|
1
|
Brillhart A, Seufferheld J, Abramor B, Duplessis R, Pronce R, Sethi S. Medical Evacuations of Climbers on Mount Aconcagua, 2022-2024. Wilderness Environ Med 2025; 36:209-215. [PMID: 40101268 DOI: 10.1177/10806032251323504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2025]
Abstract
IntroductionMount Aconcagua (6961 m) is the highest peak in the Western Hemisphere and attempted by over 3000 climbers annually. Aconcagua Provincial Park (APP) and the APP medical service oversee all rescues and medical care. This study aims to describe patients and conditions requiring rescue medical evacuation on Aconcagua.MethodsDemographic, medical, and logistics data provided by APP on all park evacuations were retrospectively reviewed from the 2022-23 and 2023-24 climbing seasons.ResultsOf 6494 total Aconcagua climbers over the study period, 302 required an evacuation response from APP (mean 151 per year), yielding an evacuation rate of 4.7%. Mean age was 43.0. Male climbers had twice the risk of requiring rescue than female climbers (OR 2.01). Most evacuees were European (40%) or North American (33%), though climbers from Africa, Asia, and Australia had over twice the incidence of rescue (OR 2.26). Most frequent reasons for evacuation included altitude illness of all types (62%), high-altitude pulmonary edema (HAPE) (49%), trauma/musculoskeletal (15%), general medical (11%), and acute mountain sickness (11%). Most were flown by helicopter (95%), with flight location primarily from 4200 to 4300 m base camps (77%) and between 5300 and 5970 m (16%).ConclusionsOn Aconcagua, 4.7% of climbers required medical evacuation. Altitude illness frequently required rescue, with HAPE representing the single most common reason for evacuation. Male sex and certain continents of origin showed increased risks. Helicopter evacuation and medical oversight by APP appear to contribute to climber safety on Aconcagua. Opportunities exist for future study and climber education of risks.
Collapse
Affiliation(s)
- Aaron Brillhart
- Department of Emergency Medicine, University of Vermont, Burlington, Vermont, USA
| | | | - Bernabé Abramor
- Extreme Medicine, Aconcagua Provincial Park, Mendoza, Argentina
| | | | - Roxana Pronce
- Extreme Medicine, Aconcagua Provincial Park, Mendoza, Argentina
| | - Sameer Sethi
- Department of Emergency Medicine, University of Vermont, Burlington, Vermont, USA
| |
Collapse
|
|
2
|
Oshiro K, Matsumoto T, Nawa T, Sakuta T, Murakami T. Clinical outcomes of challenging out-of-hospital hypothermia management: A retrospective assessment of DOKEI protocol. Am J Emerg Med 2024; 85:71-79. [PMID: 39241294 DOI: 10.1016/j.ajem.2024.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 08/18/2024] [Accepted: 08/30/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Accidental hypothermia (AH) is a major cause of death in mountainous areas globally, and the second highest of mountaineering deaths in Japan, accounting for 37 % in Hokkaido. Managing AH is a significant challenge, particularly when adverse weather complicates the application of recommended rewarming and rapid transfer. To address this, the Hokkaido Police Organization (DOKEI) AH protocol was applied in Hokkaido's remote areas from 2011 to 2022, integrating high-temperature active external rewarming (HT-AER) with on-site sustained treatment. METHODS This study retrospectively analyzed the rescue reports and hospital records of hypothermia patients treated postprotocol, excluding patients with cold exposure, undetectable vital signs at rescue, and inadequate documentation. Protocol adherence and outcomes-hypothermia stage, cardiocirculatory collapse, survival, and neurological status-were assessed. RESULTS Among the 60 protocol-treated patients (19-74 years, 85 % male), 14 had stage 2 hypothermia, and 3 had stage 3 hypothermia. HT-AER was applied in 96.7 % of the patients. A total of 98.3 % of patients improved before handover without cardiac arrest (CA) or extracorporeal life support (ECLS). Comparatively, ten preprotocol patients (18-60 years, 70 % male) had two CAs, one fatal and six with no improvement. CONCLUSION The DOKEI AH protocol demonstrates feasibility in managing stages 1-3 hypothermia, enhancing survival and neurological recovery, and can offer a vital option in challenging AH rescue scenarios.
Collapse
Affiliation(s)
- Kazue Oshiro
- Cardiovascular Department, Mountain Medicine, Research, & Survey Division, Sapporo Kojinkai Memorial Hospital, Miyanosawa2-1-16-1, Nishi-ku, Sapporo City 063-0052, Hokkaido, Japan; Division of Respiratory Medicine, Department of Internal Medicine Nihon University School of Medicine, Kandasurugadai 1-6, Chiyoda-ku, 101-8309 Tokyo, Japan; Department of Emergency Medicine, Sapporo Tokushukai Hospital, Oyachihigashi1-1-1, Atsubetsu-ku, Sapporo City 004-0041, Hokkaido, Japan; Association for Mountain Medical Rescue Japan, Odorinishi28-3-5, Chuou-ku, Sapporo City 064-0820, Hokkaido, Japan.
