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Dangers in sport parachuting
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. (Kirurgi)
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Sport parachuting is a dangerous recreational activity for which available literature appears unsatisfactory to form a basis for injury prevention.

 Aim Overall: Explore some risk factors in sport parachuting. Study I: Identify fatal incident and injury mechanisms for skydiving (sport parachuting from aircraft). Study II: Identify fatal incident and injury mechanisms for BASE jumping (sport parachuting from fixed objects) for each of the four fixed object types B-A-S-E (building, antenna, span, earth). Study III: Identify non-fatal incident and injury mechanisms for skydiving. Study IV: Evaluate the validity of a compulsory reporting system among active skydivers. Study V: Explore some aspects of the Swedish skydiving culture and its relation to injury risks and injury reporting. Study VI: Describe the mechanism of incident and injury for a free fall shoulder dislocation.

Methods Descriptive epidemiological studies of (I) fatal injury events in Swedish skydiving, (II) fatal injury events in BASE jumping worldwide, and (III) non-fatal injury events in Swedish skydiving. Self-report survey of (IV) Swedish skydivers to measure: Sensitivity, as the proportion of injury events fulfilling the reporting criterion that were actually reported; Specificity, as the proportion of false positives in relation to the defined gold standard. Content analysis of (V) Swedish skydiving participant narratives. First-person narrative and free fall video recordings (VI) of one case.

Results Overall: Risk factors associated with “free fall” flight of the human body and recreational usage of parachutes were described. Study I: Fatal risk factors in skydiving included student instability in free fall, leading to unstable parachute activation with subsequent line entanglement or parachute activation failure. Unintentional water landings also contributed to fatalities. Every fourth skydiving fatality survived impact and died during transports or in hospitals. Study II: Fatal risk factors in BASE jumping included parachutist free fall instability, miscalculation of free fall acrobatics, deployment failure by the parachutist, pilot chute malfunction and parachute malfunction. In cliff jumping (BASE object type E), parachute opening towards the object jumped with subsequent collision was a frequent factor. Poor visibility, strong or turbulent winds, cold and water also contributed to BASE jumping fatalities. Study III: Non-fatal risk factors in skydiving included experience level and type of student-training system. The lower extremities, spine and shoulders were important regions of injury. The most serious injuries were seen in experienced skydivers. Study IV: The overall sensitivity of the skydiving injury reporting system was 0.37 (95% confidence interval (CI) 0.24-0.51). With non-minor injuries as the target for reporting, the sensitivity was 0.67 (95% CI 0.43-0.85). No significant effect on reporting was found for gender, age, license level, years in the sport, total number of jumps or club affiliation. The specificity was 0.91 (95% CI 0.83-0.95). Study V: It is suggested that Swedish skydiving culture is carried by the local club; not the national association. Skydiving culture at the local drop zone and formal and informal hierarchical structures among skydivers may be what really decides how rules are enforced, risk-taking behavior is seen, and if incidents and injuries are reported. Study VI: The free fall airstream forces were in this case strong enough to dislocate a shoulder joint, which has safety implications that should be considered by participants and medical doctors performing precourse examinations.

Conclusion A number of risk factors in sport parachuting are described. Some technological, training and regulatory interventions are suggested to increase safety. 

Place, publisher, year, edition, pages
Umeå: Kirurgi , 2009. , 43 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1253
Keyword [en]
Sport parachuting, skydiving, BASE jumping, injury, risk factors, epidemiology.
National Category
Surgery
Research subject
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-19690ISBN: 978-91-7264-751-3 OAI: oai:DiVA.org:umu-19690DiVA: diva2:202326
Distributor:
Kirurgi, 901 85, Umeå
Public defence
2009-03-27, NUS sal D, 9 tr, tandläkarhögskolan, Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-03-12 Created: 2009-03-09 Last updated: 2016-06-10Bibliographically approved
List of papers
1. Fatalities in Swedish skydiving
Open this publication in new window or tab >>Fatalities in Swedish skydiving
2005 (English)In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 37, no 6, 1040-1048 p.Article in journal (Refereed) Published
Abstract [en]

Exact risk patterns in skydiving fatalities are not well known, but incomplete world injury data indicate that many are preventable. A comprehensive national material for Sweden of 37 skydiving fatalities 1964–2003 were reviewed to identify risk factors. In relation to jump volume, the period 1994–2003 had a fatality rate 11 times lower than 1964–1973. Student skydivers had the highest risk of fatal outcome, often caused by instability in freefall leading to unstable parachute activation with subsequent line entanglement, or parachute activation failure. Unintentional water landings also contributed to student fatality, with life jacket malfunctions, neglect to use life jackets, and automatic reserve parachute activation devices activated by water as aggravating factors. One-third of all fatalities had an inflated and operational parachute at some point prior to injury. A drastic worldwide increase in fatal landing incidents with fast wing parachutes during the 1990s did not occur in Sweden. Every fourth fatality caused by rapid deceleration against ground or water survived impact and died during transports or in hospitals. Rescue units and health care providers can improve management of skydiving incidents from knowledge about the incident and injury mechanisms we have described, and the skydiving community can target risk factors in preventive safety work.

Keyword
accidents, aviation/mortality, adolescent, adult, athletic injuries/mortality, aviation/statistics & numerical data, diving, equipment failure, female, humans, incidence, male, middle aged, risk assessment, risk factors, risk-taking, Sweden/epidemiology
Identifiers
urn:nbn:se:umu:diva-16272 (URN)10.1016/j.aap.2005.06.002 (DOI)16039597 (PubMedID)
Available from: 2008-10-07 Created: 2008-10-07 Last updated: 2017-12-14Bibliographically approved
2. Parachuting from fixed objects: descriptive study of 106 fatal events in BASE jumping 1981-2006
Open this publication in new window or tab >>Parachuting from fixed objects: descriptive study of 106 fatal events in BASE jumping 1981-2006
2008 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 42, no 6, 431-436 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To analyse the characteristics of fatal incidents in fixed object sport parachuting (building, antenna, span, earth (BASE) jumping) and create a basis for prevention.

