Drowning Risk in Baths, Hot Tubs and Cold Water: Who and Why

Urgent Guidance First

In the US, call 911 right away if a person is in difficulty in water, has been under water, or is unresponsive. A child in or near water needs an adult actively watching; the studies below describe how brief lapses in supervision are involved. Do not jump into cold or deep water to rescue someone; call for help and look for something that floats to reach them, as the Met Office advises. [1]

This page is for understanding risk, not for rescue training. Take a first aid and CPR course from a recognised provider.

What Drowning Is

The WHO defines drowning as the process of experiencing respiratory impairment from submersion or immersion in liquid, with outcomes classed as death, morbidity and no morbidity. [2] That means drowning includes non-fatal events, and it can happen in shallow water such as a bathtub.

Young Children and Baths

The WHO says the risk of drowning increases when children interact with water outside of active adult supervision. [2] It reports children under 5 account for nearly a quarter of all drowning deaths worldwide. [2]

A 2025 study of one US children's hospital in Central Texas (50 children aged 0 to 9 treated for bathtub drowning over ten years) reported that bathtubs pose the highest drowning risk for infants and that 56% of patients were under 1 year old. [3] In 91% of incidents a caregiver intended to supervise, but in only 24% was the caregiver engaged in supervising. The most common reasons for a lapse were retrieving a towel or clothes (39%) and caring for other children (20%). [3] The authors recommend gathering all bath supplies before starting a bath and avoiding distractions. [3] For children aged 2 to 9 the drowning was likely seizure-related in most cases. [3] See epilepsy, seizures and water safety and baby baths and water safety for infants.

This is a single-hospital descriptive study, so it shows patterns but not national rates.

Hot Tubs

A 2024 review in Cureus of 18 studies on hot tub bath-related deaths looked at blood pressure and circulation, electrolyte changes, the effect of alcohol and substances, and temperature. It reports growing concern about injuries and deaths. [4] It is a narrative review, and its abstract gives no figures, so we do not quote numbers. Proper evidence not found for current US hot tub drowning counts in sources we could read; US CDC and CPSC pages were not accessible this session.

In the UK, a study of coroners' records found 156 people with drug-related deaths found in a bath and six in a hot tub over 1997 to 2023; heroin, alcohol and cocaine were the most common substances, and multiple drugs were involved in most cases. [5] See alcohol, drugs and hydrotherapy.

Older Adults and Hot Baths

Japan has many deaths of older adults in home baths. A 2025 national study found 99,930 deaths coded as bathtub drowning or submersion at home from 1995 to 2020, highest in the 80 to 84 age group and in January. [6] The authors report research grants from Japanese science funds and from companies in housing and building products. [6]

Researchers propose several causes. A 2026 review points to cold changing rooms, blood pressure swings, overheating and low blood pressure on standing, which can cause loss of consciousness and face submersion. [7] Another Japanese paper argues heat illness may play a larger role than blood pressure swings alone. [8] A prospective study found 79% of bath-related sudden cardiac arrests were in people with faces submerged. [9] See fainting and heat illness.

Cold Water

A 2026 review says cold water immersion is a significant cause of open-water drowning mortality, and that the cold shock response can cause death through aspiration, reduced brain blood flow and cardiac arrhythmia before the body cools. [10] It notes alcohol and psychoactive substances modify the risk. [10] See cold shock and hypothermia.

Alone, Alcohol and Breath-Holding

The WHO says higher drowning rates among males are suggested to come from more exposure to water and riskier behaviour such as swimming alone and drinking alcohol before swimming alone. [2] Do not practise breath-holding or fast over-breathing in or near water. See shallow water blackout and Wim Hof-style breathing and water.

Prevention Points From the Sources

The WHO lists covering wells, doorway barriers, fencing swimming pools and supervised childcare as measures that reduce exposure. [2] The Texas study stresses active supervision. [3] For hot tubs, home pools and public pools, we do not give equipment rules because the sources we could read do not list them. See pool safety for exercise and therapy.