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January 16, 1991

The Risks of Drowning: Males in Maryland Rivers

JAMA. 1991;265(3):356. doi:10.1001/jama.1991.03460030062020

To the Editor.—  The work of Howland and collegues,1 as reported from MMWR, provides useful data, not only on alcohol use in connection with aquatic activity but also on the site of activity. The high exposure to the ocean (54% of activity) is of particular interest because ocean drowning is relatively uncommon. Maryland's popular ocean beaches were the site of only one of 117 drownings in an early study that also identified the important role of alcohol.2 The majority of the Maryland drownings occurred in rivers and creeks, where supervision is often absent, footing uncertain, and currents treacherous.Gender differences in drowning rates vary dramatically with age (Figure). The male-female ratio is approximately 9:1 for ages 15 to 29,1.4:1 for infants less than 1 year of age, and 4.3:1 for all ages combined. In the teens, there is a sharp increase in the male drowning rate that is