Risk factors

Groups, activities, and locations at higher drowning risk.
National Drowning Report 2025,, opens in a new tab Royal Life Saving Australia, (August 2025). The current report states that 357 people drowned in Australian waterways during the 2024-2025 financial year. This figure represents a 27% increase to the 10-year average. Previous annual reports are available on the website, opens in a new tab. 
Children's swimming & water safety skills: Teacher and parent perceptions,, opens in a new tab Royal Life Saving Australia, (2025). Research highlights continuing declines in children’s swimming skills, with half of Year 6 students falling below the National Swimming and Water Safety Benchmark. This trend continues into high school, putting thousands at increased risk of drowning in early adulthood. A lack of swimming skills is known to be a significant factor for drowning.
Increased drowning risk on public holidays,, opens in a new tab Surf Life Saving Australia, (1 March 2025). Surf Life Saving Australia has released its Summer Coastal Drowning Report today, which shows there were 104 drowning deaths nationally across the summer season, with almost half occurring along the coastline. The peak summer holiday periods, specifically between Christmas Eve to New Years Day and the Australia Day long weekend, were especially risky this summer recording 27% of summer coastal drowning deaths.
Alcohol and risk taking drowning prevention workshop statement,, opens in a new tab Koon W, Calverley H, Pidgeon S, et al., Australian Water Safety Council, (2024). The workshop’s think tank environment brought together researchers, practitioners, and policymakers to discuss current challenges, review relevant sections of the Australian Water Safety Strategy, and examine successful initiatives from related health sectors. The workshop’s main objectives were to foster collaborative thinking and to develop a collective agenda for tackling alcohol and risk-taking behaviours in aquatic
environments, paving the way for more targeted and effective water safety interventions across Australia. This workshop statement summarises the event and provides 10 action statements co-developed by the workshop participants.
Drowning Among Multicultural Communities in Australia: An update 2013/14 to 2022/23,, opens in a new tab Pidgeon, S., Royal Life Saving Australia, (2024). Approximately 34% drowning deaths in Australia are of people born overseas. Overall, 6% of total drowning deaths are of international visitors. For every 1 fatal drowning, it is estimated that there are 3 nonfatal drowning incidents. This increases for children aged 0-4 years to 8 non-fatal drowning incidents for every fatal drowning among this age group. Over the past 20 years, there has been an overall reduction of 26% in drowning deaths in Australia, most notably among young children (0-4 years). As of June 2023, Australia’s population now comprises of over 8 million people were born overseas, approximately 31% of the total Australian population. The most common countries of birth are: England, India, China and New Zealand. Changes in migration patterns to Australia over the past decade are now reflective in the drowning data. When calculating crude drowning rates based on 100,000 residential population (7), people born overseas drowned at a higher rate than those born in Australia (1.28 compared to 0.93).
Beyond drowning: Characteristics, trends, the impact of exposure on unintentional non-drowning coastal fatalities between 2012 and 22,, opens in a new tab Sean Kelly, Shane Daw, Jasmin C. Lawes, Australian and New Zealand Journal of Public Health, Volume 48(3), (June 2024). Drowning has been the focus of coastal safety, but a notable proportion of coastal mortality is due to other causes of death. This study describes that burden and quantifies the impact of exposure on Australian unintentional coastal fatalities not due to drowning. Cardiac conditions were the primary causal factor, involved in 52% of deaths. Higher fatality rates were seen among men and for incidents occurring in rural and remote areas. Fatality rates were disproportionately high among young adults when compared to all-cause mortality. Men, young adults, and those living in/visiting regional and remote areas represent high-risk populations. Proximity to emergency services and extended response times represent major determinants of NDCF.
The characteristics of drowning among different types of international visitors to Australia and how this contributes to their drowning risk, opens in a new tab, Stacey Willcox-Pidgeon, Lauren Miller, Peter A. Leggat, et al., Australian and New Zealand Journal of Public Health, Volume 47(3), (June 2023). A total population retrospective study exploring drowning deaths of international visitors was conducted between 2008 and 2018. Data were extracted from the Royal Life Saving National Fatal Drowning Database and categorised into four subgroups: overseas tourists, international students, working holiday makers and work-related visitors. Descriptive statistics, non-parametric tests and relative risk (RR) were calculated. In total, 201 international visitors drowned in Australia, 7% of all drowning deaths; a crude drowning rate of 0.27/100,000 visitors versus 0.95/100,000 for residents. Most deaths were males (79%) and people aged 18–34 years (50%). Visitors frequently drowned at beaches (33%), and when swimming (41%). Thirty-five percent recorded a pre-existing medical condition. Overseas tourists on holiday were the most likely to drown compared to other subgroups. International visitors have unique safety needs, requiring tailored prevention based on the purpose of travel and country of origin.
