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Unintentional fatal child drowning in the bath: A 12-year Australian review (2002-2014)
Amy E Peden1,2, Richard C Franklin1,2, John H Pearn1,3
1Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.
Insights
Unsupervised children, especially infants, are at high risk of fatal bathtub drowning in Australia. Key factors include lack of supervision, medical conditions like epilepsy, and over-reliance on bath aids.
Area of Science:
- Public Health
- Pediatric Safety
- Injury Prevention
Background:
- Unintentional fatal drowning in bathtubs is a significant concern for child safety.
- Understanding the prevalence and causes of these incidents is crucial for developing effective prevention strategies.
Purpose of the Study:
- To determine the incidence of fatal bathtub drownings among children under 18 in Australia.
- To identify the primary contributing factors to these tragic events.
Main Methods:
- A comprehensive population study analyzed all unintentional drowning fatalities in baths (including bathtubs, spa baths, and showers) among children aged 0-17 in Australia.
- Data collected included demographics, forensic details, and etiological factors such as supervision, use of bath aids, and resuscitation efforts.
Main Results:
- Seventy-eight child drowning fatalities occurred between July 2002 and June 2014.
- The majority of victims (66.7%) were under two years old, with infants under one year being most vulnerable.
- Lack of adult supervision was a universal factor; common contributing elements included inability to self-rescue, pre-existing medical conditions (e.g., epilepsy), and inadequate supervision duration.
Conclusions:
- An average of 6.5 child bathtub drownings occur annually in Australia.
- Infants and toddlers are most at risk, with factors like unsupervised bathing, misplaced confidence in bath aids, and co-bathing by other children posing significant threats.
- Epilepsy and other medical conditions are also identified as risk factors, particularly in older children left unsupervised for extended periods.
Aim:
To establish the prevalence of unintentional fatal drowning in baths involving children <18 years in Australia and to identify causal factors to underpin prevention.
Methods:
We report a total population study of all childhood (0-17 years) unintentional drowning fatalities in baths (bathtubs, spa baths and showers) in Australia between 1 July 2002 and 30 June 2014. Demographic, forensic and aetiological data (including co-bathing, use of bath aids, supervision and enactment of cardiopulmonary resuscitation) were documented for each victim.
Results:
Seventy-eight children were identified; two thirds (66.7%) were under 2 years old, of which 43.6% were aged less than 1 year (1.0/100 000/annum) and 23.1% 1-2 years (0.27/100 000/annum). Nine older children (10-17 years) also drowned. Common causes included: infants and children unable to hold their head out of water while unsupervised and associated pre-existing medical conditions, including epilepsy. All children who drowned were left without adult supervision. No child drowned in a bath with water deeper than 40 cm (M = 19.4 cm). Custodian-reported 'time left unsupervised' ranged from 30 s to 60 min. Children with pre-existing medical conditions were, on average, older (9.9 years; confidence interval: 7.9-11.9) and left unsupervised for longer (M = 15.4 min; confidence interval: 3.8-27.1) than those without.
Conclusions:
On average, 6.5 children drown every year in baths in Australia. Children aged younger than 1 year are most affected, with both genders equally represented. Infants and toddlers left unsupervised, false confidence in the preventive role of bath aids, unrealistic expectations in the supervisory capabilities of co-bathing children and epilepsy remain threats to children in the bath.
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