Fatalities in wingsuit BASE jumping

BASE Jumping in the Lauterbrunnen Valley: A Retrospective Cohort Study from 2007 to 2016

BACKGROUND

BASE jumping, and especially BASE jumping with the help of wingsuits, is considered one of the most dangerous airborne sports. The valley of Lauterbrunnen in Switzerland has become infamous for the large number of BASE jumps and the high rate of accidents and fatalities. The aim of this study was to evaluate the morbidity and mortality of BASE jumping, to determine the severity of injuries and injury patterns of BASE jumping accidents and to compare preclinical assessment with clinical diagnoses to detect under- or overtriage.

METHODS

This retrospective, descriptive cohort study covers a period of 10 years (2007-2016). The evaluation covered all BASE jumping incidents in the valley of Lauterbrunnen that required either a helicopter mission by the local HEMS (Helicopter Emergency Medical Service) company of Lauterbrunnen, Air Glaciers, or medical care in the regional hospital, the level I trauma centre or the medical practice of the local general practitioner. Besides demographic data, experience in BASE jumping and skydiving as well as BASE jumping technique(s) and details about the rescue missions were collected. The medical data focused on the severity of injuries, as expressed by the National Advisory Committee of Aeronautics (NACA) score in the prehospital assessment as well as the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) retrieved from the clinical records in the hospital or medical practice setting.

RESULTS

The patients were predominantly young, experienced male BASE jumpers. Morbidity (injury risk) ranged from 0.05% to 0.2%, and fatality risk from 0.02% to 0.08%. Undertriage was low, with only two cases. Overtriage was significant, with 73.2% of all NACA 4-6 cases not qualifying for major trauma.

CONCLUSIONS

BASE jumping remains a high-risk sport and is associated with significant rates of injuries and fatalities. Comparison with previous studies indicated that the injury rate may have decreased, but the fatality rate had not. In this known BASE jumping environment, prehospital assessment appears to be good, as we found a low undertriage rate. The high overtriage rate might be an expression of physicians' awareness of high-velocity trauma mechanisms and possible deceleration injuries.

Injuries in alpine summer sports - types, frequency and prevention: a systematic review

Introduction

Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Specifically, no single article provides a general overview, as individual studies tend to focus on one particular sport. In the present study, we performed a systematic literature review to summarize existing knowledge and explore the potential for prevention and clinical decision making in this group.

Method

Literature searches were performed using the PubMed and Scopus database for the most commonly ventured sports associated with injury: mountain biking, climbing, airborne sports, paragliding, and base jumping. From this search, studies were identified for qualitative and quantitative analyses. These searches were done according to PRISMA guidelines for systematic reviews. Studies were then analyzed regarding epidemiology of injuries, relevant anatomical considerations and prevention strategies were discussed.

Results

A broad spectrum of injury sites and mechanisms are seen in mountain biking, climbing or airborne sports. Mountain biking related injuries commonly involve the upper extremity, with fractures of the clavicle being the most common injury, followed by fractures of the hand and wrist. Scaphoid fractures remain of paramount importance in a differential diagnosis, given their often subtle clinical and radiological appearance. Paragliding, skydiving, and base jumping particularly affect transition areas of the spine, such as the thoracolumbar and the spinopelvic regions. Lower limb injuries were seen in equal frequency to spinal injuries. Regarding relative risk, mountain biking has the lowest risk for injuries, followed by climbing and airborne sports. Male alpinists are reported to be more susceptible to injuries than female alpinists. Generally, the literature surrounding hiking and water-related mountain sports is insufficient, and further work is required to elucidate injury mechanisms and effective preventative measures. A helmet seems to decrease the likelihood of face and head injuries in mountain sports and be a meaningful preventive measurement.

Safety Measures and Risk Analysis for Outdoor Recreation Technicians and Practitioners: A Systematic Review

There is no expectation to suppress all accidents in the outdoor recreation sector; nevertheless, it is expected that all possible safety measures are taken in order to minimize the risk of accidents. The objective of this study was to systematize the knowledge regarding recommended and used safety measures and risk assessments for technicians and outdoor recreation practitioners. We conducted a systematic review on PubMed, BVS, SciELO, Science Direct, ABI/INFORM, Spinger, Web of Knowledge, and Esmerald full text databases, up to February 2021. The eligible criteria followed the PICOS strategy; the included risk assessment studies on outdoor recreation (according to its definition) had methodological quality, were indexed, and peer reviewed. Ten studies, from ten countries, fulfilled these specifications, which focused on different approaches. Five studies focused on risk perception, four studies focused on safety practices, injuries, and risk assessment; three studies addressed safe behaviors; two studies addressed equipment- and risk matrix-related themes. We concluded that there was a concern for this topic, and the 28 mentioned measures could provide important information regarding health and prevention. These measures could be used to develop safety strategies and risk reduction, aimed at reducing accidents in outdoor recreation activities. In order to evaluate the pertinence and importance of the mentioned measures, namely risk perception, safe practices, sport injuries, risk analysis, safe behaviors, as well as equipment and risk assessment matrices, further investigation is needed using experimental or observational designs. These strategies and procedures can contribute to enhanced interventions by technicians with higher security and quality, and therefore, improved well-being and satisfaction of practitioners.

