Identifying risk factors and implications for beach drowning prevention amongst an Australian multicultural community

Multicultural communities in Australia are recognised as a priority area for drowning prevention, but no evidence-based study has addressed their knowledge of beach safety. This study used an online survey tool to identify and examine risk factors relating to swimming ability, beach visitation characteristics and behaviour, and beach safety knowledge of the Australian Southern Asian community to assist in the development of future beach safety interventions. Data was obtained through 249 online and in-person surveys of people aged > 18 years. Most respondents reported poor swimming ability (80%), often swam in in the absence of lifeguards (77%), did not understand the rip current hazard (58%), but reported that they entered the water (76%) when visiting beaches. Close to one-quarter (28%) had not heard, or didn’t know the purpose, of the red and yellow beach flags, which identify lifeguard supervised areas on Australian beaches. Length of time living in Australia is an important beach safety consideration for this community, with minimal differences in terms of gender and age. Those who have lived < 10 years in Australia visit beaches more frequently and are less likely to have participated in swimming lessons, be able to swim, heard of the flags or swim between them, understand rip currents, or have participated in a beach safety program. Very few (3%) respondents received beach safety information from within their own community. The importance of beach safety education and swimming lessons within the Southern Asian community should be prioritised for new and recent migrants to Australia.

Drowning: Global Burden, Risk Factors, and Prevention Strategies

Drowning has been described as a major global public health problem and has recently been acknowledged by a United Nations Declaration on Global Drowning Prevention. While drowning impacts countries of all income levels, the burden is overwhelmingly borne by low- and middle-income countries (LMICs) who account for 90% of the global death toll. In addition, there is scarce data collection on drowning in LMICs, so the magnitude of drowning may be far greater than is represented. A range of factors including sex, age, education, income, access to water, a lack of swimming skills, certain occupations like commercial fishing, geographically isolated and flood-prone locations, preexisting medical conditions, and unsafe water transport systems, influence the risk of drowning. Some behavioral factors, such as alcohol or drug consumption, not wearing life jackets, and engaging in risky behaviors such as swimming or boating alone, increase drowning risk. Geopolitical factors such as migration and armed conflict can also impact drowning risk. There is a growing body of evidence on drowning prevention strategies. These include pre-event interventions such as pool fencing, enhancing community education and awareness, providing swimming lessons, use of lifejackets, close supervision of children by adults, and boating regulations. Interventions to reduce harm from drowning include appropriate training for recognition of a drowning event, rescue, and resuscitation. An active and/or passive surveillance system for drowning, focusing on individual settings and targeting populations at risk, is required. Drowning requires coordinated multisectoral action to provide effective prevention, rescue, and treatment. Therefore, all countries should aim to develop a national water safety plan, as recommended in the WHO Global Report on Drowning. Further research is required on the epidemiology and treatment of drowning in LMICs as well as non-fatal and intentional drowning in both high-income countries (HICs) and LMICs. Effective and context-specific implementation of drowning prevention strategies, including pilot testing, scale up and evaluation, are likely to help reduce the burden of both fatal and non-fatal drowning in all countries.

Drown-proofing New Zealand: The Learn-to-Swim and Prevent Drowning Campaigns, 1936-1956

<p>This thesis examines the development of recreational amateur swimming in New Zealand between 1936 and 1956. During this period, swimming ability and drowning prevention became issues of national importance and extensive measures were introduced to encourage the expansion of amateur swimming culture. The growth of interest in swimming was partly a response to the perception that drowning deaths were too common. This thesis discusses the trends and characteristics of deaths by drowning. The extension of swimming was also largely thanks to the efforts of the Labour Government, elected in 1935, which instituted a new and active approach to enabling leisure. In 1936, just months after being elected, Labour made its first move towards extending New Zealanders’ opportunities for aquatic recreation by offering greater support to voluntary swimming and lifesaving associations. In 1938, under the newly enacted Physical Welfare and Recreation Act, the Government launched the Learn-to-Swim campaign, followed by the Prevent Drowning campaign in 1949. These campaigns helped to establish ‘proper’ swimming as a valuable part of modern life, an increasingly popular leisure pursuit, and an expected skill, as well as advocating the necessity of ‘water wisdom’. By 1956, the perceived need for government intervention into leisure had diminished and swimming and drowning prevention were once again viewed as private matters, the concern of the individual and not of the state. Consequently, the Government (now that of the National administration) withdrew its support from the campaigns. However, swimming was firmly established as an enjoyable, valuable, and important recreational pursuit. Thus, the Water Safety campaign was launched by voluntary swimming and lifesaving organisations to take the place of the Learn-to-Swim and Prevent Drowning campaigns. This thesis argues that the 1936-1956 period was one of significant growth in recreational swimming and the state was an important and active agent in this process of modernising New Zealand’s swimming culture.</p>

Drown-proofing New Zealand: The Learn-to-Swim and Prevent Drowning Campaigns, 1936-1956

