Who Drowns? Encoding the Second Component of the 4W Model

International Journal of Aquatic Research and Education Volume 3 | Number 3 Article 3 8-1-2009 Who Drowns? Encoding the Second Component of the 4W Model Stathis Avramidis Leeds Metropolitan University, Ronald Butterly Leeds Metropolitan University David Llewellyn University of Cambridge Follow this and additional works at: https://scholarworks.bgsu.edu/ijare Recommended Citation Avramidis, Stathis; Butterly, Ronald; and Llewellyn, David (2009) "Who Drowns? Encoding the Second Component of the 4W Model," International Journal of Aquatic Research and Education: Vol. 3 : No. 3 , Article 3. DOI: 10.25035/ijare.03.03.03 Available at: https://scholarworks.bgsu.edu/ijare/vol3/iss3/3 This Research Article is brought to you for free and open access by ScholarWorks@BGSU. It has been accepted for inclusion in International Journal of Aquatic Research and Education by an authorized editor of ScholarWorks@BGSU. Avramidis et al.: Who Drowns? Encoding the Second Component of the 4W Model RESEARCH International Journal of Aquatic Research and Education, 2009, 3, 224-235 © 2009 Human Kinetics, Inc. Who Drowns? Encoding the Second Component of the 4W Model Stathis Avramidis, Ronald Butterly, and David Llewellyn The aim of the current study was to identify the casualty characteristics that contribute to drowning according to the 4W model (Avramidis, Butterly, & Llewellyn, 2007, 2009). Qualitative content analysis was used to analyze drowning incident videos (n = 41) and semistructured interviews of those involved in drowning incidents (n = 34). Results confirm that human activity in, on, and around an aquatic environment can lead to drowning, regardless of the casualty’s type, gender, age, ethnicity, and area of residence. Males far outnumbered females as drowning victims. Younger persons were more likely to drown than were adults. Due to socioeconomic differences, Black people in our sample were likely to drown more often, while Whites who drowned were engaged in aquatic activities that lower socioeconomic individuals likely cannot afford or have access to. Nonswimmers, casualties who have lost consciousness, and nonresidents to specific aquatic environments also were the ones in the highest danger. Drowning is a leading cause of accidental death worldwide and a social and health problem that can produce a series of serious consequences. For example, while some researchers argue that survival after drowning may cause near-death experiences resulting in profound positive changes on the persons’ life (Holden, 2008), others link drowning with a variety of negative physical and psychological implications, such as post traumatic stress disorder (Alonzo, 2000; Bouwer & Stein, 1997; Chemtob et al., 1998; Goleman, 1995; Hidalgo & Davidson, 2000; Howsepian, 1998). Especially when the surviving drowned person is a child, the traumatic incident may evoke very strong and enduring emotions (Meyer, Theodorou, & Bergn, 2006; Shannon, 1991). An aquatic emergency can result in huge health care costs for hospitalization and therapeutic rehabilitation for a drowning casualty who survives (Ellis & Trent, 1995; Walters, Fraser, & Alleyne 1993). In the USA, the annual cost of care per year in a chronic care facility for an impaired survivor of a drowning event was approximately $100,000 in the early 1990s (American Academy of Pediatrics, 1993) but has undoubtedly expanded dramatically in the subsequent 15–20 years. Of course, a fatal drowning causes psychological pain for the family and friends of a lost one (Triantafillou, 2000). A pediatric water-submersion injury is a devastating situation that impacts all family members (parents, siblings, grandparents). Stathis Avramidis and Ron Butterly are with Leeds Metropolitan University, Faculty of Sport and Education in Leeds, UK. David Llewellyn is with the University of Cambridge in Cambridge, UK. Published224 by ScholarWorks@BGSU, 2009 1 International Journal of Aquatic Research and Education, Vol. 3, No. 3 [2009], Art. 3 Who Drowns?   225 The occurrence of such an event often alters family functioning and the ability to carry on after the crisis. Ninety percent of marriages break up within 5 years of the death of a child (Borta, 1991). According to the 4W model (Avramidis, Butterly, & Llewellyn, 2007) a drowning incident can occur due to several causes that can be categorized into four discrete interrelated factors: rescuer characteristics, casualty characteristics, location, and circumstances. The 4W model was proposed as a theoretical and practical mechanism for understanding drowning. We have previously described the first “W,” or “Who 1,” associated with characteristics, experience, and other factors associated with rescuers (Avramidis, Butterly, & Llewellyn, 2009). The current article examines the second “W” or “Who 2” qualities and characteristics associated with those casualties who suffer drowning. Since drownings often lead to profound negative consequences on individuals, family groups, and the society in general, it is important and significant to investigate “who” is most likely to be a drowning victim. Further, we should examine whether certain age groups are more vulnerable than others, the degree to which one sex is more likely to drown than the other, whether there are specific occupations that are more at risk, and whether we can foresee certain kinds of risky human behavior that lead to drowning and its negative consequences. A number of studies have investigated the fitness, abilities, age, sex, and other characteristics of drowning victims. Research has shown that even physically fit and competent swimmers can drown (e.g., Athlitiki Iho, 1996; Eleftherotipia, 1996; Hitas, 1996a, 1996b). Several types of disabilities and conditions such as epilepsy (Lip & Brodie, 1992; Osamura, Fushiki, Yoshioka, Yamanaka, & Mizuta, 1997; Saxena & Ang, 1993; Schmidt, Guggolz, & du Bois, 1991; Schmidt & Madea, 1995), autism (Sibert et al., 2002), Angelman syndrome (Ishmael, Begleiter, & Butler, 2002), Roman-Ward syndrome (Ishmael et al., 2002), cerebral palsy, Down syndrome, multiple handicaps (Shinaberger, Anderson, & Kraus, 1990), and even pregnancy (Ronsmans & Khlat, 1999) have been linked with drowning. People of all age groups have been found to be involved in drowning incidents (e.g., McGee, Krug, & Peden 2002; Royal Society for the Prevention of Accidents, 2001; Uchiyama, Tanaka, Ishii, Ikemi, & Osaka 2002). Although males are much more likely to be victims, both genders have been involved in drowning incidents (e.g., Alexe, Dessypris, & Petridou, 2002; Dunn & Gulbis, 1976; World Health Organization, n.d.). In terms of ethnicity, the drowning rate among Blacks is 2–3 times higher than among Whites in the USA (Campbell, 1991; Kizer, 1983; Palinkas, 1985). Persons of both high and low socioeconomic backgrounds can drown for different reasons. Certain high-risk recreational activities (e.g., scuba diving, sailing, windsurfing, boating) (...truncated)