*COPYRIGHT UIAA MOUNTAIN MEDICINE CENTRE*
In 1986 a storm on K2 (8613m, 28,250ft), the world's second highest
mountain led to events which claimed the lives of 13 climbers
including two British mountaineers, Alan Rouse and Julie Tullis.
Following the tragedy it was suggested that many such deaths might
be avoided if supplementary oxygen were used. In an attempt to
identify the factors involved in fatal accidents at extreme altitude
(over 7000m, 22960ft), we studied fatalities on British expeditions
to peaks above 7000m.
Methods and results
Reports relating to all British expeditions to peaks over 7000m
were collected from Mountain Magazine from 1968 until December
1987, and details noted of fatal accidents and personnel. There
were some difficulties in compiling full records of expedition
members and not all the accidents occurred at extreme altitudes
(but all were the result of membership of expedition whose aim
was a high altitude peak). Deaths of sherpas and porters are not
included.
There were 83 such expeditions, comprising 535 mountaineers visiting
the Greater Himalaya. 23 fatalities occurred on 10 of the 51 peaks
visited. The overall mortality rate was thus 4.3% of mountaineers
- or there was at least one fatality every fifth expedition.
The most frequented mountain was Everest, (8848m, 29,021ft);
there were 121 individuals on 11 expeditions with 7 deaths (overall
mortality rate 5.8%). On K2 (28 individuals on 5 expeditions)
there were three deaths (overall mortality rate 10.7%).
We attempted to identify the principal cause of death in each
case from the data available and from personal knowledge, with
the following results:
|
Cause of death
|
Number
|
Percent
|
|
Falls, rockfalls, avalanches
|
16
|
69.6
|
|
Cerebral / pulmonary oedema
|
4
|
17.4
|
|
Uncertain
|
3
|
13
|
|
Total
|
23
|
100
|
Comment
This study draws attention to the dangers involved in mountaineering
at extreme altitude. We calculated that, by contrast, the average
climber in England and Wales has only a two in a million chance
of death on a particular day of activity, which puts climbing
as the second (after air sports) most dangerous national leisure
activity. Surprisingly, there is little hard data about horse
riding, another high-risk sport.
The apparent contribution of altitude hypoxia to mortality here
is low (17.4%), but its effect is significant in that in many
fatalities apparently due to mountain accidents (e.g. avalanche)
there are components of misjudgement, disorientation or exhaustion
caused by severe hypoxia. It is likely that some of these deaths
could have been prevented if early symptoms of cerebral or pulmonary
oedema had been appreciated and treated by rapid descent and the
use of oxygen/PAC chamber, nifedipine and dexamethasone. Supplementary
oxygen would almost certainly have reduced these "medical
deaths" but its use is limited for logistic reasons. It seems
certain that the world's highest peaks will continue to be attempted
without it.
The extreme altitude mountaineers of the 21st century should
take heed of these figures when planning and undertaking expeditions
if this high mortality is to be reduced. Since assembling this
data nearly 10 years ago there have been more deaths at high altitude,
some clearly due to sudden high altitude cerebral and/or pulmonary
oedema, in apparently acclimatised people. While the data could
be updated, and brought into a more international arena, there
is little suggestion that the essential facts have altered: high
altitude climbing is high-risk activity, with an uncomfortably
high fatality rate.
References
Lloyd P, Ward M, Warren C. "Lessons of the K2 Disaster". The
Times 30th August 1986.
Holt, B. "Oxygen and the K2 Disaster". The Times, 10th September
1986.
Clarke, C."Oxygen in Climbing". The Times, 3rd October 1986.
Mountain Magazine (1968-1987) 1-118, Sheffield.
"Fatal Accidents during Sporting and Leisure Activities". OPCS
Monitor. DH4 84/3 and DH4 87/2, London.
Pollard A, Clarke C. (1988) Deaths during mountaineering at extreme
altitude. Lancet. I: 74-76.
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