Syndromic Surveillance of Emergency Department Visits Related to Unintentional Drowning, United States, 2019-2022

Objectives: To improve national drowning surveillance efforts, we developed and evaluated a definition for unintentional drowning for use in the National Syndromic Surveillance Program's ESSENCE platform (Electronic Surveillance System for the Early Notification of Community-Based Epidemics) and described drowning-related emergency department (ED) visits from 2019 through 2022 using the new definition. Methods: We adapted an unintentional drowning definition from a previous version, which included all drowning-related ED visits regardless of intent (including drowning related to assault and suicide, as well as unintentional drowning). We reviewed a random sample of 1000 visits captured by the new definition of unintentional drowning and categorized visits as likely, possibly, and unlikely to be related to unintentional drowning. We compared monthly drowning-related ED visits from 2020, 2021, and 2022 with monthly drowning ED visits from 2019, overall and by sex and age group. Results: A total of 35 431 ED visits related to unintentional drowning (10.71 per 100 000 ED visits) occurred from 2019 through 2022. Most visits (86%) captured by the new definition and manually reviewed were likely related to unintentional drowning. Rates were highest among males (14.04 per 100 000 ED visits) and children aged <1 to 4 years (65.61 per 100 000 ED visits). The number of drowning-related ED visits was higher in May and August 2020, May and June 2021, and May 2022 as compared with the same months in 2019 among people aged 18 to 44 years. Conclusions: The definition for unintentional drowning is available in the National Syndromic Surveillance Program's ESSENCE platform for state and local jurisdictions to use to monitor unintentional drowning-related ED visits in near-real time to inform prevention strategies.