Objective-To provide epidemiological data on whitewater kayaking injuries using a descriptive study. Methods-A retrospective survey was distributed at whitewater events and club meetings, and made available and advertised on the world wide web, through postings and announcements to newsgroups, related sites, and search engines. Data on sex, age, experience, and ability were collected. Injury data collected included mechanism, activity, diYculty of rapid, and self reported severity. Results-Of the 392 kayaking respondents included in the final analysis, 219 suVered 282 distinct injury events. The number of days spent kayaking per season was the only independent predictor of injury. The overwhelming majority of injuries occurred while the kayaker was still in the boat (87%). Striking an object was the most common mechanism of injury (44%), followed by traumatic stress and overuse (25% each). The most common types of injury were abrasion (25%), tendinitis (25%), contusion (22%), and dislocation (17%). The upper extremity, especially the shoulder, was the most commonly injured area of the body. Although half of injured kayakers sought medical care for their injury, and almost one third missed more than one month of kayaking because of the injury, almost all (96%) reported a complete or good recovery. Conclusions-Factors relating to likelihood of injury appear to be connected with exposure, namely the number of days a year that the sport was pursued. Except for class V (extreme) kayakers, reports of injuries paralleled the number of participants. Kayakers reported injuries predominantly on rivers that they assessed to be at a level appropriate to their skills. (Br J Sports Med 2001;35:235-241) Keywords: kayaking; whitewater; injuries Whitewater kayaking is fast becoming one of the most popular of the new "adventure sports", with images of kayaking used in advertising for everything from soft drinks to automobiles. Current estimates place the number of whitewater kayakers at between 1.4 and 2.8 million, with a growth of almost 15% annually.1-3 Although kayaking is often considered a very dangerous sport, little is actually known about the risks and types of injury. In 1981, Kizer 4 performed a survey of 1000 whitewater kayakers, with 211 responses, concerning medical problems associated with kayaking. He found that 80% of kayakers were male, with almost one half (46%) kayaking at least once a week (on average). The most common medical complaints, other than blisters (reported by 65%), were muscle strain (45%), low back strain (31%), sprains or tendinitis (28%), and submersion trauma (17%). Other articles published in the medical literature that discuss injuries and hazards related to whitewater boating have been either case studies 5-7 or review articles covering multiple whitewater related risks. [8][9][10] In addition, case reports, particularly of fatalities, have been collected and published by Charles Walbridge. 11-14As the popularity of whitewater kayaking continues to increase, doctors may expect to ...
Whitewater rafting and kayaking are growing exponentially in popularity, with almost 10 million rafters and 2 to 3 million kayakers, yet little has been published concerning the safety or hazards of these activities. This article reviews the demographics of such injuries and the types of injuries commonly encountered. Fortunately, fatalities are uncommon in these activities, with rafting and kayaking fatalities occurring at a rate of 0.55 and 2.9 per 100000 user days, respectively. Injury rates for kayaking and rafting are 3 to 6 and 0.26 to 2.1 per 100000 boating days, respectively. Acute injuries in kayaking are usually due to the transferred force of the water on the upper extremity, most often the shoulder, or the impact on an object while "swimming." Acute rafting injuries are more often due to contact with another rafter's paddle or other equipment; the next most common injury is the rafter hitting an object while "swimming." Chronic injuries are very uncommon in rafting but account for 25% to 40% of all kayaking injuries and are most often either shoulder or wrist complaints.
Background Epiboly represents the process by which keratinocytes migrate to envelop a surface. We have been investigating a living bilayered skin construct (BSC) that is used in the treatment of lower extremity wounds due to venous insufficiency and diabetes. The construct demonstrates epiboly after injury and incubation in vitro, and this model may be useful for studying epidermal migration and the process of skin maturation. Punch biopsies of the construct in vitro were cultured and immunostained for specific keratins at baseline, and at 24–72 hours. For comparison, skin biopsy specimens from human chronic venous ulcers and acute healing wounds were similarly processed. We found that K1 and K10 were fully expressed in the epidermis of the fully epibolized surface on BSC. K1 was also present in the migrating edge of specimens, while K10 was not detectable. K16 and K6 were evident in normal skin and the epibolized area of the construct; K6 expression was very prominent in the migrating edge. Importantly, K17 was distinctly limited to the epibolized surface and the migrating edge, and its expression was very similar to that observed in healing human wounds. In conclusion, differential expression of keratins in this epiboly model closely reflects in vivo studies and supports keratin specificity in the processes of migration and differentiation of new epidermis. Therefore, these findings provide further and important validity for the study of epithelialization and the hope of developing prognostic markers for venous ulcer healing.
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