Prevention of childhood drowning accidents.

The data from the Brisban Drowning Study have been analysed in this article to provide guidelines for preventive strategies. The separate causal links comprising the drowning chain have been identified, and quantitative scores have been assigned to the three identifiable groups of causative factors--environmental, parent-related and victim-related. The identifiable causes of child drowning are absence of a safety barrier or fence around the water hazard, non-supervision of a child, a parental "vulnerable period", an inadequate safety barrier, and tempting objects in or on the water. Effective environmental control can be achieved only through legislation. The complementary role of a public educational thrust in discussed. Increasing the tempo of "drownproofing* and of teaching children to swim will help, but the expected reduction in deaths and near-deaths from this strategy alone cannot yet be assessed. Compulsory first aid training for pool owners is required. Costs of implementing a total drowning preventive programme are presented.