Characteristics and beach safety knowledge of beachgoers on unpatrolled surf beaches in Australia, opens in a new tab, Lea Uebelhoer, William Koon, Mitchell D. Harley, et al., Natural Hazards and Earth System Sciences, Volume 22, pp.909-926, (2022). The majority of drowning deaths on Australian beaches occur significant distances away from lifeguard services. This study uses results of 459 surveys of beachgoers at five beaches unpatrolled by lifeguards in New South Wales, Australia, to improve understanding of who visits these beaches and why, and to identify risk factors associated with their beach safety knowledge and behaviour. Many unpatrolled beach users were infrequent beachgoers (64.9 %) with poor rip current hazard identification skills, who did not observe safety signage that was present, and yet intended to enter the water to swim (85.6 %) despite being aware that no lifeguards were present. The survey found that the main reasons why beachgoers visited unpatrolled beaches were because they were conveniently close to their holiday accommodation, or they represented a quieter location away from crowds. Future beach safety interventions in Australia need to extend beyond the standard “swim between the flags” message in recognition that many Australian beaches will remain unpatrolled, yet still frequented, for the foreseeable future. Future beach safety interventions for unpatrolled beaches should be tailored towards the varied demographic groups of beach users.
Coastal Safety Brief - Young Males (15-39 Years Old),, opens in a new tab Surf Live Saving Australia, (2022). Young males are a high-risk demographic for injury and death on our coast. They represent an average of 53 coastal deaths each year, with three out of four due to drowning (77%). To understand this high-risk population better, Surf Life Saving Australia’s National Coastal Safety Survey (NCSS) has been surveying the community to understand the behaviours, attitudes, and perceptions of young males on coastal safety and hazards.
The role of alcohol and drug intoxication in fatal drowning and other deaths that occur on the Australian coast,, opens in a new tab Journal of Safety Research, Strasiotto, L., Ellis, A., Daw, S., et al., Volume 82, pp.207-220, (2022). Alcohol and drug (illicit or prescription) intoxication impairs motor skills, coordination, decision making abilities, hazard perception, and is known to increase the risk of death in coastal environments.
Exploring a Hidden Epidemic: Drowning Among Adults Aged 65 Years and Older, opens in a new tab, Tessa Clemens, Amy Peden, Richard Franklin, Journal of Aging and Health, Volume 33(10), pp.828-837, (2021). Total population retrospective analysis of unintentional fatal drowning among people aged 65 years and older in Australia, Canada and New Zealand (2005–2014) was conducted. 1459 older adults died. Rates ranged from 1.69 (Canada) to 2.20 (New Zealand) per 100,000. Trends in crude drowning rates were variable from year to year. A downward trend was observed in New Zealand, with upward trends in Australia and Canada. Significant locations and activities associated with older adult drowning differed by country and age band. The authors conclude that drowning among older adults is a hidden epidemic claiming increasing lives as the population ages. Targeted drowning prevention strategies are urgently needed in Australia, Canada, New Zealand and other similar countries.
Analysis of Adult Swim Skills, opens in a new tab, Pidgeon, S, Larsen P, Royal Life Saving Society Australia, (2022). The Australian Water Safety Strategy 2030 recognises a lack of swimming and water safety skills as one contributing factor to drowning. There is a need to ensure that people of all ages, backgrounds and abilities can access high quality swimming and water safety education programs. This study adds to the research gap around the skills and water competencies of adults. While further research is needed, this study has broadly identified what adults are learning and achieving in
swimming programs across Australia, and highlighted gaps where data collection can be improved. This research can inform the development of future programs to best meet the needs of adult swimmers, to reduce drowning among adults and support their safe enjoyment of Australia’s diverse waterways.
