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RESEARCH LETTERS
Drowning deaths among Japanese children aged 1–4 years: different trends due to different risk reductions
  1. S Nakahara,
  2. M Ichikawa,
  3. S Wakai
  1. Department of International Community Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; shinji@m.u-tokyo.ac.jp

    https://doi.org/10.1136/ip.2003.004796

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      Drowning, once by far the most important external cause of child deaths in Japan,1 has reduced more rapidly than other injuries. Drowning mortality of children aged 1–4 years decreased from 45.4 per 100 000 in 1955, 4.5 times higher than that of traffic injuries, to 1.6 per 100 000 (ranking next to traffic injuries) in 2000. We could have achieved this by two main approaches: (1) environmental modification to reduce exposure to open water where most outdoor drownings occur2 and (2) health education to reduce risk of bathtub drowning, which causes most of the domestic drownings.2,3

      To know how these approaches contributed to the mortality reduction, we separately examined the trends of outdoor and domestic drowning mortality among children aged 1–4 years.

      Data on drowning deaths …

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