Knowing how to swim and drowning prevention in children aged 10 to 14 years. Systematic review

Drowning is 1 of the 10 leading causes of death due to unintentional injuries in children and adolescents worldwide. Knowing how to swim has been traditionally associated with water safety. However, its conceptualization may vary across studies, leading to different measurements and effects on the risk of drowning. This review sought to understand the current state of scientific evidence associating both issues.

To identify conceptualizations of knowing how to swim and to analyze the evidence indicating whether "knowing how to swim" may be a protective or a risk factor for unintentional drowning in children aged 10 to 14 years.

A systematic review of observational etiology studies was conducted, considering original peer-reviewed research published up to the year 2020. Databases including PubMed, Cochrane Central, Tripdatabase, Science Direct, Epistemonikos, Bvs and Bireme were searched for studies associating swimming skills as a risk or a protective factor for drowning (10-14 years). Study quality was assessed, and quantitative data were synthesized (without performing a meta-analysis).

A total of 6,508 results were identified, with only 6 studies meeting the criteria for inclusion in the final cohort. It was evidenced that the exclusive possession of swimming skills, without a concurrent understanding of water safety, is associated with increased exposure to aquatic environments. Consequently, this may increase the risk of drowning.

Among children aged 10 to 14 years, there is insufficient evidence regarding whether knowing how to swim serves as a protective factor against drowning compared to not knowing how to swim.

The insufficiency of evidence and a lack of consensus in the conceptualization of swimming as a form of knowledge underscores the need for further research. Such research is crucial for informing investments in drowning prevention interventions, particularly during early adolescence.