To the Editor:
Congratulations to Flores, Haileyesus, and Greenspan with regard to their excellent article on National Estimates of Outdoor Recreational Injuries Treated in Emergency Departments, United States, 2004–2005.
1.- Flores A.H.
- Haileysus T.
- Greenspan A.I.
National estimates of outdoor recreational injuries treated in emergency departments, United States, 2004–2005.
The article calls attention to recreational injuries, an important component in the need for injury control. However, when we first looked at their table 6, we thought “Where is skiing?” The omission of skiing in the table might leave the casual reader with the impression that skiing is not an important source of outdoor recreational injuries. The authors apparently excluded skiing injuries, as they were “concentrated in a few hospitals.” It is not surprising that there are more skiing injuries in hospitals near ski areas and that the hospitals selected in the Consumer Product Safety Commission's sample do not provide a reasonable estimate of skiing injuries.
A major problem in measuring the importance of recreational injuries is the following: What is to be used as a denominator? The authors have used rates per 100 000 population, which gives an estimate of the societal importance of injuries resulting from each activity. Equally important is measuring the relative danger of persons exposed to the various activities. For skiing, the denominator is particularly difficult. Is it the number of people skiing? The days of skiing? Hours spent skiing? “Double black diamonds” as compared to hours on “bunny slopes”? Although the number of “ski visits” to the northeast areas decreased from 14.7 million in 1986–1987 to 11.8 million in 2006–2007, the number of skiers still exceeds the number of snowboarders.
Although China does not seem a likely place for skiing injuries, the problem of ski injuries in the United States may be a forewarning of greater problems in China. Surprisingly, the number of people in China who skied went from 300 000 in 2000 to 3 million in 2005.
China has great opportunities for “extreme skiing,”
which is growing in popularity and should be of interest to the readers of
Wilderness and Environmental Medicine. In conclusion, we call attention to an article on skiing injuries by William Haddon, Jr, “The father of injury, epidemiology and control,” and colleagues, whose landmark 1962 paper described the frequency of specific injuries and variations with age, sex, and skiing experience.
5.- Haddon W.
- Ellison A.E.
- Carroll R.E.
Skiing injuries. Epidemiologic study.
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© 2009 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
