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| Journal of the New Zealand Medical Association,
28-January-2005, Vol 118 No 1208
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Accident and fatality characteristics in a population of
mountain climbers in New Zealand
Erik Monasterio
Mountaineering and alpine rock climbing activities are
considered by the general public to be high-risk endeavours. Historically
climbing attitudes have tended to be strongly influenced by 19th Century values
of discipline, self-denial, cooperation, and
romanticism.1 However, over the past 15 to 20
years, attitudes have shifted as commercial and market pressures have become
more pronounced. Guided ascents to most major climbing areas in the World are
now available to fee-paying clients.
Several adventure climbing companies offer novices guided
ascents of the World’s highest peaks, such as Mount Everest, for a fee of
NZ$50,000 to NZ$65,000. Despite well-publicised disasters such as the 1996
Everest tragedy where five climbers (from two commercial expeditions) died, the
number of clients continues to increase.1
Recently, significant media attention has focused on 13
reported climbing fatalities in Mount Cook National Park (MCNP) and on Mount
Aspiring in the South Island of New Zealand.2
Many of the fatal accidents have involved experienced, senior guides and their
clients—as well as experienced
mountaineers.3 Four guides (constituting 10% of
qualified New Zealand mountain guides) died from climbing misadventure during
2004.
A search of the medical and climbing literature revealed
several studies that have estimated death rates associated with mountaineering
in different settings. Malcolm examined fatality data from the New Zealand
Mountain Safety Council and the Mount Cook Field Office of the Department of
Conservation between July 1981 and June 1995.4
There were a total of 46 deaths due to mountaineering misadventure and Malcolm
estimated the fatality rate to be 1.87/1000 climbing days in MCNP.
Malcolm concluded that the risk of death from climbing in
MCNP was 5000 times greater than from work-related injuries in New Zealand.
Pollard et al examined data from an international mountaineering journal between
December1968 and December 1987 and estimated that the death rate of British
climbers on peaks over 7000 metres high was 4.3 per 100
mountaineers.5 These results support the view
that mountain climbing is associated with a high risk of death. However, the
data is limited and open to bias as it estimated death rates by examining
fatality statistics of climbers in specific, particularly dangerous mountain
regions. Furthermore, the research did not prospectively examine a population of
climbers and therefore caution must be exercised in generalising from the
results.
To our knowledge, there are no past or current studies
examining accident and fatality rates in climbing populations. The purpose of
this paper is to report the demographic characteristics, morbidity, and
mortality findings in a prospective survey of a group of climbers. Baseline and
4-year follow up reports are provided. The results are from a study that
examined the psychological characteristics in a population of mountain and
alpine rock climbers. The psychological characteristics of the study population
have been reported in a climber’s journal publication and are available
from the author.6
MethodSubjects were a diverse group
of climbers enrolled into the survey on a voluntary basis. They were recruited
from local Alpine Club meetings, adventure magazine advertisements, and from
personal communication among the climbing community. Subjects in the study were
involved in mountaineering and alpine rock climbing sports.
Subjects agreed in writing to participate in the study
and responded to several pen-and-paper questionnaires providing information on
age, gender, marital status, number of children, and number of years involved in
climbing.
The Hospital Anxiety and Depression Scale and the
Cloninger Temperament and Character Inventory were also
completed.7
Subjects were asked whether they had suffered serious
climbing accidents. Severity of accidents were rated as either:
Rock
climbing grades were rated according to the Australasian Ewbank system (5 to
34), where grade ‘5’ indicates trekking through rough terrain. Above
grade ‘10’, ropes and security devices are recommended. Grades above
‘18’ require a significant degree of technical skill. (Generally the
higher the grade, the greater the technical challenges and risks assumed.)
Mountaineering climbing grades were rated according to
the New Zealand and Australian system (1 to 7). For grade ‘3’,
technical climbing equipment (such as ice axes, crampons, security equipment,
and a rope) are required. Grade ‘5’ involves sustained technical
climbing, which may include vertical sections of ice climbing.
Grade ‘6’ involves climbing vertical sections of ice with poor
protection for the climber. Grade ‘7’ is possible but is as yet
unaccomplished. Subjects were followed up 4 years after baseline data was
obtained. Subjects were interviewed in person, over the telephone, or via email
and data collected on accident and death statistics.
A serious omission of the study was the failure to
collect specific data on risk exposure, beyond a baseline estimation of climbers
who had previously climbed in “high-risk” situations (defined in the
discussion section).
ResultsThere was a good response rate—49 out of a total of 60
questionnaires handed out were returned completed. 44 subjects (90%) were male.
The median age at the start of the study was 33 years and generally participants
were involved in the sport more than 5 years. The median rock-climbing grade was
‘23’ and the median alpine grade was ‘5’.
Results at baseline revealed that 23 (47%) climbers had been
involved in a total of 33 accidents (Table 2). There were 10 severe, 16
moderate, and 7 mild accidents. Of those who had more than one accident, four
participants were involved in three separate accidents and two were involved in
two separate accidents.
At 4-year follow-up, results were available on 46 (94%)
participants. There were five deaths—four related to climbing misadventure
and one from a medical condition. Two deaths were caused by avalanche, and one
from multiple trauma following a climber slipping and falling several hundred
meters. The cause of the accident in the fourth climber is unknown. He was on
his own and died from multiple-trauma after a fall.
