Water safety data; what are the figures telling us? Holly Henderson RoSPA Research Manager and Postgraduate of the Department of Public Health and Epidemiology,

Water safety data; what are the figures telling us?

Holly Henderson

RoSPA Research Manager and Postgraduate of the

Department of Public Health and Epidemiology, University of Birmingham

Statistics Overview:• Accidental injury is a leading cause of death

and disability and by 2020 injury will be the largest single reason for the loss of healthy human life years (WHO 2001; Towner 2001).

• Drowning is the second leading cause of unintentional injury mortality globally behind road traffic injuries.

• WHO (2002) estimates globally that there are almost half a million drownings annually

• Global Fatality Rate of 7.4 per 100, 000• Historically the UK has published a drowning

fatality rate of 1.0 per 100,000

What new research has occurred in 2004?

• SAPC and the University of Strathclyde: Scottish Water Based Accidents: The development of an accurate database

• University of Wales College of Medicine: A retrospective study of childhood swimming pool drowning deaths in the UK and abroad

• SWIM Group: Bath Seat Study• University of Birmingham: An investigation into

the epidemiological surveillance of inland water incidents in the UK

• RYA: Entrapment Study

Scottish Water Based Fatalities: The Development of and accurate database

• Retrospective data collected from 1997 – 2003

• Four Data Sources• Data includes suicides, homicides, coastal,

offshore, inland and domestic fatalities• Number of Notifications – 1490 fatalities• Total after data linkage – 1116 fatalities• New data collected 2.5 times more fatalities

than previously known

SAPC and University of Strathclyde Results (1)

Year RoSPA / RLSS Database

SAPC Database

2003 67 165 (est.)

2002 66 173

2001 63 161

2000 64 156

1999 86 157

1998 93 182

1997 66 160

Mean 72 165

SAPC and University of Strathclyde Results (2)

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60

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100120

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160

1997 1998 1999 2000 2001 2002

Year

Num

ber

of d

row

ning

s

Male

Female

SAPC and University of Strathclyde Results (3)

0

20

40

60

80

100

120

140

160

Number of

drownings

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99

Age Groups

SAPC and University of Strathclyde Results (4)

0

20

40

60

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120

Number ofDrownings

Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Month

Research Summary

• Over 100 additional drownings reported annually• Males accounted for 80.5%• Age groups of concern: 35 – 39 (8.6%) and 55-59

(8.3%)• Drownings peaked in August (10%)• 58.3% of fatalities at inland water locations• 33.4% land based activities, 27.7 on the water• Fishing accounted for 19.3%• 13.3% of fatalities in the Highlands Region• 34.1% intent undetermined, 26.1% no information

available• New rate of 3.2 per 100,000

A retrospective study of childhood swimming pool drownings in the UK

and Abroad

• Data sourced from 1993 – 2003

• Domestic, Private and Public Pools

• Total of 137 children (under 15) died

• 69.3% Males

• Average age 6.1 years

• Average of 12 per year

University of Wales College of Medicine (1)

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Nu

mb

er d

row

ned

UK

Abroad

University of Wales College of Medicine (2)

0

24

68

10

1214

1618

20

Month

Num

ber

drow

ned

UK

Abroad

University of Wales College of Medicine (3)

University of Wales College of Medicine (4)

USA13%

France13%Spain

22%

Spanish Islands

25%

Other27%

Research Summary:

• Drowning in the UK:

– Starting to decline but age increasing

– Managing of Health and Safety of Swimming Pools

– Overhaul of Pool Life guarding

– Child Admissions Policy

• Drowning Abroad:

– On the increase

– Exposure

– ANEC Research 2005

Drowning of babies in bath seats:

• Children under the age of two

• Case Study of drowning and near drowning episodes from 1989 – 2003

• All males (n = 6)

• 5 under a year old

• Bath seats appear to give a false sense of security to parents

• Further research required to look at and address exposure to risk

An Investigation into the Epidemiological Surveillance of Inland

Water Incidents in the UK

• 2545 notifications• 2068 isolated incidents• Related to 2743 people• 89.4% (2453) rescued, 10.6% (290) died• 79.0% involved were male (7.6 per 100, 000)• 88.9% who died were male (0.9 per 100, 000)• Males had a 7.6 fold increased risk of dying at

an inland water location in the UK• Males had a 3.9 fold increased risk in needing

rescue at an inland water location in the UK

Gender and Age - Survivability

• Adults accounted for 80.8% of involvement and 88.6% of fatalities

• Teenagers had the highest population based rate of involvement (8.1 per 100, 000)

