Skip to main content
Injury Prevention logoLink to Injury Prevention
. 1998 Jun;4(2):135–139. doi: 10.1136/ip.4.2.135

Drowning surveillance: how well do E codes identify submersion fatalities

G Smith 1, J Langley 1
PMCID: PMC1730358  PMID: 9666369

Abstract

Objectives—The aim was to determine in New Zealand: (1) to what degree the International Classification of Diseases Supplementary Classification (ICD) external cause (E) codes for drowning identify all deaths involving drowning; (2) how the other drowning deaths are distributed across E codes; and (3) whether the proportion of drownings not identified by traditional ICD E codes has changed over time.

Methods—Mortality files for the period 1977–92, which were coded in the range E800-E999 (external causes of injury and poisoning), were searched electronically using the keyword "drown".

Results—2718 cases that involved drowning were identified. This represents a 17.7% increase in the number of cases one would identify using ICD drowning E codes alone. The majority (65%) of the 408 drownings not coded as such were coded as motor vehicle traffic crashes. The number of drownings that were not identified by ICD E codes remained relatively constant over time, although the number of deaths E coded as drowning declined significantly in recent years.

Conclusion—Standard ICD E codes for drowning do not identify all drowning related deaths, which may make comparisons of injury rates between countries difficult, especially for injuries such as drownings and burns that can be both nature of injury and external cause codes. Multiple cause coding and the inclusion of free text narratives are an important tool to improve the value of a country's vital statistics for injury prevention, and facilitate comparisons with other countries.

Full Text

The Full Text of this article is available as a PDF (100.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brancker A. Drowning deaths: a cross-analysis of external cause and nature of injury codes. Health Rep. 1989;1(2):225–228. [PubMed] [Google Scholar]
  2. Cairns F. J., Koelmeyer T. D., Smeeton W. M. Deaths from drowning. N Z Med J. 1984 Feb 8;97(749):65–67. [PubMed] [Google Scholar]
  3. Fife D. Injuries and deaths among elderly persons. Am J Epidemiol. 1987 Nov;126(5):936–941. doi: 10.1093/oxfordjournals.aje.a114731. [DOI] [PubMed] [Google Scholar]
  4. Israel R. A., Rosenberg H. M., Curtin L. R. Analytical potential for multiple cause-of-death data. Am J Epidemiol. 1986 Aug;124(2):161–179. doi: 10.1093/oxfordjournals.aje.a114375. [DOI] [PubMed] [Google Scholar]
  5. Jenkins E. L., Hard D. L. Implications for the use of E codes of the International Classification of Diseases and narrative data in identifying tractor-related deaths in agriculture, United States, 1980-1986. Scand J Work Environ Health. 1992;18 (Suppl 2):49–50. [PubMed] [Google Scholar]
  6. Jougla E., Papoz L., Balkau B., Maguin P., Hatton F. Death certificate coding practices related to diabetes in European countries--the 'EURODIAB Subarea C' Study. Int J Epidemiol. 1992 Apr;21(2):343–351. doi: 10.1093/ije/21.2.343. [DOI] [PubMed] [Google Scholar]
  7. Kelson M., Farebrother M. The effect of inaccuracies in death certification and coding practices in the European Economic Community (EEC) on international cancer mortality statistics. Int J Epidemiol. 1987 Sep;16(3):411–414. doi: 10.1093/ije/16.3.411. [DOI] [PubMed] [Google Scholar]
  8. Langlois J. A., Smith G. S., Baker S. P., Langley J. D. International comparisons of injury mortality in the elderly: issues and differences between New Zealand and the United States. Int J Epidemiol. 1995 Feb;24(1):136–143. doi: 10.1093/ije/24.1.136. [DOI] [PubMed] [Google Scholar]
  9. Lindahl B. I., Johansson L. A. Multiple cause-of-death data as a tool for detecting artificial trends in the underlying cause statistics: a methodological study. Scand J Soc Med. 1994 Jun;22(2):145–158. doi: 10.1177/140349489402200211. [DOI] [PubMed] [Google Scholar]
  10. Moyer L. A., Boyle C. A., Pollock D. A. Validity of death certificates for injury-related causes of death. Am J Epidemiol. 1989 Nov;130(5):1024–1032. doi: 10.1093/oxfordjournals.aje.a115403. [DOI] [PubMed] [Google Scholar]
  11. Percy C., Muir C. The international comparability of cancer mortality data. Results of an international death certificate study. Am J Epidemiol. 1989 May;129(5):934–946. doi: 10.1093/oxfordjournals.aje.a115226. [DOI] [PubMed] [Google Scholar]
  12. Percy C., Stanek E., 3rd, Gloeckler L. Accuracy of cancer death certificates and its effect on cancer mortality statistics. Am J Public Health. 1981 Mar;71(3):242–250. doi: 10.2105/ajph.71.3.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Smith GS, Brenner RA. The Changing Risks of Drowning for Adolescents in the U.S. and Effective Control Strategies. Adolesc Med. 1995 Jun;6(2):153–170. [PubMed] [Google Scholar]
  14. Sorock G. S., Smith G. S., Reeve G. R., Dement J., Stout N., Layne L., Pastula S. T. Three perspectives on work-related injury surveillance systems. Am J Ind Med. 1997 Aug;32(2):116–128. doi: 10.1002/(sici)1097-0274(199708)32:2<116::aid-ajim3>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  15. Wintemute G. J., Kraus J. F., Teret S. P., Wright M. A. Death resulting from motor vehicle immersions: the nature of the injuries, personal and environmental contributing factors, and potential interventions. Am J Public Health. 1990 Sep;80(9):1068–1070. doi: 10.2105/ajph.80.9.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Injury Prevention are provided here courtesy of BMJ Publishing Group

RESOURCES