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Association Between Swimming Lessons and Drowning in Childhood: A Case-Control Study
Abstract
To estimate the association between swimming lessons and the risk of drowning among children aged 1 to 19 years.
Case-control study.
Cases were identified from medical examiners'/coroners' offices between mid-2003 and mid-2005. Jurisdictions included the states of Maryland and North Carolina, 14 districts (33 counties) in Florida, 3 counties in California, 1 county in Texas, and 1 county in New York.
Cases were children and adolescents aged 1 to 19 years who died of unintentional drowning. Interviews were conducted with 88 families of children who drowned and 213 matched controls. Main Exposure Swimming lessons. Main Outcome Measure Death due to unintentional drowning. Drownings that were intentional, of undetermined intent, or that occurred under conditions in which swimming ability was unlikely to impact risk (eg, in ice water or bathtubs) were excluded.
Of the 61 cases in the 1- to 4-year age group, 2 (3%) had participated in formal swimming lessons vs 35 of 134 matched controls (26%) (adjusted odds ratio [OR], 0.12; 95% confidence interval [CI], 0.01-0.97). Among the 27 cases aged 5 to 19 years, 7 (27%) had ever taken formal swimming lessons vs 42 of 79 matched controls (53%) (adjusted OR, 0.36; 95% CI, 0.09-1.51). In adjusted analyses, there was no statistically significant association between informal instruction and drowning risk.
Participation in formal swimming lessons was associated with an 88% reduction in the risk of drowning in the 1- to 4-year-old children, although our estimates were imprecise and 95% CIs included risk reductions ranging from 3% to 99%.
... Participation in swimming learning (in schools) has been shown to reduce the risk of drowning between the age range of 1-19 years (Brenner, R.A.;Taneja, G.S.;Haynie, D.L.;et al. 2009) Swimming is not only a competitive sport for elite athletes, but swimming is also one of the most popular and healthy types of sports (Chase et al., 2008;Oja et al., 2015); in addition, swimming can also improve heart health, fitness and body composition (Lahart & Metsios, 2018;Tanaka, 2009). Swimming is also a fundamental skill for survival. ...
... Participation in swimming learning (in schools) has been shown to reduce the risk of drowning between the age range of 1-19 years (Brenner, R.A.;Taneja, G.S.;Haynie, D.L.;et al. 2009) Swimming is not only a competitive sport for elite athletes, but swimming is also one of the most popular and healthy types of sports (Chase et al., 2008;Oja et al., 2015); in addition, swimming can also improve heart health, fitness and body composition (Lahart & Metsios, 2018;Tanaka, 2009). Swimming is also a fundamental skill for survival. ...
... Participation in swimming learning (in schools) has been shown to reduce the risk of drowning between the age range of 1-19 years (Brenner, R.A.;Taneja, G.S.;Haynie, D.L.;et al. 2009) Swimming is not only a competitive sport for elite athletes, but swimming is also one of the most popular and healthy types of sports (Chase et al., 2008;Oja et al., 2015); in addition, swimming can also improve heart health, fitness and body composition (Lahart & Metsios, 2018;Tanaka, 2009). Swimming is also a fundamental skill for survival. ...
This study aims to determine the increase in basic swimming training by introducing water techniques in the preschool, kindergarten and school-age categories. This study involved 102 swimming school students in testing the validity and reliability, and 97 students were used as research samples using accidental sampling. The research was conducted at the Bandung International Swimming School Swimming Club. The instrument used in this research is the Swimming Games Program questionnaire given to Bandung International Swimming School trainers. The data obtained were then tested statistically using SPSS Version 24 with a significance level of α = 0.05 using the paired sample t-test. The implications of this research can provide information to swimming coaches and parents that swimming games programs have the potential to help train children in increasing courage and basic swimming techniques.
... Sekalipun dalam sebuah artikel penelitian yang menjelaskan bahwasanya tidak ada hubungan antara trauma tenggelam dimasa kecil dengan kasus tenggelam pada masa usia yang lebih tua (Brenner et al., 2009). ...
