Drowning Prevention

Over the last two decades our understanding of how to prevent drowning has increased significantly. Part of this improvement has due to the work of the Royal Life Saving Society - Australia and James Cook University and it students.  The following are some of the areas the public health research has contributed to our understanding. 

Our team of researchers has decades of experience in the drowning prevention field. With backgrounds in a wide range of specialties, we're able to approach research from a variety of perspectives and develop innovative solutions to complex problems. Underpinning this work is  a good understanding of the data. 

Some publications include:

• Peden, A. E., Willcox-Pidgeon, S., Scarr, J. P., & Franklin, R. C. (2023). Lessons learned through the 20-year development of a national fatal drowning database in Australia. BMC public health, 23(1), 1499. https://link.springer.com/article/10.1186/s12889-023-16392-2
• Peden, A. E., Franklin, R. C., & Willcox‐Pidgeon, S. (2020). Media reporting of summer drowning: A partial picture, useful for advocacy. Health promotion journal of Australia, 31(3), 491-496. https://doi.org/10.1002/hpja.297
•  Peden, A. E., Franklin, R. C., & Willcox‐Pidgeon, S. (2020). Media reporting of summer drowning: A partial picture, useful for advocacy. Health promotion journal of Australia, 31(3), 491-496.  https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.297
•  Roberts, K., Thom, O., Devine, S., Leggat, P. A., Peden, A. E., & Franklin, R. C. (2021). A scoping review of female drowning: an underexplored issue in five high-income countries. BMC Public Health, 21(1), 1072.  https://link.springer.com/article/10.1186/s12889-021-10920-8 

At Public Health Research, we're committed to putting patients first. Our research is designed to improve patient outcomes and provide better treatment options for a wide range of medical conditions.

Some publications include:

•   Franklin, R. C., Peden, A. E., Hamilton, E. B., Bisignano, C., Castle, C. D., Dingels, Z. V., ... & James, S. L. (2020). The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study. Injury prevention, 26(Suppl 2), i83-i95. https://injuryprevention.bmj.com/content/26/Suppl_2/i83.abstract
• Franklin, R. C., Scarr, J. P., & Pearn, J. H. (2010). Reducing drowning deaths: the continued challenge of immersion fatalities in Australia. Medical Journal of Australia, 192(3), 123-126.  https://onlinelibrary.wiley.com/doi/full/10.5694/j.1326-5377.2010.tb03448.x
•  Franklin, R. C., Peden, A. E., & Pearn, J. H. (2018). Drowning deaths in Australia caused by hypoxic blackout, 2002–2015. The Medical Journal of Australia, 208(6), 271. https://www.mja.com.au/journal/2018/208/6/drowning-deaths-australia-caused-hypoxic-blackout-2002-2015

Children have higher rates of drowning than other age groups; a lot of effort has gone into understanding why they drown and strategies to prevent them from drowning, especially around barriers, learning to swim, supervision, CPR and lifejackets.  

Some of the work work we have undertaken includes:

•  Franklin, R. C., & Peden, A. E. (2017). Improving pool fencing legislation in Queensland, Australia: attitudes and impact on child drowning fatalities. International journal of environmental research and public health, 14(12), 1450. https://www.mdpi.com/1660-4601/14/12/1450
• Taylor, D. H., Franklin, R. C., & Peden, A. E. (2020). Aquatic competencies and drowning prevention in children 2–4 years: A systematic review. Safety, 6(2), 31. https://www.mdpi.com/2313-576X/6/2/31
•  Peden, A. E., Franklin, R. C., & Clemens, T. (2021). Can child drowning be eradicated? A compelling case for continued investment in prevention. Acta paediatrica, 110(7), 2126-2133.  https://onlinelibrary.wiley.com/doi/full/10.1111/apa.15618
•  Peden, A. E., Franklin, R. C., & Pearn, J. H. (2018). Unintentional fatal child drowning in the bath: A 12‐year Australian review (2002–2014). Journal of Paediatrics and Child Health, 54(2), 153-159. https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.13688
•  Wallis, B. A., Watt, K., Franklin, R. C., Taylor, M., Nixon, J. W., & Kimble, R. M. (2014). Interventions associated with drowning prevention in children and adolescents: systematic literature review. Injury prevention. https://injuryprevention.bmj.com/content/21/3/195

Unfortunately, when brave people put their own lives on the line to rescue others, they also get into trouble, our pioneering work in this area has led to a better understanding of this phenomenon called Aquatic Victim instead of Rescuer (AVIR).

Here are some of out papers in this area:

• Franklin, R. C., & Pearn, J. H. (2011). Drowning for love: the aquatic victim‐instead‐of‐rescuer syndrome: drowning fatalities involving those attempting to rescue a child. Journal of paediatrics and child health, 47(1‐2), 44-47.  https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1754.2010.01889.x
• Pearn, J. H., & Franklin, R. C. (2009). " Flinging the Squaler" Lifeline Rescues for Drowning Prevention. International Journal of Aquatic Research & Education, 3(3). https://scholarworks.bgsu.edu/ijare/vol3/iss3/9/ 
• Franklin, R. C., Peden, A. E., Brander, R. W., & Leggat, P. A. (2019). Who rescues who? Understanding aquatic rescues in Australia using coronial data and a survey. Australian and New Zealand journal of public health, 43(5), 477-483.  https://www.sciencedirect.com/science/article/pii/S1326020023007677
•  Pearn, J. H., & Franklin, R. C. (2012). " The impulse to rescue": rescue altruism and the challenge of saving the rescuer. International journal of aquatic research and education, 6(4), 7.  https://scholarworks.bgsu.edu/ijare/vol6/iss4/7/ 

Rivers are one of the most common locations globally where people drown.  Our work undertaking a deep dive into the issue has led to a greater understanding of the factors which lead to people drowning in rivers and also how these can be prevented.

