Caregivers’ perceptions of environmental risk factors for child drowning in different aquatic environments

Unintentional injury is a major cause of child mortality and morbidity, with drowning a leading cause of child death. Injury prevention efforts are frequently directed towards making changes to the environment to make it safer or to modifying behaviours in hazardous settings, or a complex interaction of the two. However, not all physical environments can be modified adequately to totally remove risks, or to reduce them to a negligible level. Similarly, not all behaviours of people within those environments can be changed easily to provide the solution to reducing risk. Accordingly, it is now recognised that a multifaceted approach to injury prevention is required. For drowning incidents, particularly in environments that include natural bodies of water, environmental modifications are not always practical or all encompassing of the major risk present. Consequently, additional strategies are needed that focus more on people recognising these hazards and modifying their behaviour accordingly. To date, aquatic studies have identified a number of risk factors for child drowning. Few studies however, have investigated perceptions of the risk of drowning among those engaged in recreational swimming at beaches and/or investigated the association between risk perception and safe swimming behaviour or caregiver supervision of children in aquatic environments. Consequently, the aim of this chapter is to address this knowledge gap. Using a purpose designed questionnaire, caregivers were asked about specific environmental factors which might contribute to their perceptions of the level of child injury/drowning risk. To reflect a comprehensive approach, other non-environmental factors were also considered in the questionnaire. One-hundred and fourteen caregivers, whose supervisory behaviour had been unobtrusively observed, completed the questionnaire. Caregiver demographics; perceptions of injury/drowning risk in different aquatic settings; and factors which contributed to risk perception varied among participants. Responses indicated that drowning risk was considered extreme/high on days when waves were plunging/dumping; waves were >1m; and when strong rips/currents were present. In calmer conditions (spilling waves; ≤1m; no rips/currents), caregivers were significantly more likely to report low/no drowning risk. The majority of caregivers reported that their child was at low risk of drowning in pool environments (public and home) and at flat beaches (patrolled by lifeguards or unpatrolled); moderate risk at lake, dam or lagoon; and patrolled surf beaches; and high risk at unpatrolled surf beaches. Caregivers reported water depth; type of waves; and currents/rips as environmental factors which contributed to their perceived level of risk at the beach, whilst rocks, reefs and headlands; stingers; strong winds; and water temperature were of less importance to them when judging risk. This chapter provides new insight into caregivers’ assessment of child drowning risk in diverse aquatic environments. Increased understanding of caregivers’ risk perception, coupled with understanding of factors which contribute to this perception, may guide future development of caregiver education programs and water safety campaigns which aim to reduce child drowning risk