This study aims to determine the effect of hypnotherapy on students' anxiety and motivation in learning to swim using the experimental method with a 2 x 2 factorial design. The samples used in this study were male and female students at SMAN 1 Sumenep totaling 158 students, who were placed in four groups. The instrument used in this research is the Sport Anxiety Scale and the motivation questionnaire which has been adapted. Data were analyzed using factorial ANOVA. The results of the study prove that hypnotherapy has an effect on anxiety, which is indicated by the F value of 46,418 at a significance of <0.01. Hypnotherapy also has an effect on learning motivation as indicated by the F value of 26,477 at a significance < 0.01. The variables of gender and level of suggestibility did not affect anxiety and learning motivation. In addition, there is no interaction between the suggestibility variable and the gender variable in influencing anxiety and learning motivation.Abstrak Penelitian ini bertujuan untuk mengetahui pengaruh hipnoterapi terhadap kecemasan dan motivasi siswa dalam belajar renang menggunakan metode eksperimen dengan desain faktorial 2 x 2. Sampel yang digunakan dalam penelitian ini adalah siswa putera dan siswa puteri di SMAN 1 Sumenep dengan jumlah 158 orang, yang ditempatkan dalam empat kelompok eksperimen sesuai dengan kriteria yang telah ditentukan, yakni siswa putera dengan sugestifitas tinggi, siswa putera dengan sugestifitas rendah, siswa puteri dengan sugestfitas tinggi, dan siswa puteri dengan sugestifitas rendah.Instrumen yang digunakan dalam penelitian ini adalah Sport Anxiety Scale dan angket motivasi yang telah diadaptasi. Data dianalisis dengan menggunakan anova faktorial. Hasil penelitian membuktikan bahwa hipnoterapi berpengaruh terhadap kecemasan, yang ditunjukkan dengan harga F sebesar 46,418 pada signifikansi <0,01. Hipnoterapi juga berpengaruh terhadap motivasi belajar yang ditunjukkan dengan harga F sebesar 26.477 pada signifikansi <0,01. Variabel gender dan tingkat sugestifitas tidak mempengaruhi kecemasan dan motivasi belajar. Selain itu, tidak ada interaksi antara variabel sugestifitas dan variabel gender dalam mempengaruhi kecemasan dan motivasi belajar
... Some studies examining attitudes of older adolescents and adults found that compared to weak swimmers, stronger swimmers were more likely to take risks around water or visit dangerous aquatic environments, which increases drowning risk (Brenner et al. 2003;McCool et al. 2008;Brenner et al. 2006). Conversely, other studies have reported that swimming ability and water safety knowledge may protect against drowning (Brenner et al. 2009;McCool et al. 2009). A recent systematic review identified that young children (aged 2-4 years) who participated in formal swimming lessons were more likely to be adequately supervised and the acquisition of aquatic competencies was of benefit for the prevention of drowning (Taylor et al. 2020). ...
Background
Globally, drowning is a leading cause of unintentional injury and death among children. Teaching aquatic competencies (swimming skills and water safety knowledge) to children has been proposed as a prevention strategy. In Australia, however, many children are not meeting standard aquatic competency benchmarks. Exploration of the connection between demographic and background factors and aquatic competencies could provide insight into why differences in acquisition of aquatic knowledge and skills occur.
Main body
A systematic literature review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed to identify studies that reported on the association between demographic and background factors and aquatic competencies. Nine databases were searched for English language peer-reviewed studies published since 2000. Fourteen studies fulfilled all inclusion criteria. Studies were quasi-experimental or cross-sectional in design, which is considered quality level III-2 or IV, respectively, on the National Health and Medical Research Council Evidence Hierarchy. Study quality was moderate, and risk of bias was high. While aquatic competencies can be taught, this review found that factors including age, gender, geographic residence, medical conditions/disabilities, socioeconomic status, and swimming frequency were significantly associated with the demonstration and/or acquisition of aquatic competencies.
Conclusion
This review provides insight into demographic and background factors that are significantly associated with the development of aquatic competence. Whilst further investigation is required to increase the evidence base, these findings may assist in tailoring swimming and water safety programs to accommodate those at-risk of not achieving age-appropriate aquatic competencies.
... The AAP initially advised that children should only start swimming programs after the age of 3 years; first because no evidence existed to determine if swimming programs for very young children would impact the likelihood of drowning and, second, because enrolling babies in swimming programs could develop a false sense of security in caregivers and a consequent reduction of proper supervision [8,9]. They also expressed concern that baby swimming programs could "reduce a child's fear of water and unwittingly encourage the child to enter the water without supervision" [10] (p179). 2 In light of a case-control study showing that swimming lessons did not increase the risk of drowning in 1-4 year-olds [11], the AAP subsequently changed the recommendation [10]. They softened their stance stating that swimming programs could be beneficial to children of all ages, including babies, provided other layers of protection against drowning (e.g., constant and capable supervision, effective pool barriers) were in place. ...
