Each Year in California, 140 Children Under Age 4 Drown . . . : The Lethal Luxury of Backyard Pools

Angela, Joshua and Christopher Burgess were diving and playfully splashing each other in the deep end of the family swimming pool when they suddenly spotted the face-down body of their 11-month-old sister, Jessica, floating toward them from the shallow end of the pool.

“Jessica’s dead! Jessica’s dead!” shrieked 3-year-old Joshua when he saw Jessica’s body, which had been obscured from his view and that of 7-year-old Angela and 5-year-old Christopher by a tree at the bend of the boomerang-shaped pool.

Jessica had slipped unnoticed through the unlatched gate of the wrought iron fence surrounding the pool and toddled into the shallow end of the pool. She survived her near-drowning last August, but in less than five minutes she was left severely brain damaged. She is now receiving around-the-clock nursing care in her Buena Park home at a cost of $20,000 a month.

As summer approaches, doctors fear there will be other Jessicas in Orange County, which studies show leads the nation’s counties in children’s pool drownings and near-drownings. Indeed, drownings and near-drownings now have eclipsed auto accidents as the leading cause of accidental death among children between ages 1 and 4 in Orange County and the rest of California, according to a recent state government study.

“We’ve got a climate in which you can use your pool year-round, and we’ve got a growing population of young families that’s incredibly affluent,” said Dr. Ralph Rucker, head of the Critical Care/Pulmonary Section of Childrens Hospital of Orange County, the only licensed pediatric intensive care unit in the county. “Where else would you find more than 100,000 backyard swimming pools?”

The state study found that each year in California, 140 children under age 4 drown, and another 40 children are institutionalized with permanent brain damage and resulting mental retardation caused by near-drownings.

In 1984, 11 children drowned in Orange County, all but one of them under the age of 5.

Three weeks ago, an unusual near-drowning occurred when 8-month-old Steven Christopher Dixon crawled out of his Westminster home and fell into the family pool, where he reportedly remained under water for 15 to 30 minutes before being revived. Although near-drowning victims who are submerged that long usually die or suffer severe brain damage, Steven has experienced what has been called a “miraculous” complete recovery.

While submerged Steven underwent hypothermia, the lowering of his body temperature and metabolic rate, which doctors believe saved his life and averted brain damage.

This year the Orange County Trauma Society, which seeks to prevent accidental injuries and deaths, estimates that 10 drowning deaths--and another 1,000 near-drownings--will occur in the county among children under age 10, with 75% of the fatalities in the 1 to 4 age group.

“Almost all the drownings or near-drownings occur in home pools,” Rucker said. “These are pools that the parents or grandparents put in or purchased with their homes. Few drownings occur at the beach or in motel pools.

‘Danger Not Well Appreciated’

“The danger posed by backyard pools is not well appreciated by their owners,” Rucker said during a recent tour of the hospital’s intensive care ward, where nine pool accident victims have already been treated this year, two of whom died. “It never occurs to them not to install a pool at their house or to put off buying a house with a pool until after their children are over 5 years old.”

To help avert pool drownings and near-drownings, the Trauma Society, at the behest of Rucker, this spring launched the Protect Our Kids pool drowning prevention program.

Protect Our Kids has two components. The first is a traveling puppet show that will visit 125 of the county’s 500 preschools and day care centers during the coming year to educate children on pool hazards. The second is enlisting pool builders and suppliers to install warning signs at the county’s 100,000 backyard swimming pools.

Rucker, who headed the steering committee that instituted the program after a year of extensive study, said the Trauma Society adopted this two-pronged approach because other pool accident prevention measures have failed.

Regulations Have Not Worked

While there have been laws on the books for years requiring pool owners to enclose their backyards with fences, these regulations clearly have not worked, Rucker said. The legally required fences or walls are usually around the backyard and not around the pools themselves, where they could do the most good, he noted. And even fences around the pool itself have limitations.

