School of Applied Psychology, Griffith University, Brisbane, Australia.
School of Psychology and Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia.
Drug Alcohol Rev. 2018 Sep;37(6):752-773. doi: 10.1111/dar.12817. Epub 2018 Jun 3.
Drowning is a global public health issue, and there is a strong association between alcohol and risk of drowning. No previous systematic review known to date has identified factors associated with alcohol use and engagement in aquatic activities resulting in injury or drowning (fatal and non-fatal).
Literature published from inception until 31 January 2017 was reviewed. Included articles were divided into three categories: (i) prevalence and/or risk factors for alcohol-related fatal and non-fatal drowning and aquatic injury, (ii) understanding alcohol use and aquatic activities, and (iii) prevention strategies. Methodological quality of studies was assessed using National Health and Medical Research Council (NHMRC) Level of Evidence and risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scales.
In total, 74 studies were included (57 on prevalence and/or risk factors, 15 on understanding alcohol use, and two on prevention strategies). Prevalence rates for alcohol involvement in fatal and non-fatal drowning varied greatly. Males, boating, not wearing lifejackets, and swimming alone (at night, and at locations without lifeguards) were risk factors for alcohol-related drowning. No specific age groups were consistently identified as being at risk. Study quality was consistently low, and risk of bias was consistently high across studies. Only two studies evaluated prevention strategies.
There is a need for higher quality studies and behavioural basic and applied research to better understand and change this risky behaviour.
On average, 49.46% and 34.87% of fatal and non-fatal drownings, respectively, involved alcohol, with large variations among studies observed.
溺水是一个全球性的公共卫生问题，酒精与溺水风险之间存在很强的关联。迄今为止，尚无已知的先前系统评价确定与酒精使用以及导致受伤或溺水（致命和非致命）的水上活动相关的因素。
综述了截至 2017 年 1 月 31 日出版的文献。纳入的文章分为三类：（i）与酒精相关的致命和非致命溺水和水上伤害的流行率和/或危险因素，（ii）理解酒精使用和水上活动，以及（iii）预防策略。使用国家卫生和医学研究委员会（NHMRC）的证据水平评估研究的方法学质量，并使用纽卡斯尔-渥太华质量评估量表评估偏倚风险。
共纳入 74 项研究（57 项关于流行率和/或危险因素，15 项关于理解酒精使用，2 项关于预防策略）。涉及酒精的致命和非致命溺水的流行率差异很大。男性、划船、不穿救生衣和独自游泳（夜间和没有救生员的地方）是与酒精相关的溺水风险因素。没有确定哪些特定年龄组始终处于风险之中。研究质量普遍较低，研究之间的偏倚风险普遍较高。只有两项研究评估了预防策略。
需要更高质量的研究和行为基础及应用研究，以更好地理解和改变这种危险行为。
平均而言，致命溺水和非致命溺水分别有 49.46%和 34.87%涉及酒精，观察到研究之间存在很大差异。
