A focus on sex differences in drowning deaths in Australia: the need for reporting on sex and gender in drowning research

Kym Roberts1, Ogilvie Thom1, Susan Devine1, Peter A. Leggat1,2, Richard C. Franklin1
1College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
2School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Galway, Galway, Ireland

Tóm tắt

An evidence gap exists on sex and gender differences in drowning with previous research neglecting females. Drowning studies have largely focused on accidental drowning and submersion, excluding other classifications such as intentional, water transport-related, and undetermined drowning. This study examined all external causes of drowning deaths over a 13-year period in Australia disaggregated by sex. Drowning deaths were compared by sex with drowning classification, year, month, age, place of death, Indigenous status, socioeconomic, and visitor status. This retrospective total population study included all females and males who died from drowning in Australia from 2006 to 2019. Data was extracted from the Australian Bureau of Statistics Cause of Death Unit Record Files. Australian population data were extracted to calculate the crude death rate and relative risk for drowning. There were 4007 drowning deaths recorded, and females represented 25.2% of drowning fatalities. Females were less likely than males to drown, including by drowning classification, year, month, state, remoteness and visitor status, age, socioeconomic, and Indigenous status. The highest proportion of female drowning deaths were from intentional drowning, fall into swimming pools, and in natural water. Drowning deaths among females increased as age increased. There is a clear need for improved disaggregation of sex and gender in drowning research. Without the detailed exploration of females in drowning statistics there will be limited knowledge translation specific to females. The development of drowning prevention strategies targeted to females is required to reduce the incidence and risk of drowning.

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Australian Bureau of Statistics (2016a) Australian Statistical Geography Standard (ASGS): Volume 5 - Remoteness structure 17 October 2021. Available from: https://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/1270.0.55.005Main+Features1July%202016?OpenDocument. Accessed 18 Aug 2021 Australian Bureau of Statistics (2016b) Census of population and housing: Socio-Economic Indexes for Areas (SEIFA) Australia 2016 17 October 2021. Available from: https://www.abs.gov.au/ausstats/[email protected]/mf/2033.0.55.001. Accessed 18 Aug 2021 Australian Bureau of Statistics (2018) Socio-Economic Indexes for Areas (SEIFA) Technical paper. Report No. 2033.0.55.001. Available from: https://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/756EE3DBEFA869EFCA258259000BA746/$File/SEIFA%202016%20Technical%20Paper.pdf. Accessed 18 Aug 2021 Australian Bureau of Statistics (2019) Cause of death. Available from: https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/2019. Accessed 29 Aug 2021 Australian Bureau of Statistics (2021) National, state and territory population: Estimated resident population. Available from: https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/dec-2021#data-downloads-data-cubes. Accessed 18 Aug 2021 Bessereau J, Fournier N, Mokhtari T, Brun PM, Desplantes A, Grassineau D et al (2016) Epidemiology of unintentional drowning in a metropolis of the French Mediterranean coast: a retrospective analysis (2000-2011). Int J Inj Control Saf Promot 23:317–322. https://doi.org/10.1080/17457300.2015.1047862 Bierens J, Hoogenboezem J (2022) Fatal drowning statistics from the Netherlands – an example of an aggregated demographic profle. BMC Public Health 22:339. https://doi.org/10.1186/s12889-022-12620-3 Castelle B, Brander R, Tellier E, Simonnet B, Scott T, McCarroll J et al (2018) Surf zone hazards and injuries on beaches in SW France. Nat Hazards 93:1317–1335. https://doi.org/10.1007/s11069-018-3354-4 Centers for Disease Control and Prevention (2012) Drowning-United States, 2005-2009 Contract No.: 19. