drowning
Drowning is the 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury-related deaths.
Independent article from the World Health Organisation and the reason why we started Pool Angel

Key facts about drowning

  • Drowning is the 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury-related deaths.
  • Worldwide, there are an estimated 320,000 drowning deaths annually.
  • Global estimates may significantly underestimate the actual public health problem related to drowning.
  • Children, males and individuals with increased access to water are most at risk of drowning.
Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid; outcomes are classified as death, morbidity and no morbidity.

Scope of the problem

In 2016, an estimated 320 000 people died from drowning, making drowning a major public health problem worldwide. In 2015, injuries accounted for over 9% of total global mortality. Drowning is the 3rd leading cause of unintentional injury death, accounting for 7% of all injury-related deaths.

The global burden and death from drowning is found in all economies and regions, however:

  • low- and middle-income countries account for over 90% of unintentional drowning deaths;
  • over half of the world’s drowning occurs in the WHO Western Pacific Region and WHO South-East Asia Region;
  • drowning death rates are highest in the WHO African Region, and are 15-20 times higher than those seen in Germany or the United Kingdom, respectively.

Despite limited data, several studies reveal information on the cost impact of drowning. In the United States of America, 45% of drowning deaths are among the most economically active segment of the population. Coastal drowning in the United States alone accounts for US$ 273 million each year in direct and indirect costs. In Australia and Canada, the total annual cost of drowning injury is US$ 85.5 million and US$ 173 million respectively.

There is a wide range of uncertainty around the estimate of global drowning deaths. Official data categorization methods for drowning exclude intentional drowning deaths (suicide or homicide) and drowning deaths caused by flood disasters and water transport incidents.

Data from high-income countries suggest these categorization methods result in significant under representation of the full drowning toll by up to 50% in some high-income countries. Non-fatal drowning statistics in many countries are not readily available or are unreliable.

Risk factors

Age

The Global report on drowning (2014) shows that age is one of the major risk factors for drowning. This relationship is often associated with a lapse in supervision. Globally, the highest drowning rates are among children 1–4 years, followed by children 5–9 years. In the WHO Western Pacific Region children aged 5–14 years die more frequently from drowning than any other cause.

Child drowning statistics from a number of countries presented in the Global Report on Drowning are particularly revealing:

  • Drowning is one of the top 5 causes of death for people aged 1–14 years for 48 of 85 countries with data meeting inclusion criteria (1).
  • Australia: drowning is the leading cause of unintentional injury death in children aged 1–3 years.
  • Bangladesh: drowning accounts for 43% of all deaths in children aged 1–4 years.
  • China: drowning is the leading cause of injury death in children aged 1–14 years.
  • United States of America: drowning is the second leading cause of unintentional injury death in children aged 1–14 years.

Gender

Males are especially at risk of drowning, with twice the overall mortality rate of females. They are 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.

Access to water

Increased access to water is another risk factor for drowning. Individuals with occupations such as commercial fishing or fishing for subsistence, using small boats in low-income countries are more prone to drowning. Children who live near open water sources, such as ditches, ponds, irrigation channels, or pools are especially at risk.

Other risk factors

There are other factors that are associated with an increased risk of drowning, such as:

  • lower socioeconomic status, being a member of an ethnic minority, lack of higher education, and rural populations all tend to be associated, although this association can vary across countries;
  • infants left unsupervised or alone with another child around water;
  • alcohol use, near or in the water;
  • medical conditions, such as epilepsy;
  • tourists unfamiliar with local water risks and features;

Prevention

There are many actions to prevent drowning. Installing barriers (e.g. covering wells, using doorway barriers and playpens, fencing swimming pools etc.) to control access to water hazards, or removing water hazards entirely greatly reduces water hazard exposure and risk.

Community-based, supervised child care for pre-school children can reduce drowning risk and has other proven health benefits. Teaching school-age children basic swimming, water safety and safe rescue skills is another approach. But these efforts must be undertaken with an emphasis on safety, and an overall risk management that includes a safety-tested curricula, a safe training area, screening and student selection, and student-instructor ratios established for safety.

Effective policies and legislation are also important for drowning prevention. Setting and enforcing safe boating, shipping and ferry regulations is an important part of improving safety on the water and preventing drowning. Building resilience to flooding and managing flood risks through better disaster preparedness planning, land use planning, and early warning systems can prevent drowning during flood disasters.

