Characteristics of drowning victims in a surf environment: a 6-year retrospective study in southwestern France

Abstract

Background: Drowning is the third cause of non-intentional injury death worldwide. Beaches of Gironde, in southwestern France, are exposed to strong environmental conditions, leading to rip currents and shore breaks. Bathing season usually lasts from April to October and is supervised from June till mid-September. The objective of this study was to study the characteristics of drowning victims along Gironde surf beaches and to identify peculiarities compared to national figures.

Methods: All calls originating from beaches to the emergency call center of Gironde from 2011 to 2016 were analyzed. Patient data, filled by a physician based on information given by pre-hospital care team (lifeguards, paramedics or emergency physicians), were extracted from the emergency call center database. We used Szpilman classification (0 = rescue to 6 = cardiac arrest) to assess severity. Rescues are patients without respiratory impairment who needed lifeguards or helicopter intervention. We compared our findings with national studies carried every three years (2012 and 2015).

Results: We analyzed 5680 calls from beaches and included 4398, 576 of which were rescued from the water, including 352 without respiratory impairment (stage 0). Among drownings, 155 had cough only (stage 1), 26 pulmonary rales (stage 2), 9 pulmonary edema (stage 3) and 1 had pulmonary edema with hypotension (stage 4). Five rescued people were in respiratory arrest and 28 were in cardiac arrest. 77.5% were bathers, others were mainly surfers or body-boarders. Drowning victims median age was 24 (quartiles: 17-40), and sex-ratio was 1.44 Male/Female. Men were significantly older than women (34 vs. 26 years old), and severity from stage 1 to 4 was positively associated with age. Compared to national data, Gironde drownings had a higher proportion of 15-44 year-old victims, and the case-fatality was lower in Gironde (11.5%) than at the national level (27.4%, p < 0.001).

Conclusion: Along Gironde coast, drowning is rarely severe, concerns mostly young men; the age distribution could explain the different case-fatality. Further study is needed to identify environmental predictors of drowning.

Keywords: Drowning; Epidemiology; Natural hazard.

Fig. 1

Map of Gironde, south western France, with description of the studied area and nearby hospitals

Fig. 2

Flow chart of call data from the surf beaches to the emergency medical service center of Gironde, France, during years 2011–2016

Fig. 3

Age of drowning victims according to sex and severity, Gironde surf beaches, 2011–2016. Width is proportional to number of individuals in group at a given age. Only 2 females were reported for stages 3 or 4

Fig. 4

Comparison of age of drowning victims who needed a hospitalization or died, from the database of Gironde Emergency Call Center, years 2011–2016 (SAMU33, n = 188) and along all coasts of France (SPF, data from Santé Publique France, French national institute of public health, reports of 2012 and 2015, n = 1165)