Disasters, such as flooding, are predicted to increase. Drowning is one of the leading causes of death during times of flood. This study examined the little explored topic of child drowning during floods, with the aim of identifying risk factors to inform prevention strategies. A retrospective, total population examination of cases of children and adolescents aged 0–19 years who died from unintentional flood-related drowning in Australia for the 16-year period 1 July 2002 to 30 June 2018 was undertaken. Univariate and chi-square analysis was conducted, with Fisher’s exact test used for cell counts <5. Across the study period, 44 flood-related drowning deaths occurred among children and adolescents (63.6% male; 34.1% aged 10–14 years). Almost all (84.1%) occurred in rivers, creeks, or streams in flood, with the remaining incidents occurring in storm water drains (n = 7). Leading activities immediately prior to drowning were non-aquatic transport (40.9%), swimming in floodwaters (25.0%), and falls into floodwaters (15.9%). Flood-related fatal drowning among children and adolescents is rare (0.05 per 100,000 population), however flood-drowning risk increases as remoteness increases, with children and adolescents drowning in floodwaters in very remote areas at a rate 57 times that of major cities. All drownings are preventable, and this study has identified key causal factors that must be considered in advocacy and prevention efforts. These include: the importance of adult supervision, avoiding flooded waterways when driving or for recreational purposes, and the increased risks for those residing in geographically isolated and socially disadvantaged areas. Findings must be considered when developing interventions and advocacy for the purposes of the reduction of child and adolescent drowning during times of flood.
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