What Is So Special about Wingsuit BASE Jumpers? A Comparative Study of Their Psychological Characteristics

For the general public, BASE jumping is considered the ultimate extreme activity. Among BASE jumpers, those using wingsuits are generally perceived as the most experienced but also as the most risk-taking. Starting from this observation, we wanted to know whether wingsuit users differed in their psychological characteristics from other BASE jumpers. More specifically, we hypothesized that wingsuit users would be characterized by higher levels of mental toughness and by lower levels of harm avoidance. We also expected them to use more mental training techniques than the other jumpers. To this end, we conducted a vast survey on a sample of 183 BASE jumpers. Contrary to our hypotheses, the results did not reveal any significant difference in psychological characteristics between wingsuit users and other BASE jumpers. This absence of significant differences is discussed and recommendations for the use of mixed or multi-methods in the study of extreme sports are proposed.

BASE Jumping Fatalities Between 2007 and 2017: Main Causes of Fatal Events and Recommendations for Safety

INTRODUCTION

BASE (buildings, antennae, span, earth) jumping involves jumping from fixed objects with a parachute. This practice is associated with fatal events. Despite considerable evolution in BASE jump practice over the past years, fatalities have increased. Identifying the main causes of fatal events and recommending processes to reduce fatalities is vital for safe BASE jumping practice.

METHODS

In an effort to capture worldwide cases between 2007 and 2017, we identified and classified on a Haddon matrix each fatal event from the BASE jumping fatality list. Although not devoid of limitations, this is the most comprehensive list of BASE jumping fatal events and the main source of information on BASE-related fatalities for BASE jump participants.

RESULTS

The report noted 223 fatalities, 197 of them being cliff jumps. In addition, 137 fatal jumps were wingsuit jumps. Impact and object strike were the main cause of fatal event (96%). Human factors leading to fatality were mostly low pull/no pull (64%) and bad exits (15%). Equipment factors included off-heading openings, twists, and pilot chute entanglement. Environmental factors included strong wind, poor visibility, and water.

CONCLUSIONS

BASE jump practice has undergone radical transformations in the last 10 y, especially linked to the mountain environment and the use of wingsuits. These factors were linked to most fatal events. Key recommendations are basic practical measures, such as ground preparation and equipment checks, and deep technical and personal knowledge that involves regular engagement and significant introspection.

Timing of fatal BASE jumping incidents: 1981-2018

BASE jumping, or fixed object parachuting, is a high-risk sport that has evolved significantly since its inception in the 1960s. Differences in parachute technology, teaching methods, jumping locations, practices, and popularity, among other factors, have qualitatively transformed the sport, particularly since 2000. The current study seeks to better understand how the rate of BASE jumping fatalities have changed as BASE jumping has grown. Using data from the BASE Fatality List, a resource continuously compiled by the BASE community with information on all known BASE fatalities, temporal trends in BASE fatalities that accompanied these changes over time are explored. The number of annual fatalities stayed between 0 and 5 from 1981 to 1999, but around the year 2000 began an upward trend that has continued through 2018. There appears to be large seasonal variation in monthly fatality rate, with the most deaths occurring in the northern hemisphere's summer months, the peak being in August, and the fewest deaths occurring in the northern hemisphere's winter months. The years 2013-2018 have continued the increasing fatality trend, but have otherwise deviated through increased variability in short-term and seasonal trends. Potential causes of these short-term trends, changing trends in the causes of fatal accidents, factors potentially unique to anomalous events, and directions for future research are also discussed.

BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs

BACKGROUND

BASE (building, antenna, span, earth) jumping involves jumping from fixed objects with specialized parachutes. BASE jumping is associated with less aerodynamic control and flight stability than skydiving because of the lower altitude of jumps. Injuries and fatalities are often attributed to bad landings and object collision.

METHODS

We performed a retrospective analysis of the 2010-2014 National Emergency Department Sample database, a nationally representative sample of all visits to US emergency departments (EDs). BASE jumping-associated injuries were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes [E004.0]. Outcomes evaluated included morbidity, mortality, inpatient admission, and costs. Adjusted analyses accounting for survey methodology were performed.