“I never had a thought about drowning”. Exploring water safety attitudes and practices among older adults in Western Australia,, opens in a new tab Meg Abercromby, Gemma Crawford, Lauren Nimmo, et al., Health Promotion Journal of Australia, Volume 33(2), pp.524-532, (2022). This paper was concerned with illuminating older adults experience and perspectives of water safety and drowning prevention. The study used in-depth, semi-structured interviews (n = 15) to examine knowledge, attitudes, beliefs and behaviours. This study provides insights into perceptions and experiences of water safety as individuals’ age. The findings suggest individuals who perceived themselves as strong swimmers had a decreased perception of risk, while participants who self-identified as weak swimmers were more likely to avoid risks and modified their behaviour accordingly. Findings highlighted low water safety literacy and suggest that older people not only underestimate their drowning risk, but also lack an understanding of the risk factors for drowning. The findings from this study will have a direct impact on the development of a WA health promotion program to prevent drowning among older adults.
A scoping review of female drowning: an underexplored issue in five high-income countries,, opens in a new tab Kym Roberts, Ogilvie Thom, Susan Devine, et al., BMC Public Health, Volume 21, article 1072, (2021). The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water.
Epidemiology of unintentional fatal drowning among migrants in Australia,, opens in a new tab Stacey Willcox-Pidgeon, Richard Franklin, Peter Leggat, et al., Australian and New Zealand Journal of Public Health, Volume 45(3), pp.255-262, (2021). This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25–34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000), Taiwan (2.29/100,000), and Nepal (2.15/100,000). Migrants were more likely to drown when around rocks compared with Australian-born people, who most frequently drowned in rivers. Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities.
Coastal drowning: A scoping review of burden, risk factors, and prevention strategies,, opens in a new tab William Koon, Amy Peden, Jasmin Lawes, PLOS One, (2021). Of the 146 included studies, the majority (76.7%) were from high income countries, 87 (59.6%) reported coastal drowning deaths, 61 (41.8%) reported risk factors, and 88 (60.3%) reported prevention strategies. Populations, data sources and coastal water site terminology in the studies varied widely; as did reported risk factors, which most frequently related to demographics such as gender and age. Prevention strategies were commonly based on survey data or expert opinion and primarily focused on education, lifeguards and signage. Few studies (n = 10) evaluated coastal drowning prevention strategies.
Fatal drowning among tourists and recently arrived individuals from overseas at South Australian Metropolitan beaches,, opens in a new tab Lilli Stephenson, Roger Byard, Corinna van den Heuvel, et al., Australian Journal of Forensic Science, Volume 53(5), pp.535-542, (2021). As 17% of all drownings occur at beaches, a study of unintentional fatal drownings at South Australian (SA) metropolitan beaches was undertaken, specifically evaluating the risk for individuals born overseas. All cases of fatal unintentional drowning between July 2002-June2018 at SA beaches were sourced from the Royal Life Saving National Fatal Drowning Database. Demographics and causal factors were analysed for all SA drownings and specifically for those at metropolitan beaches amongst those known to be born overseas. Fifty-seven drowning deaths at SA beaches were identified. Of the 54% (n=31) of beach drownings which occurred at metropolitan beaches, 36% (n=11) of decedents were overseas-born. Risks were highest for individuals from Burundi and lowest for those from the United Kingdom. Drowning deaths at SA metropolitan beaches among overseas-born most commonly involved children who were swimming or merely playing at the water’s edge, in summer and during afternoons. Preventive efforts aimed at reducing beach drowning among at-risk groups should also include culturally-appropriate campaigns.
Next steps for drowning prevention in rural and remote Australia: A systematic review of the literature,, opens in a new tab Danielle H. Taylor, Amy E. Peden, Richard C. Franklin, Australian Journal of Rural Health, Volume 28(5), pp.530-542, (2020). Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control.
Causes of distraction leading to supervision lapses in cases of fatal drowning of children 0–4 years in Australia: A 15-year review,, opens in a new tab Amy Peden, Richard Franklin, Journal of Paediatrics and Child Health, Volume 56(3), pp.450-456, (2020). This study has identified common scenarios for distractions leading to supervision lapses including the link between indoor household duties and bathtub drowning deaths and talking/socialising for deaths in swimming pools and at rivers. Challenges include medical issues impacting sole carers. The 7% of cases where a supervision lapse occurred due to miscommunication are opportunities to further reinforce the need for a designated supervisor, particularly with two or more adults present. Study findings on distraction causes, and strategies to minimise them, should be incorporated into national public awareness campaigns aimed at parents and care givers of this at-risk group.