| | - Takashi Matsumoto
- Mountain Search and Rescue Team, Hokkaido Prefectural Police Headquarter, Kita2-Nishi7, Chuou-ku, Sapporo City 060-8520, Hokkaido, Japan
| | - Takeshi Nawa
- Mountain Search and Rescue Team, Hokkaido Prefectural Police Headquarter, Kita2-Nishi7, Chuou-ku, Sapporo City 060-8520, Hokkaido, Japan
| | - Takayuki Sakuta
- Mountain Search and Rescue Team, Hokkaido Prefectural Police Headquarter, Kita2-Nishi7, Chuou-ku, Sapporo City 060-8520, Hokkaido, Japan
| | - Tomikazu Murakami
- Association for Mountain Medical Rescue Japan, Odorinishi28-3-5, Chuou-ku, Sapporo City 064-0820, Hokkaido, Japan
| |
Collapse
|
|
3
|
Kriemler S, Mateikaitė-Pipirienė K, Rosier A, Keyes LE, Paal P, Andjelkovic M, Beidleman BA, Derstine M, Pichler Hefti J, Hillebrandt D, Horakova L, Jean D. Frostbite and Mortality in Mountaineering Women: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2023; 24:247-258. [PMID: 37824760 DOI: 10.1089/ham.2023.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Kriemler, Susi, Kastė Mateikaitė-Pipirienė, Alison Rosier, Linda E. Keyes, Peter Paal, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, and Dominique Jean; for the UIAA MedCom Writing Group on Women's Health in the Mountains. Frostbite and mortality in mountaineering women: a scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 24:247-258, 2023. Background: The harsh environment of high altitudes (HA) poses many serious health risks for mountaineers, including cold injuries and death. The aim of this work was to review whether female mountaineers are at special risk for frostbite or death at HA compared with their male counterparts. Methods: The UIAA Medical Commission convened an international author team to review women's health issues at HA and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified with additional publications found by hand search. The primary search focus was for articles assessing cold injuries and death in women mountaineers at HA. Results: We reviewed the literature and identified 20 relevant studies: 2 studies on frostbite at HA, plus 7 studies and 1 report for death at HA. An additional 10 studies about frostbite at low altitude were included. We found that female mountaineers at HA were at lower risk of death than their male counterparts, but sex differences in frostbite were inconclusive. Conclusions: The frequency of cold injuries and mortality in female mountaineers is not yet well studied, and the studies that have been published tend to lack precise exposure data. More studies and registries with sex-differentiated data are needed.
Collapse
Affiliation(s)
- Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Dialysis Clinic, Elektrėnai, Lithuania
| | - Alison Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon, United Kingdom
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anesthesiology, Perioperative and Intensive Care, Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pediatrics, Infectious Diseases, and Altitude Medicine, Grenoble, France
| |
Collapse
|
|
4
|
Zeng L, Li RYM, Zeng H. Weibo users and Academia's foci on tourism safety: Implications from institutional differences and digital divide. Heliyon 2023; 9:e12306. [PMID: 36923855 PMCID: PMC10008990 DOI: 10.1016/j.heliyon.2022.e12306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Tourism safety is essential for tourists and tourism practitioners. This study conducted a bibliometric analysis using VOSviewer and CiteSpace for 2018 articles indexed on the Web of Science (WoS). It also analysed 7293 Weibo posts between 1977 and 2022 using Python, MYSQL, AI sentiment, and Tableau. The first tourism safety publication on WoS appeared in 1977, while the first Weibo microblog dated was dated back to 2011. Compared to the information posted on Weibo, the annual publications about tourism safety on WoS recorded a stable increment. On Web of Science (WoS), the academic staff and universities produced the largest number of tourism safety posts. On the flip side, the most productive organisations on Weibo are government agencies in popular tourism destinations. "Accident", "medical tourism", "environment", "mediating role", and "hospitality" were important burst nodes in tourism safety on WoS. "Quality", "accident", and health-related words were the foci on both Weibo and WoS. On Web of Science, the top 10 most popular keywords of tourism safety-related articles could be classified into two groups: health ("Covid-19", "restoration", "pandemics", "Sars-Cov-2", "Sars", "mental health") and IT terminologies ("big data", "artificial intelligence"). It has been concluded that "artificial intelligence (AI)" is more likely to be included in the keywords on tourism researched by academia. In contrast, the public may not know about or use AI in the tourism industry. Besides, the top 10 most popular keywords on Weibo related to tourism risks and hazards were drowning and traffic risks and hazards, such as drowning and traffic risks. The digital divide may explain such a difference: the academic circle benefits more from the digital age than laypersons. It may also be the result of institutional differences and information asymmetry.
Collapse
Affiliation(s)
- Liyun Zeng
- Civil & Architecture Engineering School, Panzhihua University, Panzhihua, China
| | - Rita Yi Man Li
- Sustainable Real Estate Research Center, Hong Kong Shue Yan University, Hong Kong, China
| | - Huiling Zeng
- Rajamangala University of Technology Tawan-ok, Bangkok, Thailand
| |
Collapse
|
|
5
|
DeLoughery EP, DeLoughery TG. Review and Analysis of Mountaineering Accidents in the United States from 1947-2018. High Alt Med Biol 2022; 23:114-118. [PMID: 35263173 DOI: 10.1089/ham.2021.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DeLoughery, Emma P. and Thomas G. DeLoughery. Review and Analysis of Mountaineering Accidents in the United States from 1947-2018. High Alt Med Biol. 23:114-118, 2022. Introduction: Given the popularity of mountaineering, it is important to better understand accidents related to this sport. We undertook this review of accidents to better understand the demographics and locations involved in mountaineering accidents over 71 years. Methods: Data collected from "Accidents in North American Mountaineering" booklets from 1947 to 2018 included the date, state and location of the accident, sex and age of the victim, type of accident, injuries sustained, and distance fallen if a fall occurred. If at least 10 accidents occurred in an individual state and/or location, these sites were separately analyzed. Results: From 1947 to 2018, 2,799 people were reported to be involved in mountaineering accidents, and 43% of these accidents resulted in death. Women were involved in 12% of cases. Falls were the most common accident (68% incidence, 45% fatal), followed by falling rock (7%, 26% fatal), avalanche (6%, 75% fatal), and falling into a crevasse (2%, 52% fatal). The average age of victims was 30 years. California had the most accidents (18%), followed by Washington (16%) and Alaska (15%). Denali had the greatest frequency of both accidents and deaths (11%, 8% of deaths), followed by Mount Rainier (6%, 7% of deaths) and Mount Hood (2%, 3% of deaths). Conclusions: Accident victims tend to be young and predominantly male, and the accidents themselves are most often falls. Avalanches were identified as an accident cause with a high fatality rate.
