Unintentional drowning in Finland 1970-2000:: a population-based study

Background While standard data on drowning reported by the World Health Organization (WHO) fails to provide a reliable picture of the burden of drowning in Finland, they suggest that the rates are much higher than those of other industrialized countries. Aim To determine the true burden of drowning in Finland and factors related to its high rates. Design Descriptive, retrospective, population-based analysis of all deaths by drowning, among residents of all ages. Setting Finland, 1970-2000. Material and Methods Mortality and population data furnished by Statistics Finland (SF) were used to determine age- and sex-specific drowning mortality rates using both nature- and cause-of-injury codes. Individual-level data from the death certificates were analysed and cross-linked to a nationwide postmortem toxicology database. Results From 1970 to 2000, 9279 unintentional drownings occurred (mean: 299.3/year SD 84.3, rate 6.1/100 000/year; M:F ratio = 8.6:1), accounting for 11.7% of all unintentional injury deaths. Drowning rates overall have decreased from 9.9/100 000/year in 1970-1972, to 4.5 in 1998-2000 (-2.7%/year; 95% CL: -3.0; -2.5). The most frequent activities related to drowning included boating (29.8%), falling (26.1%), swimming (25.0%), and activities on ice (12.4%). In non-boating-related drownings, 74.5% of males and 67.4% of females tested had a blood alcohol concentration (BAC) greater than or equal to50 mg/dl, while in boating-related drownings, the respective values were 78.1% and 71.4%. Conclusions WHO statistics underestimate the true burden of drowning in Finland by up to 40-50%. Drowning rates and alcohol involvement in drowning are much higher than in other comparable developed countries. Broad-based countermeasures to reduce alcohol use in water activities are needed as part of any strategy to reduce drowning rates.