Alcohol and other risk factors for drowning among male active duty US armysoldiers

Background: Risk factors for drowning are largely undocumented among milita ry populations. Hypothesis. Accident report narratives will provide importa nt information about the role of alcohol use and other behaviors in drownin gs among active duty male U.S. Army soldiers. Methods. Using a case series design, we describe drowning deaths reported to the U.S. Army Safety Center (1980-1997), documenting associated demographic factors, alcohol use, and other risk-taking behaviors. Results: Drowning victims (n = 352) were dispr oportionately young, black, and single, with less time-in-service, and no c ollege experience. Most drownings occurred off-duty (89%). Alcohol use was involved in at least 31% of the cases overall. Alcohol use was also associa ted with a 10-fold increase in reckless behavior (OR 9.6, 95% CI 4.5-20.7) and was most common among drownings in Europe (OR 4.3, 95% CI 1.5-13.4). Mo st drownings occurred where no lifeguard was present (68%), but almost two- thirds occurred in the presence of others, with CPR initiated in less than one-third of these cases. Drownings involving minority victims were less li kely to involve alcohol, but more likely to occur in unauthorized swimming areas. While most drownings did not involve violations of safety rules, ove r one-third of the cases involved some form of reckless behavior, particula rly for those under age 21. Conclusions: Intervention programs should be ta ilored to meet the needs of the demographic subgroups at highest risk since behavioral risk factors vary by race and age. CPR training and skills main tenance can improve survival rates. Narrative data are important for develo ping hypotheses and understanding risk factors for injuries.