Social and environmental risk factors for the accidental drowning of children under five in China
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RESEARCH ARTICLE
Open Access
Social and environmental risk factors for the accidental drowning of children under five in China Meixian Wang1†, Yuxi Liu2†, Leni Kang2, Chunhua He2, Lei Miao2, Jianwen Huang3, Xiaoyan He4, Jun Zhu1,2, Juan Liang2, Qi Li2, Yanping Wang2*† and Hanmin Liu1,5*†
Abstract Background: Accidental drowning of children under five is a serious problem in China. The present study analyzed data on environmental and sociodemographic factors and on primary caregivers of drowned children to understand factors that may contribute to this problem. Methods: The present study collected information on 563 cases of drowning in children under five from October 1, 2015, to September 30, 2016, in 334 sampling districts in China. Primary caregivers were interviewed individually using the Drowning Mortality among Children under 5 Questionnaire. Results: Most drowned children under 5 years old were boys, and 71.6% lived within 100 m of a body of water. The drownings primarily occurred in ponds, canals, rivers, and wells, and over 90% of these water bodies had no safety measures. There were 28.1% of primary caregivers who did not provide full-time care for the children, and 83.1% of them had no knowledge of first aid skills for drowning. Conclusion: Encouraging kindergarten enrollment and providing safety education for children may reduce drowning in children under 5 years of age. Public water body protection measures should be strengthened to prevent children from drowning. Encouraging primary caregivers to care full-time for the children and learning first aid skills for drowning may also help reduce fatalities. Keywords: Accidental drowning, Risk factors, Children, China
Background Drowning is a serious contributor to mortality and disability. With nearly 372,000 deaths reportedly due to drowning each year worldwide, it is a leading cause of child mortality [1]. Drowning that does not end in death * Correspondence: [email protected]; [email protected] † Meixian Wang, Yuxi Liu, Yanping Wang and Hanmin Liu contributed equally to this work. 2 National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China 1 Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Chengdu, China Full list of author information is available at the end of the article
may lead to cognitive difficulties, hypoxic-ischemic brain injury, cardiac abnormalities, and adult respiratory disease syndrome later in life [2–4]. Although the mortality rate due to drowning is decreasing [5], the associated economic burden remains significant. For example, the combined effects of fatal and nonfatal drowning in 2017–2018 cost 1.47 billion AUD (over 7.1 billion Chinese renminbi) [6]. Drowning is the main cause of accidental deaths in children worldwide under 5 years of age [7]. As the world’s largest developing country, China has a large population and abund
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