Although the number of US drowning fatalities has decreased in the past decade, the news is hardly reassuring for the 137 parents who lost children in spa and swimming pool accidents last year. Nor is it comforting to the parents of the 168 children who required emergency treatment resulting from a near-fatal incident involving water. Those numbers also don’t take into account the number of parents who lost children in other seemingly benign water locations like the bathtub or backyard pond. Drowning is the number two cause of death in children aged one to four behind only birth defects, and can happen in the time it takes to answer the phone. In fact, the majority of accidental drownings occur when an adult is within 25 feet of the child.
Pretty sobering facts, aren’t they?
Close to 33% of all accidental deaths in the United States are drownings, with one out of every five drowning cases involving children. Although these tragedies happen year round, the majority of these incidents happen during the warm months of May through August. Further, most of these accidents take place on Saturdays or Sundays. Florida leads the nation in the number of accidental drownings, but overall rates are highest in southern and western states. The death rate for drowning climbs in rural locations, due in large part to the distances required to travel for medical care, emergency or otherwise.
How can it happen?
Most environments boast a host of water settings that can contribute to accidental drowning. Though swimming pools and spas are the most obvious, other less insidious water settings are just as deadly. Infants under the age of one are more likely to drown in the bathtub, while children aged one to four are more likely to drown in home pools. Children between the ages of five and fourteen are endangered by open water settings like rivers, lakes, ponds, and oceans. But drownings have also been reported resulting from immersion in toilets, sinks, landscape ponds, and fish tanks. Even buckets—particularly five-gallon buckets—pose a hazard. With large heads and unsteady bodies, a child can easily become stuck upside down inside these containers. One inch of water is all it takes to cover small child’s mouth and nose and create a dangerous situation.
Furthermore, certain populations are at a greater risk than others. Boys are up to four times more likely to drown than girls, although girls are twice as likely to drown in the bathtub. Minority children are three times more likely to drown than white children. Children and adults with seizure disorders are especially susceptible to drowning. Drowning is the most common cause of unintentional death among people with seizure disorders; the bathtub poses the highest risk for individuals in this category.
Drowning is often preventable
More than 90% of these accidents are attributed to inadequate supervision. Two-thirds of babies who drown are unattended at the time of the accident. Yet we often misunderstand what drowning really looks like. The media often portrays drowning as a dramatic event involving bobbing, splashing, and crying for help. But surface drowning, which occurs at the surface of the water rather than through immersion, is actually a deceptively quiet event.
Francesco A. Pia, Ph.D., named this type of event the Instinctive Drowning Response for the biological responses that occur when the body is overwhelmed by water. The person struggles on the surface of the water for 20–60 seconds, unable to yell for help as the body tries to maintain breathing functions. There is no splashing: the body’s natural instinct pushes the arms downward to try to propel the body upward and out of the water. Voluntary movements like waving or speaking are shut down in an effort to preserve vital functions. The body remains in an upright position in the water until struggling becomes impossible, at which time the individual in distress goes under the water. The whole event can occur in less than 20 seconds.
An excellent article by Mario Vittone, a writer and expert on water safety, details the following signs of drowning:
- Head low in the water, mouth at water level
- Head tilted back with mouth open
- Eyes glassy and empty, unable to focus
- Eyes closed
- Hair over forehead or eyes
- Not using legs-vertical
- Hyperventilating or gasping
- Trying to swim in a particular direction but not making headway
- Trying to roll over on the back
- Appear to be climbing an invisible ladder
Parents should remember that splashing and yelling may indicate trouble, but the real trouble is indicated by silence.
Playing it safe
Perhaps the most important aspect to keep in mind is that most drownings are preventable. Knowing the signs of drowning are important, but close supervision is paramount to the children’s safety. The Center for Disease Control recommends parents practice “touch supervision” for preschool aged-children. This means that a parent should always be close enough to touch the child whenever he or she is around any water setting. One-on-one supervision is always necessary for those with seizure disorders.
Careful control of the environment can also safeguard children against accidental drownings. Risk of drowning is halved when a locked fence surrounds the pool preventing children from entering the area without appropriate supervision. Alarms are also available that can signal parents and caregivers when a child has opened the fence or gate. In addition, proper maintenance can help prevent children from accidentally tripping and falling into the water, and storing toys away from the pool can eliminate the enticement of sneaking toward it.
Some parents are lulled into a false sense of security by baby bath seats, water wings, pool noodles, life jackets, or floaties. While these are arguably safety devices, they are not a substitution for close supervision. The floatation devices may deflate in the middle of the water, allowing the child to submerge. Some children using these devices also overestimate their abilities and take risks that might lead them into a dangerous situation. Sometimes children even lose their balance and flip over with the flotation device preventing them from righting themselves in the water.
Because drownings can occur outside of a pool setting, it’s necessary to take additional precautions. All buckets should be emptied completely or lidded with a childproof closure, toilet seats should be kept closed, and all parents and caregivers should know how to safely perform CPR.
What about swimming lessons?
The idea of swimming lessons is controversial as it pertains to drownings. Though some contend that swimming lessons can make children overconfident in their abilities and lead to risky behaviors that contribute to drowning, research has found this to be untrue. In fact, separate studies from Bangladesh, China, and the United States all found that formal swimming lessons that teach basic water safety survival skills in children under the age of four lead to a significant decline in drowning rates. Some pools offer swimming lesson to children as young as three to six months old.
Last year, 3,380 people lost their lives as the result of drowning, accounting for one third of all accidental deaths in the United States. And though preventable, parents often assume the child is playing quietly, never considering the idea that the child is actually fighting for life. A twenty-second distraction is all it takes to lose a child to accidental drowning. Be vigilant, be present, and be safe.