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Notice to Readers: Drownings in Recreational Water Settings

Memorial Day marks the beginning of the swimming and boating season. Drowning is a leading cause of unintentional injury death for persons of all ages and is the second leading cause of death from injury among persons aged 1--14 years (1). Many of these deaths occur in recreational water settings, including pools, spas/hot tubs, and natural water settings (e.g., lakes, rivers, or oceans). During 2003, a total of 3,386 deaths were attributed to unintentional drowning in recreational water settings (2). During 2001--2002, an estimated 4,174 persons on average per year were treated in U.S. hospital emergency departments for nonfatal unintentional drowning injuries* in recreational water settings (3); approximately 53% of these persons required hospitalization or transfer for more specialized care. Fatal and nonfatal drowning rates were highest for children aged <4 years and for males of all ages; 50% of fatalities and 56% of nonfatal drownings occurred during June--August. Among children aged <4 years, 50% of fatalities and approximately 80% of reported nonfatal injuries occurred in swimming pools; both fatal and nonfatal drownings in natural water settings increased with age.

To reduce the number of drownings, environmental protections (e.g., isolation pool fencing, weight-bearing pool covers, and lifeguards) should be adopted. Alcohol use should be avoided while swimming, boating, or water skiing or while supervising children; all participants, caregivers, and supervisors should be knowledgeable regarding water-safety skills and be trained in cardiopulmonary resuscitation (CPR) (4). Additional CDC recommendations to prevent drowning have been published previously (3). Other agencies and organizations promoting water safety include the Consumer Product Safety Commission (, Safe Kids Worldwide (, and the National Drowning Prevention Alliance (


  1. CDC. Web-based Injury Statistics Query and Reporting System (WISQARS™). Atlanta, GA: US Department of Health and Human Services, CDC. Available at
  2. Hoyert DL, Heron M, Murphy SL, Kung HC. Deaths: final data for 2003. Natl Vital Stat Rep 2006;54(13).
  3. Gilchrist J, Gotsch K, Ryan G. Nonfatal and fatal drownings in recreational water settings---United States, 2001--2002. MMWR 2004;53:447--52.
  4. Quan L, Branche C. Interventions to prevent drowning [chapter 5]. In: Doll L, Bonzo S, Mercy J, Sleet D, eds. Handbook of injury and violence prevention. New York, NY: Springer. In press 2006.

* In 2002, for statistical purposes, the World Congress on Drowning created the following definition for drowning: "the process of experiencing respiratory impairment from submersion/immersion in liquid." This definition is used by the World Health Organization and the National Center for Injury Prevention and Control at CDC, both of which categorize drownings as fatal (i.e., resulting in death) or nonfatal (i.e., not resulting in death).

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