The risks of adventure sports

Erik Monasterio is a Bolivian/New Zealand medical doctor and mountaineer. We came across the following article that he authored and thought it must be of interest to some of you. It’s based on mr Monasterio’s four year study of mountaineers and BASE jumpers. Erik Monasterio kindly gave us a permit to post it here.

Adventure and risk-taking sports such as mountaineering, kayaking, rock climbing, downhill mountain biking and base jumping have increased in popularity in recent years. These activities court significant dangers and attract individuals who are prepared to gamble their personal safety, and at times their life in search of a rush of excitement or an unusual accomplishment. Public attention in these sports generally focuses on tragedies and as such are highly emotive and sensationalized. Dramatic accounts of accidents and hardships often lead to fierce debates on the merits and ethics of these sports.

Take, as an example, the controversial events surrounding double-amputee, Mark Inglis’ successful climb of Everest in 2006. Over forty ascending climbers, most with significant team back-up and radio contact to base camp, walked past a dying English mountaineer, David Sharp. Recent accounts reveal that film footage of the unfortunate climber was gratuitously taken and despite David’s poor health he was able to speak to the climbers. Tragically and incredulously, despite the teams being well equipped with modern equipment, oxygen and medicine, no rescue attempts were made. Ambitious mountaineers walked around David and left him to die, choosing instead to direct their energy to the climb. They gave more value to the summit than to the life of a fellow mountaineer!

The climbers once again stumbled past the moribund David on their way down, and still offered no help. The self-serving justifications that he was beyond help and that rescues at such high altitudes are impossible are not convincing, as ten days later another very sick mountaineer, Australian Lincoln Hall, was rescued from a position higher up the mountain. Himalayan climbers, and the leader of the Inglis team, Russel Brice, know very well that many successful rescues have occurred beyond the “Death Zone” (over 8000m) and that it is notoriously difficult to predict who will die from mountain sickness.

In 1996 on the same mountain, Texan pathologist Beck Weathers walked to safety despite twice having been deemed “essentially dead”. Over time 245 mountaineers have died in their quest to climb New Zealand’s highest mountain, Aoraki/ Mt Cook and more than one thousand in their quest for Europe’s highest peak, Mt Blanc. Australian sea kayaker Andrew McCauley tragically died attempting the first solo-crossing from Australia to New Zealand. Base jumping is probably the most dangerous sport in the world and involves parachute jumping from either tall natural features or man-made structures. The parachute is initially closed and is opened after a (short) free fall. A comprehensive data base of base jumping fatalities reveals that 175 jumpers have died since the sport began (approximately 30 years ago).

The surprising finding is that only 123 of those deaths were directly related to base jumping, the other deaths were related to other accidents, drug overdoses and suicides. Taking these reports into consideration the understandable public perception is that adventure sport participants are an unusual, highly selfish or odd breed of people. Why else would they willfully choose to court danger and gamble with their lives? At times to the detriment of others.

Sensationalized reports, although very good at capturing public attention, are seldom balanced or objective and therefore unhelpful in providing an understanding of the risks and motivations behind risk-taking sports. Given that New Zealand currently promotes itself as an adventure destination, where risk-taking sports and activities are popular and traded commercially, it is an important and timely subject. As a mountaineer and psychiatrist I have been involved in scientific research to try to determine the rate of accidents in adventure sports. I am also interested in finding out whether people who engage in these activities have “unusual” or unique personalities, and whether there are any biological or genetic reasons to explain why people take up these sports.

In a New Zealand based study of experienced and committed mountaineers, I found that almost half of them had suffered at least one climbing related injury. Two thirds of those injured were hospitalized and 20% required more than 3 months to recover or were left with long-term health problems. Four years after starting the study there was a 10% death rate (five deaths), four due to climbing accidents. Other studies of mountaineers have found similar results. For example Murray Malcolm, from the University of Otago found that the death rate from climbing in the Mount Cook National Park was 5000 times greater than from work-related injuries. The death rates from climbing on the highest peaks in the Park where similar to those of climbers to peaks over 7000m, approximately 4%.

