- From 2005-2014, there were an average of 3,536 fatal unintentional drownings (non-boating related) annually in the United States — about ten deaths per day.1 An additional 332 people died each year from drowning in boating-related incidents.2
- About one in five people who die from drowning are children 14 and younger.1 For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.1
- More than 50% of drowning victims treated in emergency departments (EDs) require hospitalization or transfer for further care (compared with a hospitalization rate of about 6% for all unintentional injuries).1,2 These nonfatal drowning injuries can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities, and permanent loss of basic functioning (e.g., permanent vegetative state).3,4
Who is most at risk?
- Males: Nearly 80% of people who die from drowning are male.2
- Children: Children ages 1 to 4 have the highest drowning rates. In 2014, among children 1 to 4 years old who died from an unintentional injury, one-third died from drowning.1,2 Among children ages 1 to 4, most drownings occur in home swimming pools.2 Drowning is responsible for more deaths among children 1-4 than any other cause except congenital anomalies (birth defects).1 Among those 1-14, fatal drowning remains the second-leading cause of unintentional injury-related death behind motor vehicle crashes.1
- Minorities: Between 1999-2010, the fatal unintentional drowning rate for African Americans was significantly higher than that of whites across all ages.5 The disparity is widest among children 5-18 years old. The disparity is most pronounced in swimming pools; African American children 5-19 drown in swimming pools at rates 5.5 times higher than those of whites. This disparity is greatest among those 11-12 years where African Americans drown in swimming pools at rates 10 times those of whites.5
Factors such as access to swimming pools, the desire or lack of desire to learn how to swim, and choosing water-related recreational activities may contribute to the racial differences in drowning rates. Available rates are based on population, not on participation. If rates could be determined by actual participation in water-related activities, the disparity in minorities’ drowning rates compared to whites would be much greater.6
What factors influence drowning risk?
The main factors that affect drowning risk are lack of swimming ability, lack of barriers to prevent unsupervised water access, lack of close supervision while swimming, location, failure to wear life jackets, alcohol use, and seizure disorders.
- Lack of Swimming Ability: Many adults and children report that they can’t swim.7,8 Research has shown that participation in formal swimming lessons can reduce the risk of drowning among children aged 1 to 4 years.9,10
- Lack of Barriers: Barriers, such as pool fencing, prevent young children from gaining access to the pool area without caregivers’ awareness.11A four-sided isolation fence (separating the pool area from the house and yard) reduces a child’s risk of drowning 83% compared to three-sided property-line fencing.12
- Lack of Close Supervision: Drowning can happen quickly and quietly anywhere there is water (such as bathtubs, swimming pools, buckets), and even in the presence of lifeguards.13,14
- Location: People of different ages drown in different locations. For example, most children ages 1-4 drown in home swimming pools.2 The percentage of drownings in natural water settings, including lakes, rivers and oceans, increases with age.2 More than half of fatal and nonfatal drownings among those 15 years and older (57% and 57% respectively) occurred in natural water settings.2
- Failure to Wear Life Jackets: In 2010, the U.S. Coast Guard received reports for 4,604 boating incidents; 3,153 boaters were reported injured, and 672 died. Most (72%) boating deaths that occurred during 2010 were caused by drowning, with 88% of victims not wearing life jackets.15,16
- Alcohol Use: Among adolescents and adults, alcohol use is involved in up to 70% of deaths associated with water recreation, almost a quarter of ED visits for drowning, and about one in five reported boating deaths.2,15,17 Alcohol influences balance, coordination, and judgment, and its effects are heightened by sun exposure and heat.17
- Seizure Disorders: For persons with seizure disorders, drowning is the most common cause of unintentional injury death, with the bathtub as the site of highest drowning risk.18
- Drowning is the 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury-related deaths.
- There are an estimated 360 000 annual drowning deaths worldwide.
- Global estimates may significantly underestimate the actual public health problem related to drowning.
- Children, males, and individuals with increased access to water are most at risk of drowning.
Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid; outcomes are classified as death, morbidity and no morbidity.
In 2015, an estimated 360 000 people died from drowning, making drowning a major public health problem worldwide. In 2015, injuries accounted for over 9% of total global mortality. Drowning is the 3rd leading cause of unintentional injury death, accounting for 7% of all injury-related deaths.
The global burden and death from drowning is found in all economies and regions, however:
- low- and middle-income countries account for over 90% of unintentional drowning deaths;
- over half of the world’s drowning occurs in the WHO Western Pacific Region and WHO South-East Asia Region;
- drowning death rates are highest in the WHO African Region, and are 15-20 times higher than those seen in Germany or the United Kingdom, respectively.
