Whitewater Rafting and Kayaking Deaths in Colorado: Increasing Preventative Measures by Understanding Risk Factors.

Introduction: Whitewater rafting and kayaking are popular, adventurous excursions that are provided along various rivers throughout the United States. We expect that certain individuals' comorbid medical conditions may increase the risk of mortality by preventing them from being physically able to avoid inadvertently entering the water and subsequently rescue themselves.

Methods: Retrospective data were collected from 11 El Paso County, Colorado coroner cases from 2014-2017 in which the individual was whitewater rafting or kayaking and drowning was determined to be the primary cause of death.

Results: Health characteristics and autopsy findings of several of these individuals revealed that a significant number of these individuals were overweight or obese (90.9%), with 70% of these individuals also demonstrating cardiomegaly on examination. Of the cases studied, 81.8% of individuals had little to no experience with whitewater rafting or kayaking and 45% were under the influence of marijuana or alcohol based on toxicology studies.

Discussion: While a major selling point for whitewater excursions are the perceived risks they offer, our review suggests that certain individuals demonstrate increased health risks, have little to no experience with whitewater rafting or kayaking, or practice unsafe behaviors that may increase chance of injury and death. Efforts have been made to reduce risks associated with whitewater rafting and kayaking; however, further risk can be mitigated by excluding those who may be under the influence of alcohol or drugs, implementing more stringent health requirements, and setting an upper limit of difficulty of rapids based on an individual's previous experience.