“When an adult sees a fence, he sees a barrier,” explained Rucker. “But when a 3-year-old sees a fence he sees a toy, something to be climbed. I suppose a fence around a pool could be made impenetrable by making it six-feet high and topping it off with barbed wire and stakes. But with people coming and going all the time, how are you going to make sure the gate is always locked to keep a child out?”

Continued Rucker: “After studying the problem for a long time, we concluded that a good way to go was to educate little children in their preschools, where you’ve got a captive, eager audience.”

At the conclusion of the puppet show, the preschoolers are given coloring books cautioning them to swim only when an adult is present, not to run on pool decks, not to push each other into the pool and not to float into the deep end of the pool on their water toys.

Reminded of Inherent Danger

“The children are told to take their coloring books and handouts home--little kids take everything home--so they can be read by their parents, who will be reminded of the inherent danger of pools,” Rucker said.

The traveling puppet show has a cadre of 24 volunteers, most of whom are Childrens Hospital nurses. (To volunteer for the program or to arrange for a puppet show, call the Orange County Trauma Society at 937-5030.)

In an effort to directly inform pool owners of the danger posed by their backyard pools to young children, Rucker and his supporters have obtained the assistance of pool builders and suppliers and their trade group, the National Spa and Pool Institute-South Coast chapter.

Daryl Bellissimo, owner of Valley Pool Supply in Mission Viejo, has represented the National Spa and Pool Institute on the Protect Our Kids steering committee during the past year. Bellissimo approached Rucker in October, 1983--after he learned of the deaths of two children in swimming pools on his service route--and asked what he and others in the pool industry could do about the problem.

Bellissimo, intending to discuss the subject in a newsletter he circulates among his clients, met Rucker to get statistics on pool drownings for his article. Instead, Rucker escorted Bellissimo through Childrens Hospital’s intensive care unit to see the “statistics” in person.

‘Depressed for Weeks’

“I was depressed for weeks,” recalled Bellissimo. “You don’t forget seeing little kids on five machines.”

Following meetings with the Orange County chapter of the National Spa and Pool Institute, the steering committee came up with a design and wording for warning signs to be posted by pool vendors at their customers’ pools. These weatherproof, 16-by-30-inch posters provide information on the hazards posed by pools to children and how to perform both mouth-to-mouth and cardiopulmonary resuscitation (CPR).

“Too many children have drowned,” Rucker said, “because parents aren’t able to provide basic CPR when the accident first occurs.”

Incentive to Put Up Signs

As an incentive for the pool builder and supplier to put up the signs at their customers’ pools--and to ensure that they routinely check on whether the signs are in place--each sign has space at the bottom for the pool supplier’s advertising logo. The first 1,000 signs have been prepared and are in the process of being placed at pools throughout the county. The posters, which cost from $2.35 to $4.75 each (depending on the size of the order), are being paid for by pool vendors whose ultimate goal is to install these warning signs at all the county’s 100,000 backyard swimming pools.

Start-up money for the pool drowning prevention program is being provided by a $5,000 revenue-sharing grant from the Orange County Board of Supervisors and a $1,000 donation by Bob Fluor II, a vice president of the Fluor Corp., the Irvine-based engineering, construction and natural resources company.

Fluor developed an interest in the Protect Our Kids program after his son, Andrew, then 11-months-old, nearly drowned last June in the family swimming pool.

Precautions Beefed Up

Even now, Fluor finds it too painful to recount the details of the summer day when he almost lost Andrew, the youngest of his five children. Since the accident, from which Andrew has completely recovered, Fluor said pool safety precautions have been beefed up at his Newport Beach home.

“Even before the accident,” Fluor said in a telephone interview, “we’d been very attentive about watching the gates (of the fence surrounding the pool) to make sure the spring latches locked. Since then, we’ve installed a pool cover.”

