Objective: To describe the epidemiology of domestic swimming pool drowning and near-drowning in Brisbane and to examine the efficacy of a broad range of preventive options, including pool fences.
Design: A prospective, hospital-based, injury surveillance system to describe the epidemiology of drowning and near-drowning and a community survey to describe pool fencing.
Setting: The surveillance questionnaire was completed at presentation in the Emergency Department by the parent, nurse and doctor. Personal interviews in households that were randomly selected by means of a stratified sampling scheme provided the pool fencing description.
Participants: All 139 children suffering from an immersion injury resulting in presentation at a hospital in the catchment area of The Mater Children's Hospital were included. There were 204 households with a swimming pool in the 1024 households interviewed in the community survey.
Results: The 100 domestic pool drownings and near-drownings were equivalent to 15.5 incidents per year per 100,000 children aged 0-13 years and 64.9 per year per 100,000 for the critical 1-3 years age group. Of 72 children who gained unintended access to a domestic pool, 88.9% were less than 3 years of age and 52.8% were less than 2 years. All 10 of the children who drowned and five who were severely brain damaged (age range, 12-32 months) were in this group. The risk of a drowning or near-drowning involving unintended access to an unfenced pool is 3.76 times higher than the risk associated with a fenced pool (95% confidence limits for relative risk: 2.14, 6.62).
Conclusions: Pool fences are an effective method of preventing child drownings and near-drownings. This effectiveness can be further improved if compliance with gate closure can be enhanced. This should be emphasised in health promotion accompanying the introduction of universal pool fencing.