ORIGINAL ARTICLE Injury prophylaxis in paragliding W Schulze, J Richter, B Schulze, S A Esenwein, K Büttner-Janz ............................................................................................................................. Br J Sports Med 2002;36:365–369 Objectives: To show trends in paragliding injuries and derive recommendations for safety precautions for paraglider pilots on the basis of accident statistics, interviews, questionnaires, medical reports, and current stage of development of paragliding equipment. Methods: All paragliding accidents in Germany have to be reported. Information on 409 accidents was collected and analysed for the period 1997–1999. Results: There was a substantial decrease in reported accidents (166 in 1997; 127 in 1998; 116 in 1999). The number of accidents resulting in spinal injuries was 62 in 1997, 42 in 1998, and 38 in 1999. The most common cause of accident was deflation of the glider (32.5%), followed by oversteer- ing (13.9%), collision with obstacles (12.0%), take off errors (10.3%), landing errors (13.7%), misjudgment of weather conditions (4.9%), unsatisfactory preflight checks (4.9%), mid-air collisions with other flyers (2.2%), accidents during winching (2.2%), and defective equipment (0.5%). Accidents predominantly occurred in mountain areas. Fewer than 100 flights had been logged for 40% of injured pilots. In a total of 39 accidents in which emergency parachutes were used, 10 pilots were seriously injured (26%) and an additional three were killed (8%). Conclusions: Injuries in paragliding caused by unpredictable situations can be minimised by (a) using safer gliders in the beginner or intermediate category, (b) improving protection systems, such as pad- ded back protection, and (c) improving pilot skills through performance and safety training. P aragliding is a popular extreme sport. In 1965, gliders and steerable parachutes were developed in America and, in 1977, “parascending” was described as a less dangerous alternative to hang gliding and parachuting. 12 Since 1985, the sport has increased in popularity, first in alpine regions and, in the last few years because of improved tow winching, also in flat areas. 3 With increasing flight frequency and the first seri- ous critical injuries, paragliding quickly fell into the category of high risk sports. 45 However, the risk of injury and the number of deaths in paragliding are not as high as in other aerial sports. Some 5 think that it should not be classed as a high risk sport. The number of paragliding accidents in Germany has fallen substantially over the last few years, while the number of licensed pilots has remained steady since 1993 (figs 1 and 2). Since the early days of paragliding, major improvements have been made to passive and active safety precautions. In many countries it is obligatory to carry a reserve parachute for flights more than 50 m above the ground. The use of ankle protecting, shock absorbing footwear has become standard, and wearing a helmet is a legal require- ment almost everywhere. The limit of alcohol in the blood in Germany for paraglider pilots is lower than for drivers on the road. A blood alcohol level of 0.05% in a pilot will result in conviction for being incapable of flying. Furthermore the quality and extent of training that a pilot must receive to gain a licence has increased substantially. The aim of this paper is to show the trends of paragliding injuries, and derive recommendations for active and passive safety precautions for paraglider pilots on the basis of accident statistics, interviews, questionnaires, medical reports, and current stage of development of paragliding equipment. METHODS In Germany, all accidents and problems involving German paragliders at home and abroad must be reported to the Ger- man Paragliding Association (DHV). A standardised question- naire is used to obtain information on the pilot’s training, the cause of the accident, and the area in which the accident occurred. In this study, the pilots involved or, when this was not possible, witnesses of the accident, were asked personally about the type and seriousness of the injuries, the back protection system used, the accident situation, and the position of the pilot on impact. Details from the hospitals where the injuries were treated were also included in the evaluation. This paper concentrates on the 42 accidents that occurred in 1998 that resulted in spinal injuries. From these, 29 pilots were questioned about the circumstances surrounding the acci- dent. In a further eight cases, information was received from eye witnesses because the pilots were suffering from post-traumatic amnesia. In five cases, no information at all could be gathered. The paragliders were classified in accordance with the vari- ous quality categories used by the DHV, ACFPULS (Association des Constructeurs Français de Planeurs Ultra-Légers Souples/ French Designing Engineers Association of Microlight Figure 1 Membership of the German Paragliding Association, the largest representative of the interests of licensed paragliding pilots in Germany. See end of article for authors’ affiliations ....................... Correspondence to: Dr Schulze, Orthopädische Klinik, Klinikum Hellersdorf, Myslowitzer Str 45, D-12621 Berlin, Germany; Schulzenhaus@web.de Accepted 11 February 2002 ....................... 365 www.bjsportmed.com