<p>This thesis examines the development of recreational amateur swimming in New Zealand between 1936 and 1956. During this period, swimming ability and drowning prevention became issues of national importance and extensive measures were introduced to encourage the expansion of amateur swimming culture. The growth of interest in swimming was partly a response to the perception that drowning deaths were too common. This thesis discusses the trends and characteristics of deaths by drowning. The extension of swimming was also largely thanks to the efforts of the Labour Government, elected in 1935, which instituted a new and active approach to enabling leisure. In 1936, just months after being elected, Labour made its first move towards extending New Zealanders’ opportunities for aquatic recreation by offering greater support to voluntary swimming and lifesaving associations. In 1938, under the newly enacted Physical Welfare and Recreation Act, the Government launched the Learn-to-Swim campaign, followed by the Prevent Drowning campaign in 1949. These campaigns helped to establish ‘proper’ swimming as a valuable part of modern life, an increasingly popular leisure pursuit, and an expected skill, as well as advocating the necessity of ‘water wisdom’. By 1956, the perceived need for government intervention into leisure had diminished and swimming and drowning prevention were once again viewed as private matters, the concern of the individual and not of the state. Consequently, the Government (now that of the National administration) withdrew its support from the campaigns. However, swimming was firmly established as an enjoyable, valuable, and important recreational pursuit. Thus, the Water Safety campaign was launched by voluntary swimming and lifesaving organisations to take the place of the Learn-to-Swim and Prevent Drowning campaigns. This thesis argues that the 1936-1956 period was one of significant growth in recreational swimming and the state was an important and active agent in this process of modernising New Zealand’s swimming culture.</p>

The water incident database (WAID) 2012 to 2019: a systematic evaluation of the documenting of UK drownings

Background Death by drowning is a leading cause of accidental death in the United Kingdom (UK) and worldwide. The World Health Organization (WHO) states that effective documentation of drowning is required to describe drowning frequency and to underpin effective drowning prevention intervention, thus improving the quality of data describing drowning frequency represents a key initiative. The water incident database (WAID) has been used to document UK fatal and non-fatal water-based incidents since 2009. WAID has not undergone a systematic evaluation of its data or data collection procedures to establish if the database meets the WHO requirements. The present study investigated the characteristics of UK fatal drowning incidents and audited current WAID data capture procedures. Methods Data for the fatal drowning cases recorded between 2012 and 2019 were reviewed. Descriptive data were generated 1) to describe fatal drownings in the UK’s WAID in this period; 2) a sub-set of drownings were audited i) for completeness of data entry and, based on source documents, ii) for quality of data entry; 3) these processes were used to make recommendations for onward revisions to WAID. Results A total of 5051 fatalities were recorded between 2012 and 2019. Drowning was most frequent amongst males aged 35 to 60 years (n = 1346), whilst suspected accidents and suicides accounted for 44 and 35% of fatalities. Suicide by drowning was at a peak in the most recent year of data analysed (i.e., 2019; 279 cases) highlighting an urgent need for targeted intervention. Audit part 2i) indicated that 16% of all fields were incomplete, thus indicating potential redundancy, duplication, or the need for onward review. Audit part 2ii) indicated high levels of agreement (80 ± 12%) between audited cases and the ‘true’ WAID entries. Conclusions This study confirms WAID as a rigorous, transparent and effective means of documenting UK drownings thereby meeting WHO requirements for data quality; yet future improvements are recommended. Such findings allow researchers and policy makers to use WAID to further investigate UK drowning with a view to improving public safety measures and drowning prevention interventions. Observations alongside several expert recommendations have informed a revised version of WAID.

Application of the PRECEDE–PROCEED model in the development of evidence-informed interventions for drowning prevention: a mixed-methods study protocol

IntroductionDrowning is a global public health threat, disproportionately impacting low-income and middle-income countries. In the Philippines, it is estimated that more than 5200 people die from drowning per annum. This number is likely to be higher than currently estimated with the inclusion of disaster-related and transportation-related drowning. Drowning is preventable if appropriate preventive interventions are put in place which redress known risk factors.Methods and analysisThis study uses the PRECEDE–PROCEED model (PPM), an eight-step health promotion planning and evaluation model for building and improving intervention programmes. This mixed-methods study, which can be used in any location, will be implemented in Los Baňos, Laguna, Philippines, identified as an area of concern for drowning. Using the PPM, data on drowning will be collected from death records, community observation, key informant interviews, focus group discussions and community survey. A range of analytical methods will be used to explore drowning data including univariate and χ2 analyses, analysis of variance, relative risk and calculating rates using population data. The quantitative data and themes drawn from qualitative data will be used to populate the first four phases of the PPM. Following the data collection, the remaining stages of the PPM will be designed and implemented in the barangay (village) with the highest drowning rate.Ethics and disseminationThis study has obtained ethical clearance from the University of the Philippines Manila Research Ethics Board (UPMREB 2017-425-01). Study findings will be disseminated through workshops and presentations to the local community as well as through peer-reviewed literature and conference presentations. The PPM has rarely been applied to drowning prevention and it is the aim that the study described in this protocol is expanded across other areas of the Philippines and to other countries with a high drowning burden to inform prevention efforts.