COLUMBUS, Ohio — A child dies every five days in portable pools during warm-weather months, according to a new study.
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"Parents need to be aware that these pools can present the same risks for drowning, especially for young children, as in-ground pools," which are typically thought of as a greater safety hazard, the study's senior author Dr. Gary Smith said.
The research published Monday in the journal Pediatrics shows 209 deaths and 35 near-drownings of children under 12 from 2001 through 2009. Most of the children, 94 percent, were under 5, and 81 percent of the incidents happened during summer months.
"That's a child every five days that is drowning in a backyard portable pool during the summer months," Smith said.
The study focused on portable pools, from small wading pools less than 18 inches deep to inflatable pools and other soft-sided pools that can reach depths of 4 feet. It was conducted by researchers at Nationwide Children's Hospital in Columbus and Independent Safety Consulting in Rockville, Md.
"The anecdotal evidence was suggesting that because portable pools are readily available in many convenience stores and malls, and they're relatively cheap, parents would pick them up, take them home, quickly assemble them, and all this would be done without a lot of forethought about the safety aspects," said Smith, director of the Center for Injury Research and Policy at Nationwide.
The authors found cases of drowning when kids opened the doors of their houses and climbed into the pool using a ladder or another nearby object, as well as examples of kids playing in the pool when parents were nearby but were distracted by chores or a phone call.
Many safety methods used for permanent pools, such as fencing, pool alarms, safety covers and removable or lockable ladders, are too expensive or not available for families who purchase portable pools, said Smith, who also is a pediatrics professor at the Ohio State University College of Medicine.
The Association of Pool & Spa Professionals supports "layers of protection," and the study underscores the importance of active, undistracted adult supervision, said Carvin DiGiovanni a senior director at the Alexandria, Va.-based association.
"The primary layer of protection is constant adult supervision supplemented by barriers, alarms and other related devices," he said. "We encourage homeowners to purchase the additional layer of protection that works for them knowing that they would be more likely to use it."
The study shows that children were supervised by adults in fewer than half, 43 percent, of the drownings and near-drownings, and that most, 73 percent, were at home.
Among other data, the report shows CPR was administered before emergency crews arrived in 15 percent of the fatalities and 17 percent of near-drownings, numbers that help show "it's time for us to begin requiring that people learn how to do CPR," perhaps by adding it to high school curricula, said Susan Baker, a professor at the Johns Hopkins Center for Injury Research & Policy in Baltimore.
"That to me is a reminder that every one of us ought to be knowledgeable about how to do CPR and willing to jump in and do it immediately," said Baker, who was not involved in the study.
Smith said drownings overall represent the second-leading cause of injury deaths among young children and are different from other childhood accidents because there's no second chance.
"I tell parents that drowning is quick, it's silent and it's final," he said.
Parents "can't say they're supervising having a couple drinks at a pool and chatting with their friends or talking on a cell phone," said Dr. Linda Quan, a drowning expert at Seattle Children's Hospital.
"Supervision has to be constant ... and for a very young child, even within arm's reach," Quan, who was not involved in the research, told Reuters Health.
Parents can add a layer of safety by making sure kids have a life jacket on whenever they're by the pool, Quan added.
And when they're not outside watching their kids, parents have to make sure they have no access to the pool, researchers said.
One of the simplest ways to do that is to empty the pool, especially for smaller pools, Quan explained.
Parents can also put an isolation fence around the pool and make sure there's no way kids can reach the ladder in bigger inflatable pools, Smith said.
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"Two-thirds of the children who drowned gained access to the portable pool through the ladder," he said. "Blocking access is the first step."
The authors note in Pediatrics that local jurisdictions are responsible for setting pool codes and enforcing them, and that only some require fencing around portable pools.
A cover for inflatable pools won't necessary help, the researchers said — and in at least one case, a pair of kids included in the study drowned together when they got tangled in a pool cover.
Getting parents to follow all of these prevention measures "is a challenge," Dr. Ruth Brenner, who has studied drowning at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, told Reuters Health.
"But it does represent a significant risk for children. Children can drown in very small amounts of water," said Brenner, who was not involved in the new paper.
Smith said the most important message is that parents need to take the risks of these pools very seriously — even if the pool is small and only has a couple feet of water.
"If you are on the playground equipment and you fall, you generally get another chance," Smith said.
"The problem with submersion underwater is it's very quick ... and once (a kid's) heart and breathing stops it's very difficult to revive them," he said. "You don't get a second chance."
The Associated Press and Reuters contributed to this report.