119: The Need for Safer Pool Fencing: A 10 Year Retrospective Study of Paediatric Drownings

Drowning is the second leading cause of injury related death for Canadian children. For every child who dies from drowning, another five receive emergency department care for nonfatal drowning injuries. Approximately 50% of private pool drownings involve 1–4 year olds, with the majority lacking true four-sided fencing and self-closing, self-latching gates. Private pools are key locations for interventions, as safety features can be added to prevent children from accessing pools without caregivers' awareness. Many cities in Canada have attempted to improve pool safety; however, by-laws do not fully identify with pool enclosure recommendations issued by the Office of the Chief Coroner of Ontario. To identify drowning incidences involving the paediatric population in order to focus prevention efforts and develop potential intervention strategies. A retrospective chart review was conducted from January 2004 to December 2013 for drowning and nonfatal submersion diagnoses in children under 18 across three urban hospitals. Cases where the manner of drowning was suicide or homicide were excluded. Medical records were examined using the electronic databases Sovera and Meditech. There were 61 drowning incidences during the ten years, and almost half (44%) of these occurred in private pools (Figure 1). Of those in private pools, 19 of 27 were in the 1 to 4 age group category. Moreover, 74% of incidences that occurred in private pools were classified as unsupervised/supervision distracted. Information regarding true 4-sided fencing showed no 4-sided fence in 10 of 27 cases and in 15 of 27 it was unknown. Of the eight deaths that occurred during the study period, seven of eight were within the 1 to 4 age group. Five of the deaths occurred in a private pool where there was no 4-sided pool fencing. The results identified the age group 1 to 4 as a vulnerable population to focus on with regard to drowning. In addition, a large portion of drowning incidences and deaths in this age group occurred in private pools, which offers a focal point for prevention. The results suggest that reducing the access of this age group to private pools may prevent and reduce drowning incidences and deaths. Thus, an initiative for by-law changes regarding the implementation of safer pool fencing in private pools across the country is needed to prevent drowning incidences, and has the potential to reduce the number of deaths and injuries from childhood drownings.