True or False: 90% Of All Injuries Are To The Big Toe?

And the other 10% are caused by flying beer cans and irate husbands.” At least that was what we told our passengers at Lees Ferry during the orientations in the late '70s. All said, of course, to explain how safe river trips through the Grand Canyon were.
Although the true/false question might give a false sense of safety, trips are safe and also relatively safe as shown in Fateful Journey: Injury and Death on Colorado River Trips in Grand Canyon by Thomas M. Myers, m.d.., Christopher C. Becker, m.t.. (a.m.t..), and Lawrence E. Stevens, ph.d. (Red Lake Books, po Box 1315, Flagstaff az 86002, 520-774-4923, 1-884546-02-1, 1999).
Well-known gcrg members Tom Myers and Larry Stevens, and Chris Becker, Tom's compadre at the South Rim Clinic, have combined their talents to publish this long-awaited statistical analysis of river-related accidents, injuries, and deaths. As have been previously stated at gts' and in the bqr, river running trips are still very safe. Though adrenaline is part of the appeal of triver running, safety in Grand Canyon fares very favorably with other sports, both indoor and outdoor, moderate-risk and high-risk.
Without trying to mis-interpret too many of the stats, here are some highlights:
• Regarding immersion hypothermia, “contrary to common knowledge, physical activity actually increases heat loss more than it increases heat production and should be avoided unless it aids immediate self-rescue. Due to the extremely cold temperatures of the river, and the directly related risk of hypothermia to drowning, it is the single greatest hazard for river running in Grand Canyon. It has arguably made the river more dangerous now despite controlled flows from Glen Canyon Dam, than it was in the days of the untamed Colorado prior to 1963.”
• A five-year study (1988–1992) indicates that the frequency of off-river injury mechanisms of 57.6% is higher than that of the on-river rate of 42.4%.
• “Although boat flips are dramatic, they resulted in only one-third of the total on-river injuries.”
• “On a per trip basis, no significant difference existed between the trip-related injury frequency of commercial employees, commercial passengers, or private river runners. This pattern probably resulted from interaction between a dramatically lower injury frequency among employees on a trip-related basis, but a greater cumulative exposure to risk and higher injury frequency among individual employees.”

• “Water intoxication, or hyponatremia, can be as serious a medical condition as heat prostration. This condition has only recently been identified and can easily be confused with dehydration and other heat-related conditions.”
• 68% of rescues were conducted in less than 24 hours from time of injury . “Although evacuation was occasionally substantially delayed, case history data fail to show any additional mortality” .• The fatality frequency of the pre-commercial era (1869–1937) is one in 20, for ten deaths (seven on-river, three off-river). For the commercial era (1938–1998), it is one in 18,424, for 33 deaths (17 on-river, 16 off-river).

• Crystal Creek is the rapid with the most fatalities, five. Lava Falls, 25-Mile, and probably 232-Mile had two each.
Helpful though this book may be, there are some nits to pick, most of them being historical, but a couple involve numbers and percentages that don't match from charts and tables to the text. For example, the percentages referenced to Table 7.1 on p.59 should be referenced to Table 7.3; percents are slightly different and don't match the percentages in Table 7.2.
Although statistics are far from most people's favorite reading, there are enough sidebars with stories and historical accounts spaced throughout to keep up interest. Table 15.1 (“Fatality data,” listing 45 deaths, is probably the portion I will refer to the most. One stat not discussed from this table is the unluckiest name to have when boating: William or Wilson “Willie” is the first name of 5 of 45, or 11%, of the fatalities Charles, Tom/Thomas, and Michael have 2 each; all told, these four variant names comprise 11 of 45, or 25%).
Other things of particular note are that Myers tracked down the photographer of the cover photo, a December 25, 1970, Life magazine First Prize photo award winner for “Amateur Action” of an arta rig flipping in Lava Falls, and also those of the oft-bootlegged photos of the 1983 Tour West flip in Crystal Creek.
Buy Fateful Journey; refer to it; read it. There are much valuable data contained within; this book may influence the way regulatory agencies gather and analyze their stats. They might do well to follow Tom, Chris, and Larry's example.
Richard Quartaroli
P.S. The answer to the True/False question in the title is false. Lower extremity injuries comprised 43% in the study years .

Field Notes From The Grand Canyon

A grand canyon river trip, for many, becomes an intense life-changing experience, with a huge challenge: how to make sense of, to truly understand, a landscape so vast and so stunning, and to perceive what is happening in their own psyches. How do you come to terms with this place?
Ann Zwinger talks of this dilemma in her foreword to Field Notes from the Grand Canyon: Raging River Quiet Mind. In this small and colorfully illustrated journal, Teresa Jordan comes to terms with it through her field journal writings and watercolors, done on a 12-day Outdoors Unlimited Grand Canyon trip.
Anyone who has done a Grand Canyon trip will immediately understand the feelings and places that Teresa Jordan is describing with her skilled hand and observant eye. Her watercolor sketches are lovely, and notes on rapids, hikes, guides and camp life will spark the memory of anyone who has experienced it themselves.
This account is also a valuable reminder of what it's like for most of the folks we're taking downstream for the first time. Teresa Jordan's words and paint are wonderful tools for expressing this profound experience—the soul-awakening splendor of a river journey through the most amazing geography on earth.
Mary Williams