Objective.—The purpose of this study was to determine the effect of 12°C cold exposure for 180-minutes on the hormonal responses of sleep-deprived individuals.

Methods.—Participants underwent 2 cold-air trials: 1 after a normal night of sleep (ie, 6–8 hours) and 1 after 33 hours of sleep deprivation (SDEP). A venous blood sample was taken at baseline and then at 90-and 180-minute cold-exposure time points. Repeated-measures analysis of variance was used to determine significance between a normal night of sleep and SDEP for norepinephrine, epinephrine, cortisol, insulin, thyroid hormones triiodothyronine and thyroxine, glucose, and non-esterified fatty acids.

Results.—There was no significant main effect for time, trial, or interaction for insulin, thyroid hormones, epinephrine, cortisol, and glucose (P ≤ .05). A significant main effect for time for norepinephrine and non-esterified fatty acids was demonstrated (P < .001).

Discussion.—The lack of significant differences in the hormonal and metabolic responses to cold exposure combined with SDEP may have been because of an ability of the individual to continue to respond despite the environmental stressor or the physiological effect elicited from cold exposure, thereby possibly masking physiological responses of SDEP.

Conclusions.—On the basis of these data, SDEP combined with protracted cold exposure apparently was not a great enough stressor to cause a differential response in the hormonal and metabolic parameters.

Objective.—During 1992–2000, an average of 40 fatal occupational injuries and 12 400 nonfatal occupational injuries and illnesses related to animals were recorded each year in the United States, most involving domestic farm animals. Although Alaska has a relatively small farming industry, it supports several industries that require workers to regularly be in contact with animals. This study examines the pattern and characteristics of animal-related occupational injuries in Alaska.

Methods.—Two data sources were accessed: the Alaska Trauma Registry for nonfatal injuries requiring hospitalization and the Alaska Occupational Injury Surveillance System for fatal injuries. The case definition included events in which the source of the injury was an animal or animal product (Occupational Injury and Illness Classification Manual source code 51).

Results.—In Alaska during 1991–2000, there were 43 animal-related occupational injuries requiring hospitalization and 25 animal-related fatalities. There were only 2 fatal events: 1 bird-strike aircraft accident killing 24 military personnel and 1 bear attack. The majority of the nonfatal injury events were related to marine wildlife (n = 20), with the rest related to either domesticated (n = 11) or nondomesticated (n = 12) mammals. Of events reporting a hospital charge (23 of 43), the average cost was over $9700 per person.

Conclusions.—The catastrophic aircraft crash increased bird-control efforts near airports around the state. The nonfatal animal-related injuries have received less notice, although they result in thousands of dollars in hospital costs and lost workdays. Fishing-industry workers in particular should be made aware of potential injuries and educated on how to treat them when away from definitive medical care.

Objectives.—The objectives of this study were to identify the number and types of recreational injuries sustained by visitors to Mount Rainier National Park and Olympic National Park in Washington State and to compare the nature of injuries sustained by children compared with adults.

Methods.—We retrospectively reviewed case incident reports obtained by rangers in Mount Rainer National Park and Olympic National Park between 1997 and 2001. Data collected included victim age, gender, date of injury, activity preinjury, type of injury, and mechanism of injury.

Results.—There were 535 cases of recreational wilderness injuries (including 19 total deaths), yielding a rate of 22.4 injuries per million visits. The mean age of injury victims was 34 years. Males were more likely to sustain injury than were females (59% vs 41%). Most injuries occurred during summer months between noon and 6:00 pm, and 90% occurred during daylight hours. The most common preinjury activities included hiking (55%), winter sports (15%), and mountaineering (12%), and the most common types of injuries included sprains, strains and soft tissue injuries (28%), fractures or dislocations (26%), and lacerations (15%). A total of 121 (23%) of the injuries occurred in children (<18 years of age). There were 19 deaths in the 2 national parks (18 men, 1 woman); all victims were adults. Hiking (58%) and mountaineering (26%) were the most common activities at the time of death. Mechanism of death included falls (37%), medical (eg, myocardial infarction) (21%), drowning (5%), and suicide (5%).

