The majority of drownings and near-drownings occur in residential swimming pools. However, children can drown in as little as one inch of water and are therefore at risk of drowning in wading pools, bathtubs, buckets, diaper pails, toilets, spas and hot tubs. Additionally, older children are more likely to drown in open water sites, such as lakes, rivers and oceans.
Drowning usually occurs quickly and silently. Childhood drownings and near-drownings can happen in a matter of seconds and typically occur when a child is left unattended or during a brief lapse in supervision. Two minutes following submersion, a child will lose consciousness. Irreversible brain damage occurs after four to six minutes and determines the immediate and long-term survival of a child. The majority of children who survive are discovered within two minutes following submersion (92 percent), and most children who die are found after 10 minutes (86 percent). Nearly all who require cardiopulmonary resuscitation (CPR) die or are left with severe brain injury.
DEATHS AND INJURIES
In 1996, nearly 1,000 children ages 14 and under drowned. Children ages 4 and under accounted for nearly half of these deaths. Each year, an estimated 5,000 children ages 14 and under are hospitalized due to near-drownings. Near-drownings have high case fatality rates. Fifteen percent of children admitted for near-drowning die in the hospital. As many as 20 percent of near-drowning survivors suffer severe, permanent neurological disability. For every child who drowns, an additional four are hospitalized for near-drowning; and for every hospital admission, approximately four children are treated in hospital emergency rooms. A swimming pool is 14 times more likely than a motor vehicle to be involved in the death of a child age 4 and under. jump_arrow.gif (69 bytes) Top of Page WHEN AND WHERE DROWNINGS AND NEAR-DROWNINGS OCCUR
More than half of drownings among infants (under age 1) occur in bathtubs. Drownings in this age group also occur in toilets and buckets. More than 85 percent of drownings among children ages 1 to 4 are pool related. Children ages 5 to 14 most often drown in swimming pools and open water sites. More than 320 children, 88 percent between the ages of 7 and 15 months, have drowned in buckets containing water or other liquids used for mopping floors and other household chores since 1984. Approximately 10 percent of childhood drownings occur in bathtubs; and the majority of these occur in the absence of adult supervision. Among children ages 4 and under, there are approximately 375 residential swimming pool drownings and 2,900 near-drownings requiring hospital emergency room treatment each year. More than half of these drownings occur in the child's home pool and one-third at the homes of friends, neighbors or relatives. The majority of children who drown in swimming pools were last seen in the home, had been missing from sight for less than five minutes, and were in the care of one or both parents at the time of the drowning. In-ground swimming pools without complete four-sided isolation fencing are 60 percent more likely to be involved in drownings than those with four-sided isolation fencing. Since 1980, approximately 230 children ages 4 and under have drowned in spas and hot tubs. In 1997, 31 children ages 14 and under died in boating-related incidents. Nearly 60 percent of these children drowned; the remaining deaths were associated with other injuries such as falls, burns and propeller-related injuries. In 1997, more than 200 children ages 14 and under suffered personal watercraft-related injuries while on the water. Drownings and near-drownings tend to occur on Saturdays and Sundays (40 percent) and between the months of May and August (66 percent). Drowning fatality rates are higher in southern and western states than in other regions of the United States. Rural areas have higher death rates than urban or suburban areas, in part due to decreased access to emergency medical care. jump_arrow.gif (69 bytes) WHO IS AT RISK
Children ages 4 and under have the highest drowning death rate, a rate two to three times greater than other age groups, and account for more than 40 percent of home drownings. These drownings typically occur in swimming pools and bathtubs. Male children have a drowning rate two to four times that of female children. However, females have a bathtub drowning rate twice the rate of males. Black children ages 14 and under have a drowning death rate that is two times greater than white children, in general and six times greater for drownings involving buckets. However, white children ages 1 to 4 have a drowning death rate that is twice that of black children, primarily from residential swimming pool drownings. Low-income children are at greater risk from non-swimming pool drownings. Among children hospitalized for near-drownings, prolonged submersion and time until resuscitative efforts are initiated, as well as hypothermia, are strongly associated with poor outcomes.