PT - JOURNAL ARTICLE AU - Franklin, Richard C AU - Pearn, John H AU - Peden, Amy E TI - Drowning fatalities in childhood: the role of pre-existing medical conditions AID - 10.1136/archdischild-2017-312684 DP - 2017 Oct 01 TA - Archives of Disease in Childhood PG - 888--893 VI - 102 IP - 10 4099 - http://adc.bmj.com/content/102/10/888.short 4100 - http://adc.bmj.com/content/102/10/888.full SO - Arch Dis Child2017 Oct 01; 102 AB - Objectives This study is an analysis of the contribution of pre-existing medical conditions to unintentional fatal child (0–14 years) drowning and a of critique prevention stratagems, with an exploration of issues of equity in recreation.Design This study is a total population, cross-sectional audit of all demographic, forensic and on-site situational details surrounding unintentional fatal drowning of children 0–14 years in Australia for the period of 1 July 2002 to 30 June 2012. Data were sourced from the National (Australia) Coronial Information System. Age-specific disease patterns in the general population were obtained from the Australian Institute of Health and Welfare.Results Four hundred and sixty-eight children drowned during the study period. Fifty-three (11.3%) had a pre-existing medical condition, of whom 19 suffered from epilepsy, 13 from autism and 5 with non-specific intellectual disabilities. Epilepsy is a risk factor in childhood drowning deaths, with a prevalence of 4.1% of drowning fatalities, compared with 0.7%–1.7% among the general 0–14 years population (relative risk: 2.4–5.8). Epilepsy was deemed to be contributory in 16 of 19 cases (84.2% of epilepsy cases) with a median age of 8 years. Asthma and intellectual disabilities were under-represented in the drowning cohort.Conclusion Except for epilepsy, this research has indicated that the risks of drowning while undertaking aquatic activities are not increased in children with pre-existing medical conditions. Children with pre-existing medical conditions can enjoy aquatic activities when appropriately supervised.