Background Drowning results in 3 72 000 deaths worldwide each year. Although detailed data collection in high income countries has allowed the drowning prevention community to determine the trends related to fatal drowning, data on non-fatal drowning are not routinely collected. Coronial data have identified key risk factors, targeted by the Australian Water Safety Strategy 2016–2020. However, the full burden of drowning cannot be understood until non-fatal drowning statistics are also examined.

Objective To gain a greater understanding of the full burden of drowning by focusing on non-fatal incidents, including a comparison of fatal and non-fatal drowning.

Methods Non-fatal drowning incidents that occurred 1 July 2002–30 June 2015 were collated using the Australian Institute of Health and Welfare’s (AIHW) National Hospital Morbidity Database. Hospital separations where the first reported external cause of morbidity was Accidental Drowning and Submersion (W65-W74) were included. A comparison between fatal and non-fatal drowning data was undertaken using the Royal Life Saving National Fatal Drowning Database. Economic costs were also calculated.

Findings There were 6158 cases of non-fatal drowning in Australia during the study period. Across the 13 years, for every 1 fatal drowning, there were 2.78 non-fatal drowning incidents, with non-fatal incidents increasing by 42%, while fatal incidents decreased by 17%. Fatal to non-fatal ratios were highest in children and decreased with age. The total cost of non-fatal drowning over the study period was $2.45 billion, an average of $188 million per year.

Conclusions By examining non-fatal drowning statistics in conjunction with fatal drowning data, we move closer to understanding the full burden of drowning in Australia.

Policy implications Up until now, drowning prevention strategies in Australia have largely focused on fatal drowning. This research will allow comprehensive policies to be developed, which target both fatal and non-fatal drowning and reduce the burden on the health system.

Acknowledgement This research is supported by Royal Life Saving Society – Australia. The drowning prevention research of Royal Life Saving Society – Australia is supported by the Australian Government.