We applaud the recent article by Drs. Layon and Modell as a timely and thorough review of drowning, from epidemiology to treatment. In fact, the scope of the drowning problem may be even larger than initially presented, with more than 400,000 global drowning fatalities in the year 2000 as estimated by the World Health Organization. We fully concur that further research in the area of drowning treatment is needed, but the greatest success with the least risk and most promise involves drowning prevention and rescue. This can be achieved by teaching populations to swim and encouraging swimming in lifeguard-protected areas. Lifeguard services are often among the first cut by agencies attempting to reduce operating expenses, yet lifeguards offer "significant . economic and social savings to society" because of their low relative expense and high success rate.
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