Jeremy Lasek – PHAA
With the days lengthening, the weather and water warming, and COVID-19 restrictions lifting, many of us are planning our first dip or trip to the beach.
Water safety and drownings remain a significant public health issue in Australia, and a leading cause of mortality and morbidity. Every year an average of 238 people drown in Australia, and for each fatality, a further three people are hospitalised due to non-fatal drownings. The ratio is highest among children under the age of five, with eight hospitalisations for each death.
Over many years, peak water safety bodies such as the Royal Life Saving Society – Australia, and Surf Life Saving Australia, alongside other national government and non-government organisations with interests in swimming, boating and water safety, have worked together to reduce drownings and near-drownings. Their efforts have focused on water safety research, management of aquatic locations, water safety education, and the targeting of key drowning demographics.
Drowning trends 2008-2020
A recent article in the Australian and New Zealand Journal of Public Health by Amy Peden, Justin-Paul Scarr and Alison Mahony examined the trends in drownings in Australia against targets set in the Australian Water Safety Strategy (AWSS) 2008-2020. The research will form the basis to inform the development of the next AWSS.
The previous AWSS set an aspirational target of reducing drowning deaths in Australia by 50% by 2020. This target was intended as a focal point for advocacy, as well as being an indicator that flowed through a new drowning prevention framework.
The research findings identified several events which cause drowning numbers to spike. These included the Queensland floods in 2011 in which 33 people drowned, seven of whom were swimming, wading or diving into floodwaters, and a similar number from driving vehicles on flooded roads and crossings.
The study baseline was derived from a three-year average of fatal drowning data in the financial years immediately preceding the release of the first AWSS in 2008.
Reduced childhood drownings
Children aged under five are the age group most at risk of drowning in Australia, and as such, have been a key focus of water safety policy, advocacy, programs and research. Most reductions in drownings occurred among children aged 0-4 years (-62.6%) and 5-14 years (-55.7%). Most drownings occurred in rivers and creeks, followed by beaches.
The largest reductions in drowning were observed in bathtubs and spa baths (-53.2%) and oceans and harbours (-38.8%). Rocks were the only location to record an increase in drowning over the study period (+46.3%).
The highest state and territory rates were found in the Northern Territory; the ACT held the lowest. Tasmania (-36.7%) and South Australia (-35.1%) recorded the largest reduction in drownings.
As with many other types of injury-related harm, males continued to be overrepresented in drowning statistics in Australia. This differential in drowning rates between males and females widened across the period analysed, and was mirrored by reduced drowning rates among females (-32.7%) than males (-25.2%). A range of factors influence drowning risk among males, including alcohol consumption, differing exposure to water and participation in aquatic-related activities, and a lower likelihood to wear a lifejacket.
The study shows a reduction in drownings at beaches (11.5%) and oceans/harbours (38.8%). Drowning in swimming pools also reduced by 38.8% which was attributed to a reduction in children drowning in home swimming pools and consistently low rates of drowning in public swimming pools.
Conclusion and next steps
While the study indicates that support in the form of funding, legislative change and advertising may have contributed to significant reductions over the period, most notably in the reduction of drowning among young children, there is more to be done.
The next iteration of the AWSS must continue to consider state and territory-based differences in drowning risk and identify areas of improvement with respect to preventing drowning.
The study also signposted several areas of focus, including a need to refocus drowning prevention efforts among older people in light of an ageing population. While forecasts of overseas tourism, migration and international student patterns will need to be revised, taking the medium and long-term impacts of the COVID-19 pandemic into consideration, factoring changes in populations at risk of drowning over time must be considered in future approaches.
Similarly, the next iteration of the AWSS must highlight the intersection between drowning risk (and prevention) and other public health agendas such as the impacts of climate change on flood risk and the role of swimming as both a drowning prevention strategy, and a tool to address childhood obesity, as just two examples.
The ANZJPH article Analysis of fatal unintentional drowning in Australia 2008-2020: implications for the Australian Water Safety Strategy is co-authored by Amy Peden, Justin-Paul Scarr and Alison Mahony.
Image: Manly Beach, by Sacha Fernandez/Flick