After crawling experience being pointed as the best predictor of infants' avoidance of falls into the water and not having any effect on infants' approach to slopes into the water, and infants showing less adaptive behaviour when slopes are offered to access the water when compared with their behaviour when a drop-off into the water is presented, this study investigated the effect of Baby Swimming Programs on infants' avoidance of both situations, i.e., drop-offs and slopes leading into deep water.
This study is submitted and under review for peer-review publication.
... Children aged 2-4 years can acquire the motor skills for swimming [43]. Brenner et al. found that the preschoolaged group had a reduction in the fatal drowning risk if they attended swimming lessons [44]. Swimming lessons should include parental training to improve parents' understanding of their child's actual swimming abilities and continued risk. ...
Drowning is the third leading cause of injury death in the pediatric population worldwide, with incidence peaking among those aged 1–4 years and again in adolescence.
The purpose of this commentary is to review the basic pathophysiology of drowninginjury and factors that affect the outcome, such as submersion and hypothermia. We also discuss principles of prehospital and in-hospital management, comprising resuscitation and stabilization, administration of oxygen and intravenous liquids, and central reheating.
Even though the mortality rate has decreased in recent years, further investments and safety measures are needed to prevent child drowning deaths.
... Learn-to-swim programs for both beginners and advanced swimmers are standard inclusions in physical education curricula at several different age levels in many European countries (Jurgec et al., 2016). Well-developed aquatic skills are not only essential for the prevention of drowning, but also contribute to the development and maintenance of fitness for life (Brenner et al., 2009;Elkington, 1980). Therefore, the goal of these programs is to provide appropriate water safety education and safe enjoyment to beginner swimmers. ...
In recent research, we found that the use of goggles and snorkel benefited non-swimmers with fear of water in a learn-to-swim program. Our purpose in this study was to examine the effects of using goggles and snorkel during a learn-to-swim program on the aquatic skills of young non-swimmers without fear of water. We modelled this research on our prior study. Following informed parental consent, 40 children (aged 10-11 years) were randomly divided into two groups: one that used goggles and snorkel (GS) and one that did not (NGS). After 4 weeks (five sessions per week) of learn-to-swim intervention, both groups improved aquatic skills such that the only group differences were for the blowing bubbles test, for which the learn-to-swim program resulted in smaller gains for the GS than the NGS group. Thus, the use (vs. non-use) of goggles and snorkels during the learn-to-swim program had no significant effect on most aquatic skills of young non-swimmers without fear of water. The only exception was a significant finding of reduced improvement in blowing bubbles in the goggles and snorkels group when compared to the no goggles and snorkel group. Together with past findings these results highlight important learn-to-swim differences between young non-swimmers with and without fear of water.
... The Haddon Matrix Paradigm provides interventions related to personal, equipment, physical and social environment that can help reduce the risk of drowning and identify an accidental fall earlier [8]. One study also revealed that formal swimming lessons reduced the risk of drowning by 88% in children between the ages of 1-4, while informal swimming lesson did not show a significant reduction in drowning incidences [9]. This further highlights the importance of educating parents about enrolling their children in formal swimming lessons. ...
Unintentional injuries are one of the leading causes of death in Americans. A large proportion of these deaths are attributable to accidental drownings and falls, both of which oftentimes take place in or around swimming pools and swimming pool-related apparatuses such as diving boards. The American Academy of Family Physicians (AAFP) has reported drowning incidents as the most common injury-related cause of death in children ages one to four years. Although the AAFP has outlined steps to take to prevent drownings, there has not been a current large-scale study illustrating the effectiveness of these strategies with regard to their effect on the prevalence of swimming pool drowning cases in the last 10 years. Thus, we aim to utilize the National Electronic Injury Surveillance System (NEISS) database to uncover these rates, which can ultimately help aid in the reevaluation of current recommended guidelines.
This study examined the therapeutic-educational significance of swimming and aquatic exercise for Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (AD/HD) based on the knowledge accumulated in the rehabilitation field and the ICF core sets, contributing to developing of more effective instructional methods.
(i) Swimming and aquatic exercise have the potential to support the development of physical, cognitive and socio-emotional functions due to the characteristics of water and the social interactions associated with instruction, indicating its significance in developmental science.
(ii) Swimming and aquatic exercise have the potential to reduce the risk of physical and mental illness and death, improve the health of ASD and AD/HD themselves, and contribute to the quality of life of the whole family, indicating its significance in public health.
