Regulating Extreme Sport : the case against injury rates

photo: pinkbike http://www.pinkbike.com/news/Keep-the-Torch-Lit-Joyride-150-2013.html 


This summer I entertained some media interest in regulating extreme sport. This story fascinates certain people, baffled by how something so seemingly dangerous has not fallen under some government agency’s mandate. The Globe led with a story in June (that I contributed to) on extreme sport and teenage brain development (link) noting that there is no regulation and those implications for youth, followed by a Toronto Star story in July (link). The ball was further kicked along with the CBC’s Ontario Morning, with whom I interviewed on July 27 (you can hear that interview by downloading the segment in iTunes link).
This all started with an editorial by noted lawyer Patrick Brown (link). Mr. Brown represented Ian McAdam in his case against Blue Mountain regarding his debilitating spinal injury while DH biking there. Mr. Brown is well versed in the adventure and action sport field, and has done important advocacy work, especially regarding cycling safety (link). His current push is to have ‘extreme sport’ facilities publish their injury data (and be answerable to some agency), in order to better help participating individuals assume the risks inherent in whatever activity they are pursuing. I have not seen any detailed proposal at this point.
In general, I agree with Mr. Brown and his intentions. I disagree on the means to get there, though.

First off, what is and is not an extreme sport is up for debate. In our field we don’t use the term ‘extreme sport’ (as it is usually scoffed at) and instead fall back on either adventure sports or action sports. Even these are not delineated in any clear fashion. Deciding what is in or out will be somewhat subjective. I can go on about the differences here, but will save that for a future post.
Secondly, the nut of Mr. Brown’s proposal is the public posting of injury data. His whole point is that individuals need to go into an activity with their eyes open. Here I do agree that our action and adventure operators downplay or gloss over the risks inherent, and I believe this needs to change. Posting injury rates, however, won’t do it. Here’s why:
·         Despite appearances, in these activities severe injuries are rare. This does not change the facts for those few individuals who experience life altering injuries, but injury rates are very low. At 2013 study, for example, (link)  found indoor climbing injuries to occur at 0.01 per 1000 hours of participation (more on ‘rates’ in a moment). This is a very small number. In effect, for every 100,000 hours of participation, there is 1 injury. (For the record, there are very few academic and legitimate studies on injury rates in action and adventure sports. Any data referring to such rates has to be suspect as estimation). I also see little value in dumping all injuries into this data, as a slip/fall leading to a broken finger or stitches in the knee is not life altering and potentially unrelated to the activity.
·         What’s more, injuries in action and adventure are ‘asymptomatic’. Just because someone was injured does not mean someone else was at fault. My following of the whitewater rafting industry points to a significant number of deaths in that activity occur due to heart attack, typically from middle age or older inactive men. Is this the ‘fault’ of the operator? Inherent risk is a fundamental aspect of adventure and action sports. When these risks are realized, it does not necessarily reflect back upon the host of such activities. There are some caveats to this, below.
·         A Toronto Star follow up article (link) cited injury rates of 1.01 per 20,000 hours in a climbing gym, 300 ‘accidents’ per 150,000 skier visits, and a separate ski area injury rate of 1.6 per 1000 visits. What is the public to do with this data? As I was quoted in the Star and on CBC, I don’t think people are sophisticated enough to interpret these numbers, especially without context and comparison to other activities such as hockey, football, soccer or even riding a bike on the road (let alone driving a car). Regardless, the numbers are so small I can’t see them deterring a child or parent: ‘Heck, I’m going to climb here for an hour, so I only have a 1 in 100,000 chance of getting injured’. That sounds pretty reasonable.
·         Mr. Brown’s initiative, by necessity, will be limited to pay-for-play facilities (running into the what-is-an-extreme-sport question again). It seems lift serviced mountain biking, freestyle terrain parks, indoor bike and skate parks, and climbing gyms could all fall into this area. The borders are pretty fuzzy though: a whitewater kayak instruction program? Guided mountain climbing? Races? Go carts? I saw an article that called short track speed skating an extreme sport (!). This initiative of posting injury rates puts pressure on the operators who profit from such activities and the risk inherent in these activities, even though they typically don’t pay the price (injury) when the risks are realized. I’m on board with this. Commercializing action and adventure needs to be attached to a significant social obligation to go above and beyond in informing and managing those risks. It leaves out, though, public and free skateparks, trails and the vast wilderness where adventure sports take place. Is it unduly burdening the commercial operators? I don’t think so, given the social license we grant them. But I also don’t think it effective given the points above on the effectiveness of rates.
·         Comparing apples to oranges: a side effect of this injury data could be parents shopping for the ‘safest’ operator or safest activity. Each one is different. Whistler ski resort’s terrain parks are the world’s biggest, most progressive, and busiest, so naturally they will have more injuries. I would argue that they do it better, however, than 99% of the smaller, under-managed and under-funded terrain parks trying to get a piece of that pie.
·         Tracking injury rates does not make an activity safer. Injuries happen after someone got hurt (obviously). The point is to prevent injuries. Scaring participants away is not an effective means of generating safety, especially given the significant benefits of participating in risk oriented sports. Mr. Brown’s initiative is using reactive data to pressure pro-active measures. Here is where the opportunity lies.
I don’t support posting injury data at adventure/action facilities. I do support an accreditation system that forces facilities to provide at least minimum levels of risk management and the existence of a client information system. This will improve safety. New Zealand, the UK, and the ISO have all implemented systems oriented around this with regards to adventure activities or outdoor education. Action/adventure risk management has basic principles that apply across sectors, so skate and bike parks, climbing gyms and terrain parks could all be captured. A less formal system is a self-audit type arrangement, with elevated levels of inspection and accreditation as the initiative becomes more formalized. I don’t see this as onerous on the operators, although they will certainly complain about it. Forward thinking operators will see how these ‘standards’ help develop quality facilities, and that posting an accreditation standing will help their legitimacy and therefore their marketing efforts.
Who runs this? I always support industry self-regulation, first and foremost, but most of these operators are too small and too busy to think big picture and organize themselves. Given the fuzzy borders I don’t think this will work. Insurance providers play this role by default, somewhat reluctantly. The TSSA and Canada’s D. of Transport already are involved in slices of adventure (ziplines – are they extreme sport? – for the former and rafting and sea kayaking for the latter). Occupational health and safety are involved cross sector. If this were to be a government initiative, it will best fall under a provincial health mandate. I’ll leave that to the bureaucrats.
Mr. Brown’s initiative has put this conversation in the public sector, and I believe that there are some fundamental improvements that need to be made in the action/adventure sectors dealing with informed consent and assumed risk. Injury rates are the wrong end of the equation. Risk management has evolved dramatically over the past ten years, the majority of which is centred around our new understanding of how people make choices and a sophisticated understanding of ‘need to know’. Pushing facilities to systemize their risk management will go further to building safety than shaming them or scaring off participants.