Introduction:
Drowning accounts for 7% of all injury related deaths in the world, and almost 3% of injury related deaths in Croatia. Although a seemingly small percentage, mortality rates due to drowning in Croatia are still higher than the EU average. Objectives: To determine the trends in mortality due to drowning in Croatia for the 2001-2021 period.

Methods:
We used the routine mortality data on drowning (ICD-10 codes W65-W74) collected by the Croatian Institute of Public Health. Rates were calculated using the mid-year population estimates, and standardized using the European standard population from 2013. Trends were analyzed using the Joinpoint regression analysis, for both sexes combined and separately.

Results:
During the last 21 year, an average of 88 people (23% women) died due to drowning each year in Croatia. Highest mortality rates are seen in the 65+ age group. Joinpoint regression analysis showed a 12.9% average annual decrease in mortality from 2001 to 2004 (CI=-12.9, 0.9), 6.1% increase from 2004 to 2010 (CI=-1.3, 14.0), and a 4.1% decrease from 2010 to 2021 (CI=-6.1, -1.9). When looking at the whole 2001-2021 period, regression analysis showed a 1.3% (CI=-2.4, -0.1) average annual decrease in total mortality due to drowning. There are no changes in trend in men, with 1% average annual decrease for the whole period (CI=-2.3, 0.2), and similar trend is seen in women, with 1.6% average annual decrease during the whole period (CI=-3.6, 0.4).

Conclusion:
Mortality rate from drowning is decreasing in Croatia. However, there is still room for improvement, as standardized mortality rate due to drowning is above the EU average. Due to geographical location and almost half of the population living on the coastline, swimming is often learned in childhood. Public health campaigns on safety in water are regularly conducted during summer months, and swimming lessons are often provided during elementary school. There is a public initiative to reintroduce swimming lessons as mandatory part of the elementary school curriculum. Croatian Red Cross strives towards successful implementation of the Lifeguarding network throughout Croatian costal, river, lake and other aquatic areas.

Keywords: drowning, mortality trends, drowning prevention