| Popis: |
Background Red Cross implemented a national surveillance database as a basis for water safety. Collaboration involved public health, provincial coroners, and water-safety organizations. Incidence and circumstances have been monitored since 1991. Abstraction from coroner data by many volunteers has provided a basis for reports and programs. Objective Red Cross data are structured by activity and risk factors to guide child safety, swimming, and boating programs. The objective was to use trends analysis to identify categories of water-related deaths with major, minor, and no improvement during 1991–2014, as a guide to policy. Methods Structured reviews of coroner reports were by questionnaire. Cause, activity, purpose, personal, equipment, and environment factors are documented. Trends were assessed by negative binomial (n=8) and Poisson (n=1) regression, for 758.5 million person-years of life lost to immersion. Variance and means were examined for dispersion to determine the most appropriate model. Findings Publicity and surveillance-based programs began in the early 1990s. Multisectorial reductions in incidence were major for toddler, boating, falls into water, cottage, and land/ice/air transport deaths, moderate for aquatic activities and epilepsy, and none for home and bathing. Major improvement in immersion deaths: Toddlers 1–4 year-olds (n643): −88% (p 0.000) Boating (n3452): −66% (p 0.000) Falls into water (n2175): −53.2% (p 0.000) Cottage deaths (531): −57.4% (p 0.000) Land, ice and air transport (1761): −43.4% (p 0.000) Moderate improvement in immersion deaths: Aquatic (n2647): −24% (p 0.000) Epilepsy/seizure associated (n612): −24% (p 0.008) No improvement in immersion deaths Home (n2093): ns (p 0.833) Bathing (n905): ns (p 0.457). Conclusion and policy implications Trends in categories of drownings are helpful in assessing effectiveness of interventions. As a subsequent step, other variables for categories can be explored in detail. In illustration, for toddler submersions further assessment showed one province with no improvement, indicating a need for new provincial policy. |
