Nearly everyone has childhood memories that include fun times around a family or residential pool. I remember many hours in my own childhood spent swimming and splashing in pools and they are some of my best memories. Although pools may be a source of family fun, they can unfortunately be a source of family tragedy as well.
According to information from the Centers for Disease Control, in the years 2007-2009, there were an estimated 4200 pool or spa related emergency department treated submersion injuries yearly and nearly 400 fatalities a year associated with these injuries in children less than 15 years of age. The great majority of these injuries and fatalities were associated with pools, especially in younger children who were four years of age or younger.
This is not an argument to keep children out of pools. Pools not only provide wonderful memories for children and families but they get children moving and can help contribute to a child’s love of exercise. In addition, as will be discussed below, becoming familiar with pools and swimming can also lead to decreased drowning events in certain age groups. The message to take from this is not that a parent should keep their child out of pools and spas but rather to ensure that every safety precaution that can be put in place to provide a safe environment for swimming is done so.
Here are some steps that parents can follow to maximize pool safety:
1. Install appropriate fencing. Preventing a child, particularly a child under the age of four, from accessing a pool is one of the most critical steps a parent can make to reduce the risk of drowning. In one study, 69%[a] of pediatric drowning victims were not expected to be anywhere near the pool by a parent or caregiver but were found submerged or floating in the water. In addition, 77% of victims were missing for 5 minutes or less when they were found. It is estimated that 50% of all pediatric drownings could be prevented if proper fencing were installed.
A proper fence should extend on all four sides of the pool and be at least 4 feet high. In addition, it should have a self-closing and self-latching gate that opens outward from the pool and the latch should be out of reach of children. For a more in-depth description of proper fence safety, please visit the Consumer Product Safety Commission’s Safety barrier guidelines for home pools.
2. Practice proper supervision. Proper supervision focuses on two key aspects-- keeping children from entering a pool unsupervised and appropriate safety practices when in a pool. Proper prevention devices include the fencing described above as well as proper door locks and alarms to prevent a child from leaving a house undetected and pool and gate alarm systems that are triggered when someone goes near the water with the alarm is activated. Pool safety focuses on keeping young or inexperienced swimmers within arm’s reach at all times. Never participate in activities that may distract your attention from a child who needs supervision such as reading or listening to headphones. Even if there are lifeguards around, it is most often another swimmer or bystander who notices that someone has drowned. Have a phone available at all times to make emergency calls if necessary.
3. Swimming lessons. While the decision on when to start swimming lessons depends on a lot of factors, formal swimming lessons have been endorsed by the American Academy of Pediatrics for children who are ready for them even as young as one year of age. Although the data is not absolutely clear, there is at least one study that demonstrated swimming lessons may reduce the risk of drowning by as much as 88% in children between the ages of 1-4 years of age. Even so, there is no way to “drown-proof” a child--comfort and skills around the water should never take the place of proper safety and supervision.
4. Use of appropriate life jackets. Even in pools, inexperienced swimmers may benefit from the use of appropriate life jackets. Air filled or foam filled toys such as water wings, “noodles” or inner tubes are not proper floatation devices and should only be used as toys, not as life-saving devices.
5. Ensure pools have proper safety devices installed. A federal law mandates that all public pools and spas have proper drain covers that can prevent a person from becoming entrapped in the drain, resulting in injury or death. It is recommended that all residential pool owners ensure their pools are also compliant with the Pool & Spa Safety (P&SS) Act as well.
6. Learn CPR. There is evidence that starting immediate CPR on drowning victims prior to the arrival of emergency responders can have a substantial impact in reducing death and serious brain injury. It is recommended that all pool owners be familiar with CPR and stay up-to- date on CPR training.
It is estimated that if all parents followed these steps, anywhere from 200-400 lives might be saved per year. As stated by Steven Levitt, a professor of Economics at the University of Chicago and author of the best seller Freakonomics, “This would be more lives saved than from two of the most successful safety-interventions in recent decades: the use of child car seats and the introduction of safer cribs. Potential lives saved from pool safety are far greater than from child-resistant packaging (an estimated 50 lives saved per year), keeping children away from airbags (less than five young children a year on average have been killed by air bags since their introduction), flame retardant pajamas (perhaps 10 lives saved annually), or safety drawstrings on children’s clothing (two lives saved annually). Simply stated, keeping your children safe around water is one of the single most important things a parent can do to protect a child.”
For more safety tips and to learn about Dr. Matt Dougherty, visit www.essehealth.com.
By Pediatrician Dr. Matt Dougherty
Esse Health Tesson Ferry Pediatrics & Internal Medicine
13303 Tesson Ferry Road, Suite 150
St. Louis, MO 63128
 U. S. Consumer Product Safety Commission. Safety barrier guidelines for home pools [online]. [cited 2012 May 3]. Available from URL: http://www.cpsc.gov/cpscpub/pubs/pool.pdf
 Thompson DC, Rivara F. Pool fencing for preventing drowning of children. Cochrane Database of Systematic Reviews1998, Issue 1. Art. No.: CD001047. DOI: 10.1002/14651858.CD001047.
 Pelletier AR, Gilchrist J. Fatalities in swimming pools with lifeguards: USA, 2000-2008. Injury Prevention, 2011; 17:250-253
 Brenner RA, Taneja GS, Haynie DL, Trumble AC, Qian C, Klinger RM, Klevanoff MA. Association between swimming lessons and drowning in childhood: A case-control study. Archives of Pediatrics & Adolescent Medicine 2009;163(3):203-10.