Yet Fluor believes much more should be done to alert parents of the hazards posed by “the luxury” of having a home swimming pool. That’s why he personally donated the $1,000 to the Protect Our Kids program and has suggested that the program apply for additional funding from the Fluor Foundation next year.

Assessing the public’s attitude toward pool drownings and near-drownings, Fluor said: “It’s like cancer (which his father, J. Robert Fluor, who was chairman and chief executive of the Fluor Corp., died from last September). Everybody thinks it can’t happen to them, but it does happen to a lot of people.”

Under No Illusions

Rucker is under no illusions that the Protect Our Kids program will end pool drownings.

“It’s hard to get the word out that we need to prevent childhood drownings because of inherent social problems,” Rucker acknowledged. “It’s the kind of injury that people don’t want to talk about: People blame themselves for not watching their children closely enough.

“It’s not the kind of issue you can get the public stirred up about. Parents aren’t going to stand up at a city council meeting and say: ‘My child drowned because I was negligent.’ ”

While Rucker believes that parents with children under age 5 should not have pools, he is resigned, after 10 years at the helm of Childrens Hospital’s intensive care ward, to the fact that few parents will take his advice.

“Somewhat tongue in cheek, I’ve advised couples with young children to fill their pools with dirt and gravel and plant a rose garden,” Rucker said. “But a pool is too valuable; a pool is too much a symbol of the California good life. It’s what young, achievement-oriented couples strive for.

“Since pools make homes go up in value, nobody ever takes pools down in Orange County.”

Expects More Drowning Victims

So Rucker fully expects to see more drowning and near-drowning victims, who fit an all-too-common pattern. Nearly 85% of the victims are boys.

“Little boys are simply more curious, and aggressive behavior is expected of them,” Rucker said.

And 2-year-olds are most at risk, according to Rucker, who said: “A 1-year-old is curious, but he’s not very fast. A 3-year-old is curious and fast, and he’s had some experience with hazards--getting burned by the stove or cutting his hand with a knife.

“But a 2-year-old is too fast, and he’s had no experience with hazards.”

Explaining why childhood drownings are usually confined to backyard pools or spas, Rucker said: “There are few drownings or near-drownings at the beach because you don’t send a young child to the beach by himself, though he’ll be sent to the backyard by himself. Besides, a 2-year-old is terrified by waves at the beach, and he’s likely to be spotted by a lifeguard.”

A Set Scenario

And drownings and near-drownings follow a set scenario, according to Rucker: “It’s usually the afternoon or the weekend. Many times there’ll be a baby sitter or mother watching the child, but she’s so harried with the dishes or other household work that she can’t watch the child all the time.

“Sometimes an older child is told to watch the baby, but he or she is only 8 or 9 years old and really isn’t equipped to watch a baby.

“The baby wanders out (of the house) through an open door or the dog door.

“Once outside, he’s attracted to the pool by the light. And he looks upon the pool as a pleasant experience because he’s spent nice, cozy times in the pool with his parents or brothers and sisters. Spotting a leaf, twig or butterfly floating in the pool, he’ll reach for it and fall in. Or he’ll be pushing a tricycle, which rolls into the pool with the baby following right in after it.

“Suddenly, the parent realizes that the child hasn’t been seen for a while. The parent will check to see if the baby’s watching the TV or has climbed into the pantry. The pool tends to be the last place the parent looks.

Little Chance Baby Will Survive

“She’ll see her baby floating in the pool and call for help. Paramedics arrive within minutes, but unless the parent knows CPR and has been administering it until the paramedics arrive, there’s little chance that the baby will survive. Or, if he does, he’ll probably suffer severe brain damage (which can occur in four to six minutes).”

There are currently seven children at Fairview State Hospital in Costa Mesa who are in a semi-comatose state as a result of near-drownings, according to Lisa Parks, the assistant director of the Trauma Society who is coordinating the day-to-day operations of Protect Our Kids. The care of each child will cost the state an estimated $70,000 a year.