Conclusion: No / inconclusive evidence found to make an evidence statement; effect unknown
There is no quantitative evidence on the effectiveness of informative signs to prevent children from drowning was found.
Expert opinion (WHO guidelines, 2006) states that signs regarding safe behaviours displayed in clear and simple signage are a preventive strategy in the prevention of drowning. Signage is most effective when supported by educational activities. International standardisation of symbols on signs should be used to avoid confusion.
Recommendations (for research & practice)
Practice and policy
Informative signs cannot replace adult supervision of children around water. It is highly recommended that adults are strongly encouraged to continue close supervision of children around water.
More studies on informative signs to reduce the risk and/or occurrence of drowning are needed to obtain knowledge of their effectiveness in preventing children from drowning. Signs need to be evaluated in combination with education. The relevance of studying informative signs as an stand alone intervention strategy to prevent drowning in children is debatable.
Articles (reviews) and reports were included that were published between 1991 and 2010, in English and Dutch. The outcomes of the study were reviewed by the Dutch Consumer Safety Institute.
Strategy: An online literature search was performed by a researcher of the Consumer Safety Institute and after this a more thorough search was performed by the documentation centre of CSI (Catalog CenV, Pubmed, Injury lit, Google, Websites, 'Grey' literature). Results of each search were compared on differences and potential missed studies were added. First the titles and then abstracts were scanned in order to include relevant studies. In the case of insufficient information obtained from abstracts the full text articles were obtained. Relevant articles were scrutinized and background documents were created. In addition, relevant references of included articles were checked on new and relevant articles (i.e., snowball search).
The outcomes of the study were reviewed by an expert in the field of child safety in the autumn of 2010.
Guidelines for safe recreational water environments : volume 1. coastal and fresh-waters (version 1.0)