Reasons for Policy
- Drowning is the third leading cause of unintentional injury to children under age 15.1
- Death rates from drowning are highest in children less than five years old.1
- For each childhood drowning fatality, four children are hospitalized and 14 are seen in the emergency department (ED) and released. For every child seen in the ED, there are 10 near misses (child immersed but was rapidly rescued).1
- Drowning rates are higher in locations where the weather is hot and exposure to swimming pools is greatest.1
- Swimming pools pose the greatest risk of drowning to toddlers.1
- Local Government
- Local Health Department
- State Government
- Isolation fencing (i.e., pool fencing that completely encloses a swimming pool and isolates it from the home).
- Prevention/reduction of drowning fatalities
- Prevention/reduction in near-drowning (non-fatal submersion resulting in treatment in a hospital or emergency department)
Level of Evidence Available to Evaluate Effectiveness of Policy
For all policies we describe on this website, we have applied the Standards of Evidence as defined by Flay et al. (2005) in the Standards of Evidence document published by Prevention Science.
The effectiveness level of this policy is 2: Policies with Consistent Evidence from High-Quality Observational Studies.
The levels of effectiveness as noted are:
- meets criteria for policy effectiveness (consistent, positive outcomes from at least two high-quality experimental or quasi-experimental trials using a comparison group or interrupted time series design);
- consistent evidence available linking policy with positive outcomes from high-quality observational studies only;
- insufficient evidence available for policy or policy components.
On average, isolation pool fencing can achieve:
- Large reductions in the risk of drowning (Odds Ratios: 0.17-0.29).1*
*Note: Recent studies evaluating pool-fencing ordinances indicate that the mere passage of legislation is not sufficient to reduce drowning. In those studies there was inadequate enforcement of the ordinance.
Legislation should include enforcement provisions and educational campaigns should accompany the legislation. Legislation should also require fencing of both newly constructed and existing pools.
Additional studies are needed to provide a more precise estimate of the protective effect of fencing.1
Arizona Department of Health Services, Office of Environmental Safety, Residential Pool Safety Notice
Pinellas County, Florida, Pinellas County Building and Development Review Services indicate that all new private swimming pools provide a barrier around the pool.
Links to Policy Examples
Florida Building Code § 424.2.17 Residential swimming barrier requirement
Arizona Revised Statues § 36-1681 Pool enclosures; requirements; exceptions; enforcement
† Be sure to check with your state, county, and municipal governments regarding potential existing laws that may impede any new policy development.
‡Local governments and organizations may check existing state and federal statutes and administrative codes for the authority to implement local policies.
1 Thompson, DC, Rivara, F (1998). Pool fencing for preventing drowning of children. Cochrane Database of Systematic Reviews 1998, 1, CD001047.
2 Flay, BR, Biglan, A, Boruch, RF, Ganzalez Castro, F, Gottfredson, D, Kellam, S, Moscicki, EK, Schinke, S, Valentine, JC, & Ji, P (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6(3), 151-175.