Drowning in Brazil - 179.000 deaths in 25 years. Are we stepping down?

TitleDrowning in Brazil - 179.000 deaths in 25 years. Are we stepping down?
Publication TypeConference Paper
Year of Publication2007
AuthorsDr Szpilman, MD, D
Conference NameWorld Conference on Drowning Prevention
Date Published09/2007
PublisherInternational Life Saving Federation
Conference LocationPorto, Portugal
Other NumbersPO-02
Abstract

­In 2003 the Brazilian population was 176 million inhabitants, of which 1 million died. External causes were responsible for 13% of all death, and the first one between 5 and 44 years old. Drowning was responsible for 6,688 (3.8/100,000 inhabitants) death and was the second leading cause of death for all causes among ages 1 to 14 years, fourth among 15 and 24, and sixth from 25 to 34 years old. Our purpose is to determine a 25-year (1979-2003) profile and trends of drowning death in Brazil.

Methods: Drowning rates among Brazilian residents were calculated from death certificates (1985-2003) based on DATASUS - Mortality System Information - www.datasus.gov.br - using International Classification of Disease (CID10).

Results: There were 179,207 deaths (5.2/100.000 inhabitants) and an average of 7,148 per year, due to drowning in Brazil along 25 years (1979-2003).

There was an overall decrease in incidence of drowning, from 5.42 (1979) to 3.78 (2003) (SD+/-0,6) per 100.000 (graphic 1).

The average incidence of death was: Accidental – 88,4% (SD+/-6,3) (watercraft-0,4%). Intentional death was 1,7% (homicide – 0,5% and suicide-1,2%) and unknown causes accounts for 9.9%.

Drowning rates related to 20-29 year-old individuals were the most frequent (22,1%), followed by 15-19 (16,3%), 30-39 (14,7%), 10-14 (11,1%), 40-49 (8,8%), 1-4 (8,3%) and 5-9 (7%).

The death rate in 20-29 year-olds occurs without distinction among States, coastline or not. The second leading State of absolute number of death and the first four of relative (death/100.000) isn’t coastline.

Considering all ages, males die 5 times more often from drowning than females. There is no sex distinction in death rates under 1 year of age, but males drown 8.7 times more in the age ranging from 20 to 29.

Discussion: Brazil has one of the largest recreations yearly around aquatic areas in the world. Drowning is a major, but often neglected, public health problem in Brazil. From 1984, a tremendous impulse on lifesaving occurred when firefighters started to assume life guarding the beaches around the country. This strategic, although not analyzed in their important prevention or rescue contents, was the main reason to explain the decrease of 30.2% in drowning deaths from 1979 to 2003 (p<0.0001) and the death rate of 3.8 to 100.000 inhabitants. Mortality trends by drowning are reducing while unfortunately external causes are increasing in significance in Brazil.

Learning Outcomes
  1. What is the burden of death by drowning in a developing country – Brazil?
  2. Are we facing an epidemic or endemic situation?
  3. What seems to be the future figures on death by drowning?