Conclusion: Indications for effectiveness
This evidence statement is based on five identified studies on the effectiveness of pool legislation in three countries: New Zealand (Morrison et al., 1997; Gulliver et al., 2009), Australia (Stevenson et al., 2003; Blum et al., 2000) and the United States, Los Angeles County (Morgenstern et al., 2000). The reviews on this topic of the American Academy of Pediatrics (Weiss et al, 2010) and the Harborview Injury Prevention & Research Center
(http://depts.washington.edu/hiprc/practices/topic/drowning/fencing.html) were also taken into account.
In order to be effective, pool fencing legislation should require
- isolation fencing (4-sided) with secure, self-latching gates;
- the fitting of barriers to existing pools as well as new pools;
- include enforcement provisions.
This may lead to a reduction in drowning, but is not sufficient to prevent all drowning in children.
Recommendations (for research & practice)
Practice and policy
It is highly recommended that carers be strongly encouraged to continue close supervision of their children around pools; no legislation has been provably able to replace parent supervision.
More studies on the effect of 4-sided fencing legislation supported by enforcement and inspections are needed to prove their effectiveness.
Harborview Injury Prevention & Research Center suggests future studies examining fencing enforcement might lead to better fencing legislation, eg. a case-control study comparing types of fencing-legislation and their policies (fines,periodic inspections, etc.). It also suggests future studies should examine the effect of adding a multifaceted educational campaign to legislation.
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. Irrelevant studies were excluded, i.e. the article does not comprise  the evaluation or effectiveness,  the prevention of child injuries,  the specific preventive measure studied. 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.
Achieving compliance with pool fencing legislation in New Zealand : a survey of regulatory authorities (version 1.0)
Luke Morrison, David J. Chalmers, John D. Langley ... [et al.] (1999)
Childhood drowning : barriers surrounding private swimming pools (version 1.0)
Mark R. Stevenson, Miroslava Rimajova, Dean Edgecombe ...[et al.] (2003)
Effects of pool-fencing ordinances and other factors on childhood drowning in Los Angeles County, 1990-1995 (version 1.0)
Hal Morgenstern, Trista Bingham, Avid Reza (2000)
Achieving compliance with pool fencing legislation in New Zealand : how much progress has been made in 10 years? (version 1.0)
Pauline Gulliver, David Chalmers, Kimberley Cousins (2009)
Toddler drowning in domestic swimming pools (version 1.0)
C. Blum, J. Shield (2000)
Technical report : prevention of drowning (version 1.0)
Jeffrey Weiss (2010)