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Drowning risk and climate change: a state-of-the-art review
  1. Rebecca Sindall1,2,
  2. Thomas Mecrow1,2,
  3. Ana Catarina Queiroga2,3,4,
  4. Christopher Boyer5,
  5. William Koon2,6,
  6. Amy E Peden2,4,7
  1. 1 International Department, Royal National Lifeboat Institution, Poole, UK
  2. 2 International Drowning Prevention Researchers Alliance (IDRA), Kuna, Idaho, USA
  3. 3 ITR Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health University of Porto, Porto, Portugal
  4. 4 Drowning Prevention Commission, International Lifesaving Federation, Leuven, Belgium
  5. 5 Centre for Health and the Global Environment, University of Washington, Seattle, Washington, USA
  6. 6 School of Biological, Earth and Environmental Sciences, University of New South Wales Faculty of Science, Sydney, New South Wales, Australia
  7. 7 School of Population Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
  1. Correspondence to Dr Rebecca Sindall, Royal National Lifeboat Institution, Poole, Poole, UK; becky_sindall{at}


Drowning and climate change are both significant global health threats, yet little research links climate change to drowning risk. Research into the epidemiology, risk factors and preventive strategies for unintentional drowning in high-income and in low-income and middle-income countries has expanded understanding, but understanding of disaster and extreme weather-related drowning needs research focus. As nation states and researchers call for action on climate change, its impact on drowning has been largely ignored. This state-of-the-art review considers existing literature on climate change as a contributor to changes in drowning risks globally. Using selected climate change-related risks identified by the World Meteorological Organization and key risks to the Sustainable Development Goals as a framework, we consider the drowning risks associated with heat waves, hydrometeorological hazards, drought and water scarcity, damaged infrastructure, marine ecosystem collapse, displacement, and rising poverty and inequality. Although the degree of atmospheric warming remains uncertain, the impact of climate change on drowning risk is already taking place and can no longer be ignored. Greater evidence characterising the links between drowning and climate change across both high-income and low-income and middle-income contexts is required, and the implementation and evaluation of drowning interventions must reflect climate change risks at a local level, accounting for both geographical variation and the consequences of inequality. Furthermore, collaboration between the injury prevention, disaster risk reduction and climate change mitigation sectors is crucial to both prevent climate change from stalling progress on preventing drowning and further advocate for climate change mitigation as a drowning risk reduction mechanism.

  • policy
  • public health
  • disaster
  • immigrant/refugee
  • low-middle income country
  • exposure

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  • Twitter @BexSindall, @tommecrow, @w_a_koon, @amyepeden

  • Contributors RS conceived the project and designed the manuscript and developed the first draft. All other authors drafted the original content and provided critical revision of the manuscript. All authors approved the submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Open access publication costs were supported by the Royal National Lifeboat Institution.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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