In the Drink

A Review of Morbidity and Mortality Associated with Water-Related Activities in the Top End region, Northern Territory, Australia

Bevan Jenkins, D. J. Read, Kathleen McDermott, L. M. Ward, P. John Treacy

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Study/Objective: A 10-year descriptive analysis of morbidity and mortality associated with water-related activities in the Top End, Northern Territory (NT), Australia. 

Background: An outdoor, water-orientated lifestyle characterises the Top End due to its tropical climate, lengthy coastline, many inland-waterways, and common domestic-pool ownership. However, the water holds many dangers: from drowning to the prospect of crocodile attacks. 

Methods: Data were retrospectively collected from two sources: the Trauma Registry (TR), Royal Darwin Hospital, NT and the National Coronial Information System. Inclusion criteria: all mortality or injury with an Injury Severity Score (ISS) ≥9 from water-related activity in the Top End. Exclusion criteria: envenomation. Data included: demographics, geographical location, time/mechanism of injury, injury narrative/outcome, alcohol consumption, ISS, and Indigenous race. 

Results: Ninety-five deaths occurred from 1/1/2005–12/31/2014; 87 prehospital (92%). The leading three mechanisms of injury for the 138 TR admissions were drowning (40%), falling/diving (35%), and watercraft events (14%). Median age 27 (0-90); 78% males. There were 74 children (<16 years) including 20 deaths. Indigenous Australians represent 30% of the NT population, but had 43% of deaths and 12% of admissions. Deaths from crocodile attacks are increasing with 14 deaths from 2005-2014, compared to 10 deaths from 1971-2004 (Caldicutt). Alcohol was recorded in 31% of admissions and 52% of deaths in those age >16. The Top End’s crude rate of drowning averaged over 10 years was 4.36/100,000/annum, compared to 1.31/100,000/annum in Australia. 

Conclusion: Alcohol plays a major role in the Top End’s water-related harm, associated with all mechanisms and over one-half of adult deaths. Also striking is increasing crocodile fatalities, possibly caused by population recovery from endangered to plentiful, since hunting ceased in 1971. Local authorities/advocates push water-safety and crocodile-awareness programs. However, the lure of tropical waters combined with alcohol remains a risk to life and limb. Further public health campaigns focusing on these issues are called for.

Original languageEnglish
Pages (from-to)e2
Number of pages1
JournalPrehospital and Disaster Medicine
Volume32
Issue numberS1
DOIs
Publication statusPublished - Apr 2017

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Northern Territory
Morbidity
Mortality
Water
Alligators and Crocodiles
Wounds and Injuries
Injury Severity Score
Registries
Accidental Falls
Alcohols
Tropical Climate
Diving
Ownership
antineoplaston A10
Health Promotion
Information Systems
Alcohol Drinking
Life Style
Extremities
Public Health

Cite this

@article{af415ee6c8ce4a7495837e4e68fb9a6c,
title = "In the Drink: A Review of Morbidity and Mortality Associated with Water-Related Activities in the Top End region, Northern Territory, Australia",
abstract = "Study/Objective: A 10-year descriptive analysis of morbidity and mortality associated with water-related activities in the Top End, Northern Territory (NT), Australia. Background: An outdoor, water-orientated lifestyle characterises the Top End due to its tropical climate, lengthy coastline, many inland-waterways, and common domestic-pool ownership. However, the water holds many dangers: from drowning to the prospect of crocodile attacks. Methods: Data were retrospectively collected from two sources: the Trauma Registry (TR), Royal Darwin Hospital, NT and the National Coronial Information System. Inclusion criteria: all mortality or injury with an Injury Severity Score (ISS) ≥9 from water-related activity in the Top End. Exclusion criteria: envenomation. Data included: demographics, geographical location, time/mechanism of injury, injury narrative/outcome, alcohol consumption, ISS, and Indigenous race. Results: Ninety-five deaths occurred from 1/1/2005–12/31/2014; 87 prehospital (92{\%}). The leading three mechanisms of injury for the 138 TR admissions were drowning (40{\%}), falling/diving (35{\%}), and watercraft events (14{\%}). Median age 27 (0-90); 78{\%} males. There were 74 children (<16 years) including 20 deaths. Indigenous Australians represent 30{\%} of the NT population, but had 43{\%} of deaths and 12{\%} of admissions. Deaths from crocodile attacks are increasing with 14 deaths from 2005-2014, compared to 10 deaths from 1971-2004 (Caldicutt). Alcohol was recorded in 31{\%} of admissions and 52{\%} of deaths in those age >16. The Top End’s crude rate of drowning averaged over 10 years was 4.36/100,000/annum, compared to 1.31/100,000/annum in Australia. Conclusion: Alcohol plays a major role in the Top End’s water-related harm, associated with all mechanisms and over one-half of adult deaths. Also striking is increasing crocodile fatalities, possibly caused by population recovery from endangered to plentiful, since hunting ceased in 1971. Local authorities/advocates push water-safety and crocodile-awareness programs. However, the lure of tropical waters combined with alcohol remains a risk to life and limb. Further public health campaigns focusing on these issues are called for.",
author = "Bevan Jenkins and Read, {D. J.} and Kathleen McDermott and Ward, {L. M.} and Treacy, {P. John}",
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In the Drink : A Review of Morbidity and Mortality Associated with Water-Related Activities in the Top End region, Northern Territory, Australia. / Jenkins, Bevan; Read, D. J.; McDermott, Kathleen; Ward, L. M.; Treacy, P. John.

In: Prehospital and Disaster Medicine, Vol. 32, No. S1, 04.2017, p. e2.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - Study/Objective: A 10-year descriptive analysis of morbidity and mortality associated with water-related activities in the Top End, Northern Territory (NT), Australia. Background: An outdoor, water-orientated lifestyle characterises the Top End due to its tropical climate, lengthy coastline, many inland-waterways, and common domestic-pool ownership. However, the water holds many dangers: from drowning to the prospect of crocodile attacks. Methods: Data were retrospectively collected from two sources: the Trauma Registry (TR), Royal Darwin Hospital, NT and the National Coronial Information System. Inclusion criteria: all mortality or injury with an Injury Severity Score (ISS) ≥9 from water-related activity in the Top End. Exclusion criteria: envenomation. Data included: demographics, geographical location, time/mechanism of injury, injury narrative/outcome, alcohol consumption, ISS, and Indigenous race. Results: Ninety-five deaths occurred from 1/1/2005–12/31/2014; 87 prehospital (92%). The leading three mechanisms of injury for the 138 TR admissions were drowning (40%), falling/diving (35%), and watercraft events (14%). Median age 27 (0-90); 78% males. There were 74 children (<16 years) including 20 deaths. Indigenous Australians represent 30% of the NT population, but had 43% of deaths and 12% of admissions. Deaths from crocodile attacks are increasing with 14 deaths from 2005-2014, compared to 10 deaths from 1971-2004 (Caldicutt). Alcohol was recorded in 31% of admissions and 52% of deaths in those age >16. The Top End’s crude rate of drowning averaged over 10 years was 4.36/100,000/annum, compared to 1.31/100,000/annum in Australia. Conclusion: Alcohol plays a major role in the Top End’s water-related harm, associated with all mechanisms and over one-half of adult deaths. Also striking is increasing crocodile fatalities, possibly caused by population recovery from endangered to plentiful, since hunting ceased in 1971. Local authorities/advocates push water-safety and crocodile-awareness programs. However, the lure of tropical waters combined with alcohol remains a risk to life and limb. Further public health campaigns focusing on these issues are called for.

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