The epidemiology of extreme hiking injuries in volcanic environments.

The objective of this review was to summarize the epidemiological literature for extreme hikers in volcanic environments and describe the incidence, nature and severity of injuries, the factors contributing to the injuries, and strategies for preventing injuries. Due to the relative newness of extreme hiking in volcanic environments, there are only a small handful of studies addressing the topic. Moreover, these studies are primarily focused on extreme hikers in Hawaii Volcanoes National Park. These studies found that the majority of extreme hikers in volcanic environments are inexperienced and unfamiliar with the potential hazards present in volcanic environments. The studies found that upper respiratory irritation resulting from exposure to volcanic gases and dehydration and scrapes, abrasions, lacerations, and thermal burns to the extremities were common injuries. The severity of the injuries ranged from simple on-site treat-and-release incidents to more severe incidents and even death. This review reveals a need for well-designed epidemiologic research from volcanic destinations outside of Hawaii that identify the nature and severity of injuries along with the factors contributing to injury incidents. There is also a demonstrated need for studies identifying preventive measures that reduce both the occurrence and severity of extreme hiking incidents in volcanic environments.