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6119a4.htm#:~:text=In%20the%20United%20States%2C%20an,department%20care%20for%20nonfatal%20drowning. Accessed 13 June 2020 Centers for Disease Control and Prevention (2020) Wisqars injury mortality report. Available from: https://www.wisqars.cdc.gov/fatal-reports. Accessed 18 June 2020 Claesson A, Krig A, Jonsson M, Ringh M, Svensson L, Forsberg S et al (2021) Incidence and characteristics of drowning in Sweden during a 15-year period. Resuscitation 162:11–19. https://doi.org/10.1016/j.resuscitation.2021.01.028 Clemens T, Tamim H, Rotondi M, Macpherson AK (2016) A population based study of drowning in Canada. BMC Public Health 16:1–8. https://doi.org/10.1186/s12889-016-3221-8 Coates L (2022) A flood of rain events: how does it stack up with the previous decade?: Risk frontiers [updated 05 July 2022] Available from: https://riskfrontiers.com/insights/flood-rain-events-decade-2011-2022/#:~:text=A%20total%20of%2048%20flood,to%20a%20flash%20flooding%20event. Accessed 15 Sept 2022 Dobson GP, Gibbs C, Poole C, Butson B, Lawton LD, Morris JL et al (2022) Trauma care in the tropics: addressing gaps in treating injury in rural and remote Australia. Rural Remote Health 22. https://doi.org/10.22605/RRH6928 El Sibai R, Bachir R, El Sayed M (2018) Submersion injuries in the United States: Patients characteristics and predictors of mortality and morbidity. Injury 49:543–548. https://doi.org/10.1016/j.injury.2018.02.012 Franklin RC, Peden AE, Hamilton EB, Bisignano C, Castle CD, Dingels ZV et al (2020) The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study. Inj Prev 26:i83–i95. https://doi.org/10.1136/injuryprev-2019-043484 Gahagan J (2016) Commentary on the new sex and gender editorial policy of the Canadian Journal of Public Health. Can J Public Health 107:e140–e141. https://doi.org/10.17269/CJPH.107.5584 Gahagan J, Gray K, Whynacht A (2015) Sex and gender matter in health research: addressing health inequities in health research reporting. Int J Equity Health 14:1–4. https://doi.org/10.1186/s12939-015-0144-4 Gaida FJ, Gaida JE (2016) Infant and toddler drowning in Australia: Patterns, risk factors and prevention recommendations. J Paediatr Child Health 52:923–927. https://doi.org/10.1111/jpc.13325 Gogovor A, Zomahoun HTV, Ekanmian G, Adisso EL, Tardif AD, Khadhraoui L et al (2021) Sex and gender considerations in reporting guidelines for health research: a systematic review. Biol Sex Differ 12:1–11. https://doi.org/10.1186/s13293-021-00404-0 Haw C, Hawton K (2016) Suicide and Self-Harm by Drowning: A Review of the Literature. Arch Suicide Res 20:95–112. https://doi.org/10.1080/13811118.2015.1025120 Heidari S, Babor TF, De Castro p, Tort S, Curno M (2016) Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use. Res Integrity Peer Rev 1:1-9. https://doi.org/10.1186/s41073-016-0007-6. Howland J, Hingson R, Mangione TW, Bell N, Bak S (1996) Why are most drowning victims men? Sex differences in aquatic skills and behaviors. Am J Public Health 86:93–96. https://doi.org/10.2105/AJPH.86.1.93 IBM Corp. (2019) IBM SPSS Statistics for Windows, Version 26.0. IBM Corp, Armonk, NY Keyes KM, Jager J, Mal-Sarkar T, Patrick ME, Rutherford C, Hasin D (2019) Is There a Recent Epidemic of Women's Drinking? A Critical Review of National Studies. Alcohol Clin Exp Res 43:1344–1359. https://doi.org/10.1111/acer.14082 Lunetta P, Penttila A, Sajantila A (2002) Drowning in Finland: ‘‘external cause’’ and ‘‘injury’’ codes. Inj Prev 8:342–344. http://injuryprevention.bmj.com/. Accessed 08 Sept 2022 Mazure CM, Jones DP (2015) Twenty years and still counting: including women as participants and studying sex and gender in biomedical research. BMC Womens Health 15. https://doi.org/10.1186/s12905-015-0251-9 