am J Public Health . 1974;;64:303-312.
15 +
Wintemute GJ, Kraus JF, Teret SP, Wright M.  Drowning in childhood and adolescence: a populationbased study. Am J Public Health . 1987;;77:830-832.
16 +
Howland J, Hingson R.  Alcohol as a risk factor for drownings: a review of the literature (1950-1985). Accid Anal Prev . 1988;;20:19-25.
17 +
Pearn JH, Wong RY, Brown J, Ching Y, Bart R, Hammar S.  Drowning and near-drowning involving children: a five year total population study from the city and county of Honolulu. Am J Public Health . 1979;;69:450-454.
18 +
O'Carroll PW, Alkon E, Weiss B.  Drowning mortality in Los Angeles County, 1976 to 1984. JAMA . 1988;;260:380-383.
19 +
Flood TJ, Aickin M, Englender SJ, et al.  Child drownings and near drownings associated with swimming pools—Maricopa County, Arizona, 1988 and 1989. MMWR Morb Mortal Wkly Rep . 1990;;39:441-442.
20 +
PearnJH, NixonJ, Wilkey I.  Freshwater drowning and near-drowning accidents involving children: a five year total population study. Med J Aust . 1976;;2:942-946.
21 +
Budnick LD, Ross DA.  Bathtub-related drownings in the United States, 1979-81. Am J Public Health . 1985;;75:630-633.
22 +
Mann NC, Weller SC, Rauchschwalbe R.  Bucket-related drownings in the United States, 1984 through 1990. Pediatrics . 1992;;89:1068-1071.
23 +
Jumbelic MI, Chambliss M.  Accidental toddler drowning in 5-gallon buckets. JAMA . 1990;;263:1952-1953.
24 +
Shinberger CS, Anderson CL, KrausJF.  Young children who drown in hot tubs, spas and whirlpools in California: a 26-year survey. Am J Public Health . 1990;;80:613-614.
25 +
Pitt WR, Balanda KP.  Childhood drowning and near drowning in Brisbane: the contribution of domestic pools. Med J Aust . 1991;;154:661-665.
26 +
Cass DT, Ross FI, Grattan-Smith TM.  Child drownings: a changing pattern. Med J Aust . 1991;; 154:163-165.
27 +
Pearn JH, Nixon J.  Swimming pool immersion accidents: an analysis from the Brisbane drowning study. Med J Aust . 1977;;1:432-437.
28 +
Pearn JH, Brown J, Wong R, Bart R.  Bathtub drownings: report of seven cases. Pediatrics . 1979;; 64:68-70.
29 +
Jenson LR, Williams SD, Thurman DJ, Keller PA.  Submersion injuries in children younger than 5 years in urban Utah. West J Med . 1992;;157:641-644.
30 +
Griest KJ, Zumwalt RE.  Child abuse by drowning. Pediatrics . 1989;;83:41-46.
31 +
Saunders E.  Neonaticides following 'secret' pregnancies: seven case reports. Public Health Rep . 1989;;104:368-372.
32 +
Feldman KW, Monastersky C, Feldman GK.  When is childhood drowning neglect? Child Abuse Negl . 1993;;17:329-336.

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