The Hidden Tragedy of Rivers: A Decade of Unintentional Fatal Drowning in Australia

August The Hidden Tragedy of Rivers: A Decade of Unintentional Fatal Drowning in Australia Amy E. Peden 0 1 2 Richard C. Franklin 0 1 2 Peter A. Leggat 0 1 0 Editor: Hajo Zeeb, Leibniz Institute for Prevention Research and Epidemiology (BIPS) , GERMANY 1 a Current address: Royal Life Saving Society-Australia , Broadway, New South Wales , Australia ¤b Current address: School of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University , Townsville, Queensland , Australia 2 Royal Life Saving Society-Australia , Sydney, New South Wales , Australia , 2 School of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University , Townsville, Queensland , Australia , 3 Research School of Population Health, College of Medicine, Biology and Environment, Australian National University , Canberra , Australia Design & Setting p<0.04 respectively. - Data Availability Statement: With respect to the minimum dataset underlying this research, this data is available on request however as the data is via a third party (coronial data), ethical approval and permission from the data custodians, the Australian National Coronial Information System (NCIS) is required before the authors are able to provide their dataset to the person inquiring. There are strict ethical restrictions around use of this data and it can therefore not be sent to a public repository. Once ethical approval and permission from the NCIS as data custodians has been achieved, researchers can contact the corresponding author (Amy Peden ()) to gain access to the data. Objective(s) Results Rivers (n = 770; 26.6%) were the leading location among the 2,892 people who died from unintentional fatal drowning. This is a rate of 0.37/100,000 people / annum. Within river drowning deaths common groups include; males (80.4%), adults (85.3%), adults who have consumed alcohol (25.5%), people who fell in (21.3%), people involved in non-aquatic transport incidents (18.2%) and locals (74.0%). Children were 1.75 times more likely than adults (p<0.04) to drown in rivers as a result of a fall and adults 1.50 times more likely to drown in rivers as a result of watercraft incidents when compared to children. When compared to males, females were 2.27 and 4.45 times respectively more likely to drown in rivers as a result of incidents involving non-aquatic transport (p<0.04) and being swept away by floodwaters (p<0.04). Males were 2.66 and 4.27 times respectively more likely to drown in rivers as a result of watercraft incidents (p<0.04) and as a result of jumping in (p<0.04) when compared to females. Funding: This research is supported by the Royal Life Saving Society–Australia to aid in the reduction of drowning. Research at the Royal Life Saving Society–Australia is supported by the Australian Government. Competing Interests: The authors have declared that no competing interests exist. Conclusion(s) While rivers are the leading location for drowning in Australia, little is understood about the risks. This study has identified key groups (males, adults, locals) and activities. While males were more likely to drown, the risk profile for females differed. Introduction Drowning is a neglected public health issue, with an estimated 372,000 lives lost worldwide per annum [ 1 ]. The majority occur in low and middle income countries as a result of activities associated with daily life [ 2 ]. This is in contrast to drowning deaths in high income countries which generally occur recreationally [ 1 ]. Until now drowning prevention research has focused on young children (particularly those under five). This has been successful in reducing drowning deaths of young children in private swimming pools predominantly through improved pool fencing [ 3 ]. In contrast, a systematic review of literature published between 1980 and 2014 found there had been little research that specifically focused on drowning in rivers, creeks and streams (henceforth referred to as rivers), nor is the profile of river drowning victims well understood [ 4 ]. In studies published to date internationally, the crude death rate per 100,000 people for fatal river drowning varied from a low of 0.20 to a high of 1.89 [ 4 ]. Since the completion of the systematic literature review, the World Health Organization (WHO) has published a global report on drowning, identifying it as a world-wide issue [ 1 ]. Subsequent to the release of this report, studies have continued to be published on the issue of drowning prevention [ 5–6 ]. Little research has been published on the issue of drowning in rivers, however several papers identify natural waterways (which includes rivers) as common drowning locations [ 7–9 ]. One of these studies modelled unintentional drowning mortality rates in Thailand (2000–2009), finding most drowning deaths occurred in rural areas, however did not explore specific drow (...truncated)