McGrail MR, Humphreys JS (2015) Spatial access disparities to primary health care in rural and remote Australia. Geospat Health 10:138–143. https://doi.org/10.4081/gh.2015.358 McGregor AJ, Beauchamp GA, Wira CR, Perman SM, Safdar B (2017) Sex as a bilogical variable in emergency medicine research and clinical practice: A brief narrative review. West J Emerg Med 18:1079–1090. https://doi.org/10.5811/westjem.2017.8.34997 Miller L, Alele FO, Emeto TI, Franklin RC (2019) Epidemiology, risk factors and measures for preventing drowning in Africa: A systematic review. Medicina 55:1–25. https://doi.org/10.3390/medicina55100637 Morgan D, Ozanne-Smith J, Triggs T (2009) Self-reported water and drowning risk exposure at surf beaches. Australian & New Zealand J Public Health 33:180–188. https://doi.org/10.1111/j.1753-6405.2009.00367.x Peden AE, Franklin RC, Mahony AJ, Scarr J, Barnsley PD (2017) Using a retrospective cross-sectional study to analyse unintentional fatal drowning in Australia: ICD-10 coding-based methodologies verses actual deaths. BMJ Open 7:e019407. https://doi.org/10.1136/bmjopen-2017-019407 Peden AE, Demant D, Hagger MS, Hamilton K (2018a) Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review. PLoS ONE [Electronic Resource] 13:e0196421. https://doi.org/10.1371/journal.pone.0196421 Peden AE, Franklin RC, Leggat PA (2018b) Breathalysing and surveying river users in Australia to understand alcohol consumption and attitudes toward drowning risk. BMC Public Health 18. https://doi.org/10.1186/s12889-018-6256-1 Peters SAE, Norton R (2018) Sex and gender reporting in global health: new editorial policies. BMJ Glob Health 3:e001038. https://doi.org/10.1136/bmjgh-2018-001038 Petrass LA, Blitvich JD (2018) A lack of aquatic rescue competency: a drowning risk factor for young adults involved in aquatic emergencies. J Community Health 43:688–693. https://doi.org/10.1007/s10900-018-0472-6 Quinton J, Giles AR, Rich K (2022) Missing masculinities: The need for gender transformative approaches in water safety promotion for men. Health Promot J Austr 33:148–150. https://doi.org/10.1002/hpja.490 Roberts K, Thom O, Devine S, Leggat PA, Peden AE, Franklin RC (2021) A scoping review of female drowning: an underexplored issue in five high-income countries. BMC Public Health 21:1072. https://doi.org/10.1186/s12889-021-10920-8 Royal Life Saving Society-Australia (2018) Royal life saving national drowning report 2018. Sydney, Australia. Available from: https://www.royallifesaving.com.au/__data/assets/pdf_file/0006/32685/RLS_NDR2018_ReportLR.pdf. Accessed 13 Oct 2022 Royal Life Saving Society-Australia (2019) Royal life saving national drowning report 2019. Report. Sydney, Australia. Available from: https://www.royallifesaving.com.au/__data/assets/pdf_file/0005/32684/rlssa-ndr-2019-digital.pdf. Accessed 13 Oct 2022 Royal Life Saving Society-Australia (2020) Royal life saving national drowning report 2020. Sydney, Australia. Available from: https://www.royallifesaving.com.au/__data/assets/pdf_file/0003/33861/RLS_NationalDrowningReport2020LR-FINAL.pdf. Accessed 13 Oct 2022 Royal Life Saving Society-Australia (2021) Royal life saving national drowning report 2021. Sydney, Australia. Available from: https://www.royallifesaving.com.au/__data/assets/pdf_file/0007/50110/RLS_NationalDrowningReport2021_LR.pdf. Accessed 13 Oct 2022 Royal Life Saving Society-Australia (2022) Royal life saving national drowning report 2022. Sydney, Australia. Available from: https://www.royallifesaving.com.au/__data/assets/pdf_file/0007/67687/RLS_NationalDrowningReport2022_SPG_LR.pdf. Accessed 13 Oct 2022 Scarr JP, Jagnoor J (2021) Mapping trends in drowning research: A bibliometric analysis 1995–2020. Int J Environ Res Public Health 18:1–14. https://doi.org/10.3390/ijerph18084234 Scarr JP, Buse K, Norton R, Meddings DR, Jagnoor J (2022) Tracing the emergence of drowning prevention on the global health and development agenda: a policy