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Inj Prev. Apr 2004; 10(2): 107–113.
PMCID: PMC1730083

Review of the role of alcohol in drowning associated with recreational aquatic activity

Abstract

Objective and design: To assess the role of alcohol in drowning associated with recreational aquatic activity by reviewing the English language literature published up to October 2003.

Results: Alcohol is widely used in association with recreational aquatic activity in the United States, but there is minimal information regarding the extent of use elsewhere. A priori and anecdotal evidence suggests that alcohol is an important risk factor for drowning associated with recreational aquatic activity. Specific studies provide good evidence supporting this, but the extent of increased risk associated with alcohol use, and the attributable risk due to alcohol use, is not well characterised. Drowning appears to be the overwhelming cause of death associated with recreational aquatic activity with alcohol detected in the blood in 30%–70% of persons who drown while involved in this activity. The few relevant studies on degree of increased risk suggest persons with a blood alcohol level of 0.10 g/100 ml have about 10 times the risk of death associated with recreational boating compared with persons who have not been drinking, but that even small amounts of alcohol can increase this risk. The population attributable risk seems to be in the range of about 10%–30%.

Conclusions: Alcohol consumption significantly increases the likelihood of immersions resulting in drowning during aquatic activities. However, more information is required if appropriate prevention activities are to be planned, initiated, and evaluated. This includes better information on alcohol use, and attitudes to alcohol use, in association with recreational aquatic activity, and the nature and extent of increased risk associated with alcohol use. Evaluation of interventions is also needed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Browne Marilyn L, Lewis-Michl Elizabeth L, Stark Alice D. Unintentional drownings among New York State residents, 1988-1994. Public Health Rep. 2003 Sep-Oct;118(5):448–458. [PMC free article] [PubMed]
  • Bell NS, Amoroso PJ, Yore MM, Senier L, Williams JO, Smith GS, Theriault A. Alcohol and other risk factors for drowning among male active duty U.S. army soldiers. Aviat Space Environ Med. 2001 Dec;72(12):1086–1095. [PMC free article] [PubMed]
  • Hingson R, Howland J. Alcohol and non-traffic unintended injuries. Addiction. 1993 Jul;88(7):877–883. [PubMed]
  • Howland J, Hingson R. Alcohol as a risk factor for drownings: a review of the literature (1950-1985). Accid Anal Prev. 1988 Feb;20(1):19–25. [PubMed]
  • Chalmers David, Morrison Luke. Epidemiology of non-submersion injuries in aquatic sporting and recreational activities. Sports Med. 2003;33(10):745–770. [PubMed]
  • Gooden BA. Drowning and the diving reflex in man. Med J Aust. 1972 Sep 9;2(11):583–587. [PubMed]
  • Gooden B. Drowning and alcohol. Med J Aust. 1984 Sep 29;141(7):478–478. [PubMed]
  • Howland J, Mangione T, Hingson R, Levenson S, Winter M, Altwicker A. A pilot survey of aquatic activities and related consumption of alcohol, with implications for drowning. Public Health Rep. 1990 Jul-Aug;105(4):415–419. [PMC free article] [PubMed]