Collapse
Affiliation(s)
- Emma P DeLoughery
- Department of Internal Medicine, and Pathology and Pediatrics, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Thomas G DeLoughery
- Medicine, Pathology and Pediatrics, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| |
Collapse
|
|
6
|
Miner T. Denali Sunrise. Wilderness Environ Med 2022. [PMID: 35643892 DOI: 10.1016/j.wem.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Todd Miner
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| |
Collapse
|
|
7
|
Oshiro K, Murakami T. Causes of death and characteristics of non-survivors rescued during recreational mountain activities in Japan between 2011 and 2015: a retrospective analysis. BMJ Open 2022; 12:e053935. [PMID: 35115353 PMCID: PMC8814748 DOI: 10.1136/bmjopen-2021-053935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to describe the cause of death and characteristics at the prehospital setting associated with care and rescue processes of non-survivors rescued in the mountain of Japan. DESIGN Retrospective analysis. SETTING Prehospital setting of mountain searches and rescues in Japan. A total of 10 prefectural police headquarters with >10 cases of mountain death from 2011 to 2015. PARTICIPANTS Data were generated from the existing records. Of the total 6159 rescued subjects, 548 mountain deaths were caused by recreational activities. RESULTS Among the 548 mountain deaths, 83% were men, and major causes of death were trauma (49.1%), hypothermia (14.8%), cardiac death (13.1%) and avalanche-related death (6.6%). The alive rate at rescue team arrival in all non-survivors was 3.5%, with 1, 4 and 14 cases of cardiac, hypothermia and trauma, respectively. Cardiac deaths occurred in 93.1% (67/72) of men and individuals aged >41 years, and 88.7% (63/71) were found on mountain trails. In hypothermia, callouts were made between 17:00 and 6:00 at 49% (40/81) and by persons not on-site in 59.7% (46/77). People with >6 hours in trauma or >1 hour in cardiac death already died on rescue team arrival, but some with hypothermia after 6 hours were alive. CONCLUSION This study is one of the first large-scale retrospective analyses of prehospital non-survivors in mountain emergencies. The alive rate at rescue arrival in all mountain deaths was only 3.5%. These data showed that the circumstances related to onset and the process until the rescue team arrives have different characteristics, depending on the cause of death. Survival may be enhanced by targeting better use of the time before rescue team arrival and by providing further education, particularly mountain rescue-related medical problems to rescuers including bystanders.
Collapse
Affiliation(s)
- Kazue Oshiro
- Department of Cardiovascular Medicine and Director of Mountain Medicine, Research, and Survey Division, Hokkaido Ono Memorial Hospital, Sapporo, Hokkaido, Japan
- Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Director, Association for Mountain Medical Rescue Japan, Hokkaido, Japan
| | - Tomikazu Murakami
- Director, Association for Mountain Medical Rescue Japan, Hokkaido, Japan
| |
Collapse
|
|
8
|
Szymczak RK, Błażejczyk K. Heat Balance When Climbing Mount Everest. Front Physiol 2021; 12:765631. [PMID: 34899390 PMCID: PMC8656231 DOI: 10.3389/fphys.2021.765631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Mountaineers must control and regulate their thermal comfort and heat balance to survive the rigors of high altitude environment. High altitudes feature low air pressure and temperatures, strong winds and intense solar radiation, key factors affecting an expedition’s success. All these climatic elements stress human heat balance and survival. We assess components of human heat balance while climbing Mt. Everest. Materials and Methods: We calculated climbers’ heat balance using the Man-ENvironment heat EXchange model (MENEX-2005) and derived meteorological data from the National Geographic Expedition’s in situ dataset. Three weather stations sited between 3810 and 7945 m a.s.l. provided data with hourly resolution. We used data for summer (1 May–15 August 2019) and winter (16 October 2019–6 January 2020) seasons to analyze heat balance elements of convection, evaporation, respiration and radiation (solar and thermal). Results: Meteorological and other factors affecting physiology—such as clothing insulation of 3.5–5.5 clo and activity levels of 3–5 MET—regulate human heat balance. Elevation above sea level is the main element affecting heat balance. In summer two to three times more solar radiation can be absorbed at the summit of the mountain than at the foot. Low air pressure reduces air density, which reduces convective heat loss at high altitude by up to half of the loss at lower locations with the same wind speed and air temperature. Conclusion: 1. Alpinists face little risk of overheating or overcooling while actively climbing Mt. Everest, despite the potential risk of overcooling at extreme altitudes on Mt. Everest in winter. 2. Convection and evaporation are responsible for most of the heat lost at altitude. 3. Levels of physical activity and clothing insulation play the greatest role in counteracting heat loss at high altitude.