Papers include:

•  Peden, A. E., Franklin, R. C., & Leggat, P. A. (2018). Exploring visitation at rivers to understand drowning risk. Injury Prevention.  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160709https://injuryprevention.bmj.com/content/25/5/392.abstract
•  Peden, A. E., Franklin, R. C., & Leggat, P. A. (2016). Fatal river drowning: the identification of research gaps through a systematic literature review. Injury prevention. https://injuryprevention.bmj.com/content/22/3/202.info
•  Peden, A. E., Franklin, R. C., & Leggat, P. A. (2016). The hidden tragedy of rivers: a decade of unintentional fatal drowning in Australia. PLoS One, 11(8), e0160709. 
•  Peden, A. E., Franklin, R. C., & Leggat, P. A. (2017). Alcohol and its contributory role in fatal drowning in Australian rivers, 2002–2012. Accident Analysis & Prevention, 98, 259-265. https://www.sciencedirect.com/science/article/pii/S0001457516303700

With changing climatic pattern flooding represents a significant challenge for drowning prevention.  We continue to understand why people drown during flood events.

Some of our work includes:

• Franklin, R. C., King, J. C., Aitken, P. J., & Leggat, P. A. (2014). “Washed away”—assessing community perceptions of flooding and prevention strategies: a North Queensland example. Natural hazards, 73, 1977-1998. https://link.springer.com/article/10.1007/s11069-014-1180-x 
• Peden, A. E., & Franklin, R. C. (2019). Exploring Flood-Related unintentional fatal drowning of children and adolescents aged 0–19 years in Australia. Safety, 5(3), 46. https://www.mdpi.com/2313-576X/5/3/46
• Peden, A. E., Franklin, R. C., Leggat, P., & Aitken, P. (2017). Causal pathways of flood related river drowning deaths in Australia. PLOS Currents Disasters, 1, 1-24.  https://currents.plos.org/disasters/article/causal-pathways-of-flood-related-river-drowning-deaths-in-australia/
•  Peden, A. E., Franklin, R. C., & Leggat, P. (2018). The flood-related behaviour of river users in Australia. PLoS currents, 10.  https://currents.plos.org/disasters/article/dis-the-flood-related-behaviour-of-river-users-in-australia/

Underlying medical conditions are a continued challenge when exploring why people drown; in some cases, the medical condition contributes to the drowning. In others, they drown with a medical condition and in others, it is unclear.  We are also exploring how to treat the drowned person.

Some studies exploring this issue include:

• Franklin, R. C., Pearn, J. H., & Peden, A. E. (2017). Drowning fatalities in childhood: the role of pre-existing medical conditions. Archives of disease in childhood, 102(10), 888-893. https://adc.bmj.com/content/102/10/888.abstract 
• Thom, O., Roberts, K., Devine, S., Leggat, P. A., & Franklin, R. C. (2021). Treatment of the lung injury of drowning: a systematic review. Critical Care, 25(1), 1-11. https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03687-2
• Peden, A. E., Taylor, D. H., & Franklin, R. C. (2022). Pre-existing medical conditions: a systematic literature review of a silent contributor to adult drowning. International journal of environmental research and public health, 19(14), 8863.  https://www.mdpi.com/1660-4601/19/14/8863
• Thom, O., Roberts, K., Devine, S., Leggat, P. A., & Franklin, R. C. (2023). Feasibility study of the Utstein Style For Drowning to aid data collection on the resuscitation of drowning victims. Resuscitation plus, 16, 100464. https://www.sciencedirect.com/science/article/pii/S2666520423001078
•  Thom, O., Roberts, K., Leggat, P. A., Devine, S., Peden, A. E., & Franklin, R. (2023). Cervical spine immobilisation is only required in drowning patients at high risk of axial loading of the spine. Emergency Medicine Australasia, 35(1), 18-24. https://onlinelibrary.wiley.com/doi/full/10.1111/1742-6723.14036

As we develop a better understanding around drowning we are also identifying populations who are at greater risk.

Some of our work includes:

•  Willcox-Pidgeon, S. M., Franklin, R. C., Leggat, P. A., & Devine, S. (2020). Identifying a gap in drowning prevention: high-risk populations. Injury prevention.  https://injuryprevention.bmj.com/content/26/3/279 
•  Clemens, T., Peden, A. E., & Franklin, R. C. (2021). Exploring a hidden epidemic: drowning among adults aged 65 years and older. Journal of aging and health, 33(10), 828-837. https://journals.sagepub.com/doi/full/10.1177/08982643211014770 
•  Willcox‐Pidgeon, S., Franklin, R. C., Leggat, P. A., & Devine, S. (2021). Epidemiology of unintentional fatal drowning among migrants in Australia. Australian and New Zealand journal of public health, 45(3), 255-262. https://www.sciencedirect.com/science/article/pii/S1326020023004442

This is an area that is now well understood, and more work is required.  In some parts of the world, unintentional drowning is more common than unintentional drowning.  

Some of our work in this area includes:

•  Cenderadewi, M., Franklin, R. C., Peden, A. E., & Devine, S. (2020). Fatal intentional drowning in Australia: a systematic literature review of rates and risk factors. PLoS One, 15(5), e0231861.  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231861