Global burden of drowning and risk factors across 204 countries from 1990 to 2021

Drowning is a major global public health issue with marked variations in incidence, mortality, and disability-adjusted life years (DALYs) across regions, age groups, and sexes. Although previous studies have examined global trends in drowning, few have comprehensively analyzed regional and national disparities while addressing potential reporting biases and confounding factors. Data from the Global Burden of Disease (GBD) Study 2021, focusing on drowning-related incidence, death rates, and DALYs, and examined trends from 1990 to 2021 across various regions and countries. The study used age-standardized rates to assess trends and risk factors associated with drowning. In 2021, there were 856.1 thousand drowning cases globally, leading to 274.2 thousand deaths and 15.7 million DALYs. Age-standardized rates showed significant reductions since 1990: incidence decreased by 51.5% to 11.1, deaths by 60.9% to 3.6, and DALYs by 67.3% to 211.9. Solomon Islands, Belarus, and Ukraine had the highest incidence rates, while Nauru, Central African Republic, and Marshall Islands reported the highest death and DALYs rates. DALYs rates were highest in children aged 0-5 years and declined with age. A negative correlation was observed between SDI and DALYs rates. Key risk factors included occupational injuries (13.2%), high temperature (4.6%), and alcohol use (1.7%), while low temperature had a negative contribution (-10.6%). Despite reductions, drowning remains a major public health issue, especially in low-SDI countries. Targeted interventions addressing Occupational injuries, High temperature and Alcohol use are essential to further reduce drowning-related morbidity and mortality.