Collapse
Affiliation(s)
- Robert K Szymczak
- Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Błażejczyk
- Climate Impacts Laboratory, Institute of Geography and Spatial Organization, Polish Academy of Sciences, Warsaw, Poland
| |
Collapse
|
|
9
|
Szymczak RK, Marosz M, Grzywacz T, Sawicka M, Naczyk M. Death Zone Weather Extremes Mountaineers Have Experienced in Successful Ascents. Front Physiol 2021; 12:696335. [PMID: 34290622 PMCID: PMC8287323 DOI: 10.3389/fphys.2021.696335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/08/2021] [Indexed: 01/15/2023] Open
Abstract
Background Few data are available on mountaineers’ survival prospects in extreme weather above 8000 m (the Death Zone). We aimed to assess Death Zone weather extremes experienced in climbing-season ascents of Everest and K2, all winter ascents of 8000 m peaks (8K) in the Himalayas and Karakoram, environmental records of human survival, and weather extremes experienced with and without oxygen support. Materials and Methods We analyzed 528 ascents of 8K peaks: 423 non-winter ascents without supplemental oxygen (Everest–210, K2–213), 76 ascents in winter without oxygen, and 29 in winter with oxygen. We assessed environmental conditions using the ERA5 dataset (1978–2021): barometric pressure (BP), temperature (Temp), wind speed (Wind), wind chill equivalent temperature (WCT), and facial frostbite time (FFT). Results The most extreme conditions that climbers have experienced with and without supplemental oxygen were: BP 320 hPa (winter Everest) vs. 329 hPa (non-winter Everest); Temp –41°C (winter Everest) vs. –45°C (winter Nanga Parbat); Wind 46 m⋅s–1 (winter Everest) vs. 48 m⋅s–1 (winter Kangchenjunga). The most extreme combined conditions of BP ≤ 333 hPa, Temp ≤ −30°C, Wind ≥ 25 m⋅s–1, WCT ≤ −54°C and FFT ≤ 3 min were encountered in 14 ascents of Everest, two without oxygen (late autumn and winter) and 12 oxygen-supported in winter. The average extreme conditions experienced in ascents with and without oxygen were: BP 326 ± 3 hPa (winter Everest) vs. 335 ± 2 hPa (non-winter Everest); Temp −40 ± 0°C (winter K2) vs. −38 ± 5°C (winter low Karakoram 8K peaks); Wind 36 ± 7 m⋅s–1 (winter Everest) vs. 41 ± 9 m⋅s–1 (winter high Himalayan 8K peaks). Conclusions
Collapse
Affiliation(s)
- Robert K Szymczak
- Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - Michał Marosz
- Institute of Meteorology and Water Management - National Research Institute, Warsaw, Poland
| | - Tomasz Grzywacz
- Institute of Physical Culture, Kazimierz Wielki University in Bydgoszcz, Bydgoszcz, Poland
| | - Magdalena Sawicka
- Department of Neurology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Naczyk
- Department of Nutritional Biochemistry, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| |
Collapse
|
|
10
|
Mortality in Different Mountain Sports Activities Primarily Practiced in the Summer Season-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203920. [PMID: 31618960 PMCID: PMC6843304 DOI: 10.3390/ijerph16203920] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/13/2019] [Accepted: 10/14/2019] [Indexed: 01/21/2023]
Abstract
Millions of people engage in mountain sports activities worldwide. Although leisure-time physical activity is associated with significant health benefits, mountain sports activities also bear an inherent risk for injury and death. However, death risk may vary across various types of mountain sports activities. Epidemiological data represent an important basis for the development of preventive measures. Therefore, the aim of this review is to compare mortality rates and potential risk factors across different (summer) mountain sports activities. A comprehensive literature search was performed on the death risk (mortality) in mountain sports, primarily practiced during the summer season, i.e., mountain hiking, mountain biking, paragliding, trekking, rock, ice and high-altitude climbing. It was found that the death risk varies considerably between different summer mountain sports. Mortality during hiking, trekking and biking in the mountains was lower compared to that during paragliding, or during rock, ice or high-altitude climbing. Traumatic deaths were more common in activities primarily performed by young adults, whereas the number of deaths resulting from cardiovascular diseases was higher in activities preferred by the elderly such as hiking and trekking. Preventive efforts must consider the diversity of mountain sports activities including differences in risk factors and practitioners and may more particularly focus on high-risk activities and high-risk individuals.
Collapse
|
|
11
|
Spano SJ, Seymer JA, Crane DH, Auerbach PS. Impact of a Half Dome Cable Permitting Process on Search and Rescue Activity, Hiker Mortality Rates, and Operational Costs Above Little Yosemite Valley. Wilderness Environ Med 2019; 30:113-120. [PMID: 30846401 DOI: 10.1016/j.wem.2018.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 10/23/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The summit of Yosemite's Half Dome is reached using cable handrails for the final 146 m (480 ft). Access to these cables was restricted to users with permits in 2010. The authors aim to describe the impact of permitting on search and rescue (SAR) in the region of the park most affected by permitting. METHODS An observational study from 2005 to 2009 and 2011 to 2015 comparing the number of incidents, major incidents (exceeding $500), victims, and fatalities before and after permitting the use of cable handrails on Half Dome in the area above Little Yosemite Valley (LYV) and parkwide. Each year was analyzed separately with t tests and Mann-Whitney U tests. Data are presented as mean±SD. RESULT The number of hikers in the study area was reduced by up to 66% by permitting. Above LYV from 2005 to 2009, there were 85 SAR incidents, 134 victims, 8 fatalities, 38 major incidents, and annual SAR costs of $44,582±28,972. From 2011 to 2015, the same area saw 54 SAR incidents, 156 victims, 4 fatalities, 35 major incidents, and annual SAR costs of $27,027±19,586. No parameter showed statistical significance. Parkwide SAR incidents decreased from 232 to 198 annual incidents (P=0.013) during the same time period, with parkwide mortality increasing from 8 to 12 deaths annually (P=0.045). CONCLUSIONS SAR incidents, victims, fatalities, or costs above LYV did not decrease after cable handrail permitting. Parkwide SAR activity decreased during the same intervals. This strongly suggests that overcrowding is not the key factor influencing safety on Half Dome. This discordant trend warrants close observation over 5 to 10 y.
