Original Article

Understanding Trends in Pediatric Drowning Injuries in North Carolina

Authors: Maura Olcese, MD, MPH, Anna E. Waller, ScD

Abstract

Objective: Drowning is a leading cause of injury-related death in the pediatric and adolescent population. This epidemiologic study describes the trends in emergency department (ED) visits for pediatric drowning injury in North Carolina and the impact of the coronavirus disease 2019 (COVID-19) pandemic on incidence rate.

Methods: Data were obtained using the North Carolina Disease Event Tracking and Epidemiologic Collection Tool, a public health surveillance system, to identify ED visits for drowning injury from 2016 to 2022. We performed a chart review on a subset of patients to further characterize injury.

Results: A total of 1285 ED encounters were identified. In North Carolina, the incidence rate of pediatric drowning has been decreasing, abruptly in 2019 and again in 2020. The postpandemic rate continued in the same downward trend, suggesting that the COVID-19 pandemic did not affect the overall statewide incidence rate of pediatric drowning (P = 0.14). The age distribution of children treated in the ED for drowning injury in North Carolina changed following the pandemic.

Conclusions: This study is limited by the fortunate rarity of pediatric drowning events. Injuries may be underreported because these are only ED presentations. This study relied on provider documentation in electronic health records. The definition of postpandemic is not well defined, and sequelae of the COVID-19 pandemic may not yet be fully appreciated. The incidence of North Carolina ED encounters for drowning injury in the pediatric population has decreased, and the COVID-19 pandemic had a noticeable, although not statistically significant, effect.

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References

1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). https://wisqars.cdc.gov/. Accessed June 21, 2022.
 
2. Denny SA, Quan L, Gilchrist J, et al. Prevention of drowning. Pediatrics 2021;148: e2021052227.
 
3. Migliaccio D. Pediatric drowning. https://www.reliasmedia.com/ext/resources/newsletters/t/TR/2021/03/TR030121pdf.pdf?1612371331. Published March/April 2021. Accessed June 21, 2022.
 
4. Loux T, Mansuri F, Brooks SE, et al. Factors associated with pediatric drowning admissions and outcomes at a trauma center, 2010–2017. Am J Emerg Med 2021;39: 86–91.
 
5. Webb AC, Wheeler A, Ricci A, et al. Descriptive epidemiology of pediatric drowning patients presenting to a large southern US children’s hospital. South Med J 2021;114: 266–270.
 
6. Felton H, Myers J, Liu G, et al. Unintentional, non-fatal drowning of children: US trends and racial/ethnic disparities. BMJ Open 2015;5:e008444.
 
7. Umapathi KK, Dhanpalreddy H, Thavamani A, et al. Incidence trends and predictors of in-hospital mortality in drowning and submersion in children and adolescents in the United States: a national inpatient database analysis. Clin Pediatr (Phila) 2020;59: 134–141.
 
8. Yang T. Pool or spa submersion: estimated nonfatal drowning injuries and reported drownings, 2023 report. https://www.poolsafely.gov/wp-content/uploads/2023/06/Pool-or-Spa-Submersion-Estimated-Nonfatal-Drowning-Injuries-and-Reported-Drownings-2023-Report.pdf. Published May 2023. Accessed September 27, 2023.
 
9. Bierens J, Abelairas-Gómez C, Furelos RB, et al. Resuscitation and emergency care in drowning: a scoping review. Resuscitation 2021;162:205–217.
 
10. Theodorou CM, Rajasekar G, McFadden NR, et al. Epidemiology of paediatric drowning hospitalisations in the USA: a population-based study. Inj Prev 2022;28:148–155.
 
11. Mansuri F, Loux T, Brooks SE, et al. Temporal trends in patient characteristics, injury mechanisms and outcomes in pediatric trauma admissions between 2010 and 2017. Am J Surg 2020;220:468–475.
 
12. Semple-Hess J, Campwala R. Pediatric submersion injuries: emergency care and resuscitation. Pediatr Emerg Med Pract 2022;19(6 Suppl):1–46.
 
13. Conover K, Romero S. Drowning prevention in pediatrics. Pediatr Ann 2018;47:e112–e117.
 
14. Brenner RA, Taneja GS, Haynie DL, et al. Association between swimming lessons and drowning in childhood: a case-control study. Arch Pediatr Adolesc Med 2009;163:203–210.
 
15. Petrass LA, Blitvich JD. Preventing adolescent drowning: understanding water safety knowledge, attitudes and swimming ability. The effect of a short water safety intervention. Accid Anal Prev 2014;70:188–194.
 
16. Wallis BA, Watt K, Franklin RC, et al. Interventions associated with drowning prevention in children and adolescents: systematic literature review. Inj Prev 2015;21:195–204.
 
17. NC State Center for Health Statistics, "North Carolina Population Estimates" using NCHS Bridged population data Data. https://schs.dph.ncdhhs.gov/interactive/query/population/nchspop.cfm. Accessed July 7, 2024.
 
18. American Academy of Pediatrics. Drowning prevention for curious toddlers. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Water-Safety-And-Young-Children.aspx. Published 2023. Accessed October 15, 2024.