Slippery, hard-surfaced bathrooms are not safe places to be using drugs or drinking, Australian researchers investigating bathtub drownings say.
An analysis from the National Drug and Alcohol Research Centre of 195 adults who died in a bathtub or hot tub between 2015 and 2024 found drugs or alcohol contributed to the majority of deaths.
A medical episode or injury led to 67 of the deaths, but substance use was a contributor in 113.
Many of the deaths included blood-alcohol concentrations multiple times over the legal driving limit, the study's lead author Shane Darke told AAP.
"A lot of people would like to have a bath and a glass of wine or a beer or whatever," the University of NSW emeritus professor said.
"But I think we need to get away from this view that it's a safe place to do that.
"There's a real risk there."
The deaths occurred between 2015 and 2024 at a rate of more than one every month, across a wide range of ages, with an average of 55.
"People would probably be surprised by that ... because all the attention is on rivers and ocean swimming," he said.
"There's a whole lot of unforgiving surfaces (in bathrooms).
"You're running a real risk in an environment where you could pass out, you could hurt yourself, and no one knows because the door is shut."
While two-thirds of deaths analysed were women, all people were at risk of falls, more so if drunk or on drugs.
Some drugs also put pressure on the heart, which can be exacerbated by being in a hot environment, leading to unconsciousness.
More than a quarter of the people who died had a documented history of substance use problems and more than half had past mental health problems.
"There are a lot of people, a lot of tragedy ... the role of drugs in this is quite overwhelming," Prof Darke said.
The study only analysed deaths where a coronial investigation had been finalised, meaning there were likely more deaths during the analysed period which were not included.
More than a third of the deaths had been ruled "intentional" with an average of one death each month falling outside this category.
The researchers concluded public campaigns promoting greater awareness of the risks posed by inebriated bathing could help reduce deaths, as well as checking on bathers who are at-risk of suicide.
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