Drowning is the second leading cause of unintentional injury death among children in the United States. Young children, under the age of five, are at particularly increased risk with highest rates among children ages 1-2 years. In 2003, the most recent year for which data are available, there were 1,062 unintentional drowning deaths among children 19 and under, 456 of which were 1-4 year olds. Interventions to prevent drowning are dependent on the age of the victim and on the specific circumstances surrounding the event. While mandatory pool fencing is an effective strategy for the prevention of many drownings in this young age group, studies suggest that even if all residential pools in the United States were properly fenced, many drownings among toddlers would not be prevented. The effectiveness of other prevention strategies is less well understood. One such strategy is increased swimming ability through participation in swimming lessons. This study utilizes a case-control design to evaluate the relationship between past participation in swimming lessons and the risk of drowning among children ages 1 to 4 years. Methods. Drowning deaths were identified through Medical Examiners/Coroners offices (MEs) located in twenty-one participating jurisdictions with high numbers of childhood drownings and where MEs routinely investigated drowning deaths. Information was obtained through inperson interviews about drownings among children (1-19 years old) and matched controls; the current analysis focuses on the 1-4 year age group. Among other questions, respondents reported on about child’s participation in formal and informal swimming lessons and swimming ability. Sample. These analyses included 61 cases and 136 matched controls with mean ages of 31.5 months for cases and 32.8 months for controls. Fifty-nine percent of cases and controls were males. Most often the respondent was the mother (67% cases, 76% controls). Results. Cases were more likely to be non-white and to report lower education and incomes. No differences were found for likelihood of having a fenced pool, exposure to water, liking or comfort in water. Controls were more likely than cases to be able to float on their back for 10 seconds; no difference was found on other swimming ability measures. Controls were also more likely to have had formal swimming lessons; no difference was found for informal swimming lessons. Conclusion. Participation in formal swimming instruction is unlikely to be harmful in this age group. These findings are very preliminary, based on a very small sample and may have been particularly influenced by the small number of decedents who had participated in swimming lessons. Nonetheless they suggest a potentially important avenue of research to determine of the role of swimming ability and swimming lessons in the prevention of childhood drowning. DENISE L. HAYNIE is a Staff Scientist in the Prevention Research Branch, Division of Statistics, Epidemiology and Prevention Research at the National Institute of Child Health and Human Development, National Institutes of Health. She completed her Masters of Public Health at Johns Hopkins School of Hygiene and Public Health in 1996. She received her doctorate in Developmental Psychology from The Catholic University of America in 1993. Prior to coming to NICHD, she was a Research Associate in at the Laboratory for Children's Health Promotion at Georgetown University School of Medicine. Her research interests focus on adolescents' relationships with their parents and peers, particularly how these relationships impact on health related behaviors.
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