Toddler Drowning In Backyard Swimming Pools

   Drowning immersion is the most common cause of accidental death for toddlers (0-5 years). Private swimming pools represent the single most dangerous water environment for toddlers. Eighty percent of immersions among 0-4 year olds in water have been reported to occur in backyard swimming pools.

   The NSW Swimming Pools Act 1990 required all new swimming pools to be fenced in isolation from the home, existing pools were required to have isolation fencing by 1 August 1992. This legislation was reversed and in 1992 all new swimming pools were required to have isolation fencing from the home and all pools built prior to 1990 required only perimeter fencing with appropriate door and window locks.

Factors Associated With Drowning

Age

   The peak age for swimming pool drowning is two years of age and males out-number females. After the age of four years the most significant risk of drowning has passed. The relative risk of drowning for children 0-4 years is six times that of children aged 5-14 years.

Exposure to risk

   Households with newly built swimming pools and those commencing residency with an existing pool within 6 months are at a higher risk than other households. Current (1995) estimates are that one in nine Australian households have a water filled pool within the perimeter of the home allotment, for at least several months of each year. Based on ABS data on separate dwellings and swimming pools the data indicates that there were around 650,000 pools in Australia in 1997.

   In 1991 there were 250,000 estimated swimming pools in NSW. Using an estimated increase of three percent (3%) per year the expected number of swimming pools in 1999 in NSW would be around 326,000.

Toddler Drowning 0- 5 Years

   From June 1997 to June 1998 in NSW there was a dramatic increase in drowning deaths of children aged 0-5 years with 20 recorded. Of those 16 occurred in private swimming pools or baths and the overwhelming feature of these tragedies was the lack of adult supervision.

   Drowning in baths accounted for 40% of deaths in the 0-5 year age group. 87.5% of children who drowned in the bath were not being supervised by an adult. Of those 62.5% of children who drowned were placed in the bath with a sibling under the age of five years.

   Drownings in private swimming pools also accounted for 40% of deaths in the 0-5 age group. In each case the child was not supervised by an adult. Family residences accounted for 62.5% of pool drownings while 25% were in neighbourhood pools and 12.5% were pools in other locations. In the majority of cases the pool was fenced but Police Reports noted 37.5% of pool fencing/gates had some form of fault.

   There is insufficient information on the circumstances of drowning in private swimming pools, although supervision is regarded as a major factor. NSW Health Department is supporting a pilot study on a Near Drowning Register for 0-5 year olds. This is being conducted within the New Children’s Hospital, Westmead which will investigate near drownings to determine the factors and circumstances of the incident.

   It is imperative that all fences and gates are kept in good repair as this is also a major factor in drownings and near drownings of toddlers in backyard swimming pools.

   Statistical information has been extracted from 1997/98 Report on Deaths by Drowning in NSW, The Royal Life Saving Society Australia NSW Branch. Further information can be obtained from the RLSSA, telephone:61-02- 9879 4699

PREVENTION STRATEGIES:

Backyard swimming pools

   The commonly accepted counter measures to prevent drowning in backyard swimming pools are the provision of an effective safety barrier; public education to increase awareness of potential dangers; and teaching toddlers to swim in ‘drown proofing‘ programmes.

Public media education

   High media exposure to the issue provides significant protective benefit during the time of exposure. This strategy needs to be ongoing as new parents are unaware of the risk of drowning in backyard swimming pools.

Supervision

   The public needs to be reminded of the necessity to supervise children irrespective of whether the pool is fenced. The lack of parental surveillance has been identified as one of the most important causes of childhood immersions, and yet it is acknowledged that children cannot be supervised at all times.

Teaching children to swim

   It is commonly claimed that it is important for the Government and councils to make it easy for children to learn how to swim, by providing classes throughout the year. This is highly successful in school aged children where drownings have been dramatically reduced by application of school vacation swimming classes. Swimming instruction however, is not a guarantee against drowning.

Resuscitation

   Prompt resuscitation will save lives. Many authors regard fencing swimming pools and first aid training for swimming pool owners as one of the highest preventative measures in the prevention of mortality from near drowning incidents.

Pool isolation fences

   A 1.2 m fence of suitable construction with a child-proof latch can effectively exclude at least 80% of children under four years of age. The evidence available on compliance in maintenance of gates and fences shows that about 50 per cent of fences are not properly maintained. Forty four percent of drownings occurred in nominally fenced pools in which the fencing was not functioning because the gate was open or the fencing was in disrepair. If all fences were properly installed and maintained, it is claimed that up to 88% of toddler drownings could be potentially eliminated.

   Older pools present the greatest danger to toddlers because they are not required to have a pool fence between the house and the pool and the access point to the pool from the house is often poorly protected. These houses with pools and without isolation fencing may be sold to families with young children in the future.

Gate latches

   The most common problem with immersion incidents was related to having a faulty self-locking, self-closing mechanism, thereby making the fence an ineffective safety barrier. A Brisbane study showed that access was gained through a gate or fence that was faulty, or had been propped open or the child had gained access with the assistance of a parent. Section 12 of the Swimming Pools Act imposes a requirement to keep a pool gate closed. A significant secondary problem is maintaining gate function according to the Australian Standard once the fence has been installed.

Property perimeter fences

   Perimeter fencing has been reported to address less than 3% of child drowning cases, since over 97% of drownings examined in one study were already on the property as either residents or guest. A NSW Department of Health Survey conducted in 1991 suggested that as many as one in four toddlers are exposed to a non-isolated pool at least once a year. It found that 75% of pool owners without isolation fencing had toddler visitors at least a few times a year.

Surveillance of drownings and near drownings

   Continued surveillance of immersion data is essential for the critical evaluation of preventive measures. The lack of a detailed ongoing childhood injury data base has been a major impediment to such surveillance. The Review Group (Swimming Pools Fencing Legislation) together with other investigatory bodies recommended that suitable monitoring needs to be undertaken to provide a register of drowning and immersions. The appropriate body to conduct and maintain the register was suggested to be the Department of Health. The New Children’s Hospital Westmead and the NSW Department of Health are conducting a pilot study and register of near drownings in backyard swimming pools for children 0-5 years of age.

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