Journal of Medical Sciences and Health

Introduction

Drowning is a type of asphyxia due to aspiration of fluid into air passages, caused by submersion in water or any other fluid. There are four types of drowning:

1. Wet (primary) drowning
2. Dry drowning
3. Secondary drowning (post-immersion syndrome, near drowning)
4. Immersion syndrome (hydrocution, submersion inhibition).[1]

According to National Crime Records Bureau, number of deaths due to drowning is estimated to be in 2010-28,001, 2011-29,708, 2012-27,558, 2013- 30,041, and 2014-29,903.[4]

Accidental deaths due to drowning are common. However, in India about 39,423 persons died due to suicidal drowning. Because of this drowning is one of the most common means to commit suicide. In 2014, 1276 peoples committed suicide by drowning in Maharashtra.

Homicidal drowning is rare and occurs in infants and children. In cases of drowning, if stones or other heavy objects are found tied to the body, then homicidal or suicidal drowning be suspected. However if such scenario is seen in cases of drowning in children, then it is usually suspected to be homicidal.

Materials and Methods

Inclusion criteria: The drowning cases which are autopsied in mortuary.
Exclusion criteria: Cases with doubtful history.

Results and Discussion

Maximum number of cases seen in the age group: 21-30 years (Table 1).
Sex ratio: Male: female - 2.3:1 (Table 2).
Suicidal drowning constitutes 22 cases followed by accidental drowning 12 cases (Table 3).

Discussion

In this retrospective study, total autopsied cases during the period January 1st, 2011 to December 31st, 2014 was 453, out of which drowning constitute 44 cases.
Adichunchanagiri Institute of Medical Sciences is located in Mandya district; it is almost covered by Cauvery and Hemavathi channel water. Agriculture is the main profession in this area. In the present study, maximum number of cases belonged to 21-30 years age group and male to female ratio

was 2.3:1. Accidental drowning seen in 12 cases while suicidal cases in 22 cases. Manner of death could not be assessed in 10 cases because body was completely decomposed and identity was not established by investigating officer.
In the present study, males are more (31 cases) compared to females (13 cases). This because, males are more exposed to water sources such as irrigation, fishing and swimming.
According to a study by Kanchan and Monteiro, out of 40 drowning cases males were encountered in 82.5% of cases. Most of the cases were belonged to 2nd and 3rd decades (55%), followed by children (15%).[5]
In the present study, suicidal drowning is more (22cases) compared to accidental drowning (12 cases) because of familial and financial problems.
In the present study, death due to accidental drowning occurred in 10 children’s. Accidental drowning is more common among females and children who live near open water sources, such as ditches, ponds, irrigation channels, or pools.

Factors associated with an increased risk of drowning are:

1. Middle and lower socioeconomic status;
2. lack of higher education;
3. Children’s left unsupervised around water;
4. Entering the water under alcohol influence;
5. Diseases like hydrophobia, epilepsy;
6. Visiting tourist places without guides.

Drowning is the most common cause of accidental death in Australian children. In Western Australia, 81 children drowned between 1987 and 1996, 54% of these drowning occurred in backyard swimming pools. In WA, between 1975 and 1986, an average of 13.5 children drowned annually. Private swimming pool drowning increased as a percentage total of all drowning from 38% in 1986 to 56% in 1996.[6]
According to a study done by Ahmed MK, Data are presented on deaths of children due to drowning derived from a longitudinal, population-based surveillance system in operation in a rural area of Bangladesh in 1983-1995. Deaths due to drowning ranged from about 10% to 25% of child deaths during 1983-1995.[7]

Conclusion

From this study, it is evident that suicidal drowning is more common in males and accidental drowning is more in females and children. Standard protocols should be installed to avoid accidental drowning.
WHO preventive measures are:

1. Installing barriers at the river side
2. Supervision of children’s at the river and pool side
3. Teaching school-age children basic swimming, water safety and safe rescue skills
4. Setting and enforcing safe boating, shipping and ferry regulations
5. Developing a national water safety strategy to raise awareness of safety around water.