Design: Descriptive epidemiological study.

Participants: Data on reported fatal injury events (n = 106) worldwide in 1981–2006 retrieved from the BASE fatality list.

Assessment of risk factors: Human, equipment and environmental factors.

Main outcome measurements: Identification of typical fatal incident and injury mechanisms for each of the four fixed object types of BASE jumping (building, antenna, span, earth).

Results: Human factors included parachutist free fall instability (loss of body control before parachute deployment), free fall acrobatics and deployment failure by the parachutist. Equipment factors included pilot chute malfunction and parachute malfunction. In cliff jumping (BASE object type E), parachute opening towards the object jumped was the most frequent equipment factor. Environmental factors included poor visibility, strong or turbulent winds, cold and water. The overall annual fatality risk for all object types during the year 2002 was estimated at about one fatality per 60 participants.

Conclusions: Participants in BASE jumping should target risk factors with training and technical interventions. The mechanisms described in this study should be used by rescue units to improve the management of incidents.

Place, publisher, year, edition, pages
Loughborough: British Assoc. of Sport and Medicine, 2008
Identifiers
urn:nbn:se:umu:diva-18518 (URN)10.1136/bjsm.2008.046565 (DOI)18523039 (PubMedID)
Available from: 2009-02-12 Created: 2009-02-12 Last updated: 2017-12-14Bibliographically approved
3. Injuries in Swedish skydiving
Open this publication in new window or tab >>Injuries in Swedish skydiving
2007 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 41, no 6, 356-364 p.Article in journal (Refereed) Published
Keyword
athletic injuries/epidemiology, aviation/statistics & numerical data, female, humans, incidence, male, sex distribution, Sweden/epidemiology
Identifiers
urn:nbn:se:umu:diva-16266 (URN)10.1136/bjsm.2006.031682 (DOI)17224436 (PubMedID)
Available from: 2008-10-08 Created: 2008-10-08 Last updated: 2017-12-14Bibliographically approved
4. Validity of injury reporting among active Swedish skydivers
Open this publication in new window or tab >>Validity of injury reporting among active Swedish skydivers
2009 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: Evaluation of a national compulsory reporting system for skydiving injuries.

Design: Self-report survey.

Setting: The Swedish Parachute Association (SFF).

Subjects: All persons renewing a Swedish skydiving license 2008 (n=1049).

Main outcome measures: Sensitivity was measured as the proportion of injury events fulfilling the reporting criterion that were actually reported; Specificity was measured as the proportion of false positives in relation to the defined gold standard. Self-stated bone fractures, shoulder dislocations and cruciate ligament injuries were labeled as non-minor injuries.

Results: The response rate was 100%. The overall sensitivity of the reporting system 2006/2007 was 0.37 (95% confidence interval (CI) 0.24-0.51). With selfstated non-minor injuries as the target for reporting, the sensitivity was 0.67 (95% CI 0.43-0.85). No significant effect on reporting was found for gender, age, license level, years in the sport, total number of jumps or club affiliation. The specificity was 0.91 (95% CI 0.83-0.95).

Conclusions: The low sensitivity will yield false low incidence calculations, but risk comparisons related to the candidate predictor variables appear reasonably valid. The false positive reporting warrants assortment of incoming data and a clarification of the reporting criterions. We propose the addition of “hospitalization Yes/No” in future reporting and endorse coordinating skydiving data collection in the Nordic countries. Further studies on attitudes to reporting are necessary to understand the drivers and constraints for achieving a more complete notification of skydiving injuries. 

Keyword
Sport parachuting, risk factors, injury prevention, reporting system, trauma database, sensitivity, specificity
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-19684 (URN)
External cooperation:
Available from: 2009-03-12 Created: 2009-03-09 Last updated: 2016-08-31Bibliographically approved
5. Skydiving culture and its relation to injury risks and injury reporting
Open this publication in new window or tab >>Skydiving culture and its relation to injury risks and injury reporting
(English)Manuscript (Other (popular science, discussion, etc.))
Abstract [en]

This article explores some aspects of the Swedish skydiving culture and its relation to injury risks and injury reporting. Seventeen skydivers were interviewed and the transcripts were analyzed with latent and manifest content analyses. The reference frame emerging from the narratives encompasses experiences of joy, passion and playfulness; and of injury, suffering and death. The risk of injury is viewed as an integrated element of the recreational activity, counterbalanced by its recreational value. From the text analysis we suggest that Swedish skydiving culture is carried by the local club; not the national association. Though the Swedish Parachute Association has far-reaching powers over the clubs, our findings imply that skydiving culture at the local drop zone and formal and informal hierarchical structures among skydivers are what really decide how rules are enforced, and if incidents and injuries are reported.

Keyword
content analysis, extreme sport, injury, interview, risk, skydiving
Identifiers
urn:nbn:se:umu:diva-19687 (URN)
Available from: 2009-03-12 Created: 2009-03-09 Last updated: 2016-06-10Bibliographically approved
6. Shoulder injuries have been noted as a recurring problem in skydiving
Open this publication in new window or tab >>Shoulder injuries have been noted as a recurring problem in skydiving
2005 (English)In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 59, no 4, 1033-1033 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2005
Keyword
Shoulder injuries, skydiving, trauma, dislocation
Identifiers
urn:nbn:se:umu:diva-19688 (URN)
Available from: 2009-03-12 Created: 2009-03-09 Last updated: 2017-12-13Bibliographically approved

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