[Disease burden on drowning in the Chinese population, in 1990 and 2013]

Objective: To comprehensively analyze the disease burden of drowning in the Chinese population both at the national and provincial levels in 1990 and 2013, to provide reference for the development of strategies regarding drowning prevention. Methods: Both methods related to unified measurement framework and standardized estimation on Global Burden of Disease in 2013, were used. Data on deaths caused by injuries were from the following sources which include: Disease Surveillance Points, the National Maternal and Child Health Surveillance Network, the Death Registration Reporting System of Chinese Center for Disease Control and Prevention, Death Registration System and death information from Macau and Hong Kong areas of China. Injury-related incidence data was from the National Injury Surveillance System and literature review. Parameters as death/death rate, years of life lost due to premature mortality (YLL)/standardized YLL rate, years living with disability (YLD)/standardized YLD rate and disability-adjusted of life years (DALY)/standardized DALY were used to analyze the disease burden and changing trend on drowning at both the national and all the provincial levels. Results: In 2013, the number of deaths due to drowning was63 619 in China, with the standardized mortality rate as 5.29 per 100 000, accounting for 8.0% of the total injury deaths. Drowning was the fourth leading cause of injury death in the whole population and the first leading cause of injury death among children aged <5 and 5-14 years old in 2013, with YLL of drowning as 3.49 million person years, YLD as 0.04 million person years, and DALY as 3.53 million person years. Compared with data from 1990, the rates on standardized mortality, standardized YLL, standardized YLD and standardized DALY of drowning all declined in 2013. The five provinces/districts/cities with the highest rates of drowning were Xinjiang (10.08 per 100 000), Jiangxi (8.44 per 100 000), Anhui (7.92 per 100 000), Guizhou (7.77 per 100 000) and Sichuan (7.68 per 100 000). Standardized mortality of drowning reduced in all provinces in 2013. Conclusions: Disease burden of drowning in the Chinese population, especially in children, declined significantly in 2013, comparing to 1990. However, drowning remains a serious proble, with children and males in particular, in China. Research regarding prevention on drowning is in great need in the western and central areas where drowning mortalities appeared high.