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The factors associated with submersion events among<20-year-old persons that occurred in King County from 1974 to 1983 were studied to focus prevention efforts.Near-drowning(n=103)and drowning(n=96)victims were identified from medical examiners'reports,paramedics'reports,and hospital discharge registers.Annual incidence was 5.5;the mortality rate was 2.6 per 100,000 children.Although preschool-aged children had the largest incidence(12.8),followed by older adolescents(4.9),adolescents had the largest case fatality rate,77%.Lake and river victims had the largest incidence,mortality,and case fatality rate;swimming pools,the smallest case fatality rate(25%).A total of 89%of all victims had absent or no supervision;victims supervised by lifeguards had a 42%case fatality rate. Prior seizures were part of the history of 7.5%of all victims;25%of fatal submersions by adolescents were associated with alcohol.Bathtub submersions were associated with child abuse in three of 16 preschool-aged children and epilepsy in four of five older children.Certain age groups and sites combined had the greatest incidence:preschool-aged children in swimming pools,infants in bathtubs,teenagers in lakes and rivers.Incidence decreased in public and semipublic pools coincident with fencing regulations.These findings suggest prevention strategies:extending fencing requirements to private pools,discouraging alcohol consumption during water sports,changing bathing practices of epileptics and improving lifeguard efficacy. |
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