Developing a national water safety strategy can raise awareness of safety around water, build consensus around solutions, provide strategic direction and a framework to guide multisectoral action and allow for monitoring and evaluation of efforts.

WHO response

WHO released the Global report on drowning in November 2014. This was the first time WHO had developed a report dedicated exclusively to drowning. The report pointed out that drowning has been highly overlooked to date, and that a great deal more should be done by governments and the research and policy communities to prioritize drowning prevention and its integration with other public health agendas.

The Global report on drowning provides recommendations to governments to tailor and implement effective drowning prevention programmes to their settings, improve data about drowning, and develop national water safety plans. The report also points out the multisectoral nature of drowning and calls for greater coordination and collaboration among UN agencies, governments, key NGOs and academic institutions to prevent drowning.

In May 2017, WHO released Preventing drowning: an implementation guide. This publication builds on the Global report on drowning and provides concrete guidance for drowning prevention practitioners on how to implement drowning prevention interventions.

At country level, WHO has worked with Ministries of Health in some low- and middle-income countries to prevent drowning through the use of barriers controlling access to water and the establishment of day care centres for pre-school children. In addition, WHO has also funded research in low-income countries exploring priority questions related to drowning prevention. At a regional level, WHO organizes training programmes and convenes workshops to draw together representatives of governments, NGOs and UN agencies working on drowning prevention.


(1) Mortality data for countries were considered if they met the following criteria: estimated coverage of national deaths of 70% or more; ill-defined causes of death less than 20%; 10 or more deaths in the 1–14 year old age group; and data available from 2007 or later.

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The artificial intelligence uses frame by frame comparison to detect an object that was not previously there or the disappearance of an object from the field of view.  It learns what ‘normal’ looks like and spots differences.  In ‘Supervised’ mode, alerts to objects such as pool toys or outdoor furniture being moved will be suppressed to avoid false alarms.  When you leave the pool area a new ‘normal’ is established.

By using a combination of two cameras, one to identify individuals as they enter the designated area and the other to monitor the whole area, the artificial intelligence can keep track of an identified individual for as long as they remain within the field of view.  Both cameras are connected to the same processor so the first can pass the identity to the second, allowing the second to continue showing the identity of the individual even when their face is not visible to the camera.

In case you are concerned about privacy, be assured that nobody sees the feed from your camera unless an emergency is detected and not acknowledged locally.  Instead, the artificial intelligence identifies key points on the human body such as shoulders, elbows, wrists, hips, knees and ankles.  It uses the relative position of these key points to determine the pose of the body and has been trained to recognise poses that indicate danger. 

‘Supervised’ mode is designed for use when swimming is planned, with a responsible adult present.  It won’t bother you with constant alerts as people enter the area but the system will still raise the alarm if someone disappears underwater for longer than you have deemed acceptable. 

We strongly encourage use of a Pool Angel lanyard during such sessions so that there is no doubt over who has assumed responsibility for keeping watch over children in the pool.  Child drownings can happen even with multiple adults present if they all assume that someone else is paying attention.  Pool Angel offers you an added layer of protection; by comparing the number of people detected frame by frame, the artificial intelligence can spot when someone is missing and raise the alarm.    

Because the artificial intelligence can learn from experience it can learn to tell the difference between your pet and local wildlife that might encroach on your pool area.  This means that you can keep your pets safe without being disturbed by false alarms during the night when animals may encroach on your pool area; although you might be intrigued to view clips of your nocturnal visitors in the morning.  A short video clip is stored each time something is detected.

If an adult is detected in the pool area the system will alert you and prompt you to switch to ‘Supervised’ mode if you haven’t already done so.  This mode is designed for planned use of the pool and will suppress alerts to entry and exit from the pool area.  When the last adult leaves the area the system detects that too and prompts you to switch back to keeping watch over the empty pool.  An emergency alarm is raised if the departure of that adult leaves an unsupervised child in the pool area.

Although we refer to the boundary around a swimming pool, the camera can be used to keep watch over any boundary you designate. It can keep watch over a trampoline, climbing frame, the tool shed, any area that could present a danger to unsupervised children. By comparing what was present in a previous frame with what is currently in frame, the artificial intelligence can detect the arrival of something or someone new in the designated area.