(iii) Swimming and aquatic exercise have the potential to motivate people to participate in regular exercise and sports activities, support the practice of lifelong sports, expand interactional relationships and challenge competition, indicating its significance in exercise epidemiology.
In the future, instructional methods for swimming and aquatic exercise methods should be considered in inclusive physical education classes and community sports activities.
Background:
Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. We conducted a systematic review on the impact of sociodemographic factors across different stages of POHCA.
Methods:
We searched MEDLINE, EMBASE, and Web of Science from database inception to October 2022. We included studies examining the association between sociodemographic factors (i.e., race, ethnicity, migrant status and socioeconomic status [SES]) and POHCA risk, bystander cardiopulmonary resuscitation (CPR) provision, bystander automated external defibrillator (AED) application, survival (at or 30-days post-discharge), and neurological outcome. We synthesized the data qualitatively.
Results:
We screened 11,097 citations and included 18 articles (arising from 15 studies). There were 4 articles reporting on POHCA risk, 5 on bystander CPR provision, 3 on bystander AED application, 13 on survival, and 6 on neurological outcome. In all studies on POHCA risk, significant differences were found across racial groups, with minority populations being disproportionately impacted. There were no articles reporting on the association between SES and POHCA risk. Bystander CPR provision was consistently associated with race and ethnicity, with disparities impacting Black and Hispanic children. The association between bystander CPR provision and SES was variable. There was little evidence of socioeconomic or racial disparities in studies on bystander AED application, survival, and neurological outcome, particularly across adjusted analyses.
Conclusions:
Race and ethnicity are likely associated with POHCA risk and bystander CPR provision. These findings highlight the importance of prioritizing at-risk groups in POHCA prevention and intervention efforts. Further research is needed to understand underlying mechanisms.
A new conception of sensation seeking is presented, along with a new scale [the Arnett Inventory of Sensation Seeking (AISS)]. The new conception emphasizes novelty and intensity as the two components of sensation seeking. Two studies were conducted to validate the new scale. In the first study, the AISS was found to be more strongly related to risk behavior than Zuckerman's Sensation Seeking Scale (SSS) among 116 adolescents aged 16–18 years, although the new scale contains no items related to risk behavior (in contrast to the SSS). In the second study, involving 139 adolescents, similar relations were found between the AISS and risk behavior, and the new scale was also found to be significantly correlated with the Aggression subscale of the California Psychological Inventory (CPI). In addition, adults (N = 38) were found to be lower in sensation seeking than adolescents. In both studies, males were higher in sensation seeking than females.
To describe the epidemiology of domestic swimming pool drowning and near-drowning in Brisbane and to examine the efficacy of a broad range of preventive options, including pool fences.
A prospective, hospital-based, injury surveillance system to describe the epidemiology of drowning and near-drowning and a community survey to describe pool fencing.
The surveillance questionnaire was completed at presentation in the Emergency Department by the parent, nurse and doctor. Personal interviews in households that were randomly selected by means of a stratified sampling scheme provided the pool fencing description.
All 139 children suffering from an immersion injury resulting in presentation at a hospital in the catchment area of The Mater Children's Hospital were included. There were 204 households with a swimming pool in the 1024 households interviewed in the community survey.
The 100 domestic pool drownings and near-drownings were equivalent to 15.5 incidents per year per 100,000 children aged 0-13 years and 64.9 per year per 100,000 for the critical 1-3 years age group. Of 72 children who gained unintended access to a domestic pool, 88.9% were less than 3 years of age and 52.8% were less than 2 years. All 10 of the children who drowned and five who were severely brain damaged (age range, 12-32 months) were in this group. The risk of a drowning or near-drowning involving unintended access to an unfenced pool is 3.76 times higher than the risk associated with a fenced pool (95% confidence limits for relative risk: 2.14, 6.62).
Pool fences are an effective method of preventing child drownings and near-drownings. This effectiveness can be further improved if compliance with gate closure can be enhanced. This should be emphasised in health promotion accompanying the introduction of universal pool fencing.
