Recreational Outdoor Injury and Mortality in Texas State Parks Between 2012 and 2021

IntroductionThe outdoor recreation industry in Texas has witnessed a large growth. There are no publications about the epidemiology of outdoor recreation injury and mortality in Texas. This work analyzes the Texas Parks and Wildlife Department (TPWD) outdoor injury reports to address this gap.MethodsWe analyzed TPWD injury incident reports filed from July 2012 to April 2021. Statistical analysis included descriptive statistics, Wilcoxon Rank Sum test for continuous data, χ² analysis for categorical data, Fisher exact test for small sample cross tables, and two multivariable logistic regression models for the effects of season, activity, and location on morbidity and mortality.ResultsThere were 4882 outdoor recreational events, including injuries (<i>n</i> = 4401, 90.1%), mortalities (<i>n</i> = 124, 2.5%), and search and rescue operations (<i>n</i> = 357, 6.4%). The injury and mortality rates were 5.20 and 0.15 per 100 000 visits, respectively. Activities preceding injury included hiking (<i>n</i> = 1112, 24.3%), walking/running (<i>n</i> = 1078, <i>n</i> = 23.6%), water sports (<i>n</i> = 533, 11.6%), biking (<i>n</i> = 393, 8.6%), and climbing (<i>n</i> = 260, 5.7%). The most common injuries were skin-related (<i>n</i> = 1194, 27.1%), musculoskeletal (<i>n</i> = 804, 18.3%), and heat injuries (<i>n</i> = 393, 8.9%). Activities preceding mortality included water sports (<i>n</i> = 52, 42.6%) and hiking (<i>n</i> = 20, 16.4%). Injuries contributing to mortality included respiratory events and drowning (<i>n</i> = 46, 37.41%), cardiac events (<i>n</i> = 13, 10.5%), and heat injury (<i>n</i> = 9, 7.3%). Most incidents occurred in Hill Country (<i>n</i> = 1170, 24.01%) and Prairies and Lakes (<i>n</i> = 1144, 23.48%) areas.ConclusionThis study evaluates outdoor recreational injuries in the state of Texas. It uncovers and summarizes important trends that may inform the development of prevention and education efforts.