Beneath the Surface: A Retrospective Analysis of Pediatric Drowning Trends & Risk Factors in Quebec

Abstract

Purpose

Despite the known importance of water safety, and recent efforts to enact pool safety legislation, drowning remains a leading cause of unintentional injury death in Canada. To date, little is known about the rates of pediatric drownings in Québec, the severity of these drownings, and the trends associated with the adoption of provincial regulations of pool enclosures – legislation which has been delayed twice, and remains to be fully enacted. This study aims to assess these knowledge gaps.

Methods

Retrospective observational study of all provincial pediatric drownings from January 1, 2017 to December 31, 2021. Three databases were accessed and subsequently analysed using descriptive statistics to identify trends and risk factors in the data, categorized by drowning severity (emergency room visits, hospitalizations, deaths).

Results

Throughout the study period, 655 drowning events were identified (an average of 92 ER visits, 29 hospitalizations, and 10 deaths, per year). Drownings were most prevalent in pools, and among children aged 1–4 (Table 1). The highest number of drownings occurred in 2020, possibly linked to the COVID-19 pandemic. Drowning events peaked in summer months, averaging 1 per day. The presence of safety features such as enclosures, or the presence of an accompanying individual was uncommon among drowning deaths.

Conclusion

Our results illustrate that younger children, particularly those aged 1–4, are at greatest risk of drowning events. Drowning deaths occurred most commonly in the absence of safety features, indicating an opportunity for improved drowning prevention education, and enforcement of evolving enclosure legislature to improve water safety.

Level of Evidence

Level 2 (prospectively collected data, retrospective analysis).