I also found that the personality of climbers was quite different to that of average people. Climbers scored higher in the areas of Novelty-Seeking and Self-Directedness and lower on Harm-Avoidance. What this suggests is that climbers generally enjoy exploring unfamiliar places and situations. They are easily bored, try to avoid monotony and so tend to be quick-tempered, excitable and impulsive. They enjoy new experiences and seek out thrills and adventures, even if other people think that they are a waste of time. Climbers therefore also participate in other adventure sports, such as mountain biking. When confronted with uncertainty and risk climbers tend to be confident and relaxed. Difficult situations are often seen by climbers as a challenge or an opportunity. They are less responsive to danger and this can lead to foolhardy optimism. Climbers also have good self-esteem and self-reliance and therefore tend to be high-achievers.

I am completing a similar study of base jumpers and the initial results are sobering as they show that almost two-thirds have suffered at least one base-jumping accident. Almost all of those injured required hospital treatment and two-thirds needed more than 3 months to recover or were left with long-term health problems. All base jumpers estimated that they had had near-misses and all of them had friends die from the sport. Overall the personality of the base jumpers appears to be very similar to those of mountaineers. These findings are similar to those of other personality studies of risk-taking sports people, which have found high scores on the measure of Sensation Seeking (essentially the same as Novelty-Seeking). What these findings suggest is that biology and genetics play at least a moderate role in determining who will take up these sports. We know that the amount of Harm-Avoidance, Novelty-Seeking and Sensation-Seeking are inherited from our parents and are determined by the levels of a number of brain neurotransmitters, called monoamines. These monoamines (Dopamine and Serotonin) are chemicals that pass information between lower and higher brain regions.

High Novelty-Seeking and Sensation-Seeking are both associated with low levels of Dopamine and the current theory is that involvement in risk-taking activities helps to boost the levels of this brain neurotransmitter. High Harm-Avoidance, which confers a propensity to become anxious or scared in the face of risk or uncertainty is related to high levels of Serotonin. In my studies risk-taking sports people had low levels of Harm-Avoidance and this may explain why they are able to tolerate risk and uncertainty without becoming overwhelmed by fear and anxiety. In fact the low levels of Harm-Avoidance may contribute to a tendency to underestimate danger and therefore may partially account for the high rates of accidents.

An interesting observation of serious risk-taking sports people is that despite frequent near misses and accidents, they continue to participate in adventure sports. This persistence in the face of trauma is in my view quite unique. Average people who experience or witness trauma to the levels found in my studies would be expected to develop psychological complications, such as Post Traumatic Stress Disorder, and other mood or anxiety problems. In the studies however participants appeared to be immune to these reactions. Researchers in Switzerland who studied a large number of professional mountain guides also found that they had unusually low levels of trauma-related psychological complications. The researchers commented that the level of trauma experienced by the mountaineers was similar to that experienced by fire-fighter and army personnel, yet they had only 10-20% the rate of psychological disturbance. Only 3% of mountaineers developed Post Traumatic Stress Disorder, whereas rates in firefighters are up to 20%.

The mountaineers in that study were also found to have low levels of Harm-Avoidance. What emerges as an interesting possibility is that risk-taking sports people may be protected from the psychological complications that generally accompany serious trauma. This could explain why accidents don’t put them off adventure sports and low Harm-Avoidance may account for this immunity. At a community level, psychological complications from trauma are relatively common and it is estimated that at least 5% of the population will suffer from these debilitating problems at some point in their lives. A major difficulty for health workers following traumatic events such as natural disasters or terror attacks is identifying which people are at risk or are protected from these conditions. If a link between Harm-Avoidance and a lower incidence in these conditions is established, then it may eventually help to identify vulnerable individuals and offer early interventions. Further studies of risk-taking sports people could therefore have important public health benefits.

The study of risk-taking sports people yields interesting results. Not surprisingly sports such as mountaineering and base jumping are associated with significant risk of accidents and fatalities. People who choose to take up these sports appear to have a biological make-up which is different to that of average people in the community and these differences in brain chemistry help to explain why they put themselves in perilous situations.

Biological correlations however must not be taken too far. In my view adventure sports are rewarding and exhilarating for reasons that go beyond the explanation of biology. A very significant number of participants in these studies pointed out that their involvement in risk-taking sports were richly rewarding for reasons far more profound than the simple thrill of risk-taking. They often described a connectedness to nature and respect for the natural environment. Others spoke of the special relationships that eventuates from trusting partners in challenging times. Ultimately however, whatever the reasons behind risk-taking sports, participants will be judged not so much by their achievements, but by their response to the needs of others at times of crisis and need. The risk that personal ambitions and economic pressures erode acceptable standards of behavior and moral values are sadly as present in adventure sports as in any other human endeavor.