Of the 44-surviving climbers seven (15%) had retired from
the sport. There were nine further accidents (seven mild and two moderate)
involving seven (15%) climbers.
Several attempts were made to contact the three study
participants lost to follow-up. All these were non-New Zealanders who had left
the country without providing a contact address. Their names were not recorded
in the fatality reports of the New Zealand Mountain Safety Council and the
Mount Cook Field Office of the Dept. of Conservation. Review of Internet data
located one of the three participants, but unfortunately he did not reply to an
email interview.
Table 1 Baseline and demographic characteristics of
study participants (N=49)
Table 2. Accident characteristics of study
participants
DiscussionTo the author's knowledge, this is
the first prospective study reporting morbidity and mortality data in a
population of mountaineers and alpine rock climbers. The study captured a
population of serious, committed and experienced climbers, who had been involved
in the sport for many years and had reached high levels of technical
proficiency.
Ninety-six percent of participants estimated that (on at
least two occasions) they had climbed in situations of high-risk. High-risk was
defined as climbing in dangerous terrain (under unstable ice cliffs, over
avalanche prone terrain and in crevassed glaciers), in dangerous weather
conditions, or in situations were the climber did not feel fully confident in
their abilities and where a climbing mistake would lead to significant risk of
serious injury or death. (Mountaineers practice their sport in glaciated,
dangerous environments and so generally this exposure to high risk is an
inherent and unavoidable part of the sport.)
At baseline, 47% of climbers had been involved in accidents.
Serious accidents involving multiple bone fractures, head, and spinal injuries
were not uncommon and interestingly had not dissuaded many climbers from
continuing to practice the sport.
A climbing-related death rate of 8.2% over a 4-year period
is alarming, and supports other evidence that climbing is a dangerous sport.
Mountaineering-related deaths in this study did not appear to be related to
inexperience, as all fatal accidents involved participants who had practised the
sport more than 5 years, and two who were qualified mountain guides.
All deaths appear to have been a consequence of the
hazardous mountain environment. This is similar to Pollard et al’s study,
which found that 70% to 80% of fatalities were related to environmental
factors.5 This study did not specifically
examine the role that altitude-related problems (cerebral and pulmonary oedema)
played on morbidity and mortality. However, given the relatively low altitude of
New Zealand mountains (all under 4000 metres), the contribution was likely to be
very modest.
There are a several methodological limitations that must be
considered in interpreting the results of this survey. The main purpose of the
study was to collect information on the psychological characteristics of
climbers. As part of the study, demographic and accident data were also
collected. The findings were therefore from a survey rather than a cohort study.
Data on climbing frequency over the study period was not
obtained and so there was no measure of risk exposure to index to the rate of
morbidity and mortality. The findings are therefore quite crude. Follow-up of
participants was via a single telephone or email interview (4 years after
baseline data was collected). This time length may have led to recall bias, as
respondents were more likely to forget minor injuries and ‘near
misses’ than major accidents and fatalities. It may account for the high
death to injury ratio at follow-up and the high moderate-and-severe injury to
mild injury ratio at baseline.
The relatively lower injury rate at follow up (compared to
baseline) may be due to the fact that 15% of climbers had retired from the sport
and that the participants were older and potentially less inclined to take
risks.
The population was not strictly a random sample. General
difficulties in recruiting sufficient volunteers from a relatively uncommon
sport (to make up a meaningful sample size) led to the inclusion of all climbers
whom volunteered to participate in the study. This sample may represent a
population of particularly high-risk-taking climbers, as 47% of the population
at baseline had been involved in accidents yet persisted with the sport. It is
also possible that more cautious climbers, who had given up the sport following
an accident or a fear inducing experience, were no longer involved in climbing
and so were not included. However, it is also possible that less experienced,
more impulsive, and higher-risk-taking climbers were involved in fatal accidents
at earlier stages of their climbing careers and so were excluded from the study.
This study examined the risks associated with mountain
climbing—and despite the methodological limitations, the results are
sobering. Serious injury and death not only contribute to considerable emotional
and physical suffering and loss of productivity, but also to a significant
burden on medical services. Urgent priority should be given to replication
studies to further explore the relationship between mountaineering, morbidity
and mortality.
The reasons that determine an individual’s choice to
climb mountains are complex. An adventurous spirit appears to be part of human
nature and clearly mountain climbing provides participants with many positive
experiences and enhanced physical and psychological wellbeing through regular
participation in outdoor activities.
Interestingly, many participants in the study made
unprompted positive comments about the benefits of climbing and seemed keen to
point out that they chose to climb despite the perceived risks of the sport.
Author information:
M Erik Monasterio, Forensic Psychiatrist, Medlicott Academic Unit, Hillmorton
Hospital, Christchurch
Acknowledgements:
The research was supported by a grant-in-aid from the Royal Australian
and New Zealand College of Psychiatrists. I would also like to formally thank
all climbers who generously participated in this study, as well as Dr L Childs
(for helpful comments) and Maureen Weir (for secretarial support).
Correspondence: Dr
Erik Monasterio, Forensic Psychiatrist, Medlicott Academic Unit, Hillmorton
Hospital. Private Bag 4733, Christchurch. Fax: (03) 3391149; email:
erik.monasterio@cdhb.govt.nz
References:
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