title: Epidemiologic trends in medically-attended tree stand fall injuries among Wisconsin deer hunters.
abstract: BACKGROUND
  Tree stand falls are the most common injury to hunters in the USA, but there is limited research on the topic. This study examined the 5-year trends in incident tree stand fall injuries in rural north-central Wisconsin and described patient demographics and injury features.
  
  
  METHODS
  A retrospective analysis was conducted on five prior hunting seasons, 2009-2013. Cases were ascertained from electronic health records via natural language processing that identified patients from the Marshfield Epidemiologic Study Area who received medical attention for a tree stand fall. Annual incidence rates were calculated using the number of hunting license holders in the target population, per administrative data from the Wisconsin Department of Natural Resources.
  
  
  RESULTS
  There were 16,556-16,902 deer hunters in any given year, with 39 (92% male) confirmed medically-attended tree stand fall injuries in 2009-2013. Injuries mainly occurred in the lower extremities (n=23), and included two fatalities and one paralysis case. The risk of tree stand fall injuries went from 6.0 (95% CI: 3.2, 11.1) per 10,000 hunters in 2009 to 3.6 (95% CI: 1.6, 7.9) per 10,000 hunters in 2013, which was not a significant change over 5 years (p=0.79). Most falls occurred among archery hunters, in the evening and when descending from a tree stand. Cases were demographically similar to the general population of Wisconsin deer hunters.
  
  
  CONCLUSIONS
  The current seasonal incidence rate of tree stand fall injuries is relatively low in rural Wisconsin, but with limited signs of improvement. Continued efforts are needed to promote the long-term safety of the hunting public.
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, United States. Electronic address: vanwormer.jeffrey@mcrf.mfldclin.edu.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: VanWormer
authors.affiliation: Bureau of Sciences Services, Wisconsin Department of Natural Resources, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Holsman
authors.affiliation: Bureau of Sciences Services, Wisconsin Department of Natural Resources, United States.
authors.forename: Jordan B
authors.initials: JB
authors.lastname: Petchenik
authors.affiliation: Bureau of Sciences Services, Wisconsin Department of Natural Resources, United States.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Dhuey
authors.affiliation: National Farm Medicine Center, Marshfield Clinic Research Foundation, United States.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Keifer
mesh_terms: D000056:Accident Prevention; D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000818:Animals; D003670:Deer; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D011998:Recreation; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014197:Trees; D014922:Wisconsin / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control
keywords: Epidemiology; Falls; Hunters; Injuries