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Pool fencing for preventing drowning in childrenThompson DC, Rivara FP
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SummaryFencing which completely encloses all sides of a swimming pool and isolates it from the home is effective in preventing drowning of young childrenIn most industrialized countries, drowning is one of the top killers of children, especially young children. Medical care offers little to help drowning victims, and thus survival must rely on prevention of the drowning. The review found no trials of pool fencing. However evidence from other studies found that pool fencing that adequately prevents children reaching the pool unsupervised can prevent about three-quarters of all child drownings in pools. Fencing which completely encircles the pool and isolates it from the house is much more effective than methods where children can still gain access to the pool through the house.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 2, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
January 26. 1998 AbstractBackgroundIn most industrialized countries, drowning ranks second or third behind motor vehicles and fires as a cause of unintentional injury deaths to children under the age of 15. Death rates from drowning are highest in children less than five years old. Pool fencing is a passive environmental intervention designed to reduce unintended access to swimming pools and thus prevent drowning in the preschool age group. Because of the magnitude of the problem and the potential effectiveness of fencing, we decided to evaluate the effect of pool fencing as a drowning prevention strategy for young children. ObjectivesTo determine if pool fencing prevents drowning in children (under 14 years of age). Search strategyWe searched the Cochrane Injuries Group's Specialised Register, CENTRAL, MEDLINE, EMBASE, National Research Register, Zetoc and other specialist databases. We searched reference lists of relevant articles and contacted relevant organisations and experts. The searches were last updated in October 2006. Selection criteriaIn order to be selected, a study had to be designed to evaluate pool fencing in a defined population and provide relevant and interpretable data that objectively measured the risk of drowning or near-drowning or provided rates of these outcomes in fenced and unfenced pools. Data collection and analysisData were extracted by two authors using a standard abstract form. Odds ratios (OR) with 95% confidence intervals (CI), and incidence rates, were calculated for drowning and near-drowning. Main resultsThree case-control studies met the selection criteria. The results of these studies indicate that pool fencing significantly reduces the risk of drowning. The OR for the risk of drowning or near drowning in a fenced pool compared to an unfenced pool is 0.27 (95% CI 0.16 to 0.47). Isolation fencing (enclosing pool only) is superior to perimeter fencing (enclosing property and pool); the OR for the risk of drowning in a pool with isolation fencing compared to a pool with three-sided fencing is 0.17 (95% CI 0.07 to 0.44). Authors' conclusionsPool fences should have a dynamic and secure gate and should isolate the pool from the house (that is, four-sided fencing). Legislation should require isolation fencing with secure, self-latching gates for all pools, public, semi-public and private. Legislation should require fencing of both newly constructed and existing pools and include enforcement provisions, in order to be effective. |