Children Under Five at Greatest Risk for Drowning

July 20, 2005 – Drowning is the second leading cause of accidental death among Ontario children under five years old, according to new data released today by the Canadian Institute for Health Information (CIHI). Children under the age of five are involved in more drowning or near-drowning incidents than those in any other age group, at a rate of 5.24 per 100,000 population, more than four times the rate for those over the age of 19. The second most at-risk age group is that of children aged 5 to 9 years old, with a rate of 4.12 per 100,000 population.

“For every child that drowned in 2002-2003, there were 6 to 10 more who almost drowned and required hospitalization,” says Margaret Keresteci, Manager of Clinical Registries at CIHI. “When you take into account that one in four children in Ontario who experience near-drowning sustain permanent brain damage, you start to get an idea of how vital it is to make water safety a priority.”

The most commonly recorded injuries in near-drowning incidents were hypoxia (lack of oxygen) and internal (lung) injuries (83%). Almost half (48%) of all near-drowning injuries in Ontario occurred among toddlers.

Most drowning incidents do not actually involve people swimming. In fact, 76% of children involved in a drowning incident were playing or walking near water when drowning or near-drowning occurred.

“It is important to remember that a small child can drown in a matter of seconds and in just a few inches of water,” says Nicole Beben of Safe Kids Canada. “As families prepare for summer vacations by the lake, and trips to the local or backyard pool, it is necessary to stress the importance of remaining vigilant when small children are near even shallow water.”

Drownings Account for Over Half of Water-Related Injuries

Overall, more than 1,000 (1,166) people visited an Ontario emergency department (ED) in 2002-2003 because of injuries sustained in a water-related incident, and 68% of these were drownings or near-drownings. Of the remaining 32%, a problem with watercraft-for example, an engine fire or a collision-caused 111 water-related injuries, and incidents on board watercraft, such as slipping on the deck, resulted in 268 injuries. The majority (91%) of water-related injuries were sustained in the summertime. Between May and September, an average of seven people per day were treated at an Ontario ED because of water-related injuries.

Of those treated in an ED after sustaining water-related injuries, 30 patients succumbed to their injuries and died and 230 (20%) were later admitted to hospital. Most were eventually discharged home; however, 22% required a transfer to another facility (chronic care, rehabilitation or continuing care) and 10 more patients died after admission. These deaths include only those that occurred in hospital. According to the Canadian Red Cross, the total number of drowning deaths in Canada is estimated to be an average of 500 per year.

Most Drowning Cases Involve Water Transport Devices

Incidents involving water transport devices-for example, boats, jet skis, or canoes-accounted for most of the drowning-related cases seen in Ontario EDs (72%) in 2002-2003; one quarter of these individuals were aged 19 or younger. Approximately 70% of deaths associated with water transport incidents are due to drowning. “These incidents usually involve people who don’t expect to end up in the water and are not wearing any form of life preserver, nor are they adequately dressed for protection from cold water,” explains Margaret Keresteci. “When you are going to be around the water it is essential to be prepared for any possibility.”

Regional Variations

The Northern Ontario (Sudbury) region reported the highest rate of ED visits due to water-related injury incidents, with 11.8 per 100,000 population, followed by Central East (Peterborough/Simcoe) and Central South (Niagara), with a rate of 11.4 per 100,000 population. The lowest rate of ED visits due to water-related injuries was reported in the Toronto region, which had a rate of 4.6 per 100,000 population.

“It is possible to reduce the number of water-related injuries, including drowning and near drowning, sustained by Ontarians,” says Barbara Underhill, co-founder of The Stephanie Gaetz KEEPSAFE Foundation. Underhill’s 8-month-old daughter drowned in a backyard pool 12 years ago. She has since initiated the Swim to Survive Program with the Lifesaving Society of Canada. “As children move beyond the toddler stage, learning to swim is a necessary life skill. We teach our children bike safety and road safety, but we also need to equip them with the swimming ability necessary for survival.”

Canadian Institute for Health Information

The Canadian Institute for Health Information (CIHI) is an independent, pan-Canadian, not-for-profit organization working to improve the health of Canadians and the health care system by providing quality health information. CIHI’s mandate, as established by Canada’s health ministers, is to coordinate the development and maintenance of a common approach to health information for Canada. To this end, CIHI is responsible for providing accurate and timely information that is needed to establish sound health policies, manage the Canadian health system effectively and create public awareness of factors affecting good health. Visit