Where Do People Drown? Encoding the Third Component of the 4W Model

International Journal of Aquatic Research and Education Volume 3 | Number 3 Article 4 8-1-2009 Where Do People Drown? Encoding the Third 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) "Where Do People Drown? Encoding the Third Component of the 4W Model," International Journal of Aquatic Research and Education: Vol. 3 : No. 3 , Article 4. DOI: 10.25035/ijare.03.03.04 Available at: https://scholarworks.bgsu.edu/ijare/vol3/iss3/4 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.: Where Do People Drown? Encoding the Third Component of the 4W Mod International Journal of Aquatic Research and Education, 2009, 3, 236-254 © 2009 Human Kinetics, Inc. Where Do People Drown? Encoding the Third Component of the 4W Model Stathis Avramidis, Ronald Butterly, and David Llewellyn When there is human activity in, above, or around an aquatic environment, a drowning incident may occur due to rescuer characteristics, casualty characteristics, location, and general circumstances (Avramidis, Butterly, & Llewellyn, 2007). The aim of the current study was to identify locations where people drown. Qualitative content analysis was used to analyze drowning incident videos (n = 41), and semistructured interviews were conducted of those involved in drowning incidents (n = 34). Drowning incidents may occur in any aquatic environment with a water depth that allows immersion or submersion, under a variety of environmental conditions where the ground is sloping, at any distance from safety, where anxiety exists, in the absence of safety regulations, or when the law is breached. Keywords: drowning, lifeguarding, lifesaving, water safety, swimming, rescues Drowning is a leading cause of accidental death and a serious social and health problem worldwide (Avramidis & Butterly, 2008; World Health Organization, 2003). According to the 4W model of drowning, the place of occurrence of a drowning incident is an important factor in determining the outcome of the casualty (Avramidis, Butterly, & Llewellyn, 2007), but where people actually drown is largely uncertain. Consequences of Aquatic Locations Lack of understanding of where a drowning incident might occur has a several potential adverse consequences. First, it may increase the likelihood that a drowning death might occur (Avramidis & Butterly, 2008). Second, regardless of whether the casualty survives or not, rescues often incur a significant financial burden due to the use of rescue vehicles such as ATVs, helicopters, or ambulances (Muller, 2002; Vandevelde, 2002) and treatment costs (e.g., hospitalization; Ellis & Trent, 1995; Walters, Fraser, & Alleyne, 1993). Third, during the rescue, other people’s lives might be placed at risk (e.g., amateur lifesavers, professional lifeguards or rescuers; Avramidis & Avramidou, 2008; Jones, 1985; Raphael et al., 1983; Shepherd & Hodgkinson, 1990). Fourth, the local authorities or the lifeguards might be liable for negligence that could result in litigation (Kozlowski, 1992; Mone, 1980; Morizot, 2002b). Fifth, the aquatic facility might be closed to 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. Published236 by ScholarWorks@BGSU, 2009 1 International Journal of Aquatic Research and Education, Vol. 3, No. 3 [2009], Art. 4 Where Do People Drown?   237 investigate the cause of drowning, which may in turn result in unemployment for associated aquatic professionals (e.g., BBC1, 2000). Taking the significance of the above negative consequences together, some of the important questions that may arise are the following: Where is it likely a drowning incident occurs? Are there any aquatic environments more likely to host drowning events than others? Is the actual location of the incident most important to know to avoid drowning or are there also other factors related to the where? Do the specific geographical characteristics of a country constitute a variable worth considering in the prevention of drowning? Do other variables play a vital role in our understanding of the place of occurrence of drowning? Aquatic Environments The aquatic environment in which drowning can take place includes numerous aquatic locations. More precisely, research has shown that people drown in open water (Lifesaving Society, 2000; Mackie, 1999; Water Safety New Zealand, 2003); in inland water (Bierens et al., 1996; Nichter & Everett, 1993; Pearn et al., 1976; Royal Life Saving Society Australia, 2001b; Water Safety New Zealand, 2003); in public or home swimming pools (Mackie, 1999; Victorian Injury Surveillance System, 1990); in water parks (Raging Waters, 2001); in residential hot tubs, spas, and whirlpools (Shinaberger et al., 1990; Royal Life Saving Society Australia, 2001b); in waterholes, dams, and garden ponds (Pearn et al., 1976; Royal Society for the Prevention of Accidents, 2001); in unattended buckets even partially filled with water (Department of Trade Industry, 1996); and in bath tubs and even toilets (Pearn et al., 1976, 1979; Petridou & Klimentopoulou, 2006; Quan et al., 1989). Geography and Shape of Aquatic Environments The geographical characteristics of a country might be a second cause of drowning. For example, countries such as New Zealand and Greece are surrounded by and contain a wide variety of aquatic environments that provide outstanding opportunities for aquatic recreational and sporting activities (Avramidis, 1998; Water Safety New Zealand, 2000). The more water in an environment the greater the likelihood of increased number of drowning incidents. No research has yet related the number of drowning incidents to the number of the kilometers of a country’s coast line, the total diameter or area of inland lakes, or the total length of all rivers. The size and the shape of the aquatic environment might be related to the incidence of drowning. People supposedly can drown in as little as 2 cm of water depth (Ridder, Hoofwijk, Dijk, & Hemmes, 2002). In terms of the distance from safety, 42% of drownings occur within 2 m of safety and 55% within 3 m, and 90% of all drowning deaths occur within 10 m of safety (Orlowski & Szpilman, 2001). Many drownings occur in water only just deeper than the person’s height (Stallman, 2008; Stallman, Junge, & Blixt, 2008). In terms of the water density, people can drown in fresh water (Lifesaving Society, 2000; Orlowski, 1987) and even in the extremely buoyant water of the De (...truncated)