The Truths and Myths about Drowning

Do drownings and injuries occur because parents are neglectful and are not supervising their children?

No. Most injuries happen when at least one adult is at home. The adult usually assumes the child is safely away from the pool in the home. When two adults are present, each person believes the other is supervising the child. Once the parent realizes the child is missing, the last place searched is the pool. When children are around the water someone should be assigned as the Water Watcher.

Won’t early swimming instruction prevent drowning or near drowning?

No. Most water safety experts from the American Academy of Pediatrics and the American Red Cross recommend that swimming instruction should start in the 4- to 5-year old age group. Earlier instruction is poorly retained. Toddlers don’t reason well enough to respond to an emergency or have the strength the show water competancy. These toddlers don’t understand the dangers of deep water any more than they recognize the dangers of an unprotected stairway or open window

Swimming instruction is one layer of protection and are not a substitute for safety barriers (which have been the most studed to show evidence of benefit).

Why should homes without children be required to install fencing or other safety barriers?

There are very few households where children never visit. These adults are not prepared for the constant challenge that young children place on their surroundings – such as climbing, pushing and testing. Also, it is not possible to supervise children every second, so extra safety measures are essential. For example, you can use safety fencing, separating the home and the pool, alarm devices alerting the adult about children leaving the home or self-closing and self-latching sliding doors, gates or safety pool covers.

Established safety standards must be implemented in order to protect everyone.

Do safety measures work?

Yes, there have been many studies done that evaluated the effectiveness of safety fencing. The results show a 50% to 80% reduction in injuries.

Most fencing and other safety barriers are expected to work best on children 4 years old and younger.

Unfortunately, virtually all fatal drownings and non-fatal drownings occur because there is easy access directly from the family home to the family pool, so peripheral yard fencing is inadequate to protect the young child at risk for drowning.

The Pool Barrier Law

In the fall of 1996, the Governor signed legislation that went into effect, requiring increased standards for every community in California. Unfortunately updates to that first legislation have created options that don’t have the same level of study to show benefits. Alarms, covers, and new technology may have some benefits, but there are not enough studies to prove reliability in comparison to approved fencing. Current state codes require that one of these choices be implemented for any new pool 18 inches deep or more constructed after January 1, 1997:

1. 60-inch tall fences separating the home and pool;

2. Alarm devices alerting the pool owner of passage through doors leading to the pool; or

3. Manual or automatic pool covers.

Each one of these options must meet certain minimum standards described in the Assembly Bill 3305.

Analysis Association Between Swimming Lessons and Drowning in Childhood: (see reference below):

1. Sample Size and Statistical Precision: The estimate of an 88% reduction is based on a relatively small sample size, particularly in the 1- to 4-year-old age group. Only 2 of the 61 drowning cases (3%) in this group had taken formal swimming lessons, compared to 35 of the 134 controls (26%). The adjusted odds ratio (OR) of 0.12 (interpreted as an 88% reduction in drowning risk) comes with a wide 95% confidence interval (CI) of 0.01 to 0.97. This means the true reduction could range from as low as 3% to as high as 99%, reflecting a high degree of uncertainty.

 2. Potential Selection Bias: The study only interviewed the families of 38% of the identified drowning cases for the 1- to 4-year-old group and 26% for the 5- to 19-year-old group. This low participation rate could introduce bias, as the families who chose to participate may differ in important ways from those who did not【5†source】.

 3. Confounding Variables: Several confounders, such as race, income, education, and risk-taking behavior, were associated with drowning risk. Although the study adjusted for these factors in its analysis, it’s possible that other unmeasured confounders may have influenced the results. Additionally, swimming ability itself was not considered a confounder, despite its potential influence on drowning risk.

 4. Limitations in Generalizability: The study focused on specific jurisdictions in the U.S., meaning the results may not be generalizable to other regions or countries with different environments, water exposure patterns, or swimming lesson programs. Additionally, the study excluded certain drowning scenarios where swimming ability would not have played a role (e.g., drownings in bathtubs or ice water), which may have affected the representativeness of the sample.

 5. Formal vs. Informal Instruction: The study did not find a significant protective effect for informal swimming instruction, and the results for older children (5-19 years) were also not statistically significant. This suggests that the observed protective effect may be more limited to certain contexts, or the impact of swimming lessons may not be as strong as the headline figure suggests.

 These points suggest that while swimming lessons are beneficial, the precise extent of their protective effect is uncertain and may not be as large or as universally applicable as the 88% figure suggests.

 NIH Article Swimming Lessons and Drowning in Childhood (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151293/)

Last Updated 9/19/2024