Introduction
There are 4 factors that could lead to a drowning. This is known as the drowning chain and is summarised as follows:
- Ignorance, disregard or misjudgement of, or, unprepared for the danger,
- Uninformed, unexpected or unrestricted access to the hazard,
- Lack of supervision or surveillance,
- An inability to cope once in difficulty,
A ‘preventable drowning’ is therefore a drowning which could be avoided if the appropriate preventative action was in place to ‘break’ the drowning chain described above.We must look at strategies to address all 4 factors if we want to reduce drowning – not just to provide additional surveillance. A total lifesaving service plan is therefore required.
Introduction
There are 4 factors that could lead to a drowning. This is known as the drowning chain and is summarised as follows:
- Ignorance, disregard or misjudgement of, or, unprepared for the danger,
- Uninformed, unexpected or unrestricted access to the hazard,
- Lack of supervision or surveillance,
- An inability to cope once in difficulty,
A ‘preventable drowning’ is therefore a drowning which could be avoided if the appropriate preventative action was in place to ‘break’ the drowning chain described above.We must look at strategies to address all 4 factors if we want to reduce drowning – not just to provide additional surveillance. A total lifesaving service plan is therefore required.
This paper highlights options to assist in the prevention of drowning. Options highlighted in the total lifesaving service plan may not suite all locations. However, succesful strategies from various member organisations are highlighted so that alternatives for local conditions and circumstances can be considered.
The work of the ILS Rescue Committee is a work in progress. This paper outlines the work done to date and calls for comment prior to formally presenting this information to the ILS Lifesaving Commission and the ILS Board of Directors in July 2008.
Background
The International Lifesaving Federation (ILS) Rescue Committee has addressed the above issues by developing a Total Life Saving Service Plan.
This helps us identify the gaps, and also enables priorities to be set when addressing the strategies that we need to put in place to address each of the 4 aspects of the drowning chain. The strategies can be grouped as follows:
- Education and information
- Denial of access and or provision of warnings
- Provision of supervision, and
- Acquisition of survival skills
The ILS Rescue Committee has established a list of the different programs that individual member organisations have developed to address each of these 4 areas.
Discussion
Currently, the World Health Organization (WHO) collates the most comprehensive global data on drowning mortality. Even while acknowledging that drowning deaths are significantly under reported, WHO identifies drowning as the second leading cause of unintentional injury death after motor vehicle collisions. The World Health Organization estimated that 409 272 people died from drowning in 2000
- There are a number of factors that could lead to death by drowning:
- Ignorance, disregard or misjudgement of, or, unprepared for the danger,
- Uninformed, unexpected or unrestricted access to the hazard,
- Lack of supervision or surveillance,
- An inability to cope once in difficulty.
We therfore need startegies in each of these areas to break this cycle or chain.
These can be grouped as follows:
- Education and information,
- Denial of access and or provision of warnings,
- Provision of supervision, and
- Acquisition of survival skills.
This sequence is depicted in the following diagram
The various initiatives under each of these four factors can be listed as follows.
The Drowning Chain – Summary of Control Measures
The Sequence |
Counter Measure |
Control Measures |
Applications |
Factor One |
Education and information |
Pre-arrival education |
|
Arrival information |
|
||
Safe Beach Access |
|
||
On-site Education |
|
||
Factor Two |
Denial of access and/or provision of warnings |
Barriers |
|
Signage |
|
||
Byelaw Development |
|
||
Factor Three |
Provision of supervision |
Trained Observers |
|
First Aid Facilities |
|
||
Lifeguard Services |
|
||
Activity Management |
|
||
Activity Restrictions |
|
||
Factor Four |
Acquisition of survival skills |
Community Training |
|
Emergency Communications |
|
||
Public Rescue Equipment |
|
Table 1 – Summary of control measures to address factors that could lead to a drowning
Conclusion
ILS has identified that there are a number of factors that could lead to death by drowning. ILS has collated a number of control measures that may either by themselves or jointly lead to a reduction in the number of people drowning worldwide. Organizations interested in reducing the number of deaths by drowning should perform both a risk assessment in relation to the nature and causes of drowning in their location and then to prioritise according to the number and nature of resources at their disposal to ensure that the greatest benefit is derived from those resources.
Best practice in relation to the various control measures will be referenced on the ILS web site from July 2008 once the Total Lifesaving Service Plan initiative has been adopted by ILS.
Take Home Messages
- To understand the factors that could lead to a drowning.
- To review options that various organisations have adopted to address aspects of the drowning chain.
- To share learning and to contribute ideas to assist in the prevention of drowning.
Acknowledgments
Surf Life Saving Australia
Surf Life Saving New Zealand
Royal National Lifeboat Institution