Every five days during the summer months, a child drowns in a portable, above-ground swimming pool. These findings from a retrospective study published online June 20 in the journal Pediatrics, suggest that portable swimming pools are more dangerous than most parents realize. Nor do these popular, easily-installed pools have the built-in safety features of many in-ground pools.
The research team, led by Gary Smith, M.D., from the Nationwide Children’s Hospital in Columbus, Ohio, reviewed data about children’s drownings and near-drownings from the U.S. Consumer Product Safety Commission (CPSC). Their analysis showed that between 2001 and 2009, 209 children died after being submerged in a portable pool, and at least 35 children were submerged but lived.
Researchers noted that the actual number of submersions in above-ground, portable pools is probably far greater. Data were in many cases incomplete. In addition, many submersions may not have been reported to the CPSC. In addition, information about the long-term effects of the near-drowning incidents was not analyzed. Near-drowning can cause brain damage, leading to memory problems, learning disabilities, or even a vegetative state.
The children ranged in age from one month to 11 years. The vast majority of submersions – 94 percent – involved children younger than five years of age. More than half (56 percent) were males. Nearly three-quarters (73 percent) of submersions occurred in the child’s own yard, while 15 percent of submersions occurred at a relative’s home.
Attentive Supervision: The Key to Safety
Whether the child was supervised was documented in only 66 percent of cases. Of the 160 cases in which researchers were able to glean information about supervision, children were supervised by an adult 18 or older only 43 percent of the time. Almost four out of ten children were not supervised at all. But lapses in supervision were common. In five cases, the adult who was supposed to be supervising the child was answering the telephone; in other cases, supervisors were performing chores outside or in the house. In one instance, the supervisor fell asleep in the pool while holding the child; in another, the adult was chatting with a neighbor.
Two double-drownings occurred. A set of three-year old twins unlocked the door of their own house, went to a neighbor’s yard, and entered the neighbor’s four-foot pool. In another case, two nine-year-old girls became entangled in a pool cover after they jumped into a covered inflatable pool.
Why Study Portable Pools?
Most previous studies had focused on children’s drowning in in-ground pools located near children’s home. And indeed, pools are dangerous, especially at home: From 2005 and 2007, more than half (54 percent) of children’s pool-related deaths occurred at the child’s home, the researchers reported. But researchers chose to examine drowning in portable, above-ground pools, because these pools have become more popular in recent years. They are easily installed, affordable, and widely available. Prices range from $6 for a small wading pool to $1,000 for a large model that can hold as much water as an in-ground pool.
Many parents do not perceive the pools as dangerous, the researchers wrote, partly because of their wide availability and ease of installation. Portable pools may not be subject to the same zoning regulations as in-ground pools, which often require fencing and gates for security.
Nor do manufacturers provide the same safety features as for in-ground pools. In more than two-thirds of cases, children got into pools using a ladder. Locking or securing ladders – or removing the ladder altogether – might have helped prevent the children from accessing the pools. Yet the ladders typically supplied with portable, above-ground pools usually cannot be easily locked, secured, or removed.
How to Prevent Drowning
Study authors wrote that preventing further drowning will require a “multi-layered” approach that includes regulations, changes in manufacturers’ practices, and parent education. Most of their recommendations revolved around reducing children’s access to pools and educating parents about the dangers of portable pools. They urged manufacturers to change designs and add elements like safety covers, fencing, and safety alarms to the pools. In addition, they wrote, “a strong and pervasive consumer education campaign is needed to make consumers aware of the dangers of portable pools because these small, inexpensive, consumer-installed pools may not generate the same sense of risk as an underground pool.”
Here’s how you can reduce the risk of drowning for your child and others in your neighborhood:
- Supervise your child any time she or he is near or in the pool. Supervision does not mean performing household or outdoor chores, taking a nap by the pool, or having a few drinks. It means actively participating with or watching your child in the pool. The younger the child, the closer she should be – no more than arm’s reach for very young children.
- Teach your child how to swim (and know how to swim yourself). According to the Centers for Disease Control and Prevention (CDC), the risk of drowning drops by as much as 88 percent for children ages 1 to 4 who participate in formal swimming lessons.
- Teach your child about the risks of swimming. Set clear rules about pool use, and make it clear that they are never to enter the pool without a responsible adult close by.
- Make sure a telephone is available near the pool.
- Keep a life preserver, personal flotation device, and shepherd’s crook near the pool. Learn how to use them properly.
- If you’re using a small wading pool, empty it when it’s not in use.
- Enforce pool etiquette. Three submersion events occurred because of dangerous and inappropriate play. In one fatal case, a child drowned because another child held him or her under water for too long.
- Create barriers to keep children out of the pool. Pool fencing should be four-sided and four foot high. Gates should be self-latching and open away from the pool. Slats should be no wider than four inches, and there should be no opening at the bottom of the fence. The fence should separate the pool from the house and play area of the yard. Smith and colleagues estimated at least 48 deaths could have been prevented if the pool had been properly fenced,
- Install a pool safety alarm.
- Remove or block pool ladders, and remove nearby objects that children could climb on to access the pool.
- Do not use foam or air-filled toys as flotation devices. Such devices are not designed to help children float and may actually force them to float face-down.
- Keep the deck clear. Removing toys and other play objects from the deck or pool area may reduce children’s temptation to access the pool without an adult nearby.
- Learn CPR. Practice your CPR skills at least every three months.
References
Centers for Disease Control and Prevention. (Last updated May 13, 2011). Unintentional drowning: Fact Sheet. Available at http://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.html
Shields, B.J., Pollack-Nelson, C., & Smith, G.B. (2011). Pediatric submersion events in portable above-ground pools in the United States, 2001-2009. Pediatrics. DOI: 10.1542/peds.2010-3033 Available at http://pediatrics.aappublications.org/content/early/2011/06/16/peds.2010-3033