Drowning and near drowning in children in the United Kingdom: lessons for prevention.

OBJECTIVES--To determine the pattern of drowning and near drowning of children in Britain and identify means of prevention. DESIGN--Study of drowned and nearly drowned children under 15 years old. SETTING--United Kingdom, 1988 and 1989. SUBJECTS--Children under 15 years either drowning or admitted to hospital after a submersion incident. MAIN OUTCOME MEASURES--Number of nearly drowned children, obtained from consultant paediatricians returning monthly notification cards through the British Paediatric Surveillance Unit. Number of drowned children notified by the Office of Population Censuses and Surveys and other national epidemiological offices; information from coroners. RESULTS--306 children had confirmed submersion incidents: 149 died and 157 survived after near drowning. The annual incidence in England and Wales was 1.5/100,000, and mortality 0.7/100,000. Mortality was lowest in public pools 6% (2/32) and highest in rivers, canals, and lakes (78%, 56/73). Most of the children (263, 83%) were unsupervised at the time of the accident. 208 (68%) children were under 5 years old. CONCLUSIONS--Drowning and near drowning of children are problems in the British Isles. Appropriate supervision and safety barriers seem important for preventing such accidents. Improving information on dangers of drowning given to parents through the child surveillance programmes, encouraging fencing or draining of garden ponds and domestic swimming pools, and increasing supervision of swimming in lakes, rivers, and beaches should reduce the number of accidents.     

Human drowning: Phylogenetic origin

Because most animals are able to survive much longer when in water than most humans and apes, it is likely that at some time during human phylogeny the-innate-ability to swim like animals has been lost. Paleontology and comparative zoology provide indications for selective pressures and adaptations explaining this phenomenon. Among these are (a) buoyancy having become reduced slightly due to a smaller lung air/body weight ratio, less air trapped in the body covering hairs and reduction in gastrointestinal gas, (b) the caudally directed nasal entrance cranially to which there is the heavy neurocranium, (c) the low position of the laryngeal entrance, (d) the ineffective propulsion by the human innate crawling and walking movements, and (e) the well developed cerebrum being present cranially to the airway entrance, being sensitive for anoxia and hypothermia, and causing behaviour adding to drowning risks.