Global, regional, and national drowning trends from 1990 to 2021: Results from the 2021 Global Burden of Disease Study.

Background: Drowning is a preventable public health concern that burdens emergency care systems globally. This study comprehensively evaluated fatal drowning patterns across population, time, and geography from 1990 to 2021 to inform effective prevention strategies.

Methods: Using the 2021 Global Burden of Disease Study framework and standardized estimation methods, the study analyzed global and regional drowning burden in terms of mortality, incidence, and disability-adjusted life-years (DALYs), based on population registry data and drowning-related epidemiological covariates.

Results: Global drowning incidents decreased by 33.67% from 1990 to 2021. The drowning incidence rate and mortality rate declined from 24.20 and 9.68 per 100,000 in 1990 to 10.85 and 3.48 per 100,000 in 2021, respectively. Years of life lost and DALYs rates due to drowning also decreased significantly, from 715.80 and 718.69 per 100,000 in 1990 to 197.64 and 198.92 per 100,000 in 2021. Regionally, East Asia had the highest drowning mortality (27.15% of global deaths), while the high-income Asia Pacific region experienced the highest incidence rate (21.38 per 100,000). South Asia had the greatest number of drowning deaths (75,639). Tropical Latin America showed the largest incidence decline, while high-income Asia Pacific exhibited increasing trends. Drowning disproportionately affected children under 5 and the elderly in most regions.

Conclusions: While global drowning rates have declined, progress varies across regions. To improve prevention, focus should target low-income/middle-income countries and vulnerable populations like children and the elderly. Increased investment in safety education and rescue resources is vital to address their disproportionate risks.