RT Journal Article SR Electronic T1 Risky business: a 15-year analysis of fatal coastal drowning of young male adults in Australia JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP 442 OP 449 DO 10.1136/injuryprev-2020-043969 VO 27 IS 5 A1 Jasmin C Lawes A1 Annabel Ellis A1 Shane Daw A1 Luke Strasiotto YR 2021 UL http://injuryprevention.bmj.com/content/27/5/442.abstract AB Introduction Drowning is a leading cause of unintentional death, especially for males. In Australian coastal waters, young male adults account for 25% of the burden of male drowning. This study aims to describe young male coastal drowning deaths and to examine the prevalence of risk factors, especially alcohol and drugs.Methods Characteristics of unintentional fatal drowning involving males (15–34 years) were compared with other adults (15 years and older). Data were sourced from the National Coronial Information System (Australia) and Surf Life Saving incident reports (2004/2005–2018/2019). Relative risk was calculated and χ2 tests of independence were performed (p<0.05). Blood alcohol and drug concentrations were analysed with permutational analyses of variance.Results Young males drowned more while jumping (9.85 times), swimming/wading (1.41 times), at rock/cliff locations (1.42 times) and on public holidays (1.8 times). Young males drowned less while boating (0.81 times), scuba diving (2.08 times), offshore (1.56 times) or due to medical factors (3.7 times). Young males drowned more (1.68 times) after consuming illicit drugs (amphetamines 2.26 times; cannabis 2.25 times) and less with prescription drugs (benzodiazepines 2.6 times; opiates 4.1 times; antidepressants 7.7 times). Blood serum concentrations of cannabis were higher in young males, while amphetamine and alcohol were lower.Discussion Unsafe behaviours alongside certain activities or locations create deadly combinations of risk factors. A relationship between age, activity, attitude and affluence is proposed, where young males drown more in affordable activities with fewer regulations. Our results support multilevel strategies (spanning life stages) to reduce young male coastal drowning.Data may be obtained from a third party and are not publicly available. 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: ncis@ncis.org.au.