Unrealised potential of pool fencing and life jackets to prevent US drownings

Abstract

Background: Drowning causes more than 4500 deaths annually and is the leading cause of death among children aged 1-4 years old in the USA. Isolation pool fencing (ie, four-sided fencing to limit access from all adjoining areas including residences and yards) and use of US Coast Guard-approved life jackets while boating can prevent drowning, but preventable deaths still occur. This study aimed to estimate the annual health and economic burden of drowning likely attributable to inadequate pool fencing and not wearing life jackets while boating to highlight the unrealised value of these known prevention strategies. Methods: A simple mathematical model used the most recent annual number of drowning deaths by decedent age in combination with previous study data to estimate the number of drowning deaths that might have been prevented through: (1) adequate isolation fencing for swimming pools among children aged <5 years old and (2) use of life jackets while boating for people of all ages. Prevention effectiveness estimates of pool fencing and life jackets were based on previous studies. Unit costs for drowning-related medical spending and avoidable mortality using the value of statistical life were from existing sources. Results: Proper use of swimming pool isolation fencing and always wearing a life jacket while boating could prevent an estimated 348 US drowning deaths and an economic cost of US$4.5 billion per year. Conclusions: Highlighting the effectiveness of drowning prevention strategies can help inform public attention to this issue and support cost-effective public health decision-making.