  • Howland J, Smith GS, Mangione T, Hingson R, DeJong W, Bell N. Missing the boat on drinking and boating. JAMA. 1993 Jul 7;270(1):91–92. [PubMed]
  • Bross MH, Clark JL. Near-drowning. Am Fam Physician. 1995 May 1;51(6):1545–1555. [PubMed]
  • Johnstone JR. Alcohol and drowning. Med J Aust. 1985 Feb 4;142(3):234–235. [PubMed]
  • O'Neal CL, Poklis A. Postmortem production of ethanol and factors that influence interpretation: a critical review. Am J Forensic Med Pathol. 1996 Mar;17(1):8–20. [PubMed]
  • Plueckhahn VD, Ballard B. Factors influencing thhe significance of alcohol concentrations in autopsy blood samples. Med J Aust. 1968 Jun 1;1(22):939–943. [PubMed]
  • Plueckhahn VD. The significance of blood alcohol levels at autopsy. Med J Aust. 1967 Jul 15;2(3):118–124. [PubMed]
  • Wintemute GJ, Teret SP, Kraus JF, Wright M. Alcohol and drowning: an analysis of contributing factors and a discussion of criteria for case selection. Accid Anal Prev. 1990 Jun;22(3):291–296. [PubMed]
  • Hadley Jeffrey A, Smith Gordon S. Evidence for an early onset of endogenous alcohol production in bodies recovered from the water: implications for studying alcohol and drowning. Accid Anal Prev. 2003 Sep;35(5):763–769. [PubMed]
  • Logan P, Sacks JJ, Branche CM, Ryan GW, Bender P. Alcohol-influenced recreational boat operation in the United States, 1994. Am J Prev Med. 1999 May;16(4):278–282. [PubMed]
  • Howland J, Hingson R, Mangione TW, Bell N, Bak S. Why are most drowning victims men? Sex differences in aquatic skills and behaviors. Am J Public Health. 1996 Jan;86(1):93–96. [PMC free article] [PubMed]
  • Ciraulo DL, Smith P, Ciraulo SC. A trauma systems assessment of boating safety: a comparison of commercial and recreational boating practices. Am Surg. 2000 Jun;66(6):604–607. [PubMed]
  • Glover ED, Lane S, Wang MQ. Relationship of alcohol consumption and recreational boating in Beaufort County, North Carolina. J Drug Educ. 1995;25(2):149–157. [PubMed]
  • Howland J, Mangione TW, Minsky S. Perceptions of risks of drinking and boating among Massachusetts boaters. Public Health Rep. 1996 Jul-Aug;111(4):372–377. [PMC free article] [PubMed]
  • Bell NS, Howland J, Mangione TW, Senier L. Boater training, drinking and boating, and other unsafe boating practices. J Drug Educ. 2000;30(4):467–482. [PubMed]
  • Smith GS, Keyl PM, Hadley JA, Bartley CL, Foss RD, Tolbert WG, McKnight J. Drinking and recreational boating fatalities: a population-based case-control study. JAMA. 2001 Dec 19;286(23):2974–2980. [PubMed]
  • Warner M, Smith GS, Langley JD. Drowning and alcohol in New Zealand: what do the coroner's files tell us? Aust N Z J Public Health. 2000 Aug;24(4):387–390. [PubMed]
  • Smith GS, Branas CC, Miller TR. Fatal nontraffic injuries involving alcohol: A metaanalysis. Ann Emerg Med. 1999 Jun;33(6):659–668. [PubMed]
  • Cummings P, Quan L. Trends in unintentional drowning: the role of alcohol and medical care. JAMA. 1999 Jun 16;281(23):2198–2202. [PubMed]
  • Wintemute GJ, Kraus JF, Teret SP, Wright MA. The epidemiology of drowning in adulthood: implications for prevention. Am J Prev Med. 1988 Nov-Dec;4(6):343–348. [PubMed]
  • Dietz PE, Baker SP. Drowning: epidemiology and prevention. Am J Public Health. 1974 Apr;64(4):303–312. [PMC free article] [PubMed]
  • Plueckhahn VD. The aetiology of 134 deaths due to "drowning" in Geelong during the years 1957 to 1971. Med J Aust. 1972 Nov 18;2(21):1183–1187. [PubMed]
