Background and Objectives: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in low- and middle-income countries with inadequate prevention measures. The highest rates of drowning are observed in Africa. The aim of this review is to describe the epidemiology of drowning and identify the risk factors and strategies for prevention of drowning in Africa. Materials and Methods: A review of multiple databases (MEDLINE, CINAHL, PsycINFO, Scopus and Emcare) was conducted from inception of the databases to the 1st of April 2019 to identify studies investigating drowning in Africa. The preferred reporting items for systematic review and meta-analysis (PRISMA) was utilised. Results: Forty-two articles from 15 countries were included. Twelve articles explored drowning, while in 30 articles, drowning was reported as part of a wider study. The data sources were coronial, central registry, hospital record, sea rescue and self-generated data. Measures used to describe drowning were proportions and rates. There was a huge variation in the proportion and incidence rate of drowning reported by the studies included in the review. The potential risk factors for drowning included young age, male gender, ethnicity, alcohol, access to bodies of water, age and carrying capacity of the boat, weather and summer season. No study evaluated prevention strategies, however, strategies proposed were education, increased supervision and community awareness. Conclusions: There is a need to address the high rate of drowning in Africa. Good epidemiological studies across all African countries are needed to describe the patterns of drowning and understand risk factors. Further research is needed to investigate the risk factors and to evaluate prevention strategies.

Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency ‘Triple Zero’ (000) calls to Queensland Ambulance (QAS) from 2010–2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event.

Australia is a popular destination for international visitors. This study reviews international visitor drowning deaths in Australia and analyses drowning by visitor type. A total population retrospective study exploring drowning deaths of international visitors was conducted between 2008 and 2018. Data were extracted from the Royal Life Saving National Fatal Drowning Database and categorised into four subgroups: overseas tourists, international students, working holiday makers and work-related visitors. Descriptive statistics, non-parametric tests and relative risk (RR) were calculated. In total, 201 international visitors drowned in Australia, 7% of all drowning deaths; a crude drowning rate of 0.27/100,000 visitors versus 0.95/100,000 for residents (RR=0.19 [95% CI: 0.16-0.22]). Most deaths were males (79%) and people aged 18-34 years (50%). Visitors frequently drowned at beaches (33%), and when swimming (41%). Thirty-five percent recorded a pre-existing medical condition. Overseas tourists on holiday were the most likely to drown compared to other subgroups. International visitors represent a small but increasing proportion of people drowning in Australia. The circumstances of which visitors drown vary by travel purpose, age, country of origin, location of drowning and activity. International visitors have unique safety needs, requiring tailored prevention based on the purpose of travel and country of origin.

The purpose of this study was to analyse 20 years of drowning data in Australia, using the Royal Life Saving - Australia National Fatal Drowning Database (NFDD). This study is a retrospective, total population epidemiological analysis of unintentional fatal drowning in Australia between 1 July 2002 and 30 June 2022. Data were extracted from the NFDD, which was collected over the years using coroner's findings, toxicology reports, autopsy reports and police reports from the National Coronial Information System (NCIS), in conjunction with media reports. There were 5,692 unintentional drowning deaths during the study period. Overall, drowning trends were found to decrease at a statistically significant rate of 2.60% annually over the 20-year period. The average annual age-standardised mortality rate was 1.22 per 100,000. Rivers/creeks were the leading location for drowning, accounting for 26.3% of cases. Trend analysis identified a significant decrease in the drowning rate among children aged 0-4-years, with an annual decrease of 5.41%, while there was no statistically significant change in older adults (+65 years), who had an annual decrease of 0.59%. There was no evidence of statistical change in drowning rates at beaches or among people aged 65 years and over, indicating that this demographic and location remain priorities for drowning prevention campaigns. There is an opportunity to enhance existing strategies and develop new and innovative strategies focusing on key populations, activities and risk factors. In addition, this study highlights the need to broaden our focus beyond just specific age groups and locations and to improve the availability of exposure data.

The Royal Life Saving Report - Analysis of unintentional drowning in Australia 2002-2022: progress, challenges, and data to inform prevention, provides two decades of data for fatal drowning incidents in Australia. Each number in this report represents a life lost and countless other lives forever affected by tragedy. To this end, the data presented here is intended to inform action that prevents future fatal and non-fatal drowning. By understanding and highlighting the details and long-term trends of these events, we can better design and implement national, regional and community responses that address the burden of drowning in Australia.