January 17, 2012

Fewer children require hospitalization after drowning incidents

Fewer children required hospitalization following a drowning incident over the last two decades, according to a new study by the Johns Hopkins Center for Injury Research and Policy.

According to the study, pediatric hospitalizations from drowning-related incidents declined 51 percent from 1993 to 2008. The rates declined significantly for all ages and for both genders, although drowning-related hospitalizations remained higher for boys at every age.

Hospitalization rates also decreased significantly across the United States, with the greatest decline in the South. Despite the steep decline, the South still experienced the highest rate of pediatric hospitalizations for drowning. The study will be published in the February issue of Pediatrics and is available now on the journal’s website.

Drowning is the second-leading cause of unintentional injury death of children ages 1 to 19 in the United States. For every pediatric drowning death, another two children are hospitalized for nonfatal drowning injuries. “We found a significant decline in the rate of pediatric drowning hospitalizations, which is consistent with documented decreases in pediatric deaths from drowning,” said lead study author Stephen Bowman, an assistant professor with the Johns Hopkins Center for Injury Research and Policy, part of the Johns Hopkins Bloomberg School of Public Health. “Our findings provide evidence of a true decrease in drowning-related incidents rather than simply a shift toward more children dying before reaching a hospital.”

The authors note that over the study time period, important public and private efforts to reduce the risk of drowning in children have been promoted, such as installation of four-sided pool fencing, the use of personal flotation devices and the endorsement by public health authorities of childhood swim lessons. Reductions in bathtub drowning hospitalizations, most common among children younger than 4, may be a result of targeted injury prevention efforts aimed at parents and caregivers of young children that encourage vigilance in supervision and offer education on the risks of infant bathtub seats.

“Continued funding and support for these efforts offer the potential to further reduce drowning hospitalizations in children,” Bowman said.

Drowning accounts for more than 1,000 pediatric deaths and more than 5,000 related injuries annually in the United States. Total lifetime costs associated with drowning were estimated to exceed $5.3 billion in 2000, including $2.6 billion for children ages 0 to 14 years.

To document the trends, the study authors used data from the 1993–2008 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality.

Support for this study was provided by the National Center for Injury Prevention and Control and by the Centers for Disease Control and Prevention, through a grant to the Johns Hopkins Center for Injury Research and Policy, and through support from the National Institutes of Health/National Center for Research Resources Clinical and Translational Research grant UL1RR029884 (Arkansas Translational Research Institute, University of Arkansas for Medical Sciences).