Abstract: According to the World Health Organization (WHO), 0.7% of all deaths worldwide — or more than 500,000 deaths each year — are due to unintentional drowning. Since some cases of fatal drowning are not classified as such according to the codes of the International Classification of Disease, this number underestimates the real figures, even for high-income countries, and does not include drownings that occur as a result of floods, tsunamis, and boating accidents.

Drowning is a leading cause of death worldwide among boys 5 to 14 years of age. In the United States, drowning is the second leading cause of injury-related death among children 1 to 4 years of age, with a death rate of 3 per 100,000, and in some countries, such as Thailand, the death rate among 2-year-old children is 107 per 100,000. In many countries in Africa and in Central America, the incidence of drowning is 10 to 20 times as high as the incidence in the United States. Key risk factors for drowning are male sex, age of less than 14 years, alcohol use, low income, poor education, rural residency, aquatic exposure, risky behavior, and lack of supervision. For people with epilepsy, the risk of drowning is 15 to 19 times as high as the risk for those who do not have epilepsy.  Exposure-adjusted, person-time estimates for drowning are 200 times as high as such estimates for deaths from traffic accidents. Coastal drownings are estimated to cost more than $273 million per year in the United States and more than $228 million per year (in U.S. dollars) in Brazil. For every person who dies from drowning, another four persons receive care in the emergency department for nonfatal drowning.

Citation: Szpilman, D., Bierens, J. J., Handley, A. J., & Orlowski, J. P. (2012). Drowning. New England journal of medicine, 366(22), 2102-2110.