Wilderness Injury, Illness, and Evacuation: National Outdoor Leadership School's Incident Profiles, 1999–2002

Objective. This paper describes field injury, illness, near miss, and evacuation profiles of the National Outdoor Leadership School (NOLS).Methods. The NOLS incident database is used to record injuries, illnesses, near-miss incidents (close calls), evacuations, and nonmedical incidents. The database has been used continually since 1984.Results. During the period September 1, 1998, through August 31, 2002, there were 630 937 program days on which 1940 incidents were reported involving 1679 students and 233 staff. Athletic injuries account for 50% of all injuries, and soft-tissue injuries account for 30%. Athletic injuries are most often sprains and strains of knees (35%), ankles (30%), and backs (13%). Falls and slips around camp or while hiking are the leading contributing factors. The most common illnesses are gastrointestinal symptoms such as nausea, vomiting, and diarrhea (26.4%) and all flu-like illness, including flu symptoms and respiratory symptoms (16.6%). Rock fall was the leading near-miss incident. Two hundred fifty-seven (53%) medical evacuees received treatment and were able to rejoin and finish their course. There was one fatality from 1999 to 2002. The fatality rate for this period is 0.002 per 1000 program days.Conclusions. The number of injuries and, specifically, the number of athletic injuries have declined. The number and rate of near-miss incidents increased as a result of better reporting; the rate of nonmedical incidents held steady. Motivation continues to be our leading category of nonmedical incident. Efforts at collecting incident data provide a useful measurement from which we can gauge our risk-management performance. Objective. This paper describes field injury, illness, near miss, and evacuation profiles of the National Outdoor Leadership School (NOLS). Methods. The NOLS incident database is used to record injuries, illnesses, near-miss incidents (close calls), evacuations, and nonmedical incidents. The database has been used continually since 1984. Results. During the period September 1, 1998, through August 31, 2002, there were 630 937 program days on which 1940 incidents were reported involving 1679 students and 233 staff. Athletic injuries account for 50% of all injuries, and soft-tissue injuries account for 30%. Athletic injuries are most often sprains and strains of knees (35%), ankles (30%), and backs (13%). Falls and slips around camp or while hiking are the leading contributing factors. The most common illnesses are gastrointestinal symptoms such as nausea, vomiting, and diarrhea (26.4%) and all flu-like illness, including flu symptoms and respiratory symptoms (16.6%). Rock fall was the leading near-miss incident. Two hundred fifty-seven (53%) medical evacuees received treatment and were able to rejoin and finish their course. There was one fatality from 1999 to 2002. The fatality rate for this period is 0.002 per 1000 program days. Conclusions. The number of injuries and, specifically, the number of athletic injuries have declined. The number and rate of near-miss incidents increased as a result of better reporting; the rate of nonmedical incidents held steady. Motivation continues to be our leading category of nonmedical incident. Efforts at collecting incident data provide a useful measurement from which we can gauge our risk-management performance.