Conclusions.—The most common type of injury was soft tissue injury, and injuries occurred most commonly while hiking, during daylight hours, and in the summer. Preinjury activities and types of injuries were different in children compared with adults. Knowledge of how and when injuries occur in national parks can assist in determining what resources are needed to help provide a safer environment for park visitors. This study may also aid prevention strategies in the national parks, guide training of rangers, aid in the preparation of first aid kits, and further the education of people who participate in wilderness activities.

Objective.—To compare altitude responses of 2 ultraendurance athletes and 2 nonathletes during a 2-week expedition on Denali (Mount McKinley).

Methods.—The severity of acute mountain sickness (AMS) symptoms (Lake Louise AMS guidelines) and pulmonary function parameters (forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow) as well as resting heart rate and arterial oxygen saturation measurements were taken during the climb. Baseline measurements were made at 375 m, and field tests were performed at altitudes of 2200 m, 2400 m, 3000 m, 3400 m, 4100 m, 4300 m, and 10 m.

Results.—Nonathletes reported moderate AMS symptoms at altitudes up to and including 3000 m, whereas ultraendurance athletes reported moderate AMS symptoms at altitudes above 3000 m. Considerable daily variation existed in pulmonary function measures within and between groups; however, the largest shift from baseline and between groups occurred at 3000 m where ultraendurance athletes had increased and nonathletes had decreased peak expiratory flow and forced vital capacity. Resting heart rate increased and arterial oxygen saturation decreased with altitude.

Conclusions.—Highly aerobically fit individuals may be more susceptible to delayed and more prolonged onset of AMS than are moderately fit individuals. Pulmonary function, although highly variable, also may be dissimilar between these groups.

Objective.—To assess the prevalence of stings by small spiny driftwood catfish (carataí) of the genus Centromochlus (Auchenipteridae) accidentally caught in buckets during bucket bathing by riverside people along the Brazilian Amazon and to determine the probability of catching specimens of these fish during random throws of a bucket into the river.

Methods.—We interviewed 27 adult residents living at the confluence of the Negro and Solimões rivers in Brazil regarding whether or not they had ever been stung by driftwood catfish while bucket bathing. To assess the likelihood of catching catfish in bathing buckets, we randomly threw a typical plastic bucket used for bathing in 4 series of 10 throws into the river at dusk or night around a floating house.

Results.—Seventeen of the 27 subjects (63%) reported being injured by driftwood catfish during bucket bathing. Three individuals (17.6%) had been injured 2 to 3 times, totaling 23 puncture accidents. All stings occurred at dusk or early night. In the 4 series of 10 bucket throws, we caught 3 driftwood catfish (in 1 series we did not catch any fish). Thus, the chance of catching a driftwood catfish in a single bucket throw at dusk was slightly less than 10%.

Conclusions.—The prevalence of stings by driftwood catfish to people bucket bathing in this section of the Brazilian Amazon is high, partly because of the relatively high chances of catching these small catfish during random throws of a bathing bucket into the river.

We report the successful use in a wilderness environment of rectally administered oral rehydation fluid to resuscitate a patient who was in shock. The subject was a 21-year-old Nepali man who had experienced a major upper gastrointestinal hemorrhage.

We report a case of a porter who presented with acute dyspnea during an expedition in Nepal at 5000 m above sea level. We present the difficulties involved in making the correct diagnosis in this patient under austere conditions and discuss the difficult decisions that must be made in caring for such a patient.

NOAKES, TIMOTHY D., NEIL GOODWIN, BRIAN L. RAYNER, TREVOR BRANKEN, and ROBERT K.N. TAYLOR. Water intoxication: a possible complication during endurance exercise. Med. Sci. Sports Exerc., Vol. 17. No. 3, pp. 370–375, 1985. Four athletes developed water intoxication (hyponatremia) during endurance events lasting more than 7 hours. The etiology of the condition appears to be voluntary hyperhydration with hypotonic solutions combined with moderate sweat sodium chloride losses. The reason why the fluid excess in these runners was not corrected by increased urinary losses is unknown. When advised to drink less during prolonged exercise, three of the athletes have subsequently completed prolonged endurance events uneventfully.