RESULTS

After weighting, 1790 BASE-associated ED presentations were identified with 358±28 injuries annually. A total of 1313 patients (73%) were aged 18 to 44 y, and 1277 (71%) were male. Nine hundred seventy-six (55%) multiple body system injuries and 677 (38%) isolated extremity injuries were reported. There were 1588 (89%) patients discharged home from the ED; only 144 (7%) were admitted as inpatients. On multivariate logistic regression, only anatomic site of injury was associated with inpatient admission (odds ratio=0.6, P<0.001, 95% CI 0.5-0.8). Including ED and inpatient costs, BASE injuries cost the US healthcare system approximately $1.7 million annually. No deaths were identified within the limitations of the survey design.

CONCLUSIONS

Although deemed one of the most dangerous extreme sports, many patients with BASE injuries surviving to arrival at definitive medical care do not require inpatient admission.

Self-Transcendence in Mountaineering and BASE Jumping

The “extreme sports” of mountaineering and BASE Jumping are growing in popularity and are associated with significant risk of injury and death. In recent years there have also been increasing numbers of reports of reckless disregard and selfishness in the pursuit of mountaineering goals, including severe environmental degradation. Extant research has focused predominantly on personality variables that contribute to engagement, participation, and stress responsivity in these extreme sports. The Temperament and Character Inventory (TCI) provides a comprehensive account of personality traits, measuring seven dimensions of personality that are moderately heritable and associated with distinct brain networks and psychological characteristics. One of these traits is Self-Transcendence, which is associated with spiritual ideas and experiences, such as searching for something elevated and greater than one's individual self. High Self-Transcendence can motivate people to act altruistically even if that requires personal sacrifices and hardship. This article draws on the extant research literature, which has consistently found that despite substantial heterogeneity in their individual personality profiles, mountaineers, and BASE jumpers are adventurous in temperament and highly self-controlled and organized in character. Between 75 and 85% of the character configurations observed in these populations are associated with low Self-Transcendence. The purpose of this paper is to consider the role of Self-Transcendence and its effect on individual personality profiles of extreme athletes, in particular in moderating potentially self- destructive, and regressive ethical and moral behaviors in mountaineering and BASE jumping.

Extreme Sports Injuries to the Pelvis and Lower Extremity

Extreme sports are growing in popularity, and physicians are becoming increasingly aware of injuries related to these activities. Imaging plays a key role in diagnosing and determining clinical management of many of these injuries. This article describes general imaging techniques and findings in various injuries specific to multiple extreme sports.

Comparison of the Personality Traits of Male and Female BASE Jumpers

BASE jumping is an extreme adventure sport which consists of jumping from a fixed object with specially adapted parachutes. A few studies of the personality of BASE jumpers have been conducted, but little is known about how the women in this sport compare to the men. The purpose of this study is to compare the personality traits among a sample of men and women who are experienced BASE jumpers, as this provides an interesting and important opportunity to better understand the motivation for extreme sports. Eighty-three participants completed the Temperament and Character Inventory the day before the jump at the New River Gorge Bridge Day BASE Jumping event, West Virginia, United States. The sample included 64 men and 19 women. Results show that men and women BASE jumpers shared similar personality traits both in terms of temperament and character, except for the character trait of cooperativeness on which women scored higher than men. This suggests that the basic drive for participation in extreme sports is self-regulation of personal emotional drives and needs for self-actualization, rather than to oppose social pressure or cultural bias against female participation. These findings are discussed in relation with other studies conducted among extreme athletes and in terms of congruence between personality and activity.

An Ecological Conceptualization of Extreme Sports

Currently, there are various definitions for extreme sports and researchers in the field have been unable to advance a consensus on what exactly constitutes an 'extreme' sport. Traditional theory-led explanations, such as edgeworks, sensation seeking and psychoanalysis, have led to inadequate conceptions. These frameworks have failed to capture the depth and nuances of experiences of individuals who refute the notions of risk-taking, adrenaline- and thrill-seeking or death-defiance. Instead, participants are reported to describe experiences as positive, deeply meaningful and life-enhancing. The constant evolution of emerging participation styles and philosophies, expressed within and across distinguishable extreme sport niches, or forms of life, and confusingly dissimilar definitions and explanations, indicate that, to better understand cognitions, perceptions and actions of extreme sport participants, a different level of analysis to traditional approaches needs to be emphasized. This paper develops the claim that a more effective definition, reflecting the phenomenology, and framework of an ecological dynamics rationale, can significantly advance the development of a more comprehensive and nuanced future direction for research and practice. Practical implications of such a rationale include study designs, representative experimental analyses and developments in coaching practices and pedagogical approaches in extreme sports. Our position statement suggests that extreme sports are more effectively defined as emergent forms of action and adventure sports, consisting of an inimitable person-environment relationship with exquisite affordances for ultimate perception and movement experiences, leading to existential reflection and self-actualization as framed by the human form of life.