  • Plueckhahn VD. Alcohol and accidental drowning. A 25-year study. Med J Aust. 1984 Jul 7;141(1):22–25. [PubMed]
  • Davis S, Smith LS. The epidemiology of drowning in Cape Town--1980-1983. S Afr Med J. 1985 Nov 9;68(10):739–742. [PubMed]
  • Patetta MJ, Biddinger PW. Characteristics of drowning deaths in North Carolina. Public Health Rep. 1988 Jul-Aug;103(4):406–411. [PMC free article] [PubMed]
  • Steensberg J. Epidemiology of accidental drowning in Denmark 1989-1993. Accid Anal Prev. 1998 Nov;30(6):755–762. [PubMed]
  • Browne Marilyn L, Lewis-Michl Elizabeth L, Stark Alice D. Watercraft-related drownings among New York State residents, 1988-1994. Public Health Rep. 2003 Sep-Oct;118(5):459–463. [PMC free article] [PubMed]
  • Lunetta P, Penttilä A, Sarna S. Water traffic accidents, drowning and alcohol in Finland, 1969-1995. Int J Epidemiol. 1998 Dec;27(6):1038–1043. [PubMed]
  • Molberg PJ, Hopkins RS, Paulson J, Gunn RA. Fatal incident risk factors in recreational boating in Ohio. Public Health Rep. 1993 May-Jun;108(3):340–346. [PMC free article] [PubMed]
  • Smith GS, Howland J. Declines in drowning: exploring the epidemiology of favorable trends. JAMA. 1999 Jun 16;281(23):2245–2247. [PubMed]
  • Skog Ole-Jørgen. Alcohol consumption and fatal accidents in Canada, 1950-98. Addiction. 2003 Jul;98(7):883–893. [PubMed]
  • Adams AI. The descriptive epidemiology of drowning accidents. Med J Aust. 1966 Dec 31;2(27):1257–1261. [PubMed]
  • Fenner PJ, Harrison SL, Williamson JA, Williamson BD. Success of surf lifesaving resuscitations in Queensland, 1973-1992. Med J Aust. 1995 Dec 4;163(11-12):580–583. [PubMed]
  • Fenner P. Drowning awareness. Prevention and treatment. Aust Fam Physician. 2000 Nov;29(11):1045–1049. [PubMed]
  • Girasek DC. Public beliefs about the preventability of unintentional injury deaths. Accid Anal Prev. 2001 Jul;33(4):455–465. [PubMed]
  • Gulaid JA, Sattin RW. Drownings in the United States, 1978-1984. MMWR CDC Surveill Summ. 1988 Feb;37(1):27–33. [PubMed]
  • Mackie IJ. Patterns of drowning in Australia, 1992-1997. Med J Aust. 1999 Dec 6;171(11-12):587–590. [PubMed]
  • McKnight AJ, Lange JE, McKnight AS. Development of a standardized boating sobriety test. Accid Anal Prev. 1999 Jan-Mar;31(1-2):147–152. [PubMed]
  • Pearn J. Drowning and alcohol. Med J Aust. 1984 Jul 7;141(1):6–7. [PubMed]
  • Scher AT. Diving injuries of the spinal cord. S Afr Med J. 1992 Mar 21;81(6):291–292. [PubMed]
  • Wintemute GJ, Kraus JF, Teret SP, Wright M. Drowning in childhood and adolescence: a population-based study. Am J Public Health. 1987 Jul;77(7):830–832. [PMC free article] [PubMed]
  • Pless IB. The challenge of drowning prevention. Inj Prev. 1997 Dec;3(4):237–238. [PMC free article] [PubMed]
  • Quan L, Bennett E, Cummings P, Henderson P, Del Beccaro MA. Do parents value drowning prevention information at discharge from the emergency department? Ann Emerg Med. 2001 Apr;37(4):382–385. [PubMed]
  • Howland J, Birckmayer J, Hemenway D, Cote J. Did changes in minimum age drinking laws affect adolescent drowning (1970-90)? Inj Prev. 1998 Dec;4(4):288–291. [PMC free article] [PubMed]
  • Browne Marilyn L, Lewis-Michl Elizabeth L, Stark Alice D. Investigation and reporting practices for drownings: implications for injury prevention research in new york state. Am J Forensic Med Pathol. 2002 Dec;23(4):398–401. [PubMed]

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