Identifying a gap in drowning prevention: high-risk populations,, opens in a new tab Stacey Willcox-Pidgeon, Richard Charles Franklin, Peter Leggat, et al., Injury Prevention, Volume 26(3), pp.279-288, (2020). Some populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies. In total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0–18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour.
Drowning deaths among Aboriginal and Torres Strait Islander peoples: A 10-year analysis 2008/09 to 2017/18,, opens in a new tab Royal Life Saving Australia, (2020). Aboriginal and Torres Strait Islander people are considered to be at higher risk of drowning. This report presents an analysis of fatal drowning among Aboriginal and Torres Strait Islander people across Australia between 1st July 2008 and 30th June 2018. During this time, 152 people lost their lives to drowning.
Identifying Risk Factors Associated with Fatal Drowning Accidents in the Paediatric Population: A Review of International Evidence,, opens in a new tab Martin Davey, Sean Callinan, Leona Nertney, Cureus, Volume 11(11), (2019). Evidence suggests that boys are at highest risk of drowning (1-4 yrs in swimming pools; adolescents in freshwater) with inadequate surveillance, inadequate availability of first responders, certain clinical diagnoses (developmental delay and seizure disorders), lack of swimming ability, and substance misuse in adolescents all posing an increased risk. Formal swimming education in those aged 4+ years, training of supervising adults in safe rescue, installation of isolation barriers, enforcing water safety guidelines, and regulations are all recommended by International Advisory Groups for prevention of drowning.
Behavioural Water Safety and Autism: A Systematic Review of Interventions,, opens in a new tab Catriona Martin, Karola Dillenburger, Review Journal of Autism and Developmental Disorders, Volume 6, pp.356–366, (2019). People with autism are approximately twice as likely to die from drowning than members of the general population. Drowning can take place in quite small bodies of water. Therefore, acquiring good water safety skills is of the utmost importance. A systematic review of research into effective behavioural interventions for water safety and swim skills was conducted. In total, 11 studies were identified. Findings suggest that behaviourally based interventions can improve a range of water safety and swim skills in individuals with autism.
Epidemiology, risk factors and strategies for the prevention of global unintentional fatal drowning in people aged 50 years and older: a systematic review,, opens in a new tab Amy E Peden, Richard C Franklin, Ana Catarina Queiroga, Injury Prevention, Volume 24(3), pp.240-247, (2018). Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people. Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies; a lack of consensus on risk factors; a lack of total population, country-level analysis; and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated. This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies.
Causal pathways of flood related river drowning deaths in Australia,, opens in a new tab Peden, Amy, Franklin, Richard, Leggat, Peter, et al., PLoS Currents: Disasters, (2017). There were 129 (16.8%) deaths involving river flooding, representing a crude drowning rate of 0.06 per 100,000 people per annum. Half (55.8%) were due to slow onset flooding, 27.1% flash flooding and the type of flooding was unknown in 17.1% of cases. Those at an increased risk were males, children, driving (non-aquatic transport) and victims who were swept away (p<0.01). When compared to drownings in major cities, people in remote and very remote locations were 79.6 and 229.1 times respectively more likely to drown in river floods. Common causal factors for falls into flooded rivers included being alone and a blood alcohol content ≥0.05% (for adults). Non-aquatic transport incident victims were commonly the drivers of four wheel drive vehicles and were alone in the car, whilst attempting to reach their own home or a friend’s. Flood related river drownings are preventable. Strategies for prevention must target causal factors such as being alone, influence of alcohol, type/size of vehicle, and intended destination. Strategies to be explored and evaluated include effective signage, early warning systems, alternate routes and public awareness for drivers.
