Most of us are drawn to water. It sparkles, things float in it and it is fun to splash around in, especially on a hot summer's day. Many people do not realise, however, that a person can drown in as little as four millilitres of water per kilogram of body weight. In South Africa drowning is one of the top five causes of unnatural death among children under 15 years of age and for every child that dies from drowning, five are left with permanent brain damage as a result of the prolonged lack of oxygen which occurs during a near drowning. It takes only four minutes without oxygen for irreversible brain damage to occur. With the summer months fast approaching it is imperative to transform this serious public health issue from one that is often neglected, to one that is addressed by national, regional and global programmes.
To add to the overall understanding of the problem and to identify possible patterns or trends in drowning deaths, Prof Gert Saayman, Head of the Department of Forensic Medicine at the University of Pretoria (UP), along with Dr Lorraine du Toit-Prinsloo and Mr Neil Morris, both also from the Department, conducted a ten-year review of the institutional records at the Pretoria Medico-Legal Laboratory (PMLL). Their study involved the retrospective review of a total of 346 drowning cases from January 2002 to December 2011, and included the records of cases admitted as probable/possible drowning deaths, as well as all cases that presented as (deceased) bodies retrieved from water, cases where resuscitation had been applied/attempted at the site of immersion and cases where a person who suffered immersion had been admitted to hospital but did not survive. The results were published in the Journal of Forensic and Legal Medicine.
The team found that, overall, children accounted for more than half (152 – 55%) of the cases examined. This number comprised 41 (15%) infants (children younger than one year of age), 52 (19%) toddlers (aged 1–2 years), 49 (18%) young children (aged 2–13 years) and 10 (3%) adolescents (aged 13–18 years). Adults (above 18 years) accounted for 126 (45%) of the cases.
The team also correlated the place of drowning with the age groups of victims and found that the majority of children drowned in swimming pools. Seven infant drownings were in buckets. The adult drownings occurred mostly in swimming pools, rivers and dams. Eleven adults drowned in bath tubs, of whom six were known to be epileptics, two had underlying cardiac pathology and in one case prescription medication may have played a predisposing or contributory role. Post mortem blood alcohol analysis was undertaken in 113 cases and alcohol was detected in 48 (42%) of these samples – with 40 cases (35%) having blood alcohol concentrations in excess of 0,05 g per 100 ml.
According to the UP team that undertook this study, many drowning deaths may be preventable by introducing greater public awareness of the risks involved and instituting relatively simple, protective measures such as encouraging people to always keep a watchful eye on young children around water and limiting access to swimming pools through fences and pool nets.