• Once involved in an inland water incident males were twice as likely to die

Incidents Resulting in a Fatality – Monthly Trends

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5.0

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15.0

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25.0P

erce

ntag

e

% of incidents resulting in afatality

21.0 20.6 21.5 9.1 14.4 20.5 16.5 13.7 11.7 13.8 17.5 23.2

J an Feb Mar Apr May J un J ul Aug Sep Oct Nov Dec

Incident Start Time and Month by the Number of People Involved

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1-31 31-61 61-91

Incidents Resulting in a Fatality – Day of Week Trends

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% of incidents resultingin a Fatality

9.0 8.3 20.7 17.0 15.7 14.2 20.0

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Incident Day of Week and Month by the Number of People Involved

Sat

Sun

Mon Tu

eW

ed Thu

Fri Jan

FebMarAprMayJunJulAug SepOctNovDec

Day of Week

Month 20-30

10-20

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Incident Day of Week and Incident Start Time by the Number of People Involved

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1-31 31-61 61-91

By Location

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Moving Water(River Stream)

Enclosed (LakeLough Loch)

Canal Ex Industrial(Quarry Pit etc)

Location

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Incidents

People

By Activity

0 200 400 600 800 1000

BlankBoating

Row ing - SportOther

Not know nAngling

Involuntary AccessVoluntary Accees

Motor VehicleCommercial Fishing

Danger of Drow ningDiving

CanoeingClimbingAir CraftA

ctiv

ity

Number of People

Multivariate Analysis:

• Predictive model used by NHS and Public Health Specialists

• Considers factors associated and predictors• Model predicted 98.8% of outcomes of the

research

• LOGODDS = -1.827 – 0.590 * AGR (2) – 1.627 * AGR (3) – 1.474 * WKD (6) – 1.837* WKD (5) – 0.093 * WKD (4) - 0.016 * WKD (3) – 0.049 * WKD (2) – 0.599 GEN (1) + 1.655 * LT (2) + 3.968 * LT (1)

Research Summary:

• First time incident data analysed for the UK• Use of descriptive epidemiology• Capture Recapture Analysis (n = 228)• New use of relative risk, odds ratios and

multivariate analysis• Creates a new population based rate for

inland waters in the UK • Identification of Population most at risk• Provides a baseline for prevention and

intervention strategies through education and resource deployment

Entrapment Study:

• Study started in 2003

– Due to the public concern regarding the risk of getting trapped in inverted or partially inverted dinghy

– Well publicised “near misses”

• Process

– Logging entrapment incidents (Web Report)

– Discussions with major dinghy manufacturers

– Air gap tests

– Rescue Techniques

– Methods of Prevention

Incident Records:

• 44 incidents logged during 2003 and 2004

• 41% of these reported incidents were serious and a potential threat to life

• Biggest risk results from complete inversion of the boat with the sailor tangled or stuck underneath

• Probability of inversion occurring unaffected by conditions

• Major Factor - Speed of Inversion– Depends on design

– Capsizing to windward whilst sailing downwind

NWSF Information Group

Aim:• To bring together in one place, information and

research about incidents, casualties and fatalities in water

• Improve the quality of information and data available enabling it, for the first time, to develop strategies and policies based on statistics, analysis and research

Objectives:• To encourage the gathering, monitoring and

evaluation of drowning/incident data and relevant research

• To assess the need for intervention • To assess the need for better information and data

NWSF Information Group

Outputs:

• Improvements to statistics and levels of analysis• Regular reporting to the Co-ordinating committee• A data led approach to drowning prevention

Contributors:

• Nominated person from each of the NWSF Advisory Groups

• Academics with specialist interest in water safety

Finally:• Each of the research projects has brought new

valid and credible knowledge into the water safety community

• Collecting data routinely and the appropriate analysis is key to success– Organisational understanding of data and

statistical analysis– Dataset Development– Data Linkage Strategy– Reporting Mechanisms– Population based and risk based analysis– Development of a Hierarchy of Evidence

• The NWSF Information Group will help co-ordinate and facilitate research like this in the future