title: The epidemiology of falling-through-the-ice in Alaska, 1990-2010.
abstract: BACKGROUND
  Climate change has contributed to increasing temperatures, earlier snowmelts and thinning ice packs in the Arctic, where crossing frozen bodies of water is essential for transportation and subsistence living. In some Arctic communities, anecdotal reports indicate a growing belief that falling-through-the-ice (FTI) are increasing. The objective of this study was to describe the morbidity and mortality associated with unintentional FTIs in Alaska.
  
  
  METHODS
  We searched newspaper reports to identify FTI events from 1990 to 2010. We also used data from a trauma registry, occupational health and law enforcement registries and vital statistics to supplement the newspaper reports. Morbidity and mortality rates were calculated for Alaska Native (AN) people and all Alaskans.
  
  
  RESULTS
  During the 21-year period, we identified 307 events, affecting at least 449 people. Events ranged from no morbidity to fatalities of five people. More than half of the events involved transportation by snow machine. Mortality rates were markedly higher for AN people than that for all Alaskans.
  
  
  CONCLUSIONS
  We provide a numeric estimate of the importance of FTI events in Alaska. FTIs may represent an adverse health outcome related to climate changes in the Arctic, and may be particularly critical for vulnerable populations such as AN people.
authors.affiliation: Epidemic Intelligence Service Assigned to the National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA Present address: Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, 800 Sumter St, Columbia, SC 29208, USA.
authors.forename: N L
authors.initials: NL
authors.lastname: Fleischer
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
authors.forename: P
authors.initials: P
authors.lastname: Melstrom
authors.affiliation: National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
authors.forename: E
authors.initials: E
authors.lastname: Yard
authors.affiliation: Center for Climate and Health, Alaska Native Tribal Health Consortium, 4000 Ambassador Drive, Anchorage, AK 99508, USA.
authors.forename: M
authors.initials: M
authors.lastname: Brubaker
authors.affiliation: Alaska Native Tribal Health Consortium, 4000 Ambassador Drive, Anchorage, AK 99508, USA.
authors.forename: T
authors.initials: T
authors.lastname: Thomas
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000413:Alaska / Q000453:epidemiology; D057231:Climate Change; D004332:Drowning / Q000453:epidemiology; D005260:Female; D006801:Humans; D007053:Ice; D008297:Male; D012042:Registries; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology
chemical_list: D007053:Ice
keywords: morbidity and mortality; public health; social determinants