TY - JOUR
T1 - Medical risks of wilderness hiking
AU - Boulware, David R.
AU - Forgey, William W.
AU - Martin, William J.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003/3
Y1 - 2003/3
N2 - PURPOSE: We sought to determine the extent to which injuries and illnesses limit long-distance or endurance outdoor recreational activities. METHODS: In a prospective surveillance study, 334 persons who hiked the Appalachian Trail for at least 7 days (mean [± SD] length of hike, 140 ± 60 days) in 1997 were interviewed. At the end of their hike, subjects completed a questionnaire on injuries, illnesses, water purification methods, and hygiene practices. RESULTS: Of the 280 backpackers who responded (a combined 38,940 days of wilderness exposure), 69% (n = 192) achieved their goal. The most important reasons for ending a hike prematurely were injury, time limitation, and psychosocial reasons. The most common medical complaints were feet blisters (64%; n = 180), diarrhea (56%, n = 156), skin irritation (51%, n = 143), and acute joint pain (36%, n = 102). The incidence of vector-borne disease was 4% (n = 11); physician-diagnosed Lyme disease was the most common, and 24% of hikers (n = 68) reported tick bites. The risk of diarrhea was greater among those who frequently drank untreated water from streams or ponds (odds ratio [OR] = 7.7; 95% confidence interval [CI]: 2.7 to 23; P <0.0001), whereas practicing "good hygiene" (defined as routine cleaning of cooking utensils and cleaning hands after bowel movements) was associated with a decreased risk (OR = 0.46; 95% CI: 0.22 to 0.97; P =0.04). CONCLUSION: Diarrhea is the most common illness limiting long-distance hikers. Hikers should purify water routinely, avoiding using untreated surface water. The risk of gastrointestinal illness can also be reduced by maintaining personal hygiene practices and cleaning cookware.
AB - PURPOSE: We sought to determine the extent to which injuries and illnesses limit long-distance or endurance outdoor recreational activities. METHODS: In a prospective surveillance study, 334 persons who hiked the Appalachian Trail for at least 7 days (mean [± SD] length of hike, 140 ± 60 days) in 1997 were interviewed. At the end of their hike, subjects completed a questionnaire on injuries, illnesses, water purification methods, and hygiene practices. RESULTS: Of the 280 backpackers who responded (a combined 38,940 days of wilderness exposure), 69% (n = 192) achieved their goal. The most important reasons for ending a hike prematurely were injury, time limitation, and psychosocial reasons. The most common medical complaints were feet blisters (64%; n = 180), diarrhea (56%, n = 156), skin irritation (51%, n = 143), and acute joint pain (36%, n = 102). The incidence of vector-borne disease was 4% (n = 11); physician-diagnosed Lyme disease was the most common, and 24% of hikers (n = 68) reported tick bites. The risk of diarrhea was greater among those who frequently drank untreated water from streams or ponds (odds ratio [OR] = 7.7; 95% confidence interval [CI]: 2.7 to 23; P <0.0001), whereas practicing "good hygiene" (defined as routine cleaning of cooking utensils and cleaning hands after bowel movements) was associated with a decreased risk (OR = 0.46; 95% CI: 0.22 to 0.97; P =0.04). CONCLUSION: Diarrhea is the most common illness limiting long-distance hikers. Hikers should purify water routinely, avoiding using untreated surface water. The risk of gastrointestinal illness can also be reduced by maintaining personal hygiene practices and cleaning cookware.
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U2 - 10.1016/S0002-9343(02)01494-8
DO - 10.1016/S0002-9343(02)01494-8
M3 - Article
C2 - 12681456
AN - SCOPUS:0037355407
SN - 0002-9343
VL - 114
SP - 288
EP - 293
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 4
ER -