Despite limited data, several studies reveal information on the cost impact of drowning. In the United States of America, 45% of drowning deaths are among the most economically active segment of the population. Coastal drowning in the United States alone accounts for US$ 273 million each year in direct and indirect costs. In Australia and Canada, the total annual cost of drowning injury is US$ 85.5 million and US$ 173 million respectively.
There is a wide range of uncertainty around the estimate of global drowning deaths. Official data categorization methods for drowning exclude intentional drowning deaths (suicide or homicide) and drowning deaths caused by flood disasters and water transport incidents.
Data from high-income countries suggest these categorization methods result in significant underrepresentation of the full drowning toll by up to 50% in some high-income countries. Non-fatal drowning statistics in many countries are not readily available or are unreliable.
Child drowning statistics from a number of countries are particularly revealing:
- Australia: drowning is the leading cause of death by unintentional injury in children aged 1-3 years.
- Bangladesh: drowning accounts for 43% of all deaths in children aged 1-4 years.
- China: drowning is the leading cause of injury death in children aged 1-14 years.
- United States: drowning is the second leading cause of unintentional injury death in children aged 1-14 years.
In the United States:
- Since 2005, unintentional drowning has replaced motor vehicle traffic incidents as the leading cause of death from unintentional injury for boys aged 1-4 years. For girls aged 1-4, unintentional drowning is the second leading cause of unintentional death after traffic accidents.
- 76% of reported pool-related fatalities involved children younger than 5 years of age.
- Swimming pools accounted for more than 50% of all unintentional drowning death locations for children aged 1–4 years.
- Residential locations dominated incidents for victims under the age of five (61% for injuries and 84% for fatalities).
Non-Fatal Submersion Injuries:
- 78% percent of the Emergency Department (ED)-treated submersion injuries involved children younger than 5 years of age.
- The overwhelming majority of reported submersion injuries happen in pools.
- 51% of the victims of ED-treated pool or spa submersion injuries for 2010 through 2012 were admitted to the hospital or treated and transferred to another hospital, compared to 4% for ED-treated injuries to children that age involving all types of consumer products during the same time.
- Nonfatal drowning can cause brain damage that may result in long-term disabilities including memory problems, learning disabilities, and permanent loss of basic functions.
The good news is that drowning can be prevented.
Prevention Is Vital.
“Once someone starts to drown, the outcome is often fatal. Unlike other injuries, survival is determined almost exclusively at the scene of the incident and depends on two highly variable factors: how quickly the person is removed from the water, and how swiftly proper resuscitation is performed. Prevention, therefore, is vital.”
– World Health Organization
For more information on recommended community-based action and ways to prevent pool-related injuries and deaths, please see our article on Pool Safety.
*Global estimates may significantly underestimate the actual public health problem related to drowning.
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. [cited 2012 May 3]. Available from: URL: http://www.cdc.gov/injury/wisqars.
CDC. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov.
Cummings P, Quan L. Trends in Unintentional Drowning: The Role of Alcohol and Medical Care. JAMA, 1999; 281(23):2198-2202.
Spack L, Gedeit R, Splaingard M, Havens PL. Failure of aggressive therapy to alter outcomes in pediatric near-drowning. Pediatric Emergency Care 1997; 13(2):98-102.
Branche CM, Dellinger AM, Sleet DA, Gilchrist J, Olson SJ. Unintentional injuries: the burden, risks and preventive strategies to address diversity. In: Livingston IL, editor. Praeger handbook of Black American health (2nd edition): Policies and issues behind disparities in health. Westport (CT): Praeger Publishers; 2004. p. 317-27.
Gilchrist J, Sacks JJ, Branche CM. Self-reported swimming ability in U.S. adults, 1994. Public Health Reports 2000;115(2–3):110–1.
Irwin CC, Irwin RL, Ryan TD. Urban minority youth swimming (in)ability in the United States and associated demographic characteristics: toward a drowning prevention plan. Injury Prevention 2009; 15: 234-239.
Brenner RA, Taneja GS, Haynie DL, Trumble AC, Qian C, Klinger RM,
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U. S. Consumer Product Safety Commission. Safety barrier guidelines for home pools [online]. [cited 2012 May 3]. Available from URL: http://www.cpsc.gov.
Thompson DC, Rivara FP. Pool fencing for preventing drowning in children. Cochrane Database of Systematic Reviews 2000; 2.
U. S. Consumer Product Safety Commission. Submersions related to non-pool and non-spa products, 2011 report.[online]. [cited 2012 May 9]. Available from URL: http://www.cpsc.gov.
Pelletier AR, Gilchrist J. Fatalities in swimming pools with lifeguards: USA, 2000-2008. Injury Prevention, 2011;17:250-253.
Cummings P, Mueller BA, Quan L. Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Injury Prevention 2011;17:156-159.14.
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