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Epidemiology, risk factors and strategies for the prevention of global unintentional fatal drowning in people aged 50 years and older: a systematic review
  1. Amy E Peden1,2,
  2. Richard C Franklin1,2,
  3. Ana Catarina Queiroga1,2,3
  1. 1 Royal Life Saving Society – Australia, Broadway, New South Wales, Australia
  2. 2 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
  3. 3 EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
  1. Correspondence to Amy E Peden, Royal Life Saving Society – Australia, PO Box 558, Broadway, NSW 2007, Australia; apeden{at}


Purpose Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people.

Methods A systematic literature review was undertaken using English-language, Portuguese-language and Spanish-language papers published between 1980 and 2015. The review explores gaps in the literature with a focus on the epidemiology, risk factors and strategies for the prevention of unintentional fatal drowning among people 50 years and over.

Results Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies; a lack of consensus on risk factors; a lack of total population, country-level analysis; and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated.

Conclusion This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies.

  • drowning
  • older people
  • systematic review
  • risk factor research
  • epidemiology
  • public health

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  • Twitter Follow Amy Peden at @amyepeden, follow Richard Franklin at @Franklin_R_C, follow Ana Catarina Queiroga at @ac_queiroga and follow Royal Life Saving Society - Australia at @royallifesaving

  • Contributors AEP, RCF and ACQ conceptualised and designed the study. ACQ conducted the literature searches, and AEP, RCF and ACQ reviewed titles, abstracts and full text equally. ACQ reviewed all papers in languages other than English. AEP conducted the analysis, drafted the initial manuscript and approved the final manuscript as submitted. RCF reviewed and revised the manuscript and approved the final manuscript. ACQ reviewed and revised the manuscript and approved the final manuscript as submitted.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.