Collapse
Affiliation(s)
- Susanne J Spano
- University of California, San Francisco (Fresno), Fresno, CA.
| | | | - Desiree H Crane
- University of California, San Francisco (Fresno), Fresno, CA
| | | |
Collapse
|
|
12
|
Procter E, Brugger H, Burtscher M. Accidental hypothermia in recreational activities in the mountains: A narrative review. Scand J Med Sci Sports 2018; 28:2464-2472. [PMID: 30203539 DOI: 10.1111/sms.13294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 01/16/2023]
Abstract
The popularity of recreational activities in the mountains worldwide has led to an increase in the total number of persons exposed to cold and extreme environments through recreation. There is little conclusive evidence about the risk of hypothermia for specific activities or populations, nor is it clear which activities are represented in the literature. This is a non-systematic review of accidental hypothermia in different recreational activities in the mountains, with a specific focus on outdoor or winter activities that potentially involve cold exposure. Cases of hypothermia have been reported in the literature in mountaineering, trekking, hiking, skiing, activities performed in the backcountry, ultra-endurance events, and databases from search and rescue services that include various types of recreation. Of these activities, hypothermia as a primary illness occurs most commonly during mountaineering in the highest elevation areas in the world and during recreation practiced in more northern or remote areas. Hypothermia in skiers, snowboarders, and glacier-based activities is most often associated with accidents occurring off-piste or in the backcountry (crevasse, avalanche). Organizers of outdoor events also have a role in reducing the incidence of hypothermia through medical screening and other preparedness measures. More complete collection and reporting of data on mild hypothermia and temperature measurement would improve our understanding of the incidence of hypothermia in outdoor recreation in future.
Collapse
Affiliation(s)
- Emily Procter
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bozen/Bolzano, Italy
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Austrian Society for Alpine and Mountain Medicine, Innsbruck, Austria
| |
Collapse
|
|
13
|
L’accidentologie des sports de montagne en France : un état des lieux basé sur l’exploitation de données secondaires. Sci Sports 2017. [DOI: 10.1016/j.scispo.2017.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
|
14
|
Soulé B, Lefèvre B, Boutroy E. The dangerousness of mountain recreation: A quantitative overview of fatal and non-fatal accidents in France. Eur J Sport Sci 2017; 17:931-939. [DOI: 10.1080/17461391.2017.1324525] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Bastien Soulé
- Laboratoire sur les Vulnérabilités et l’Innovation dans le Sport (L-ViS, EA 7428), Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Confédération Recherches Interdisciplinaires en Sport (CRIS, FED 4272), Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Brice Lefèvre
- Laboratoire sur les Vulnérabilités et l’Innovation dans le Sport (L-ViS, EA 7428), Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Confédération Recherches Interdisciplinaires en Sport (CRIS, FED 4272), Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Eric Boutroy
- Laboratoire sur les Vulnérabilités et l’Innovation dans le Sport (L-ViS, EA 7428), Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Confédération Recherches Interdisciplinaires en Sport (CRIS, FED 4272), Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| |
Collapse
|
|
15
|
In reply to Brillhart et al. Wilderness Environ Med 2016; 27:345-6. [DOI: 10.1016/j.wem.2016.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 02/15/2016] [Accepted: 02/16/2016] [Indexed: 11/18/2022]
|
|
16
|
Brillhart A, McIntosh S, Dow J, Grissom C. In response to Epidemiology of Search and Rescue in Baxter State Park: Dangers of Descent and Fatigue. Wilderness Environ Med 2016; 27:344-5. [PMID: 27009909 DOI: 10.1016/j.wem.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 02/03/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Aaron Brillhart
- Department of Emergency Medicine, Northwestern Medical Center, St. Albans, VT
| | - Scott McIntosh
- Division of Emergency Medicine, University of Utah, Salt Lake City, UT
| | - Jennifer Dow
- National Park Service-Alaska Region, Anchorage, AK
| | | |
Collapse
|
|
17
|
Weinbruch S, Nordby KC. Fatalities in High Altitude Mountaineering: A Review of Quantitative Risk Estimates. High Alt Med Biol 2013; 14:346-59. [DOI: 10.1089/ham.2013.1046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stephan Weinbruch
- Institute of Applied Geosciences, Technical University Darmstadt, Darmstadt, Germany
| | - Karl-Christian Nordby
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| |
Collapse
|
|
18
|
Schöffl V, Küpper T. Feet injuries in rock climbers. World J Orthop 2013; 4:218-28. [PMID: 24147257 PMCID: PMC3801241 DOI: 10.5312/wjo.v4.i4.218] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 07/17/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023] Open
Abstract
While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless almost 50 percent of acute injuries involve the leg and feet. Acute injuries are either caused by ground falls or rock hit trauma during a fall. Most frequently strains, contusions and fractures of the calcaneus and talus. More rare injuries, as e.g., osteochondral lesions of the talus demand a highly specialized care and case presentations with combined iliac crest graft and matrix associated autologous chondrocyte transplantation are given in this review. The chronic use of tight climbing shoes leads to overstrain injuries also. As the tight fit of the shoes changes the biomechanics of the foot an increased stress load is applied to the fore-foot. Thus chronic conditions as subungual hematoma, callosity and pain resolve. Also a high incidence of hallux valgus and hallux rigidus is described.
