Current recommendations for rescue and resuscitation of people buried in avalanches are based on Swiss avalanche survival data. We analyzed Canadian survival patterns and compared them with those from Switzerland.
We extracted relevant data for survivors and nonsurvivors of complete avalanche burials from Oct. 1, 1980, to Sept. 30, 2005, from Canadian and Swiss databases. We calculated survival curves for Canada with and without trauma-related deaths as well as for different outdoor activities and snow climates. We compared these curves with the Swiss survival curve.
A total of 301 people in the Canadian database and 946 in the Swiss database met the inclusion criteria. The overall proportion of people who survived did not differ significantly between the two countries (46.2% [139/301] v. 46.9% [444/946]; p = 0.87). Significant differences were observed between the overall survival curves for the two countries (p = 0.001): compared with the Swiss curve, the Canadian curve showed a quicker drop at the early stages of burial and poorer survival associated with prolonged burial. The probability of survival fell quicker with trauma-related deaths and in denser snow climates. Poorer survival probabilities in the Canadian sample were offset by significantly quicker extrication (median duration of burial 18 minutes v. 35 minutes in the Swiss sample; p
We prospectively studied parental mental health after suddenly losing a son in a military training accident. Parents (N = 32) were interviewed at 1, 2 and 23 years after the death of their son. The General Health Questionnaire and Expanded Texas Inventory of Grief were self-reported at 1, 2, 5, and 23 years; the Inventory of Complicated Grief was self-reported at 23 years. We observed a high prevalence of psychiatric disorders at 1- and 2-year follow-ups (57% and 45%, respectively), particularly major depression (43% and 31%, respectively). Only one mental disorder was diagnosed at the 23-year follow-up. Grief and psychological distress were highest at 1- and 2-year follow-ups. Spouses exhibited a high concordance of psychological distress. Mothers reported more intense grief reactions than did fathers. The loss of a son during military service may have a substantial impact on parental mental health particularly during the first 2 years after death. Spouses' grief can be interrelated and may contribute to their psychological distress.
Avalanches are a significant cause of winter recreational fatalities in mountain regions. The purpose of this study was to determine the relative contributions of trauma and asphyxia to avalanche deaths.
We reviewed all avalanche fatalities between 1984 and 2005 that had been investigated by the offices of the British Columbia Coroners Service and the Chief Medical Examiner of Alberta. In addition, we searched the database of the Canadian Avalanche Centre for fatal avalanche details. We calculated injury severity scores for all victims who underwent autopsy.
There were 204 avalanche fatalities with mortality information over the 21-year study period. Of these, 117 victims underwent autopsy, and 87 underwent forensic external examination. Asphyxia caused 154 (75%) deaths. Trauma caused 48 (24%) deaths, with the rate of death from trauma ranging from 9% (4/44) for snowmobilers to 42% (5/12) for ice climbers. In addition, 13% (12/92) of the asphyxia victims who underwent autopsy had major trauma, defined as an injury severity score of greater than 15. Only 48% (23/48) of victims for whom trauma was the primary cause of death had been completely buried.
Asphyxia and severe trauma caused most avalanche fatalities in western Canada. The relative rates differed between snowmobilers and those engaged in other mountain activities. Our findings should guide recommendations for safety devices, safety measures and resuscitation.
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To discover possible associations between the human factors and avalanche incidents.
Self-report, intercept, and Web-based, 1-year retrospective, cross-sectional study.
Mountain Equipment Co-op stores in Calgary and Vancouver, Canada.
People shopping at the store and who had entered avalanche terrain in the past 12 months were invited to complete the survey (n = 447).
Sex, age, sport activity, days of exposure, years of experience, socioeconomic status, level of training, risk propensity, and motivation.
Experiencing an avalanche incident.
Women and those traveling with women were less likely to experience an avalanche incident [odds ratio (OR) = 0.45; 95% confidence interval (CI), 0.21-0.96]. Those with the most training were more likely to report experiencing an avalanche incident (OR = 6.86; 95% CI, 2.37-19.83), but this difference was attenuated (OR = 2.25) and not statistically significant (95% CI, 0.57-8.81) after adjustment for exposure. Experience was not found to be a factor. Being motivated to seek intense experiences was found to be a factor (OR = 2.19; 95% CI, 1.03-4.66), whereas being motivated to create memorable experiences was protective (OR = 0.29; 95% CI, 0.10-0.86).
The results of this study suggest that people exposing themselves to avalanche risk do so to satisfy inherited and learned motivational needs and that some motivations are associated with higher or lower risk taking than others. Training appears to be exploited so as to increase access to these benefits rather than reduce risk. Within this risk/reward paradigm, risk taking among men is moderated by the presence of a woman in the group.