May 24, 2024 – If you follow the Farmer’s Almanac, you know the U.S. is in for yet another season of above-average summer temperatures. And what better way to cool off than a dip in a pool, a plunge in a quarry or lake, or riding the surf?
Water’s allure is a double-edged sword. According to the CDC, more than 4,000 people die from unintentional drowning in the U.S. every year, an average of 11 people per day. The problem is especially serious in children between the ages of 1 and 4, in whom drowning is the single leading cause of death. In this group alone, unintentional drowning deaths increased 28% from 2019 to 2022. Native Americans and Indigenous Alaskans, people ages 65 and older, and Black and Hispanic people also saw significant increases in drowning deaths.
“There’s a big misconception of what drowning is and what safety steps are in this country,” said Adam Katchmarchi, PhD, CEO of the National Drowning Prevention Alliance. “Parents don’t know the correct information about drowning, how it happens, or how it can be prevented.”
A Silent Killer
Most are familiar with a drowning victim in the movies – arms flailing in the air, screams for help. But in reality, people who are drowning can no longer support themselves. They are suffocating because they’ve inhaled water into their lungs. And while their head might be close to the water's surface, they can't break the surface for air.
“When I do lectures, I ask everyone to exhale all of the air out of their lungs and try to scream for help; that’s what a drowning victim is facing,” said Katchmarchi, who's also an assistant professor in the Department of Kinesiology, Health, and Sport Sciences at Indiana University of Pennsylvania in Indiana, PA.
That’s why he tells parents that drowning is silent and not easily recognized.
Marla C. Levine, MD, an emergency medicine doctor and director of point-of-care ultrasound at Monroe Carell Jr. Children's Hospital at Vanderbilt University in Nashville, has seen her share of near-fatal and fatal drownings in children.
“It’s a time-limited event,” she said. “It’s hard to know exactly at what point the child was submerged and potentially not getting enough oxygen. How much water is in the child’s lungs,” she said. A bystander may be the one who does rescue breaths, get them breathing again, and, possibly, save their life.
Laura Metro recalled the day that her son Clay, then 3 years old, was visiting a community pool in her father’s Bethany Beach, DE, neighborhood. As the case with many residential pools, there was no lifeguard on duty, but Clay was not swimming at the time.
He fell in after he tripped on his towel near the pool’s edge at the deep end. Although Metro and her husband were not there at the time, their friends were, and it was a 4-year-old who alerted her dad that Clay was at the bottom of the pool. A bystander and family friend who began rescue breaths right away was able to prevent Clay’s death on site until paramedics arrived and took him to a nearby children’s hospital, where he survived after a 2-day coma.
Six-year-old Cati DelaPeňa of Austin, TX, was not as lucky.
“We thought we had asked all the right questions – for example, if we needed to bring a life jacket – when we dropped her off at day camp. We told the program director that Cati couldn’t swim,” said Cati’s mom, Kori DelaPeňa. Though her parents were assured that Cati would stay in the pool’s shallow end, wear a life jacket, and be supervised by counselors, she drowned. Later, Kori and her husband, John, learned that the pool had been over capacity, life jackets were not provided, and the counselors had not been trained in water safety.
“The state of Texas requires all sorts of training – baby shaking syndrome, CPR, all kinds of training – for personnel taking care of children.” Yet, training to prevent a number one killer of children was completely absent, DelaPeňa said.
Five Steps of Prevention
Since Cati’s drowning and through Kori and John’s relentless efforts, the Texas Legislature passed a bill requiring organizations to provide life jackets to children in their care who cannot swim and ensure that they wear them near water. This effort complements the work that the DelaPeňas are doing with their nonprofit organization, LiveLikeCati, which provides life jackets and water safety training.
On a national level, a comprehensive U.S. National Water Safety Action Plan – which aims to reduce drowning deaths using input from communities, counties, and states – is underway. The plan addresses disparities in drowning rates among ethnic and racial groups, in children with neurological disorders, and among older adults with medical conditions. It also wants to make swimming lessons more affordable for these groups.
The alarming increase in drowning deaths underscores the need for immediate action, especially with summer just around the corner. “There’s not a single thing that parents can do to completely eliminate the risk of drowning for their children or themselves,” said Katchmarchi.
But there are steps you can take to reduce the risk:
- Ensure that backyard pools are surrounded on all sides by isolation fencing that completely separates the pool from the home and reduces unauthorized access. Pool covers, locked entry, and alarms are also recommended. “People don’t understand that 70% of toddler drownings happen during non-swim time,” said Katchmarchi. “I’ve been present in cases where children have managed to open the doors of homes and then have been victims of horrible drowning events,” Levine said.
- Provide close, constant, and attentive supervision, even if the swimmers are adults. “It’s the responsibility of every parent to have credible vigilance in watching their children around any water source, regardless of the child’s age, swimming proficiency, or if they’re on a lake or in your home pool,” said Levine.
- Learn water competency and water safety skills. Swimming competency means being able to enter the water fully submerged and surface, float, or tread water for 1 minute, swim 25 feet, and exit the water without a ladder. Formal swimming lessons can reduce the risk of drowning in young children by 88%, according to the National Drowning Prevention Alliance. And the American Academy of Pediatrics recommends that children begin swimming lessons as early age 1, when they are developmentally ready. Adults are encouraged to take first-time swimming lessons (check your local YMCA, YWCA, or county pools) or refresher courses. Many organizations also offer scholarships that cover the cost of lessons.
- Use life jackets that are tested and approved by the U.S. Coast Guard when in or around bodies of water or during boating. But be mindful that life jackets don’t replace the need for swimming competency.
- Know when to call for help, and make sure you know the physical address of your location. Have your cellphone ready and charged, as emergencies can strike at a moment’s notice.
It’s usually when parents or friends are having fun and take their eyes away when drownings happen. “Those are the moments that things happen,” said Levine. “You can’t get that moment back.”