Whitewater safety

It’s been a rough week in southeast Tennessee. Two people died in two days on Grumpy’s rapid past Ocoee Dam No. 2. Just how common is death due to whitewater rafting?

Wilson et al reviewed 16 articles in the primary literature to determine the specific types of injuries that occur from whitewater rafting and paddling. They found that the rate on injury is low, and that specific injuries occur with each sport. Paddling (including kayaking and canoeing) had mostly upper extremity injuries while in the boat. Lower limb injuries occurred during the hike in or out, or while in the water apart from the boat. Rafting injuries generally occurred while “swimming” (ie fell out of the boat), and were typically from collision trauma. Paddling injury rates are roughly 4.5 per 1000 days for novice paddlers, and rafting rates are 26.3 per 100,000 participants (different measures theirs, not mine). There was likely reporting bias for minor injuries, as people not seeking treatment were not reported.

Mildly relevant to the news article, fatality rates from commercial whitewater rafting in New Zealand to range from 0.16-0.27 per 100,000 participants per year. Drowning was indicated in 94% of the fatalities. Paddling death rates were much higher, at 2.9 per 100,000 participants per year. The authors attribute this to the fact that most paddling is done with commercial groups, as well as the fact that it is easier to sink a canoe than an 8 person raft.

Perhaps it was simply bad luck, as the death rates in this sport are fairly low. Perhaps more can be done to prevent drowning beyond the required helmets and life jackets. Better epidemiological studies may tease out this. In the meantime, be safe out there.

Wilson I, McDermott H, Munir F, Hogervorst E. Injuries, ill-health and fatalities in white water rafting and white water paddling. Sports Med. 2013 Jan;43(1):65-75 [PMID 23315757]

EBM Gone Wild sea 700 400

EBM Gone Wild

Wilderness Medicine

Emergency physician with interests in wilderness and prehospital medicine. Medical Director of the Texas State Aquarium, Padre Island National Seashore, Robstown EMS, and Code 3 ER | EBM gone Wild | @EBMGoneWild |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.