Collapse
|
|
19
|
Westensee J, Rogé I, Van Roo JD, Pesce C, Batzli S, Courtney DM, Lazio MP. Mountaineering fatalities on Aconcagua: 2001-2012. High Alt Med Biol 2013; 14:298-303. [PMID: 24028641 DOI: 10.1089/ham.2013.1018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
High altitude mountaineering is a dangerous endeavor due to the hypoxic hypobaric environment, extreme weather, and technical skills required. One of the seven summits, Aconcagua (6962 m) is the highest mountain outside of Asia. Its most popular route is nontechnical, attracting >3000 mountaineers annually. Utilizing data from the Servicio Médico Aconcagua (park medical service), we performed a retrospective descriptive analysis with the primary objective of deriving a fatality rate on Aconcagua from 2001 to 2012. The fatality rate on Aconcagua was then compared to other popular mountains. For climbers who died, we report all available demographic data, mechanisms of death, and circumstances surrounding the death. Between 2001 and 2012, 42,731 mountaineers attempted to summit Aconcagua. There were 33 fatalities. The fatality rate was 0.77 per 1000, or 0.077%. The fatality rate on Aconcagua is lower than that on Everest or Denali but higher than that on Rainier.
Collapse
Affiliation(s)
- Jeffrey Westensee
- 1 Central Michigan University College of Human Medicine , Saginaw, Michigan
| | | | | | | | | | | | | |
Collapse
|
|
20
|
McIntosh SE, Campbell A, Weber D, Dow J, Joy E, Grissom CK. Mountaineering medical events and trauma on Denali, 1992-2011. High Alt Med Biol 2013; 13:275-80. [PMID: 23270445 DOI: 10.1089/ham.2012.1027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Denali (Mt. McKinley) is the tallest mountain in North America and a popular climbing destination for high altitude mountaineering expeditions. National Park Service (NPS) personnel care for and manage medical incidences and traumatic injuries for mountaineers each year. We retrospectively examined NPS medical reports from the climbing seasons of 1992-2011. Medical complaints, diagnoses, treatment, provider training, and overall numbers of injuries and illness were analyzed. Fatalities were included only if they were cared for by NPS medical personnel prior to death. Of the 24,079 climbers on Denali during this period, 831 (3.5%) required medical assistance from the NPS. There were 819 diagnoses; 502 were due to medical illness and 317 were traumatic injuries. Patient encounters occurred most frequently (71%) at the 4328 m camp. Frostbite was the most common individual diagnosis (18.1%), while altitude-related syndromes were the most common illness category (29%). Most patients (84%) were treated and released to descend without additional intervention, whereas 11% needed air evacuation, and 4% needed another type of NPS assistance to descend. The only fatality in this series was caused by traumatic brain injury due to a climbing fall. A broad variety of medical complaints were evaluated and treated by NPS personnel, most commonly altitude related problems and frostbite. The results of the study will enhance the awareness of potential illness and injuries encountered by medical providers participating in high altitude mountaineering expeditions. Additionally, providers responsible for evaluating mountaineers prior to their expeditions can educate them on the spectrum of physical and environmental conditions that increase the chances of illness or injury. This ideally will decrease the incidence of morbidity on both Denali and other high altitude mountaineering destinations.
Collapse
Affiliation(s)
- Scott E McIntosh
- Division of Emergency Medicine, University of Utah, Salt Lake City, UT 84132, USA.
| | | | | | | | | | | |
Collapse
|
|
21
|
Platts-Mills TF, Hunold KM. Increase in older adults reporting mountaineering-related injury or illness in the United States, 1973-2010. Wilderness Environ Med 2012; 24:86-8. [PMID: 23131755 DOI: 10.1016/j.wem.2012.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/23/2012] [Accepted: 08/26/2012] [Indexed: 11/28/2022]
|
|
22
|
Moore GWK, Semple JL. A tale of two climbers: hypothermia, death, and survival on Mount Everest. High Alt Med Biol 2012; 13:51-6. [PMID: 22429233 DOI: 10.1089/ham.2011.1061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Hypothermia is an acknowledged risk for those who venture into high altitude regions. There is however little quantitative information on this risk that can be used to implement mitigation strategies. Here we provide an analysis of the meteorological and hypothermic risk parameters, wind chill temperature, and facial frostbite time, during the spring 2006 Mount Everest climbing season. This season was marked by two high profile events where a solo climber was forced to spend the night in highly exposed conditions near the summit. One climber survived, while the other did not. Although this retrospective examination of two individual cases has admittedly a small sample size, and there are other factors that undoubtedly contributed to the difference in outcomes, we show that wind chill temperature and facial frostbite time experienced by the two climbers were dramatically different. In particular, the climber who did not survive experienced conditions that were approximately one standard deviation more severe that usual for that time of the year; while the climber who survived experienced conditions that were approximately one standard deviation less severe then usual. This suggests that the environmental conditions associated with hypothermia played an important role in the outcomes. This report confirms the importance of providing quantitative guidance to climbers as the risk of hypothermia on high mountains.
