title: Zipline-related injuries treated in US EDs, 1997-2012.
abstract: OBJECTIVE
  To investigate the epidemiology of zipline-related injuries in the United States.
  
  
  METHODS
  The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates.
  
  
  RESULTS
  From 1997 through 2012, an estimated 16850 (95% CI, 13188-20512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place.
  
  
  CONCLUSIONS
  This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used.
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH; The Ohio State University, Columbus, OH.
authors.forename: Rachael M
authors.initials: RM
authors.lastname: Billock
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH; The Ohio State University, Columbus, OH.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Anderegg
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
authors.forename: Tracy J
authors.initials: TJ
authors.lastname: Mehan
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
authors.forename: Thiphalak
authors.initials: T
authors.lastname: Chounthirath
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH; Child Injury Prevention Alliance, Columbus, OH. Electronic address: gary.smith@nationwidechildrens.org.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011998:Recreation; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult