1
|
Peden AE, Willcox-Pidgeon S, Scarr JP, Franklin RC. Lessons learned through the 20-year development of a national fatal drowning database in Australia. BMC Public Health 2023; 23:1499. [PMID: 37550757 PMCID: PMC10408144 DOI: 10.1186/s12889-023-16392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Co-ordinated, evidence-based policy and programmatic efforts are needed to respond to complex drowning prevention problems. Comprehensive, current, and robust data are vital for agenda setting, burden and risk factor identification, intervention design and evaluation, as well as setting policy. We aim to record methods used in, and identify impacts of, the development of a national fatal drowning database (NFDD) in Australia, including lessons learned across research, policy, and practice. METHODS We employ a case study method using process mapping and document review to explore the evolution, drivers and impacts of the NFDD. We analyse methodological approaches including those relating to data definitions, drowning case collection, and management, as well as tracking the various outputs of the NFDD. We describe a development timeline that presents impact of drowning prevention policy, and research agendas on database development, and research investments more specifically. RESULTS Our study identified that the collected variables grew 20-fold from 2002 to 2022, reaching 259 variables, and 5,692 unique cases of fatal drowning. The NFDD employs data triangulation methodology, combining keyword and targeted searches of coronial files, media report monitoring, and organisational data provision. Database development is influenced by the Australia Water Safety Strategy, policymaker and practitioner-initiated research agendas, and identification of knowledge gaps. We identified numerous outputs spanning publications, media, intervention development, and legislative submissions. CONCLUSION A comprehensive and robust NFDD informed by policymaker and practitioner input can enhance surveillance, policy, and intervention development for drowning prevention. Employing mixed data collection and validation methods can supplement weaknesses in official data sources. There is a need for the NFDD to continue to evolve in its application while maintaining rigorous case identification and data quality assurance processes. Despite significant investment, the outputs and influence on drowning prevention practice in Australia has been extremely valuable and contributed to sizeable reductions in Australia's fatal drowning rate.
Collapse
Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia.
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, 2052, Australia.
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
| | - Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Justin-Paul Scarr
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| |
Collapse
|
2
|
Willcox-Pidgeon S, Miller L, Leggat PA, Peden AE, Brander RW, Wilks J, Franklin RC. The characteristics of drowning among different types of international visitors to Australia and how this contributes to their drowning risk. Aust N Z J Public Health 2023:100050. [PMID: 37117115 DOI: 10.1016/j.anzjph.2023.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVE Australia is a popular destination for international visitors. This study reviews international visitor drowning deaths in Australia and analyses drowning by visitor type. METHODS A total population retrospective study exploring drowning deaths of international visitors was conducted between 2008 and 2018. Data were extracted from the Royal Life Saving National Fatal Drowning Database and categorised into four subgroups: overseas tourists, international students, working holiday makers and work-related visitors. Descriptive statistics, non-parametric tests and relative risk (RR) were calculated. RESULTS In total, 201 international visitors drowned in Australia, 7% of all drowning deaths; a crude drowning rate of 0.27/100,000 visitors versus 0.95/100,000 for residents (RR=0.19 [95% CI: 0.16-0.22]). Most deaths were males (79%) and people aged 18-34 years (50%). Visitors frequently drowned at beaches (33%), and when swimming (41%). Thirty-five percent recorded a pre-existing medical condition. Overseas tourists on holiday were the most likely to drown compared to other subgroups. CONCLUSION International visitors represent a small but increasing proportion of people drowning in Australia. The circumstances of which visitors drown vary by travel purpose, age, country of origin, location of drowning and activity. IMPLICATIONS FOR PUBLIC HEALTH International visitors have unique safety needs, requiring tailored prevention based on the purpose of travel and country of origin.
Collapse
Affiliation(s)
- Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
| | - Lauren Miller
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia; School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; UNSW Beach Safety Research Group, UNSW Sydney, Australia
| | - Robert W Brander
- UNSW Beach Safety Research Group, UNSW Sydney, Australia; School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, Australia
| | - Jeff Wilks
- Southern Cross University, Bilinga, QLD, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, NSW, 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| |
Collapse
|
3
|
Willcox-Pidgeon S, Franklin RC, Leggat PA, Devine S. Epidemiology of unintentional fatal drowning among migrants in Australia. Aust N Z J Public Health 2021; 45:255-262. [PMID: 33900674 DOI: 10.1111/1753-6405.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. METHODS A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. RESULTS There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25-34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85-8.25), Taiwan (2.29/100,000 95%CI: 0.27-13.44), and Nepal (2.15/100,000 95%CI: 0.23-11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001). CONCLUSIONS Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities.
Collapse
Affiliation(s)
- Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, New South Wales.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Richard C Franklin
- Royal Life Saving Society - Australia, New South Wales.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Susan Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland
| |
Collapse
|
4
|
Peden AE, Willcox-Pidgeon S. Autism spectrum disorder and unintentional fatal drowning of children and adolescents in Australia: an epidemiological analysis. Arch Dis Child 2020; 105:869-874. [PMID: 32169851 DOI: 10.1136/archdischild-2019-318658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study explored unintentional fatal drowning among children and adolescents (0-19 years) diagnosed with autism spectrum disorder (ASD) in Australia. DESIGN This total population, cross-sectional audit used data from the Royal Life Saving National Fatal Drowning Database to explore demographic and causal factors in ASD drowning cases between 1 July 2002 and 30 June 2018. Rates and relative risk (RR) with a 95% confidence interval (CI) were calculated for drowning cases with and without ASD, using estimated population-level prevalence data. RESULTS Of the 667 cases of drowning among 0-19 year olds with known medical history, 27 children and adolescents (4.0%) who drowned had an ASD diagnosis. Children and adolescents with ASD were three times more likely to drown than those without ASD (RR=2.85; CI 0.61 to 13.24). Among those with ASD, 0-4 year olds record the highest rate (11.60/100 000 diagnosed). Children and adolescents with ASD were significantly more likely to drown when compared with those without ASD: if aged 5-9 years (44.4% of ASD-yes cases; 13.3% of ASD-no cases); in a lake or dam (25.9% vs 10.0%) and during winter (37.0% vs 13.1%). CONCLUSION Heightened awareness of drowning risk for children and adolescents with ASD is required, including adult supervision and barriers restricting water access. Further evaluation of the effectiveness of personal alarms to alert caregivers to an unsupervised child is warranted. Challenges exist regarding accurate estimates of population-level ASD prevalence and identification of ASD in coronial files. As the diagnosis of ASD does not often occur until age five, results may be an underestimate.
