Pool fencing for preventing drowning in children.
ABSTRACT In most industrialized countries, drowning ranks second or third behind motor vehicles and fires as a cause of unintentional injury deaths to children under the age of 15. Death rates from drowning are highest in children less than five years old. Pool fencing is a passive environmental intervention designed to reduce unintended access to swimming pools and thus prevent drowning in the preschool age group. Because of the magnitude of the problem and the potential effectiveness of fencing we decided to evaluate the effect of pool fencing as a drowning prevention strategy for young children.
To determine if pool fencing prevents drowning in young children.
We used Cochrane Collaboration search strategy of electronic databases, searched reference lists of past reviews and review articles, Cochrane International Register of RCT's, studies from government agencies in the United States and Australia, and contacted colleagues from International Society for Child and Adolescent Injury Prevention, World Injury Network, and CDC funded Injury Control and Research Centers.
In order to be selected a study had to be designed to evaluate pool fencing in a defined population and provide relevant and interpretable data which objectively measured the risk of drowning or near drowning or provided rates of these outcomes in fenced and unfenced pools. The completed studies meeting selection criteria employed a case-control design. No randomized controlled studies have been identified.
Three published studies met selection criteria. Data were extracted by two reviewers using standard abstract form. Odds ratios with 95% CI, and incidence rates, were calculated for drowning and near-drowning. Attributable Risk percent (AR%) was calculated to report the reduction in drowning due to pool fencing.
Case control studies which evaluate pool fencing interventions indicate that pool fencing significantly reduces the risk of drowning. Odds ratio for the risk of drowning or near drowning in a fenced pool compared to an unfenced pool is 0.27 95%CI (0.16, 0.47). Isolation fencing (enclosing pool only) is superior to perimeter fencing (enclosing property and pool) because perimeter fencing allows access to the pool area through the house. Odds ratio for the risk of drowning in a pool with isolation fencing compared to a pool with three sided fencing is 0.17 95%CI (0.07, 0.44)
Pool fences should have a dynamic and secure gate and isolate (i.e., four-sided fencing) the pool from the house. Legislation should require isolation fencing with secure, self-latching gates for all pools, public, semi-public and private.
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ABSTRACT: Worldwide, epidemiological data indicate that children are a high-risk group for drowning and while progress has been made in understanding toddler drownings, there is a lack of empirical evidence regarding the drowning risk and protective factors inherent for adolescents and young adults. This study used a self-report questionnaire to establish swimming and water safety knowledge and attitudes of young adults and objectively measured their actual swimming ability using formal practical testing procedures. Participants then completed a short, 12-week intervention that encompassed swimming, survival and rescue skills, along with water safety knowledge applicable to a range of aquatic environments. Knowledge, attitudes and swimming ability were then re-measured following the intervention to evaluate its effectiveness. The Wilcoxon matched pairs signed ranks test was performed to detect whether there were significant differences between knowledge, attitude and swim ability scores pre-intervention and post-intervention. A total of 135 participants completed the baseline and follow up questionnaire and all practical testing. Results indicated that these young adults had a very low level of water safety knowledge pre-intervention, although the majority had sound swimming and water safety skills and attitudes. Overall, significant improvements were evident in knowledge (p<0.001) and swim ability (p<0.001) post-intervention, although no changes were observed in attitudes (p=0.079). Previous participation in formal swimming lessons and/or swimming within the school curriculum had no significant impact on water safety knowledge, skills or attitudes of these young adults, and there were few significant gender differences. While it is important to conduct further studies to confirm that these findings are consistent with a more representative sample of young adults, our findings are the first to provide empirical evidence of the value of a comprehensive aquatic education program as a drowning prevention strategy for young adults.Accident; analysis and prevention 05/2014; 70C:188-194. DOI:10.1016/j.aap.2014.04.006 · 1.65 Impact Factor
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ABSTRACT: Drowning is the leading cause of death from unintended injury in children globally. Drowning is preventable, and mechanisms exist which can reduce its impact, however the peer-reviewed literature to guide public health interventions is lacking. This paper describes a protocol for a review of drowning prevention interventions for children. Electronic searching will identify relevant peer-reviewed literature describing interventions to prevent child drowning worldwide. Outcome measures will include: drowning rates, water safety behaviour change, knowledge and/or attitude change, water safety policy and legislation, changes to environment and water safety skills. Quality appraisal and data extraction will be independently completed by two researchers using standardised forms recording descriptive and outcome data for each included article. Data analysis and presentation of results will occur after data have been extracted. This review will map the types of interventions being implemented to prevent drowning amongst children and identify gaps within the literature.Open Journal of Preventive Medicine 03/2014; 4(3):100. DOI:10.4236/ojpm.2014.43014