A study of random digit dialing as a method of control selection was conducted as part of a matched case-control study of risk factors for neuroblastoma. The study was conducted in 1981–1982 in the Greater Delaware Valley region. Participation involved parents submitting to a 2–4-hour telephone interview. Potential control telephone numbers were selected by substituting the last two digits of the case family's telephone number with randomly selected digits. Successive random telephone numbers were called until a family with a child matching the case by year of birth plus or minus three years and race who agreed to participate was identified. A total of 3,245 telephone numbers were dialed to select controls for 101 cases, an average of 32.1 telephone numbers per case. Among 1,908 residential households contacted, 25.5% refused to give information about household characteristics. Of households with known characteristics, 45% had children under 25 years of age and 14.9% had a child eligible for the study. Among 181 households invited to participate, 101 agreed. For 18.6% of all calls, residential respondents were randomly offered $10 as an inducement to participate. This inducement did not significantly Influence participation rates among families invited to participate.
Control groups selected by random digit dialing are frequently used in case-control studies. Concern about the potential for bias in these control groups has been expressed, primarily because of low response rates. This study compares the characteristics of a hypothetical control group consisting of 341 men and women aged 40-74 years, selected by random digit dialing and participating in an interview in 1990, with the characteristics of 15,563 men and women aged 40-74 years who participated in a privately conducted census in the same upstate New York county in 1989. For most measures, no differences were seen between the random digit dialing sample and the census population. However, the hypothetical control group was more likely to have had their cholesterol checked in the past 2 years and was somewhat more likely to have had other screening tests as well. In addition, the hypothetical control group was somewhat better educated. The results suggest that, at least in this setting, control groups selected by random digit dialing are representative of the general population in most respects; however, caution should be used when studying the relation between screening tests and disease occurrence by means of case-control studies using controls selected by random digit dialing.
There is a need for practical and cost-effective measures of the behavioral characteristics that predict subsequent injury in children. Previous research has focused on the predictive power of child problem behavior (e.g., hyperactivity, aggression, noncompliance) and has found reliable, but relatively weak associations with injury frequency. In an effort to improve upon this level of prediction using child behavioral measures, a care-giver report checklist of specific "risky" behaviors was developed for toddlers and preschoolers, called the Injury Behavior Checklist (IBC). A preliminary test of the reliability and validity of this instrument was undertaken in a sample of middle-class families (N = 253). Results indicated that the IBC has acceptable reliability (internal consistency = .87; 1-month test-retest correlation = .81) and is able to significantly discriminate children with two or more injuries from those with one or none (p less than .001). Multiple regression analyses indicated that the IBC was a better predictor of injury than parent-reported levels of child problem behavior using the Conners Parent Rating Scale.
Abstract A revised validated version of the Toddler Temperament Scale (TTS) was used to develop normative data for temperament in Australian toddlers. Results confirm the accepted practice of dividing the group into younger and older toddlers, with normative data reported for those younger and older than 24 months. The TTS can be used above the normal cut-off age of 36 months. Care must be taken with interpretation of temperament scores, especially when comparing children of different backgrounds.
This research investigated the effects of aquatic training on the swimming performance of 126 children, ages 2.5 to 5.5 yr., over 8 mo. Two groups of children were enrolled in an aquatic training program. Group 1 were returning program participants at the beginning of this study, and Group 2 were new participants. The control children (Group 3) received no aquatic training during the research. Subjects performed six categories of swimming tasks at three points in time--1st mo., 4th mo., and 8th mo. The categories were Locomotion: Front, Locomotion: Back, Kicking, Entry: Jump, Diving, and Ring Pick-up. A 2 X 3 X 2 X 3 (sex X group X age X time) repeated-measures analysis of variance procedure showed that returning participants performed each category of swimming tasks at a more advanced level than the other groups at each time of measurement. New participants after training performed five of the categories of tasks at a more advanced level than the control group. Amount of training significantly influenced swimming, and training effects were task-specific when data were interpreted in terms of specific movement characteristics.
The initial development of the Toddler Temperament Scale (TTS) for determining temperamental characteristics in 1- to 3-year-old children is reported. The 97-item questionnaire was based on the conceptualization of Thomas, Chess, and associates in the New York Longitudinal Study and standardized on 309 children in two pediatric practices. Test-retest reliability (1 month) and alpha reliability are both satisfactory, with median correlations of .81 and .70, respectively, for the nine categories. Preliminary evidence of external validity is presented. The instrument should provide more objective and organized temperament data for research and clinical purposes. Language: en
A method for estimating the risks of drowning in fenced and unfenced domestic swimming pools is presented. Application of this method suggests that the probability of drowning occurring in an unfenced pool is between two to five times higher than that of a fenced pool. It is also estimated that the introduction of pool fencing would reduce the number of drownings in domestic swimming pools by 40% to 67%.