Collapse
Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia .,School of Public Health and Community Medicine, University of New South Wales Faculty of Medicine, Kensington, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia
| | - Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
5
|
Peden AE, Franklin RC, Willcox-Pidgeon S. Media reporting of summer drowning: A partial picture, useful for advocacy. Health Promot J Austr 2019; 31:491-496. [PMID: 31562788 DOI: 10.1002/hpja.297] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/17/2019] [Accepted: 09/24/2019] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Media reporting of drowning deaths can be used for multiple purposes, including advocacy, enhancing data on drowning and supporting policy development. Accurate, current and comprehensive data help ensure the development of effective prevention programs as well as being a tool for advocacy. Advocacy for drowning prevention through the media can create behaviour change aligned to the Health Belief Model (HBM). METHODS This study compares media reports of fatal unintentional drowning across the 2017/18 Australian summer (1-December-2017 to 28-February-2018) with drowning cases in the National Coronial Information System (NCIS). RESULTS Media monitoring identified 84 cases, of which nine (11%), were deaths but not drowning. There were 104 NCIS deaths during this time of which 75 were reported in the media (72% capture). Media captured 100% of drowning incidents involving people 0-24 years and in ocean/harbour locations. Drowning incidents among older people (75+ years; 36% capture), in bathtubs (0% capture), swimming pools (33% capture) and with an unknown activity (27% capture) were poorly reported. CONCLUSIONS Where there are a lack of timely data on drowning, the use of media can help capture deaths, with limitations. Transmission of messages about drowning risk factors and prevention strategies, during summer, may lead to behaviour change at a time when drowning risk is highest. SO WHAT?: Working with the media to help enhance advocacy efforts, in particular the development and use of effective drowning prevention messages, is key to informing the public about risk factors in the HBM to achieve behaviour change.
Collapse
Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,School of Public Health and Community Medicine, UNSW Sydney, Kensington, NSW, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Broadway, NSW, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| |
Collapse
|
6
|
Willcox-Pidgeon S, Peden AE, Franklin RC, Scarr J. Boating-related drowning in Australia: Epidemiology, risk factors and the regulatory environment. J Safety Res 2019; 70:117-125. [PMID: 31847986 DOI: 10.1016/j.jsr.2019.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/02/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Recreational boating is a popular pastime in many high income countries, and is a leading activity prior to drowning. This study reports on unintentional fatal drowning associated with boating-related incidents in Australia. METHODS A total population, retrospective, cross sectional design examined all boating-related unintentional drowning deaths between July 1, 2005 and June 30, 2015. Variables examined included age, sex, location of drowning incident, vessel type, activity, presence of alcohol/drugs, and lifejacket wear. Relative risk (with a 95% confidence interval) was calculated using fatal drowning rates per 100,000 population and rates per 100,000 registered vessels. Chi square analysis and non-parametric tests for significance were applied. Statistical significance was deemed p < .05. RESULTS A total of 415 people drowned while boating during the study period, 91.8% male and 35.7% aged between 25 and 44 years. Men were 10 times more likely to drown when boating than females (RR = 10.64 CI:7.55-14.97). Over one-quarter (28.7%) of incidents involved alcohol, in 30.6% drugs were identified (31.3% were illegal) and 90.4% were not wearing a lifejacket. Children were more at risk of drowning on a houseboat than adults (RR = 7.13; CI:1.61-31.61). Females were more likely to drown than males when using a personal watercraft (RR = 10.53; CI:2.75-40.33). CONCLUSION Boaters may be taking unnecessary risks by disregarding safety regulations, such as not wearing lifejackets and substance use (such as alcohol and illegal drugs). Boating in remote locations presents a high risk of drowning. While safety regulations are in place, enforcement and behavior change remain challenges. Practical application: Findings support recommendations for increased enforcement of alcohol-related regulations and introducing drug-testing for boaters. Consistency of boating safety regulations, especially around lifejacket wear, is recommended to influence behavior change. The effectiveness of current lifejacket regulations need to be critically evaluated in the context of increasing wear rates for adults and children.
Collapse
Affiliation(s)
- Stacey Willcox-Pidgeon
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Amy E Peden
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Justin Scarr
- Royal Life Saving Society - Australia, Sydney, NSW, Australia, PO Box 558, Broadway, NSW 2007, Australia.
| |
Collapse
|
7
|
Affiliation(s)
- Stacey Willcox-Pidgeon
- School of Population Health, The University of Auckland, Auckland, New Zealand
- Royal Life Saving Society – Australia, Broadway, New South Wales, Australia
| | - Bridget Kool
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Kevin Moran
- Faculty of Education, The University of Auckland, Auckland, New Zealand
| |
Collapse
|