Recommendations for water safety and drowning prevention for travelers.

Drowning is a serious worldwide, mostly preventable injury problem, particularly among international travelers. In 2000, approximately 449,000 people have drowned worldwide, and the exact number of travelers is not precisely known. Although comprehensive infectious disease information has been available to international travelers for many years, advice on injury risk and prevention, more specifically on drowning prevention, has received little attention. The goals of this review were to develop research-based drowning prevention and water-safety recommendations for travelers and to identify research needs for future recommendations. A group of injury-prevention and travel-medicine experts conducted several rounds of voting and ranking of the strength and evidence of drowning-prevention recommendations. Each of the thirty-two recommendations created have also been categorized using the Committee to Advise on Tropical Medicine and Travel scale and have been framed in the context of preevent, event, and postevent categories commonly used in injury-control theory and Haddon's Matrix. These recommendations were developed for use by travel-medicine professionals or others who prepare individuals for travel. Several of the identified interventions to prevent drownings lack conclusive scientific evidence of their effectiveness and warrant further studies to better understand their true effectiveness. Furthermore, funding for the studies of intervention effectiveness and the implications of these interventions for international travelers are essential, yet insufficient.