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Study Outlines Where Kids Drown

Tubs worst for babies, pools for tykes, freshwater for teens

MONDAY, July 2, 2001 (HealthDayNews) -- It's bathtubs for babies, swimming pools for toddlers, and lakes, ponds and rivers for teens.

These are the most likely places for kids under age 20 to drown, says a study of U.S. drowning deaths. The study also shows that African-American boys are at a much higher risk of drowning than white boys, especially in swimming pools.

Thirty-seven percent of children who drowned were ages 1 to 4, and 29 percent were 15 to 19, the researchers say. Nearly 75 percent of all kids who drown were male.

The research may help parents keep a closer and age-appropriate eye on their children at where they are most vulnerable, says Dr. Ruth Brenner, an investigator with the National Institute of Child Health and Human Development (NICHD).

"We've known from regional studies that infants were most likely to drown in bathtubs, toddlers in swimming pools and older children in other bodies of water, and now we've confirmed that nationally. What this study shows is that we need a multi-faceted approach to prevent drowning. Drowning continues to be a big problem in this country," says Brenner.

More than 1,500 Americans under age 20 drowned in 1998, and 93 percent of those deaths were unintentional and not boating-related, the study says.

Brenner and colleagues at Johns Hopkins University School of Public Health, the Consumer Product Safety Commission and the Maternal and Child Health Bureau reviewed more than 1,420 death certificates for drowning victims, starting in 1995.

"We looked at actual copies of death certificates of children from birth to 19 years old and extracted information on the specific site of drowning and used that data to classify the site," Brenner says.

"Of the 1,420 drownings, 57 were in salt water," Brenner says, "So there were some in salt water, but much fewer than in other sites. There were 669 in freshwater, 435 in swimming pools, which includes Jacuzzis, hot tubs and the like, and 125 were at domestic sites -- bathtubs and buckets."

"But a fair number of these drownings were at other sites as well," Brenner says. "Among toddlers ages 1 to 4, about 25 percent of the drownings were at freshwater sites like ponds and lakes. And among adolescents males, particularly African-Americans, there was an increased risk for drowning in a swimming pool."

Other studies have shown that black males over age 5 are at higher risk from drowning than white males, Brenner says. After that age, the risk of black males drowning in a swimming pool was up to 15 times greater than white males.

"Our study really didn't look at the reasons for these drownings, and it's something that needs to be examined more carefully," Brenner says. "We know that swimming pools don't seem to carry the same kind of natural risks that freshwater conditions pose, like currents, for instance. It may be that pools are more crowded for African-Americans, or there is a difference in opportunities for African-Americans to learn how to swim."

The findings appear in the July issue of Pediatrics.

The National Campaign for Safe Kids calls the study groundbreaking.

"I want to commend the authors for doing this research," says Angela Mickalide, program director for the National Safe Kids Campaign in Washington, D.C. "We've been waiting very eagerly to see these results so that we can improve and refine our own messages that we are distributing to families."

The study has two key findings, Mickalide says. "I learned that 25 percent of toddlers are drowning in freshwater sites, and most of our recommendations have been focused on swimming pools. We also need to redouble our efforts at the community level to educate parents about the risks of young people drowning in ponds and lakes and rivers."

"The other key finding is the fact that black males are more likely to drown in public swimming pools," Mickalide says. "And while the authors did not study the reasons why this happens, I do think the findings will encourage the public health community to understand the causes of drowning in black males and figure out new strategies."

What To Do

While this study details the more likely places children drown, don't let it lull you into thinking that your 4-year-old can be unsupervised in the bathtub.

Brenner says the American Academy of Pediatrics recommendations to prevent drowning should be followed. They include:

  • Swimming lessons for all children over age 5;
  • Constant supervision of infants and young children when they are in the bathtub or around other bodies of water;
  • Installation of fencing to separate homes from residential pools;
  • Use of personal floatation devices when riding on a boat or playing near a river, lake or ocean;
  • Teaching children never to swim alone or without adult supervision;
  • Teaching children the dangers of drug and alcohol consumption while swimming or when near water;
  • And making sure that adults and teens learn cardiopulmonary resuscitation.

For more on how to protect your children near water, see the Centers for Disease Control and Prevention or the National Safe Kids Campaign.

SOURCES: Interviews with Ruth Brenner, M.D., M.P.H., investigator, National Institute of Child Health and Human Development, Bethesda, Md., and Angela Mickalide, Ph.D., program director, National Safe Kids Campaign, Washington, D.C.; July 2001 Pediatrics
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