Risk Factors for Drowning

Key points

  • Drowning is the leading cause of death for children ages 1-4 in the U.S.
  • Participating in formal swimming lessons can reduce the risk of drowning among children and young adults.
  • Life jackets can prevent drowning during water activities, especially boating and swimming.
  • Proper pool fencing can prevent young children from gaining access to the pool area without caregivers' awareness.
Child on pool ledge with hands and feet in water

U.S. populations at increased risk

Children

Parents with children in pool
Children have increased risk of drowning
  • Drowning is the leading cause of death for children 1-4.1
  • Most drownings in children 1–4 happen in swimming pools.2
  • Drowning can happen even when children are not expected to be near water, such as when they gain unsupervised access to pools.
  • Drowning is the second leading cause of unintentional injury death for children 5-14, behind motor vehicle crashes.1

Males

Nearly 80% of people who die from drowning are male.1 Many factors might contribute to higher rates of drowning among males, including increased exposure to water, risk-taking behaviors, and alcohol use.345

Conditions that can increase risk

  • People with seizure disorders such as epilepsy are at a higher risk of fatal and nonfatal drowning than the general population.
  • Drowning is the most common cause of unintentional injury death, with the bathtub being the most common site of drowning, for people with seizure disorders.467
  • Heart conditions are also associated with a higher risk of drowning.48

Autism Spectrum Disorder (ASD)‎

Deaths among people with autism spectrum disorder are nearly 40x as likely to be caused by drowning as deaths in the general population.4910

What makes the impacts worse

Not being able to swim

  • Many adults and children report that they can't swim or that they are weak swimmers.111213
  • Participation in formal swimming lessons can reduce the risk of drowning among children and young adults.412131415

Lack of close supervision

  • Drowning can happen quickly and quietly anywhere there is water, especially to unsupervised children.
  • It happens in lakes and oceans, pools, bathtubs, and even buckets of water.4161718

Not wearing life jackets

young males with life jackets on boat on lake
Wear a life jacket whenever on a boat.
  • Life jackets can prevent drowning during water activities, especially boating and swimming.419
  • The U.S. Coast Guard reported 658 boating-related deaths in 2021—81% died by drowning, and 83% of these people were not wearing life jackets.20

Drinking alcohol

  • Among adolescents and adults, alcohol use is involved in:
    • up to 70% of deaths associated with water recreation, like boating or swimming,21
    • nearly 1 in 4 emergency department visits for drowning,21 and
    • about 1 in 5 reported boating deaths.2021
  • Alcohol impairs balance, coordination, and judgment, and it increases risk-taking behavior.21

Using drugs and prescription medications

  • Certain medications can increase the risk of drowning, especially psychotropic medications commonly prescribed for depression, anxiety, bipolar disorder, schizophrenia, and other conditions.22
  • Side effects from these medications can be similar to the effects of alcohol, such as difficulty thinking clearly and decreased motor skills.22
  • Other drugs and prescription medications might also increase drowning risk.2223

Places with increased risk

Pools with missing or ineffective fences

Proper pool fencing can prevent young children from gaining access to the pool area without caregivers' awareness.4161718 A four-sided isolation fence which separates the pool area from the house and yard reduces a child's risk of drowning by 83% compared to three-sided property-line fencing (which encloses the entire yard, but does not separate the pool from the house).24

Bathtubs, swimming pools, natural water

The highest risk locations for drowning vary by age.

  • Among infants under 1 year old, three quarters of all drownings occur in bathtubs.2
  • Most drownings happen in home swimming pools among children ages 1–4.2
  • Over 40% of drownings among children 5-14 occur in natural water, and over 35% occur in swimming pools.2
  • Almost half of fatal drownings among people 15 years and older occur in natural waters like lakes, rivers, or oceans.2
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Content Source:
National Center for Injury Prevention and Control
  1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Accessed 27 November 2023.
  2. Centers for Disease Control and Prevention, National Center for Health Statistics. Wide-ranging Online Data for Epidemiologic Research (WONDER). Accessed 27 November 2023.
  3. Lawes JC, Ellis A, Daw S, Strasiotto L. Risky business: a 15-year analysis of fatal coastal drowning of young male adults in Australia. Injury prevention 2021;27(5):442-559.
  4. Denny, Sarah A., Linda Quan, Julie Gilchrist, Tracy McCallin, Rohit Shenoi, Shabana Yusuf, Jeffrey Weiss, and Benjamin Hoffman. Prevention of drowning. Pediatrics 2021;148(2):e2021052227.
  5. Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, Yusuf S, Hoffman B, Weiss J. American Academy of Pediatrics (AAP) – Council on Injury, Violence, and Poison Prevention. Policy Statement – Prevention of Drowning. Pediatrics 2019;143(5): e20190850
  6. Lhatoo SD, Sander JWAS. Cause-specific mortality in epilepsy. Epilepsia 2005;46(S11):36–39.
  7. Bell GS, Gaitatzis A, Bell CL, Johnson AL, Sander JW. Drowning in people with epilepsy – How great is the risk? Neurology 2008;71(8):578–582.
  8. Semple-Hess J, Campwala R. Pediatric submersion injuries: emergency care and resuscitation. Pediatric Emergency Medicine Practice 2014;11(6)1–22.
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  10. Guan J, Li G. Characteristics of unintentional drowning deaths in children with autism spectrum disorder. Injury Epidemiology 2017;4(32):1–4.
  11. Gilchrist J, Sacks JJ, Branche CM. Self-reported swimming ability in U.S. adults, 1994. Public Health Reports 2000;115(2–3):110–111.
  12. Irwin CC, Irwin RL, Ryan TD, Drayer J. Urban minority youth swimming (in)ability in the United States and associated demographic characteristics: toward a drowning prevention plan. Injury Prevention 2009;15(4):234–239.
  13. Pharr J, Irwin C, Layne T, Irwin R. Predictors of Swimming Ability among Children and Adolescents in the United State. Sports 2018;6(1):17.
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  18. World Health Organization (WHO). Preventing drowning: an implementation guide. Accessed 4 May 2021.
  19. Cummings P, Mueller BA, Quan L. Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Injury Prevention 2011;17(3):156–159.
  20. U.S. Coast Guard, U.S. Department of Homeland Security. Recreational Boating Statistics –2021 [PDF – 83 pages] Accessed 9 September 2022.
  21. Driscoll TR, Harrison JA, Steenkamp M. Review of the role of alcohol in drowning associated with recreational aquatic activity. Injury Prevention 2004;10(2):107–113.
  22. Pajunen T, Vuori E, Vincenzi FF, Lillsunde P, Smith G, Lunetta P. Unintentional drowning: Role of medicinal drugs and alcohol. BMC Public Health 2017;17(388):1–10.
  23. Ahlm K, Saveman B-I, Björnstig Ulf. Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs – a retrospective study, 1992–2009. BMC Public Health 2013;13(216):1–10.
  24. U.S. Consumer Product Safety Commission (CPSC). Safety Barrier Guidelines for Residential Pools [PDF – 20 pages]. Accessed 16 April 2019.