LAUSR

Background Young people are the leading contributor to the global drowning burden with children under five at highest risk. This study explored temporal trends in fatal child drowning across three high income countries: Australia, Canada and New Zealand. Methods A total population analysis of all unintentional drowning deaths among 0–19 year olds from 2005–2014 was undertaken using data from national drowning prevention organisations from each country. Results 1,454 children and adolescents (17.8% of all drowning deaths) died from drowning across the three countries; rates ranged from 0.92 (Canada) to 1.35 (New Zealand) per 100,000. When examining linear trends over time of crude drowning rates, both Australia (y=-0.041) and Canada (y=-0.048) reduced with New Zealand (y=0.005) showing a slight increase, although highly variable year-to-year. Reductions in all three countries have been seen at rivers and swimming pools. For New Zealand drowning deaths while boating and in lakes/ponds have increased. Conclusions Investment in prevention in Australia and Canada is showing results. Lessons from each country may help enhance drowning prevention across the three countries and other high-income contexts. Further research is needed to definitively confirm effectiveness of preventative strategies such as mandating pool fencing through legislation and enforcement, bystander CPR and increased public awareness. Learning Outcomes Routinely collated data with consistently reported variables allows comparison between and across countries. This study highlights where achievements have been made in the reduction of unintentional fatal child drowning to strengthen investment in existing prevention strategies or to encourage investment or policy change where needed.