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What does the evidence show?

Sweat Science

Who Lives and Who Dies After Climbing Accidents

Falls put 3,000 climbers a year in hospital, costing more than $20 million, according to a new study

Deaths under extreme circumstances exert a powerful fascination. (RG&B Images/Stocksy)
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Falls put 3,000 climbers a year in hospital, costing more than $20 million, according to a new study

Since 1930, a total of 31 people have died on Yosemite’s majestic Half Dome, thanks to improperly secured harnesses, lost anchors, avalanches, lightning strikes, tangled chutes, and one case of “slip and fall on mossy rock.” These deaths, tallied in a study published in this month’s Wilderness & Environmental Medicine, often make headlines in newspapers and on websites like this one. For some reason (and I’m not judging), deaths under extreme circumstances exert a powerful fascination.

But these headlines represent only a tiny fraction of the overall picture of climbing accidents. Another study in the same journal issue, from a research team led by Joseph Forrester of Stanford University, zooms out to explore just how many climbers end up in the emergency department each year, how they get there, and what happens to them. The findings offer a reminder that climbing’s ongoing boom in popularity comes with a cost—and may convince you to freshen up your safety check routine next time you head out.

The study involved combing through a database called the National Emergency Department Sample, which is a huge collection of records from about 1,000 representative hospitals of all types across the country. Records for any patients older than 16 whose diagnosis code corresponded to mountaineering, rock climbing, or wall climbing between 2010 and 2014 were extracted and analyzed. From this sample, they were able to estimate that there were roughly 3,023 climbers who presented to an emergency department in the U.S. each year during that period. Notably, that’s a 34 percent increase since a study that ended in 2007.

The climbers showing up in emergency had an average age of 33, and were 62 percent male. They were pretty well off, with 38 percent reporting an income in the top quartile relative to their zip code, and mostly (63 percent) in the West census region. The majority of the patients (60 percent) came in with injuries to multiple body regions, while 32 percent had isolated extremity injuries to the arms or legs, and just five percent had head or neck injuries. Taking care of all these patients isn’t cheap: the total billing cost of these hospital visits was just over $20 million a year, and that doesn’t include subsequent rehab and medical appointments.

One interesting detail: during the entire four-year sample period, only 2 of the 3,275 patients in the sample died. As the Half Dome stats make clear, that doesn’t mean climbers weren’t dying during this period. It just means that those who died were almost always dead before they made it to the hospital. There’s an important lesson here for rescuers, the researchers suggest: “Although rapid transport of survivors to definitive care is important, this should not occur at the cost of rescuer safety.”

So how common are these injuries? Well, the Outdoor Industry Association’s estimate is that there were more than 6 million indoor and outdoor climbers in the U.S. in 2016, which suggests that you have a 1-in-2,000 chance of ending up in the emergency department in any given year. Some contexts and climbing styles are more risky than others, of course. In fact, it’s possible that a few wild climbers are having accidents once a month and being counted multiple times in the database, skewing the numbers. Still, that seems like a reasonable baseline estimate.

In practice, the more common medical issues encountered by climbers are chronic overuse injuries. I come from the running world, where there’s lots of handwringing over the fact that pretty much everyone gets injured eventually, no matter what supposedly magical shoe (or lack thereof) you use. The stats in climbing don’t look much better. In a survey-based study of more than 700 climbers published last year, the average number of reported injuries in the previous two years was 2.0—pretty grim odds. Moreover, more than half the subjects reported returning to climbing before their injury was fully healed, and 45 percent of them reported developing chronic problems related to the injury. Ugh.

One of the motivators for the Half Dome study was the fact that overcrowding has led to a permit system for the cable handrails for hikers that lead up the back of Half Dome. In fact, only one of the deaths turned out to have any possible link to overcrowding or bumbling hikers; instead, the main source of deaths was accidents befalling skilled climbers. There’s no way to turn climbing into a zero-risk activity, and it seems reasonable to assume that plenty of people wouldn’t want it that way anyway. But the stats suggest that many of the injuries we currently see, both acute and chronic, are preventable. Take an occasional day off, and check your harness—twice.


My new book, Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance, with a foreword by Malcolm Gladwell, is now available. For more, join me on Twitter and Facebook, and sign up for the Sweat Science email newsletter.

Filed To: Rock Climbing / Mountaineering / Injury Prevention / Science
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