RT Journal Article SR Electronic T1 PW 1060 Understanding lapses in supervision of children 0–4 years who drowned in australia JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP A151 OP A151 DO 10.1136/injuryprevention-2018-safety.418 VO 24 IS Suppl 2 A1 Amy E Peden A1 Richard C Franklin YR 2018 UL http://injuryprevention.bmj.com/content/24/Suppl_2/A151.1.abstract AB Background Active adult supervision is promoted as a key strategy for preventing drowning among young children. Little is known about the contributory factors in supervision lapses in child drowning.Objective This study aims to explore the causes of distraction leading to lapses of supervision in fatal drowning cases of children under five in Australia.Methods A total population survey of all fatal unintentional drownings among children aged 0–4 years between 1-July-2002 and 30-June-2017 was undertaken using data primarily from the Australian National Coronial Information System (NCIS). Information was collected on demographics, location (geographic and water body), activity, type of distraction, number of supervisors and presence of siblings/other children. Data were extracted from coronial findings, autopsy, toxicology and police reports.Findings 447 children drowned (males; 62%). Swimming pools accounted for 54% and bathtub/spa baths 17%. Common causes of supervision lapses were indoor (27%) and outdoor household chores (11%), or talking/socialising (9%). In 16% of cases two parents were supervising and both were distracted. Common scenarios for pool drowning were a single supervisor, distracted by indoor household chores, talking or socialising during social settings or caring for other siblings while the child who drowned was alone. Common bathtub scenarios were a single supervisor, distracted by household chores or taking care of other children. A child was more likely to be in the presence of another child (often sibling) while bathing compared to a pool.Conclusions Supervision is a critical prevention tool, when children are in or around the water. This study builds on current knowledge of supervision, specifically, understanding why lapses occur.Policy implications Types of distractions leading to supervision lapses in fatal child drowning and how to minimise them, should be incorporated into national public awareness and drowning prevention campaigned and directed to parents and carers of this at risk group.Acknowledgement This research is supported by Royal Life Saving Society – Australia. The research at Royal Life Saving Society – Australia is supported by the Federal Government.