The characteristics of drowning among different types of international visitors to Australia and how this contributes to their drowning risk

Objective: Australia is a popular destination for international visitors. This study reviews international visitor drowning deaths in Australia and analyses drowning by visitor type. Methods: A total population retrospective study exploring drowning deaths of international visitors was conducted between 2008 and 2018. Data were extracted from the Royal Life Saving National Fatal Drowning Database and categorised into four subgroups: overseas tourists, international students, working holiday makers and work-related visitors. Descriptive statistics, non-parametric tests and relative risk (RR) were calculated. Results: In total, 201 international visitors drowned in Australia, 7% of all drowning deaths; a crude drowning rate of 0.27/100,000 visitors versus 0.95/100,000 for residents (RR=0.19 [95% CI: 0.16–0.22]). Most deaths were males (79%) and people aged 18–34 years (50%). Visitors frequently drowned at beaches (33%), and when swimming (41%). Thirty-five percent recorded a pre-existing medical condition. Overseas tourists on holiday were the most likely to drown compared to other subgroups. Conclusion: International visitors represent a small but increasing proportion of people drowning in Australia. The circumstances of which visitors drown vary by travel purpose, age, country of origin, location of drowning and activity. Implications for public health: International visitors have unique safety needs, requiring tailored prevention based on the purpose of travel and country of origin.