/ death rates in the himalaya: front page of the BMJ

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no_more_scotch_eggs - on 30 Jun 2012
This week's BMJ has an editorial about himalayan mountaineering, prompted by a study they publish in the same edition

(Westhoff, Koepsell and Littell, 2012, for anyone with access to pubmed or the BMJ)

the study looked at nearly 24000 expedition members (over 39000 ascents) who went above base camp, over a 40 year period. they found no evidence that death rates were higher on commercial expeditions than traditional ones, and no evidence that death rates reduced with repeated participation.

i suppose it makes some intuitive sense, in that those taking part in traditional expeditions are likely to be on new, probably harder and riskier routes, rather than the trade routes of the mountain.

the editorial had an interesting table, with relative risks of death from a range of activities- in deaths per 1,000,000 days of exposure

downhill skiing had 1.1 death

alpine "rock and ice climbing" 9.7

trekking (Nepal) 11

climbing 8000m peaks 544

aside from the very high risk of 8000m climbing, the trekking in nepal stat was a bit of an eye opener.

any thoughts..?

cheers
gregor
Mr Lopez - on 30 Jun 2012
In reply to no_more_scotch_eggs:

> any thoughts..?
>
> cheers
> gregor

Shit happens.

cheers
oscar

AndyC - on 30 Jun 2012
In reply to no_more_scotch_eggs:

Deaths / days of exposure? Hmmm... climb faster, reduce risk!
no_more_scotch_eggs - on 30 Jun 2012
In reply to Mr Lopez:
> (In reply to no_more_scotch_eggs)
>
> [...]
>
> Shit happens.
>


thats actually quite a nice put summary of the findings- as they would suggest that the risk does not seem to be modifiable by experience- its more like every time you enter that environment, you shake the dice...

possible confounder though- would it be likely that people going on multiple expeditions would generally be trying something harder each time- so an increase in danger may be offset by an increase in experience, though some risks can only be managed by spending as little time in that environment as possible, as andy says

shame the format of new research reports is so short in the BMJ, no space to discuss any of these possibilities

Siward on 01 Jul 2012
In reply to no_more_scotch_eggs:

Re: the trekking if I read it right the death rate is 11 deaths per 1 million days of exposure?

If so I'd venture to suggest that it is no higher a rate than walking around your home town (not that I have any statistics to hand)...
no_more_scotch_eggs - on 01 Jul 2012
In reply to Siward:

That would depend on your home town...!

The comparator was downhill skiing in the alps, with only 1.1 deaths per million days exposure

The thing that really surprised me was trekking was higher risk than alpine climbing- I wonder how many EBC trekkers are aware of that

(Not that it should stop them going, its still hardly Russian roulette)
Trangia - on 01 Jul 2012
In reply to no_more_scotch_eggs:
> (In reply to Siward)
> > The thing that really surprised me was trekking was higher risk than alpine climbing- I wonder how many EBC trekkers are aware of that
>

Probably because Cerebral Oedema and Pulmanory Oedema are less likely to occur in the Alps? Also Himalayan avalanches are bigger and more frequent during the treking seasons than in the Alps?

Still suprising though given that there are approximately 500 mountain related deaths a year throughout the Alps.

I wonder if the skiing comparison included avalanche deaths?

Does treking include climbing treking peaks with the increased objective dangers (a bit of a misnomer when it comes to defining treking)?

no_more_scotch_eggs - on 01 Jul 2012
In reply to Trangia:

No, I don't think trekking peaks included

Not clear if skiing figure included off piste, I'd have thought probably not

And yes, I think you must be right about causes of death, just a little surprised that they made such an impact on death rates

Cheers
Gregor
MJ - on 01 Jul 2012
In reply to Trangia:

Still suprising though given that there are approximately 500 mountain related deaths a year throughout the Alps.

I believe the figure quoted (alpine "rock and ice climbing" 9.7) is for alpine style climbing in the Himalaya and not for the actual Alps.

no_more_scotch_eggs - on 01 Jul 2012
In reply to MJ:

No, its definitely for the alps

It also gives a figure for "mountain walking", which has a death rate of about 5/1,000,000 days, 5 times that for skiing. Its hard to believe that would be the case for walking on trails, so the "rock and ice climbing" figure might be for harder routes, rather than the normal routes

Cheers

Gregor
balmybaldwin - on 01 Jul 2012
In reply to no_more_scotch_eggs:


The Trekking figures are probably adversly effected by the distance from decent medical care - It may be just as likely to have that many deaths from trekking accidents in north wales if it to >24 hrs to get you to a medical centre?
no_more_scotch_eggs - on 01 Jul 2012
In reply to balmybaldwin:


Right enough. The average Nepal trekker is probably a little more, Er, mature... And has recently got off a long haul flight and started fairly vigorous exercise. That must lead to a fair few MIs and pulmonary emboli I guess.

Cheers
Gregor
chiz - on 01 Jul 2012
In reply to no_more_scotch_eggs:
Is that deaths of tourists trekking in Nepal, or does it include the locals (porters, sirdars etc) working on the treks?
Bee_1 - on 01 Jul 2012
In reply to chiz:

No, high altitude porters were specifically excluded from the analysis, which is a shame, as I think this would hae been an interesting area of research though it opens up many more avenues about acclimitasion e.t.c.

Certainly both an interesting paper and editorial, providing plenty of areas of further research, anyone interested in looking at this further?!

Definitely don't want to climb annapurna now, with a rate of 1334 deaths, compared to downhill skiing of 1.1!
roxyroundtheworld - on 07 Jul 2012
In reply to no_more_scotch_eggs:

I did a trek last year which incorporated EBC and you wouldn't believe how many ill/dead people you encounter on that trek (which is a very easy trek if you take the altitude away). At the most busy point in the season there were helicopters flying up and down the valley almost constantly with sick trekkers on board. My theory is that a lot of unfit/non-trekkers do EBC and also people don't acclimatise properly, often due to time constraints rather than impatience (employers in the UK actually quite generous letting us have 2-3 week holidays as standard compared to other Western world countries...) All adds up to a dangerous predicament at 4000-5000m+
TP on 10 Jul 2012
In reply to no_more_scotch_eggs:

Interesting, but the data do not look right. Alpine rock and ice is 10 deaths per 1e6 days, or 1 death per 1e5 days. If there are, say, 100 alpine rock and ice climbing deaths each year (order of magnitude, ie greater than 10 and less than 1000) then there must be 1e7 participation days. The average length of a trip would be of order 10 days, meaning that there would be 1e6 different participants. This doesnt feel like the right order of magnitude.

In fact, there is a general scarcity of data on alpine rock and ice risks. The BPA and the USPA do very detailed analysis of skydiving death statistics on an annual basis. I'm not aware of a single source that regularly collects statistics for alpine deaths.

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