Covid-19 and outdoor recreation - Lessons learned? Introduction to the special issue on "Outdoor recreation and Covid-19: Its effects on people, parks and landscapes"

Sex- and Age-Specific Analysis of Mountain Biking Injuries: A 10-Year Review of National Injury Data

Background

Mountain biking (MTB) is a quickly growing sport, with many athletes sustaining high-impact injuries. Current literature has not analyzed the most recent MTB-related national emergency department (ED) injury data.

Hypothesis

It was hypothesized that (1) the total number of injuries presenting to US EDs would significantly increase over the study period, (2) male patients would experience higher rates of shoulder injuries and airborne injury mechanisms than female patients, and (3) youths would present more frequently with injuries of the head and face than adults.

Study Design

Descriptive epidemiology study.

Methods

All data were extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs. The NEISS was queried for MTB-related injuries between January 1, 2013, and December 31, 2022.

Results

A total of 2543 MTB-related cases presented to US EDs between 2013 and 2022, which extrapolated to a national estimate (NE) of 109,558 injuries using NEISS sample weights. MTB-related injuries increased significantly between 2013 and 2022 (P = .009), including a 64% increase between 2019 and 2020. The most common injury mechanism was falling off the bike (62.6%; NE = 68,536), and the upper extremity was the most frequently injured body region (22.4%; NE = 24,511). Male patients presented with significantly more shoulder (21.1% vs 7.4%, respectively; P < .001) and trunk (21.4% vs 19.8%, respectively; P < .001) injuries than female patients as well as more airborne injury mechanisms (15.7% vs 10.8%, respectively; P < .001). Female patients sustained significantly more concussions (7.2% vs 3.5%, respectively; P < .001) than male patients. Children presented with higher rates of head/face injuries (34.1%), concussions (6.0%), and airborne mechanisms of injury (19.4%) than any other age group.

Conclusion

MTB injuries increased significantly between 2013 and 2022 likely because of the popularity of outdoor sports during COVID-19. The upper extremity was the most frequently injured body region, and falling off the bike was the most common mechanism. Leading injuries and mechanisms varied significantly by sex and age. This study recommends additional MTB safety measures such as shoulder support for male riders, better coaching on front brake control for youth riders, and an increased emphasis on concussion protocols for female riders.

COVID-19 could accelerate the decline in recreational hunting: A natural experiment from Northern Italy

Although many studies highlighted the potential of COVID-19 to reshape existing models of wildlife management, empirical research on this topic has been scarce, particularly in Europe. We investigated the potential of COVID-19 pandemic to accelerate the ongoing decline in an aging population of recreational hunters in Italy. Namely, we modelled spatiotemporal trends between 2011 and 2021 in the number of recreational hunters in 50 Italian provinces with a varying incidence of COVID-19, and temporally delayed waves of infection. Compared to projections from 2011-2019 data, we detected a lower number of hunters who enrolled for the hunting season, both in 2020 (14 provinces) and in 2021 (15 provinces). The provinces with the highest incidence of COVID-19 in the Lombardy and Emilia-Romagna regions were also those experiencing the most marked decrease in hunting participation. Our findings revealed that a wildlife management system based on recreational hunting can be rapidly destabilized by epidemics and their associated public health measures, particularly when the average age of hunters is high, like in Italy. Considered the high incidence attained by COVID-19 in many European countries, where hunters are pivotal for the management of large ungulates and where they were already declining before the pandemic, our findings call for further large-scale research about the impact of COVID-19 on hunting participation.

Outdoor recreation, tick borne encephalitis incidence and seasonality in Finland, Norway and Sweden during the COVID-19 pandemic (2020/2021)

During the pandemic outdoor activities were encouraged to mitigate transmission risk while providing safe spaces for social interactions. Human behaviour, which may favour or disfavour, contact rates between questing ticks and humans, is a key factor impacting tick-borne encephalitis (TBE) incidence. We analyzed annual and weekly TBE cases in Finland, Norway and Sweden from 2010 to 2021 to assess trend, seasonality, and discuss changes in human tick exposure imposed by COVID-19. We compared the pre-pandemic incidence (2010-2019) with the pandemic incidence (2020-2021) by fitting a generalized linear model (GLM) to incidence data. Pre-pandemic incidence was 1.0, 0.29 and 2.8 for Finland, Norway and Sweden, respectively, compared to incidence of 2.2, 1.0 and 3.9 during the pandemic years. However, there was an increasing trend for all countries across the whole study period. Therefore, we predicted the number of cases in 2020/2021 based on a model fitted to the annual cases in 2010-2019. The incidences during the pandemic were 1.3 times higher for Finland, 1.7 times higher for Norway and no difference for Sweden. When social restrictions were enforced to curb the spread of SARS-CoV-2 there were profound changes in outdoor recreational behavior. Future consideration of public health interventions that promote outdoor activities may increase exposure to vector-borne diseases.

Health perception and restorative experience in the therapeutic landscape of urban wetland parks during the COVID-19 pandemic

Introduction

The effects of restoration and inspiration in the therapeutic landscape of natural environments on visitors during the COVID-19 pandemic have been well-documented. However, less attention has been paid to the heterogeneity of visitor perceptions of health and the potential impacts of experiences in wetland parks with green and blue spaces on visitors' overall perceived health. In this study, we investigate the impact of the restorative landscapes of wetland parks on visitors' health perceptions in the context of the COVID-19 pandemic.

Methods

In our survey, 582 respondents participated in an online questionnaire. We analyzed the respondents' health perceptions in terms of latent class analysis, used multinomial logistic regression to determine the factors influencing the potential categorization of health perceptions, and used structural equation modeling to validate the relationships between health perceptions of different groups and landscape perceptions of wetland parks, restorative experiences, and personality optimistic tendencies.

Results

The results identified three latent classes of health perceptions. Gender, marital status, education, occupation, income, distance, frequency of activities, and intensity of activities were significant predictors of potential classes of perceived health impacts among wetland park visitors.

Discussion

This study revealed the nature and strength of the relationships between health perception and landscape perception, restorative experience, and dispositional optimism tendencies in wetland parks. These findings can be targeted not only to improve visitor health recovery but also to provide effective references and recommendations for wetland park design, planning, and management practices during and after an epidemic.