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Effects of experience and commercialisation on survival in Himalayan mountaineering: retrospective cohort study

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3782 (Published 13 June 2012) Cite this as: BMJ 2012;344:e3782
  1. John L Westhoff, staff physician1,
  2. Thomas D Koepsell, professor2,
  3. Christopher T Littell, program director of residency in public health and general preventive medicine1
  1. 1Department of Preventive Medicine, Madigan Healthcare System, Tacoma, WA 98431-1100, USA
  2. 2Department of Epidemiology, University of Washington, Seattle, WA
  1. Correspondence to: J L Westhoff john.westhoff{at}us.army.mil
  • Accepted 24 April 2012

Abstract

Objectives To determine whether previous Himalayan experience is associated with a decreased risk of climbing death, and whether mountaineers participating in commercial expeditions differ in their risk of death relative to those participating in traditional climbs.

Design Retrospective cohort study.

Setting Expeditions in the Nepalese Himalayan peaks, from 1 January 1970 to the spring climbing season in 2010.

Participants 23 995 non-porters venturing above base camp on 39 038 climbs, 23 295 on 8000 m peaks.

Outcome Death.

Results After controlling for use of standard route, peak, age, season, sex, summit success, and year of expedition, increased Himalayan experience was not associated with a change in the odds of death (odds ratio 1.00, 95% confidence interval 0.96 to 1.05, P=0.904). Participation in a commercial climb was associated with a 37% lower odds of death relative to a traditional venture, although not significantly (0.63, 0.37 to 1.09, P=0.100). Choice of peak was clearly associated with altered odds of death (omnibus P<0.001); year of expedition was associated with a significant trend toward reduced odds of death (0.98, 0.96 to 0.99, P=0.011).

Conclusions No net survival benefit is associated with increased Himalayan experience or participation in a traditional (versus commercial) venture. The incremental decrease in risk associated with calendar year suggests that cumulative, collective knowledge and general innovation are more important than individual experience in improving the odds of survival.

Footnotes

  • We thank Elizabeth Hawley, whose life’s work is distilled in the Himalayan Database; Richard Salisbury, whose efforts to convert Hawley’s archives into an electronic database made this project possible, and for providing a customised modification of the Himal programme that allowed the inclusion of the standard route variable in this analysis; and Raymond Huey, for his recommendations on the study design and feedback on the manuscript.

  • This manuscript describes a systematic analysis of data archived in the Himalayan Database. The authors have obtained permission via written correspondence with Richard Salisbury (database author and administrator) and the American Alpine Club (publisher) to analyse the data for the purposes of this study. We have agreed that any publication resulting from the project will give due credit to “The Himalayan Database copyright 2004 by Richard Salisbury and Elizabeth Hawley.”

  • Contributors: JLW conceived the study, carried out the analysis, drafted the original manuscript, and is the study guarantor. TDK guided the epidemiological methodology of the study, and CTL provided direction on design and conception of the project. All authors iteratively and collaboratively revised the manuscript and subsequently approved the final text.

  • Funding: No specific funding was received for this research.

  • Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: The Human Subjects Division of the University of Washington reviewed the protocol associated with this research and determined that it does not constitute “human subjects research” and therefore does not require review by the institutional review board (exemption no 39319). A copy of the letter of exemption is available from JLW on request.

  • Data sharing: Statistical code available from JLW; data available from publisher via www.himalayandatabase.com.

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