University of Washington School of Medicine, Seattle, USA.
Inj Prev. 2011 Feb;17 Suppl 1:i28-33. doi: 10.1136/ip.2010.026849.
Drowning is second cause of paediatric injury death in Washington State. Child death review (CDR) data provide the unique opportunity to identify regional risk factors and opportunities for drowning prevention.
CDR teams' data for drowning deaths of children <18 years between 1999 and 2003 were analysed for victim and event characteristics, and existing prevention/protective factors. A working group made data driven recommendations. Subsequent interventions were noted.
Drowning death rates were significantly higher among Asian Pacific Islander children (3.3 per 100,000). Disproportionately, 32% of deaths involved families with prior child protective services (CPS) referrals. Most deaths (73%) occurred in open water; the proportion in open water increased from 42% of <5-year-olds, 83% of 5-9-year-olds, to 90% of 10-17-year-olds. Thirty per cent drowned at parks; 29% drowned in residential settings. Pre-drowning activity for 42% was swimming or playing in the water. Alcohol and drug use were low. Neglect/poor supervision was considered a factor in 68% (21/31) of the deaths of children <5 years of age. State CDR recommendations led to the development of a drowning prevention campaign targeted to an Asian American community, intra-agency changes resulting in reinstatement of lifeguard staffing and addition of lifejacket loaner programmes, collaboration with state commissions to enforce a state pool fencing ordinance, and model legislation prohibiting swimming in dangerous waterways.
CDR data collection and review process was an effective surveillance tool. It identified specific regional high risk groups and sites for drowning prevention and led to recommendations and implementation of effective local and state injury prevention interventions.
在华盛顿州，溺水是导致儿童受伤死亡的第二大原因。儿童死亡审查（CDR）数据为识别区域性溺水预防风险因素和机会提供了独特的机会。
对 1999 年至 2003 年期间 18 岁以下儿童溺水死亡的 CDR 小组数据进行了分析，以了解受害者和事件特征，以及现有的预防/保护因素。一个工作组根据数据提出了建议。随后注意到了干预措施。
亚太裔儿童的溺水死亡率明显更高（每 10 万人 3.3 人）。不成比例的是，32%的死亡涉及有先前儿童保护服务（CPS）转介的家庭。大多数死亡（73%）发生在开放水域；在 5 岁以下儿童中，这一比例为 42%，5-9 岁儿童为 83%，10-17 岁儿童为 90%。30%的溺水事件发生在公园；29%的溺水事件发生在住宅环境中。42%的溺水事件发生前的活动是游泳或在水中玩耍。酒精和毒品的使用较低。忽视/监督不力被认为是 68%（21/31）5 岁以下儿童死亡的一个因素。州 CDR 建议导致了针对亚裔美国社区的溺水预防运动的发展，机构内部的变化导致恢复了救生员的人员配备，并增加了救生衣出借计划，与州委员会合作执行州游泳池围栏条例，以及禁止在危险水道游泳的示范立法。
CDR 数据收集和审查过程是一种有效的监测工具。它确定了特定的区域性高风险群体和溺水预防地点，并提出了建议，并实施了有效的地方和州伤害预防干预措施。
