Effectiveness of legislative and regulatory measures to prevent drowning: a systematic scoping review
1
Injury Division, The George Institute for Global Health, Australia, Sydney, Australia
2
School of Population Health, University of New South Wales, Australia, Sydney, Australia
3
Injury Division, The George Institute for Global Health, India, New Delhi, India
4
Faculty of Medicine, University of New South Wales, Australia, Sydney, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A3772
ABSTRACT
BACKGROUND:
Drowning is a major public health problem responsible for nearly 2,36,000 deaths every year worldwide, which are mostly preventable. Regulation, whether as a legislation, guideline, or a policy, is considered as potentially effective strategy for reducing drowning burden. However, regulatory approaches and coverage differ substantially across countries and settings. Thus, this study aimed to: (1) identify regulatory mechanisms used to address drowning burden; (2) map the extent of regulatory coverage globally; (3) assess effectiveness of these regulatory interventions; (4) explore lessons learned from development, implementation, and enforcement of related regulations; and (5) evaluate the overall quality of existing literature.
METHODS:
We conducted a systematic scoping review of both academic and grey literature. Studies were included if they provided any insights on regulatory coverage or reported findings explicitly related to drowning prevention policies, legislation, or regulatory frameworks. Narrative synthesis was conducted on 25 studies meeting eligibility criteria (21 peer-reviewed and four grey literature studies).
RESULTS:
The analysis provided limited but valuable insights into regulatory approaches to drowning prevention, varying substantially. The most common regulatory mechanism was for maritime safety with pool fencing as least regulated. Only 14 of 25 studies directly examined effectiveness of regulatory interventions, while fewer studies examined regulatory coverage, implementation challenges or enabling factors for enforcement. Evidence on effectiveness was limited to only high-income countries, majorly from Australia (n=6) and United States (n=6), with no evidence from low-and-middle- income countries. The overall quality of evidence across study designs included in the review was found to be generally acceptable.
CONCLUSIONS:
Regulatory coverage for drowning prevention differs substantially across regions. When designed well and implemented effectively, regulation appears to be a promising drowning prevention strategy. However, given the limited and geographically concentrated evidence base, further research is required to better understand which regulatory approaches work, for whom, and why.
Drowning is a major public health problem responsible for nearly 2,36,000 deaths every year worldwide, which are mostly preventable. Regulation, whether as a legislation, guideline, or a policy, is considered as potentially effective strategy for reducing drowning burden. However, regulatory approaches and coverage differ substantially across countries and settings. Thus, this study aimed to: (1) identify regulatory mechanisms used to address drowning burden; (2) map the extent of regulatory coverage globally; (3) assess effectiveness of these regulatory interventions; (4) explore lessons learned from development, implementation, and enforcement of related regulations; and (5) evaluate the overall quality of existing literature.
METHODS:
We conducted a systematic scoping review of both academic and grey literature. Studies were included if they provided any insights on regulatory coverage or reported findings explicitly related to drowning prevention policies, legislation, or regulatory frameworks. Narrative synthesis was conducted on 25 studies meeting eligibility criteria (21 peer-reviewed and four grey literature studies).
RESULTS:
The analysis provided limited but valuable insights into regulatory approaches to drowning prevention, varying substantially. The most common regulatory mechanism was for maritime safety with pool fencing as least regulated. Only 14 of 25 studies directly examined effectiveness of regulatory interventions, while fewer studies examined regulatory coverage, implementation challenges or enabling factors for enforcement. Evidence on effectiveness was limited to only high-income countries, majorly from Australia (n=6) and United States (n=6), with no evidence from low-and-middle- income countries. The overall quality of evidence across study designs included in the review was found to be generally acceptable.
CONCLUSIONS:
Regulatory coverage for drowning prevention differs substantially across regions. When designed well and implemented effectively, regulation appears to be a promising drowning prevention strategy. However, given the limited and geographically concentrated evidence base, further research is required to better understand which regulatory approaches work, for whom, and why.
| eISSN: | 2654-1459 |
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