Monthly Archives: December 2014

Better food safety through technology

When travelling, much thought goes into what  to eat. Not only do you have to get your party to agree on something, you have to make sure it’s safe. While guidebooks and travel websites often give advice, they might not be detailed enough for your specific situation.

Then what to do? Maybe go get this “Can I Eat This” app thoughtfully created by the CDC. It was reviewed in Travel Medicine and Infectious Disease in August, and came away with a recommendation for all travellers, especially those with young children.

I agree that there is probably a group of people this app would help immensely. It is well received, with a current 4 star rating at iTunes, and 3.5 star rating at google play. The app is organized by simple questions with discrete answers, so you’re basically going down a flowchart. Unfortunately, you would probably get the same information from this infographic, also provided by the CDC. Most of the negative reviews point out the flaws, in that even though it asks you your country, it really doesn’t have country specific advice. It simply breaks down countries into “developed” and “developing”.

It definitely errs on the side of being overly safe rather than possibly making you sick. It even goes so far as to tell you that you probably should not to eat sushi in the US (or Japan!). It is comical that the picture of “uncooked meat” is a few sushi rolls, so maybe there is a hidden message there. There is also a fair amount of humor to be found in their answers that you can find while perusing the app.

So while I think the information is reasonable, and the message is right, I can’t imagine trying to use this on a trip. It’s still too clunky to pull out and use while ordering, even with the simple menus. I do think it is worth a look before travelling to a country simply to get an idea of how you should expect to eat and drink while there. Maybe it will encourage the traveller to look for a more in-depth listing of foods safe to eat.

“Can I Eat This” – Review of a CDC app
http://www.travelmedicinejournal.com/article/S1477-8939(14)00160-4/abstract

What leads to rock climbing rescues?

Rock climbing is a popular sport, but most rock climbing areas are either remote or sparsely populated with climbers, leading to poor data collection with regards to rescue events.The US National Park Service has data that shows only 3% of SAR are for technical roped climbing, versus 48% for hiking.  Thus, preventive education for climbers, as well as preparation for SAR, used to need a lot of educated guessing about what types of incidents occur.

Thankfully, there is one place where the density of climbers and the number of SAR events are high enough to get decent data. That place is Boulder County, CO, home of the Rocky Mountain Rescue Group. The incident reports by the RMRG allow consistent data for rock climbing rescues that break them down into specific injuries and climbing practices that led to them. It’s worth noting that climbing SAR accounts for 19.5% of the total SAR for RMRG, which is quite different from what the NPS reports. This is likely due to ease of access to popular climbing sites next to a highly populated area.

It’s not surprising that more incidents happen in summer and autumn. Weekends accounted for slightly more than half of the incidents as well. The most common victim is a male aged 20-29. In order of frequency, the activities that led to injuries were technical roped climbing (including belay incidents), unroped climbing, bouldering, mountaineering, and lastly simply being a bystander when a rock fall occurs.

For roped climbing, most injuries and incidents were lead falls, accounting for more than a third of incidents, followed by belay accidents at slightly over 20%. Being lost or stranded comes next, and have nearly twice as many victims per incident as any of the other activations. Second fall, anchor failure, rock fall, and medical causes are small players in this data set, accounting for single digit percentages each.

Incidents involving belay or rappelling most commonly resulted from the ropes being used not being long enough to reach the ground. A smaller amount resulted from the belayer losing control of the rope. Many of the rest of the incidents are from ropes getting stuck, with only 1 coming from a knot coming untied.

Unroped climbing includes free climbing as well as scrambling. The distinction is that free climbers are often experienced, and scramblers are not. The authors point out that their data does not distinguish between the two, so level of experience is not factored in to their incidents. They don’t show the data, but report that unroped climbing most often leads to victims being stranded but uninjured. However, they then report that unroped climbers are the most common climbers involved in fatalities, with 39% of fatal incidents.

Rock falls account for few injuries compared to the other activities, but their data demonstrates an important point. While rock falls are seemingly random, they most frequently occur during times of freeze-thaw cycling. Thus, in the spring they occur at lower altitudes, and this elevation goes up during the summer until the weather turns colder again.

Now that the activities have been identified, let’s turn to the injuries themselves. More than half (56.5) of the victims met by the RMRG had 1 or more injuries. Of those injuries, most were lower extremity injuries at 29.5%. This was followed by head injuries at 17%, and spinal injuries at 12.5%. Upper extremity, chest, abdomen, and “dislocated shoulder” (listed separately from upper extremity by the authors) were all less than 3% of the injuries each. Sadly, just under 10% (23/247) were fatalities. Of note, these are the suspected injuries listed by the RMRG, not actual identified injuries at definitive care, so be cautious with interpretation of severity of injury.

So what does this mean? Well, for the SAR guys, it means being prepared for more than just rescuing the lost, as many of them will be injured. However, preventing these incidents would have more health benefits. I’m not sure how to convince people not to climb without safety ropes, but the data shows that it is inherently riskier than all other forms of climbing. Also, making sure that your rope can get the climber all the way to the ground is quite important. When belaying or spectating, don’t stand in the fall line. Lead climbers should be extra careful based on this data set, as they are most at risk of injury.

Limitations are many. This is narrative data that is often presumptive as to injury, as well as missing many features such as length of fall, experience level, and other events leading to injury. There is also reporting bias, as it is likely that many minor injuries do not get reported to SAR. However, it is a robust set of data that hopefully can lead to changes in climbing education at popular areas.

Rock Climbing Rescues: Causes, Injuries, and Trends in Boulder County, Colorado

http://www.ncbi.nlm.nih.gov/pubmed/22727678

Props to the authors for giving a rather comprehensive list of definitions of the climbing terms used in their article. While many readers probably knew them, assuming that all readers do leads to decreased understanding of the article. I wish more authors would be as thorough with their explanations of possibly unfamiliar terms.