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Exploring visitation at rivers to understand drowning risk
  1. Amy E Peden1,2,
  2. Richard C Franklin1,2,
  3. Peter A Leggat2,3
  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 School of Public Health, Faculty of Health Sciences, University of the Witwatersand, Johannesburg, South Africa
  1. Correspondence to Ms Amy E Peden, Royal Life Saving Society - Australia, Broadway NSW 2007, Australia; apeden{at}


Introduction Globally, rivers are a common drowning location. In Australia, rivers are the leading location for fatal drowning. Limited information exists on exposure and impact on river drowning risk.

Methods Australian unintentional fatal river drowning data (sourced from coronial records) and nationally representative survey data on river visitation were used to estimate river drowning risk based on exposure for adults (18 years and older). Differences in river drowning rates per 100 000 (population and exposed population) were examined by sex, age group, activity prior to drowning, alcohol presence and watercraft usage.

Results Between 1 January 2014 and 31 December 2016, 151 people drowned in Australian rivers; 86% male and 40% aged 18–34 years. Of survey respondents, 73% had visited a river within the last 12 months. After adjusting for exposure: males were 7.6 times more likely to drown at rivers; female drowning rate increased by 50% (0.06–0.09 per 100 000); males aged 75+ years and females aged 55–74 years were at highest risk of river drowning; and swimming and recreating pose a high risk to both males and females. After adjusting for exposure, males were more likely to drown with alcohol present (RR=8.5; 95% CI 2.6 to 27.4) and in a watercraft-related incident (RR=25.5; 95% CI 3.5 to 186.9).

Conclusions Calculating exposure for river drowning is challenging due to diverse usage, time spent and number of visits. While males were more likely to drown, the differences between males and females narrow after adjusting for exposure. This is an important factor to consider when designing and implementing drowning prevention strategies to effectively target those at risk.

  • drowning
  • descriptive epidemiology
  • risk factor research
  • exposure
  • surveys

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  • Contributors AEP and RCF conceptualised the study, designed the survey questionnaire, conducted the analysis, drafted and revised the manuscript. AEP collated and analysed the fatal drowning data. PAL provided oversight and advice on study design, analysis and revised the manuscript. All authors approve the submitted manuscript.

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

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethics approval for the fatal drowning data was received from the Victorian Department of Justice (JHREC-CF/16/19581) and James Cook University (HREC-H6282). The CATI survey received approval by the Human Ethics Research Review Panel at Central Queensland University before administration to the general public (H14/09-203).

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

  • Data sharing statement Researchers can apply for approval to access the coronial data presented in this study. For those interested, please contact the Australian National Coronial Information System for more information: