title: Epidemiology of low-level bridge jumping in Pittsburgh: a 10-year study.
abstract: BACKGROUND
  Outcomes of patients who fall from bridges lower than 160 feet above water have been poorly characterized. Pittsburgh offers a unique setting in which to study these patients as the city has 41 major bridges, only four of which are above 70 feet.
  
  
  OBJECTIVE
  This study examined patients who fell or jumped from Pittsburgh bridges over a 10-year period for their characteristics, injury patterns, and the effects of prehospital care on outcomes.
  
  
  METHODS
  We conducted a retrospective cohort study of patients who jumped or fell from bridges in Pittsburgh, Pennsylvania, over a 10-year period. Subjects were identified through manual searches of three data repositories: City of Pittsburgh Bureau of Emergency Medical Services (EMS), Pittsburgh River Rescue, and Allegheny County Medical Examiner records. Data abstracted included patient name, age, gender, date of birth, and address; incident date, time, location, and river conditions; prehospital interventions; emergency department intervention; hospital disposition; evidence of prior or subsequent psychiatric admission; toxicology results or evidence of substance involvement; and causes of death.
  
  
  RESULTS
  Seventy-four subjects were identified. Most were male (80%) young adults (mean age 34.3 years) who lived near the bridges from which they jumped or fell. Mortality from bridges less than 50 feet high was 18%; mortality from bridges 180 feet high was 75%. All patients who required prehospital interventions beyond warming or intravenous (IV) fluids died. Injury patterns were similar to those described for high-bridge patients, concentrated in the trunk or skull, but low-bridge injuries were milder and less common. Cause of death was predominantly drowning (84%). More than a third (47.3%) of the patients had previous psychiatric histories, but evidence of a previous attempt to jump was uncommon (5.4%).
  
  
  CONCLUSIONS
  People who jump from low- to medium-rise bridges may suffer injuries, but most often die from drowning. EMS interventions beyond water rescue are typically not helpful, emphasizing the importance of prevention and a water rescue plan.
authors.affiliation: Department of Emergency Medicine, Division of Emergency Medical Services, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7594, USA. brice@med.unc.edu
authors.forename: Jane H
authors.initials: JH
authors.lastname: Brice
authors.forename: Chailee
authors.initials: C
authors.lastname: Moss
authors.forename: Patti
authors.initials: P
authors.lastname: Purpura
authors.forename: Theodore R
authors.initials: TR
authors.lastname: Delbridge
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D004332:Drowning / Q000453:epidemiology / Q000401:mortality; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000401:mortality; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology*