Drowning

Key facts

• There are around 300 000 annual drowning deaths worldwide.
• Drowning disproportionately impacts children and young people. Children aged under 5 years account for nearly a quarter of all drowning deaths.
• Drowning is the fourth leading cause of death for children aged 1–4 years and the third leading cause of death for children aged 5–14 years.
• Ninety-two percent of drowning deaths occur in low- and middle-income countries.
• Resolutions endorsed by the United Nations General Assembly and the World Health Assembly provide a roadmap for global drowning prevention efforts.

Overview

Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid. Outcomes are classified as death, morbidity and no morbidity.

The global burden of drowning impacts all economies and regions, however:

• drowning death rates are more than three times higher in low- and middle-income countries than in high-income countries;
• over half of the world’s drowning occurs in the WHO Western Pacific Region and WHO South-East Asia Region;

Since 2000 the global drowning death rate has fallen by 38%, from 6.1 to 3.8 per 100 000 population. Despite this progress, drowning deaths remain a preventable public health crisis, and the declines seen in the past two decades fall short of what is needed to meet the many Sustainable Development Goals to which drowning prevention contributes.

Risk factors

Age

Young children are at a particularly high risk of drowning due to an underdeveloped ability to assess risk, and a lack of swimming and water safety skills. The risk of drowning increases when children interact with water outside of active adult supervision.

Children and young adults aged 0–29 years account for over half (57%) of all drowning deaths. The highest drowning rates per population are among children aged 0–4 years. At the regional level, drowning rates among children 0-4 years are highest in the WHO Eastern Mediterranean Region at 16.8 deaths per 100 :000 population. In the WHO Western Pacific Region children aged 5–14 years die more frequently from drowning than any other cause.

Sex

The drowning death rate among males is more than twice as high as females. Males are also more likely to be hospitalized than females for non-fatal drowning. Studies suggest that the higher drowning rates among males are due to increased exposure to water and riskier behaviour such as swimming alone, drinking alcohol before swimming alone and boating.

Poverty and inequality

Drowning disproportionately affects poor and marginalized people. Whether it be through the use of ponds, rivers or lakes for bathing and washing clothing, or using open wells for collecting water, the pattern of daily exposure in low- and middle-income countries brings a higher risk of drowning.

Occupational exposure

Individuals with occupations such as commercial or subsistence fishing face a substantially higher risk of drowning. The United Nations Food and Agriculture Organization estimates that more than 32 000 fishers die while working every year. Climate change has aggravated the hazardous conditions under which most fishers work, as extreme weather and natural disasters become more prevalent and destructive.

Climate-related risks

Climate change is causing more extreme weather events, such as floods and heatwaves. Drowning accounts for 75% of deaths in flood disasters. Drowning risks due to floods are particularly high in low- and middle-income countries where early warning systems and flood mitigation infrastructure are underdeveloped.

Heatwaves increase the risk of drowning. As temperatures rise, more people seek water for heat relief and typically spend longer periods of time in and on the water.

Transport on water

Travelling on water, particularly in dangerous weather conditions or without appropriate safety equipment, can increase drowning risk. In many low- and middle-income countries, water transport is significantly less regulated than in high-income countries. Daily commuting often takes place on overcrowded and unsafe vessels, operated by staff who have not been trained to recognize hazardous conditions or perform high-seas navigation.

Migration and seeking refuge

Increasing numbers of people are being displaced or migrating due to conflict, political and or economic instability and climate change. Many people resort to irregular channels for migration that are extremely hazardous, including across large expanses of water in treacherous conditions, often using overcrowded, unsafe vessels that lack safety equipment or are operated by untrained personnel.