Abstract 584 Poster Session I, Saturday, 5/1 (poster 206)

Introduction: Drowning is a major cause of injury death with highest rates in toddlers and adolescent males. Details on the specific site of the event are important for implementation of primary prevention efforts, but are not available from national data. Objectives: To describe the epidemiology of childhood drowning in the U.S. in greater detail than previously possible through abstraction of both coded and narrative sections of death certificates. Setting: United States, 1995. Design: Information was abstracted from death certificates where age ≤19 years and underlying cause of death was drowning. Study data were compared to national mortality data. Demographic factors abstracted from death certificates and national public use data tapes included age, race, and gender of the victim; state, month, and day of week of death. Details about the death were coded from the free text of the death certificate. Denominator data were obtained from the U.S. Bureau of the Census. Results:1,447 unintentional non-boat related, drownings were identified. Rates were highest among black adolescent males (4.9 and 5.9 per 100,000 for ages 10-14 and 15-19 years, respectively) and white males ages 1-4 years (4.5/100,000). The narrative describing the event was abstracted from hard copies of the death certificate for 1369 (95%) of the drowning deaths with the site of drowning specified in 1252. The majority (60%) of infant drownings were in bathtubs and 53% of drownings in children ages 1-4 were in swimming pools. Among older children the most frequent site of drowning varied with race (see table). For example, the overall rate of drowning among 15-19 year old black males was 1.6 times that of white males, but black teens were over 10 times as likely to drown in a swimming pool (RR 13.4 95%CI 6.5-27.9).

Table 1 Rates of death from drowning for males by race and site (per/100,000 population)
Full size table

Conclusions: Information about the site of drowning has important implications for planning and implementing prevention efforts. One unexpected finding was the high rate of swimming pool drowning in black males.