Abstract
To the Editor:
Few locations like Western North Carolina have high concentrations of documented, easily accessible waterfalls and large numbers of visitors. 1 Because of these characteristics, waterfalls are popular places for outdoor recreation and play an important role in the state’s tourism industry. Unfortunately, despite preventive measures by emergency management and resource managers, injuries and fatalities occur. This research analyzed the frequency of North Carolina waterfall injuries and fatalities over a 13-year period and identified the root cause of waterfall accidents.
Data were gathered by conducting an Internet search using a set of keyword phrases (eg, North Carolina waterfall accidents, North Carolina waterfall injuries, North Carolina waterfall deaths) for years 2001 to 2013. The content of each source was reviewed, and the following information was documented for analysis: year, month, and day of incident; waterfall name; sex and age of victim; and victim’s place of residence. The root cause for each incident was also recorded. Root cause is the initial factor in the chain of events leading to an incident. For use in this study, 2 categories for root cause were used: unsafe acts and unsafe conditions. Unsafe acts relate to the actions, behaviors, and attitudes of the waterfall visitor. Unsafe conditions are hazards related to the waterfall environment that, if not addressed, can result in an incident. Data were collated and coded, and then analyzed using Microsoft Excel for Mac, version 14.0.0 (Microsoft, Redmond, WA).
Between the years 2001 and 2013, 39 cases, or an average of 3.0 incidents per year, were recorded. Reported incidents involved 42 victims at 27 different waterfalls. Eighty-three percent of victims were male. More than half (54%) of the victims were between the ages of 19 and 29 years (mean 27 years). Twenty-eight incidents (66%) resulted in a fatality (mean 2.1 deaths per year). Content analysis identified the place of residence for 34 of the 42 victims and found more than half (n = 22; 69%) lived outside the region. More than half (59%) of the incidents occurred during the years 2010 to 2013. Seasonal distribution showed incidents peaked during the summer months of June, July, and August (62%), followed by spring (23%), and were equally distributed between weekdays (46%) and weekends (51%).
Eight of 10 victims (81%) fell from the waterfall, and 62% of these falls resulted in a fatality. Drowning accounted for 18% of all fatalities reported. The primary unsafe condition leading to injury or death (66%) involved victims losing their footing on slippery, wet rock or trail. Unsafe acts leading to injury or death usually involved an activity above the waterfall (eg, wading, swimming) and made up 15% of incidents and 21% of fatalities. Jumping into or swimming in a plunge pool produced 12% of victims and 11% of fatalities. Ignoring a safety barrier was a factor in death or injury to 12% of victims. Engaging in photography (ie, getting in a better position for a photograph) accounted for 7% of incidents. “Would-be rescuers” and “reaching for a dropped object” made up a small percentage (5%) of the unsafe acts recorded. Alcohol or drugs may have played a role in 5% of fatalities.
The 2 primary risk groups identified in this study were males and young adults aged 19 to 29 years. This finding is similar to the morbidity and mortality statistics noted for other outdoor recreation activities and may be explained by higher risk acceptance of males. 2 Research also noted that men 22 to 40 years of age fall from heights at a higher rate than women. 3
Data also revealed that more than half of North Carolina victims lived outside the region. Previous research suggested tourists are involved in accidents because they are unfamiliar with their surroundings, are of a holiday mindset, and are more willing to take risks. 4 The high number of waterfall accidents may also be related to the large number of easily accessible waterfalls throughout western North Carolina. These factors, coupled with inexperienced visitors unfamiliar with the dangers associated with waterfall environments, can lead to the unexpected consequences identified in this study.
The root cause for falling from a waterfall is rarely a single unsafe act or condition, but more often a combination of the two. Most falls from waterfalls happen when victims lose their footing by slipping on wet or algae-covered rock. Waterfall visitors can mitigate the possibility of slipping by being more aware of slippery surfaces and wearing appropriate footwear. Drowning was also associated with waterfall incidents, occurring exclusively in the plunge pools formed by hydraulic erosion at the base of waterfalls that make great “swimming holes.” Swimmers new to an area should observe or talk to local residents or officials who are familiar with the site or should reconnoiter the area above and below the plunge pool for hidden dangers. A small number of visitors ignore safety barriers. Similar behavior was reported by Heggie and Heggie, 5 who noted that many tourists hiked beyond posted warning signs near active lava flows, exposing themselves to dangerous conditions. Barriers are erected to protect the public from harm. Many waterfalls in North Carolina do not have safety barriers, however, because of their location.
Despite safety information, warning signs, and barriers designed to protect the public, falls from a waterfall can result in serious, often fatal accidents. Both direct and indirect management approaches—including posted warning signs; working with landowners, resource managers, and local businesses near waterfalls; providing online access to information about stream flow (with instructions how to use the information to prevent injuries); developing a public awareness campaign; and enhanced monitoring—could be implemented to make visitors more aware of the risks involved with recreation around waterfalls. Preventive efforts focused on males and adults aged 19 to 29 years that address issues of judgment, preparation, and experience should also be considered. Future research should incorporate observations at various waterfalls to document visitor behavior and how it contributes to waterfall accidents. Investigations into the types and severity of injuries sustained by waterfall victims will also enhance the knowledge base for waterfall education.