Submersion injury is not a problem unique to the United States.
In Scotland, the rate of submersions in 1999 was 1.6 per 100,000
persons per year, where most events occurred not in private swimming
pools, but in cold waters such as the sea or a reservoir.4 In
Canada, the overall, unintentional submersion rate declined from
21.7 per 100,000 persons per year in 1979 to 5.8 per 100,000 in
2002.5 Drowning is the third most common cause
of death (13.5%) in children. Populations that appear to be
at particularly high risk of submersion injury include toddlers
ages 1 to 4 years (1.85 deaths per 100,000) and youth ages 15 to
19 years (1.28/100,000). Submersion injury is a particular
problem in China, where it is estimated that more than one fifth
of worldwide submersion deaths occur.6 In Guangxi
province of China, the mortality rate for submersions in male and
female children ages 1 to 4 years was 29.8 per 100,000 and 29.6
per 100,000, respectively.7 Submersion injury is also
a serious public health problem in India, where a study in one region
showed average unintentional submersion injury rate for ages 1 to
12 years was 25.9 per 100,000.8 There, young children
were most likely to drown in vessels containing water, since there
are no piped water supplies in most villages. In the 10- to 12-year
age group, 80% of the submersion injuries were in large
open-irrigation wells without protective walls.