Spatio-temporal clustering of drowning mortality in Iran, from 2005 to 2022

Background Drowning is a serious and neglected public health threat, and prevention of drowning has a multisectoral nature and requires multidimensional research. Therefore, this study aimed to evaluate the spatio-temporal variation in fatal unintentional drowning rates among the Iranian population from 2005 to 2022.Methods In this repeated cross-sectional study, registry data were extracted from legal medicine organisations during 2005-2022. The mortality rate per 1 million population was calculated by gender and province. The joinpoint regression model was fitted to estimate average annual percentage changes and an annual percentage change in the drowning mortality rate. We used spatial scan statistics to detect high-risk clusters of drowning deaths at the provincial level.Results Over 17 years 19 547 people died due to unintentional drowning. The highest yearly drowning rate was 15.58 per 1 000 000, and men had the highest rates of death (25.91) compared with women (4.98) in 2019. The overall mortality rate has decreased from 18.69 in 2005 to 12.87 in 2022. In the spatio-temporal analysis, four statistically significant high-risk clusters were detected in the north, southeast and centre of Iran.Conclusion The overall mortality rate in 2022 decreased compared with the 17-year period. In the spatial analysis, several high-risk clusters were identified in different locations, which highlights the importance of targeted and more comprehensive interventions. It seems that the prevention of drowning requires the effective participation of all responsible organisations and risk reduction plans in the field of environmental and individual risk factors.