The skeletal trauma resulting from a fatal B.A.S.E jump: A case study showing the impact of landing feet-first under extreme vertical deceleration

The term 'B.A.S.E jump' refers to jumping from a building, antenna, span (i.e., bridge) or earth (i.e., cliff) structure, and parachuting to the ground. There are numerous hazards associated with B.A.S.E jumps which often result in injury and, occasionally, fatality. This case report details the skeletal trauma resulting from a fatal B.A.S.E jump in Australia. In this case, the jumper impacted the ground from a fall of 439m in a feet-first landing position, as a result of a partially deployed parachute, under extreme vertical deceleration. Skeletal trauma was analyzed using full-body post mortem computed tomography (PMCT) and contextual information related to the circumstances of the jump as reported by the Coroner. Trauma to 61 skeletal elements indicates the primary impact was to the feet (i.e., feet-first landing), followed by an anterior impact to the body (i.e., fall forwards). Details of the individual fracture morphologies indicate the various forces and biomechanics involved in this fall event. This case presents the types of fractures that result from a B.A.S.E jump, and highlights the value of using PMCT and coronial data as tools to augment skeletal trauma interpretations.

'Leave Your Ego at the Door': A Narrative Investigation into Effective Wingsuit Flying

In recent years there has been a rapid growth in interest in extreme sports. For the most part research has focused on understanding motivations for participation in extreme sports and very little research has attempted to investigate the psychological structure of effective performance. Those few studies that have attempted to explore this issue have tested models designed for traditional sport on adventure sports. However, extreme sports are not the same as adventure sports or traditional sports. This study employed a narrative approach to investigate experiences of effective performance in the extreme sport of proximity wingsuit flying. An overarching theme we labeled ‘leave your ego at the door,’ emerged based on four sub-themes: (1) know thy self, (2) know thy skills, (3) know the environment now, and (4) tame the ‘inner animal.’ These themes are presented and discussed in relation to performance and discovery narratives identified within elite sport, thereby shedding light on how participants’ experiences of the extreme sport of proximity wingsuit flying differ from dominant stories within traditional sports.

Transformations through Proximity Flying: A Phenomenological Investigation

Participation in extreme sports has been linked to personal transformations in everyday life. Descriptions of lived experience resulting from transformative experiences are limited. Proximity flying, a relatively new discipline involving BASE jumping with a wingsuit where participants fly close to solid structures, is arguably one of the most extreme of extreme sports. The aim of this paper, part of a larger phenomenological study on the lived experience of proximity flying, is to explicate the ways in which participating in proximity flying influences the everyday lives of participants. Interpretative phenomenological analysis was used to explicate the lived experience of six proximity pilots. An analysis of interview transcripts revealed three significant themes describing the lived experience of participants. First, experiences of change were described as positive and skills developed through proximity flying were transferable into everyday life. Second, transformative experiences were considered fundamental to participants' perspectives on life. Third, experience of transformation influenced their sense of personal identity and facilitated flourishing in other aspects of everyday life. Participants were clear that their experiences in proximity flying facilitated a profound process of transformation which manifest as changes in everyday capabilities and behaviors, values and sense of identity.

Injuries in extreme sports

Extreme sports (ES) are usually pursued in remote locations with little or no access to medical care with the athlete competing against oneself or the forces of nature. They involve high speed, height, real or perceived danger, a high level of physical exertion, spectacular stunts, and heightened risk element or death.Popularity for such sports has increased exponentially over the past two decades with dedicated TV channels, Internet sites, high-rating competitions, and high-profile sponsors drawing more participants.Recent data suggest that the risk and severity of injury in some ES is unexpectedly high. Medical personnel treating the ES athlete need to be aware there are numerous differences which must be appreciated between the common traditional sports and this newly developing area. These relate to the temperament of the athletes themselves, the particular epidemiology of injury, the initial management following injury, treatment decisions, and rehabilitation.The management of the injured extreme sports athlete is a challenge to surgeons and sports physicians. Appropriate safety gear is essential for protection from severe or fatal injuries as the margins for error in these sports are small.The purpose of this review is to provide an epidemiologic overview of common injuries affecting the extreme athletes through a focus on a few of the most popular and exciting extreme sports.