Study identifies scenarios that precede at-home pool drownings of young children

Very young children who live in a home with a swimming pool are at risk of drowning, a leading cause of injury death among toddlers. A study abstract presented Monday, Oct. 17, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Boston identifies three likely scenarios that precede the drowning of a very young child (ages 1 to 4) in an at-home swimming pool.

In the study, "Patterns of Drowning in Young Children," researchers reviewed Orange County, Calif., Coroner data from 2000 to 2007 to examine the circumstances prior to an at-home pool drowning, in the hopes of crafting messages to prevent future deaths. Information on 46 drownings was reviewed, including incident site, barriers and pool access, supervision, emergency preparedness and response, and family/social history.

In general, more of the younger children (ages 1 and 2) were last seen in the house prior to the drowning (67 percent), while the older children (ages 3 and 4) were more often last seen in or near the water (69 percent). In addition, three specific patterns emerged:

• A 1- or 2-year-old child who was last seen in the house, most often under the supervision of a parent or caregiver who was distracted with household or childcare activities, or in a changed daily routine
• A 3- or 4-year-old child who was in or near the water just prior to drowning
• A 1- or 2-year-old child last seen outside, often with more neglectful supervision and environments

"Most of the 1- to 2-year-olds were able to access the pool without the adult supervisor realizing it. That's why pool fencing is critical," said lead study author Phyllis Agran, MD, FAAP. Any home pool should have a four-sided fence with a self-closing, self-latching gate in good condition, which is never left open.

"When in the pool or playing outside around the pool, hands-on supervision is necessary," Dr. Agran said. "Older children who drown were more often outside with inadequate supervision." Dr. Agran also said that parents may overestimate their child's abilities to be safe around water. Teaching children water safety and to swim will also help to reduce risk.

"First and foremost, however, is pool fencing so children cannot gain access to the pool by themselves," said Dr. Agran. If possible parents should not have a home with a swimming pool in the yard until the child is older than 5 years.