Collapse
Affiliation(s)
- G W Kent Moore
- Department of Physics, University of Toronto, Toronto, Ontario, Canada.
| | | |
Collapse
|
|
23
|
Weber D. That others may live: lessons learned from the 2011 Denali climbing season. Wilderness Environ Med 2012; 23:104-5. [PMID: 22656653 DOI: 10.1016/j.wem.2012.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 03/12/2012] [Indexed: 10/24/2022]
|
|
24
|
Moore GWK, Semple JL. Freezing and frostbite on mount everest: new insights into wind chill and freezing times at extreme altitude. High Alt Med Biol 2012; 12:271-5. [PMID: 21962071 DOI: 10.1089/ham.2011.0008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cold injury is an acknowledged risk factor for those who venture into high altitude regions. There is, however, little quantitative information on this risk that can be used to implement mitigation strategies. Here we provide the first characterization of the risk of cold injury near the summit of Mount Everest. This is accomplished through the application of a meteorological dataset that has been demonstrated to characterize conditions in the region as inputs to new parameterizations of wind chill equivalent temperature (WCT) and facial frostbite time (FFT). Throughout the year, the typical WCT near the summit of Everest is always <-30°C, and the typical FFT is always less than 20 min. During the spring climbing season, WCTs of -50°C and FFTs of 5 min are typical; during severe storms, they approach -60°C and 1 min, respectively; values typically found during the winter. Further, we show that the summit barometric pressure is an excellent predictor of summit WCT and FFT. Our results provide the first quantitative characterization of the risk of cold injury on Mount Everest and also allow for the possibility of using barometric pressure, an easily observed parameter, in real time to characterize this risk and to implement mitigation strategies. The results also provide additional confirmation as to the extreme environment experienced by those attempting to summit Mount Everest and other high mountains.
Collapse
Affiliation(s)
- G W K Moore
- Department of Physics, University of Toronto, Toronto, Canada.
| | | |
Collapse
|
|
25
|
Rodway GW, McIntosh SE, Dow J. Mountain Research and Rescue on Denali: A Short History from the 1980s to the Present. High Alt Med Biol 2011; 12:277-83. [DOI: 10.1089/ham.2010.1063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- George W. Rodway
- University of Utah College of Nursing and School of Medicine, Salt Lake City, Utah, USA
| | - Scott E. McIntosh
- University of Utah Division of Emergency Medicine and School of Medicine, Salt Lake City, Utah, USA
| | - Jennifer Dow
- Denali National Park and Preserve, Alaska Regional Hospital, Anchorage, Alaska, USA
| |
Collapse
|
|
26
|
Abstract
High altitude pulmonary oedema (HAPE) is an important and preventable cause of death at high altitudes. However, little is known about the global incidence of HAPE, in part because most cases occur in remote environments where no records are kept. Furthermore, despite international efforts to achieve consensus, there is wide disparity in the diagnostic criteria in clinical and research use. We have reviewed the literature on the incidence and epidemiology of HAPE. There is broad agreement between studies that HAPE incidence at 2500m is around 0.01%, and increases to 1.9% at 3600m and 2.5-5% at 4300m. Risk factors for HAPE include rate of ascent, intensity of exercise and absolute altitude attained, although an individual pre-disposition to developing the condition is also well described and suggests an underlying genetic susceptibility. It is increasingly recognised that clinically-detectable HAPE is an extreme of a continuous spectrum of excess pulmonary fluid accumulation, which has been demonstrated in asymptomatic individuals. There is a continued need to ensure awareness of the diagnosis and treatment of HAPE among visitors to high altitude. It is likely that HAPE is preventable in all cases by progressive acclimatisation, and we advocate a pragmatic "golden rules" approach. Our understanding of the epidemiology and underlying genetic susceptibility to HAPE may be advanced if susceptible individuals register with the International HAPE Database: http://www.altitude.org/hape.php. HAPE has direct relevance to military training and operations and is likely to be the leading cause of death at high altitude.
Collapse
Affiliation(s)
- D P Hall
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | | |
Collapse
|
|
27
|
Knott JW. Causes of Injuries in the Mountains: A Review of Worldwide Reports into Accidents in Mountaineering. J ROY ARMY MED CORPS 2011; 157:92-9. [DOI: 10.1136/jramc-157-01-16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
|
28
|
The UIAA Medical Commission Injury Classification for Mountaineering and Climbing Sports. Wilderness Environ Med 2011; 22:46-51. [DOI: 10.1016/j.wem.2010.11.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 02/08/2023]
|
|
29
|
Abstract
High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS) which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.
