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Pediatric Drowning: A 20-Year Review of Autopsied Cases: III. Bathtub Drownings

Somers, Gino R. MD, PhD*†; Chiasson, David A. MD*†; Smith, Charles R. MD*†

The American Journal of Forensic Medicine and Pathology: June 2006 - Volume 27 - Issue 2 - p 113-116
doi: 10.1097/01.paf.0000220981.54069.b8
Original Article

Bathtub drownings are a significant cause of mortality in the pediatric population. Infants and preambulatory children are disproportionately affected, and several studies have suggested that preventative campaigns have been ineffective in the prevention of such deaths. To obtain a better understanding of the factors associated with bathtub drownings, a retrospective review of autopsy records over a 20-year period (1984–2003) was performed. Eighteen consecutive cases of bathtub drownings were identified in 8 males and 10 females (ratio, 0.8; P = 0.6374). The age ranged from 6 months to 70 months (mean, 17 months; median, 11 months), and most cases occurred in infants aged 12 months or less (72%). Males tended to be older than females (mean, 23 months versus 11 months; P = 0.1889). Associated factors included inadequate adult supervision (89%), cobathing (39%), the use of infant bath seats (17%), and coexistent medical disorders predisposing the infant or child to the drowning episode (17%). The pathologic findings included a frothy exudate (28%), pleural effusion (28%), and increased lung weight (61%). All toxicologic samples submitted for analysis were negative. The present study highlights the factors associated with bathtub drownings and may aid in the prevention of such deaths in the pediatric population.

From the *Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; and the †Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada.

Manuscript received February 18, 2005; accepted June 15, 2005.

Reprints: Dr Gino R. Somers, Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada, M5G 1X8. E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.