analysis. Lancet Glob Health 10:E1058–E1066. https://doi.org/10.1016/S2214-109X(22)00074-2 Smith GS, Langley JD (1998) Drowning surveillance: how well do E codes identify submersion fatalities. Inj Prev 4:135–139. https://doi.org/10.1136/ip.4.2.135 Sugimoto CR, Ahn JY, Smith E, Macaluso B, Lariviere V (2019) Factors affecting sex-realted reporting in medical research: a cross-disciplinary bibliometric analysis. Lancet 393:550–559. https://doi.org/10.1016/S0140-6736(18)32995-7 Tannenbaum C, Greaves L, Graham ID (2016) Why sex and gender matter in implementation research. BMC Med Res Methodol 16:145. https://doi.org/10.1186/s12874-016-0247-7 Taylor DH, Peden AE, Franklin RC (2020) Next steps for drowning prevention in rural and remote Australia: A systematic review of the literature. Australian J Rural Health 28:530–542. https://doi.org/10.1111/ajr.12674 Tourism Research Australia (2020) Summation options by type of traveller, stopover interstate/intrastate and age group by stopover state/region, years ending and gender 05 February 2022. Available from: https://www.tra.gov.au/. Accessed 18 Aug 2022 Tyler MD, Richards DB, Reske-Nielsen C, Saghafi O, Morse EA, Carey R et al (2017) The epidemiology of drowning in low- and middle-income countries: a systematic review. BMC Public Health 17:413. https://doi.org/10.1186/s12889-017-4239-2 van Hagen LJ, Muntinga M, Appleman Y, Verdonk P (2021) Sex and gender-sensitive public health research: an analysis of research proposals in a research institute in the Netherlands. Women Health 61:109–119. https://doi.org/10.1080/03630242.2020.1834056 von Elm E, Altman DG, Egger M, Pocock SJ, Gotzche P, Vandenbroucke JP (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Int J Surg 12:1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013 Wainer Z, Carcel C, Hickey M, Schiebinger L, Schmiede A, McKenzie B et al (2020) Sex and gender in health research: updating policy to reflect evidence. Med J Aust 212:57–62. https://doi.org/10.5694/mja2.50426 Wallis BA, Watt K, Franklin RC, Kimble RM (2015a) Drowning in Aboriginal and Torres Strait Islander children and adolescents in Queensland (Australia). BMC Public Health 15:1–11. https://doi.org/10.1186/s12889-015-2137-z Wallis BA, Watt K, Franklin RC, Nixon JW, Kimble RM (2015b) Drowning mortality and morbidity rates in children and adolescents 0-19 yrs: a population-based study in Queensland, Australia. PLoS One 10:e0117948. https://doi.org/10.1371/journal.pone.0117948 Water Safety New Zealand (2018) Drowning report. Report. Available from: http://drowningreport.watersafety.org.nz/. Accessed 20 Oct 2021 Webber J, Moran K, French C, Fozard F, Pearless O (2020) Fatal costal drowning incidents: A 10-year review of body recovery times in New Zealand. Forensic Sci Int 317. https://doi.org/10.1016/j.forsciint.2020.110573 Wilcox-Pidgeon S, Peden AE, Franklin RC, Scarr J (2019) Boating-related drowning in Australia: Epidemiology, risk factors and the environment. J Saf Res 70:117–125. https://doi.org/10.1016/j.jsr.2019.06.005 Wilcox-Pidgeon S, Franklin RC, Devine S, Leggat PA, Scarr J (2021) Reducing inequities among adult female migrants at higher risk for drowning in Australia: The value of swimming and water safety programs. Health Promot J Austr 32:49–60. https://doi.org/10.1002/hpja.407 World Health Organization (2014) Global report on drowning: preventing a leading killer. Geneva, Switzerland. Available from: https://www.who.int/publications/i/item/global-report-on-drowning-preventing-a-leading-killer. Accessed 08 Aug 2022 World Health Organization (2016) International statistical classification of diseases and related health problems 10th revision 18 June 2021. Available from: https://www.who.int/classifications/icd/en/. Accessed 04 Apr 2022 World Health Organization (2021) Drowning. [Fact Sheet]: World Health Organization [29 March 2022]. Available from: https://www.who.int/news-room/fact-sheets/detail/drowning. Accessed 08 Aug 2022