Collapse
|
|
30
|
Schöffl V, Morrison A, Schwarz U, Schöffl I, Küpper T. Evaluation of injury and fatality risk in rock and ice climbing. Sports Med 2010; 40:657-79. [PMID: 20632737 DOI: 10.2165/11533690-000000000-00000] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Rock and ice climbing are widely considered to be 'high-risk' sporting activities that are associated with a high incidence of severe injury and even death, compared with more mainstream sports. However, objective scientific data to support this perception are questionable. Accordingly, >400 sport-specific injury studies were analysed and compared by quantifying the injury incidence and objectively grading the injury severity (using the National Advisory Committee for Aeronautics score) per 1000 hours of sporting participation. Fatalities were also analysed. The analysis revealed that fatalities occurred in all sports, but it was not always clear whether the sport itself or pre-existing health conditions contributed or caused the deaths. Bouldering (ropeless climbing to low heights), sport climbing (mostly bolt protected lead climbing with little objective danger) and indoor climbing (climbing indoors on artificial rock structures), showed a small injury rate, minor injury severity and few fatalities. As more objective/external dangers exist for alpine and ice climbing, the injury rate, injury severity and fatality were all higher. Overall, climbing sports had a lower injury incidence and severity score than many popular sports, including basketball, sailing or soccer; indoor climbing ranked the lowest in terms of injuries of all sports assessed. Nevertheless, a fatality risk remains, especially in alpine and ice climbing. In the absence of a standard definition for a 'high-risk' sport, categorizing climbing as a high-risk sport was found to be either subjective or dependent on the definition used. In conclusion, this analysis showed that retrospective data on sport-specific injuries and fatalities are not reported in a standardized manner. To improve preventative injury measures for climbing sports, it is recommended that a standardized, robust and comprehensive sport-specific scoring model should be developed to report and fully evaluate the injury risk, severity of injuries and fatality risk in climbing sports.
Collapse
Affiliation(s)
- Volker Schöffl
- Department of Sportorthopedics, Orthopedics and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany.
| | | | | | | | | |
Collapse
|
|
31
|
McIntosh SE, McDevitt M, Rodway GW, Dow J, Grissom CK. Demographic, Geographic, and Expedition Determinants of Reaching the Summit of Denali. High Alt Med Biol 2010; 11:223-9. [DOI: 10.1089/ham.2009.1067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Scott E. McIntosh
- Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Marion McDevitt
- Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - George W. Rodway
- University of Utah College of Nursing and School of Medicine, Salt Lake City, Utah, USA
| | | | - Colin K. Grissom
- Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center and the University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
|
32
|
|
|
33
|
Weinbruch S, Nordby KC. Fatal Accidents among Elite Mountaineers: A Historical Perspective from the European Alps. High Alt Med Biol 2010; 11:147-51. [PMID: 20586599 DOI: 10.1089/ham.2009.1079] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Stephan Weinbruch
- Institute of Applied Geosciences, Technical University Darmstadt, Darmstadt, Germany
| | | |
Collapse
|
|
34
|
Search and Rescue Activity on Denali, 1990 to 2008. Wilderness Environ Med 2010; 21:98-9. [DOI: 10.1016/j.wem.2010.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 11/30/2009] [Accepted: 01/20/2010] [Indexed: 11/23/2022]
|
|
35
|
|
|
36
|
Wang SH, Hsu TY, Kuan JT, Chen JC, Kao WF, Chiu TF, Chen YC, Chen HC. Medical Problems Requiring Mountain Rescues from 1985 to 2007 in Yu-Shan National Park, Taiwan. High Alt Med Biol 2009; 10:77-82. [DOI: 10.1089/ham.2008.1070] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shih-Hao Wang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tai-Yi Hsu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jen-Tse Kuan
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jih-Chang Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Fong Kao
- Department of Emergency Medicine, Veterans General Hospital, Taipei, Taiwan
| | - Te-Fa Chiu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Cheng Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hang-Cheng Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| |
Collapse
|
|
37
|
Firth PG, Zheng H, Windsor JS, Sutherland AI, Imray CH, Moore GWK, Semple JL, Roach RC, Salisbury RA. Mortality on Mount Everest, 1921-2006: descriptive study. BMJ 2008; 337:a2654. [PMID: 19074222 PMCID: PMC2602730 DOI: 10.1136/bmj.a2654] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine patterns of mortality among climbers on Mount Everest over an 86 year period. DESIGN Descriptive study. SETTING Climbing expeditions to Mount Everest, 1921-2006. PARTICIPANTS 14,138 mountaineers; 8030 climbers and 6108 sherpas. MAIN OUTCOME MEASURE Circumstances of deaths. RESULTS The mortality rate among mountaineers above base camp was 1.3%. Deaths could be classified as involving trauma (objective hazards or falls, n=113), as non-traumatic (high altitude illness, hypothermia, or sudden death, n=52), or as a disappearance (body never found, n=27). During the spring climbing seasons from 1982 to 2006, 82.3% of deaths of climbers occurred during an attempt at reaching the summit. The death rate during all descents via standard routes was higher for climbers than for sherpas (2.7% (43/1585) v 0.4% (5/1231), P<0.001; all mountaineers 1.9%). Of 94 mountaineers who died after climbing above 8000 m, 53 (56%) died during descent from the summit, 16 (17%) after turning back, 9 (10%) during the ascent, 4 (5%) before leaving the final camp, and for 12 (13%) the stage of the summit bid was unknown. The median time to reach the summit via standard routes was earlier for survivors than for non-survivors (0900-0959 v 1300-1359, P<0.001). Profound fatigue (n=34), cognitive changes (n=21), and ataxia (n=12) were the commonest symptoms reported in non-survivors, whereas respiratory distress (n=5), headache (n=0), and nausea or vomiting (n=3) were rarely described. CONCLUSIONS Debilitating symptoms consistent with high altitude cerebral oedema commonly present during descent from the summit of Mount Everest. Profound fatigue and late times in reaching the summit are early features associated with subsequent death.
Collapse
Affiliation(s)
- Paul G Firth
- Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, MA 02114, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|