Alcohol and its contributory role in fatal drowning in Australian rivers, 2002–2012,, opens in a new tab Amy Peden, Richard Franklin, Peter Leggat, Accident Analysis and Prevention, Volume 98, pp.259-265, (2017). Cases of unintentional fatal river drowning in Australia, 1-July-2002 to 30-June-2012, were extracted from the National Coronial Information System. Alcohol was known to be involved in 314 cases (40.8%), 279 recorded a positive BAC, 196 (70.3%) recorded a BAC of ≥0.05%. 40.3% of adult victims had a BAC of ≥0.20%. Known alcohol involvement was found to be more likely for victims who drowned as a result of jumping in (χ2 = 7.8; p < 0.01), identify as Aboriginal and Torres Strait Islander (χ2 = 8.9; p < 0.01) and drowned in the evening (χ2 = 7.8; p < 0.01) and early morning (χ2 = 16.1; p < 0.01) hours.
The Hidden Tragedy of Rivers: A Decade of Unintentional Fatal Drowning in Australia,, opens in a new tab Amy Peden, Richard Franklin, Peter Leggat, PLOS One, (2016). This study is a cross-sectional, total population audit of all unintentional fatal drownings in Australian rivers between 1-July-2002 and 30-June-2012 using Australian coronial data. Rivers (n = 770; 26.6%) were the leading location among the 2,892 people who died from unintentional fatal drowning. Within river drowning deaths common groups include; males (80.4%), adults (85.3%), adults who have consumed alcohol (25.5%), people who fell in (21.3%), people involved in non-aquatic transport incidents (18.2%) and locals (74.0%). Children were 1.75 times more likely than adults to drown in rivers as a result of a fall and adults 1.50 times more likely to drown in rivers as a result of watercraft incidents when compared to children. When compared to males, females were 2.27 and 4.45 times respectively more likely to drown in rivers as a result of incidents involving non-aquatic transport and being swept away by floodwaters. Males were 2.66 and 4.27 times respectively more likely to drown in rivers as a result of watercraft incidents and as a result of jumping in when compared to females.
International travelers and unintentional fatal drowning in Australia—a 10 year review 2002–12,, opens in a new tab Amy Peden, Richard Franklin, Peter Leggat, Journal of Travel Medicine, Volume 23(2), (2016). International travellers pose a unique challenge from a drowning prevention perspective. The ability to exchange information on water safety is complicated due to potential language barriers, possible differences in swimming ability, different attitudes to safety in the traveler’s home country and culture, a lack of opportunities to discuss safety, a relaxed attitude to safety which may result in an increase in risk taking behaviour and alcohol consumption.
Interacting Factors Associated with Adult Male Drowning in New Zealand,, opens in a new tab James Croft, Chris Button, PLOS One, (2015). Numerous interacting factors are responsible for male drownings. In New Zealand, drowning locations and activities differ by age and ethnicity which require targeted intervention strategies. Alcohol was involved in a high proportion of Accidental Immersion drownings (61%) and was highest for males aged 20-24 years. When alcohol was involved there were proportionally more incidences where a life jacket was Available But Not Worn and less incidences where a life jacket was Worn. Many 30-39 year old males drowned during underwater activities (e.g., snorkeling, diving). Older men (aged +55 years old) had a high incidence of drowning while boating. Different ethnicities were over-represented in different age groups (Asian men aged 25-29, and European men aged 65-74) and when involved in different activities.
Drowning in Aboriginal and Torres Strait Islander children and adolescents in Queensland (Australia),, opens in a new tab Belinda Wallis, Kerrianne Watt, Richard Franklin, et al., BMC Public Health, Volume 15, Article number: 795, (2015). Aboriginal and Torres Strait Islander (Indigenous) children are at greater risk of drowning than other children, however little is known about drowning of Indigenous children. This study identifies the previously unpublished incidence and characteristics of fatal and non-fatal drowning in Indigenous children and adolescents. There were 87 (6.7 % of all events) fatal and non-fatal (combined) Indigenous drowning events yielding a crude Incidence Rate of 16.8/100,000/annum. This is 44 % higher than the incidence rate for Non-Indigenous children. For every fatality, nine others were rescued and sought medical treatment (average 12 per year). The apparent over-representation of Indigenous adolescent females should be weighed against the absence of drowning among Indigenous male adolescents in the same age group in consecutive years of the study. Further investigation around behaviour and culture may highlight protective factors. Culturally specific prevention strategies which take into account social and demographic indicators identified in this study should be delivered to carers and peers of vulnerable age groups who frequent specific locations. Females, swimming ability, supervision and the young are areas which need to be incorporated into Indigenous-specific interventions for drowning prevention.
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