Background National population-based data on home drownings are scarce. They represent 17% (1995/11280) of submersion fatalities in Canada.

Objective Assess circumstances of drownings in/around homes, i.e., activities, personal, equipment, environment.

Methods Using structured questionnaires, coroners’ data were collected prospectively in 1991–2013 during national surveillance of water-related injury deaths. Population averaged 30 million.

Findings 11 915 deaths included 11 280 immersions with drowning and/or hypothermia, 584 trauma 39 other 12 unknown. 18% (n=1,995) occurred at home and 5% (n=515) at cottages/cabins.

Activities Bathing accounted for 43%(n=864), aquatic 23%(n=466), falls into water 28%(n=565), other knowns 6%(n=111), unknown 2%(n=36).

Personal factors Victims were 60% male. 61% of females and 32% of males drowned in bathtubs. 32% of males drowned in swimming pools, 22% of females. Infants<1 year-old accounted for 3%(n=57) of deaths, toddlers 1–4 years-old 17%(n=344), 5–14 year-olds 5%(n=107), 15–24 year-olds 7%(n=140), 25–74 year-olds 51%(n=1014), and ≥75, 17%(333). 3% were indigenous peoples. Medical conditions included seizures 17%(n=353), mental disabilities 5%, depression 7%, alcoholism 10%, schizophrenia 2%, physical disabilities 5%, diabetes 5%, and acute medical condition such as cardiac 3%. For ≥15 years-olds, 29% were alcohol associated, 22% above 80 mg%, 5% below, 2% suspected, 48% zero; Illegal drugs 5%. 14% were non-swimmers, 3% weak.

Environment 77% (n=1567) involved person-made structures: bathtubs 56%(n=877), swimming pools 36% (n=557), hot tubs 8%(n=119), ornamental ponds 1%(n=14). Flatwater, i.e., lakes, ponds, reservoirs and dugouts accounted for 11%(n=228), moving water, i.e., rivers and streams 5%(n=96), oceans<1%(n=6).

Supervision/accompaniment For children 1–14 years old, 68% were alone, 22% with minors, and 10% with adults.

Resuscitation CPR and/or rescue breathing was done for 55%.

Trends There was a mean 87 deaths/year, 0.28/100,000 population/year and no significant change.

Conclusion and policy implications Nearly all fatalities involved consumer products in built environments and should be avertable by design, eliminating or modifying pools and adult bathtubs. Alcohol and seizures were other modifiable hazards.