Amusement park injuries and deaths

doi:10.1067/mem.2002.120127

Annals of Emergency Medicine

Volume 39, Issue 1, January 2002, Pages 65-72

https://doi.org/10.1067/mem.2002.120127 Get rights and content

Abstract

Media coverage of amusement park injuries has increased over the past several years, raising concern that amusement rides may be dangerous. Amusement park fatalities and increases in reported injuries have prompted proposed legislation to regulate the industry. Since 1979, the medical literature has published reports of 4 subdural hematomas, 4 internal carotid artery dissections, 2 vertebral artery dissections, 2 subarachnoid hemorrhages, 1 intraparenchymal hemorrhage, and 1 carotid artery thrombosis with stroke, all related to roller coaster rides. In this article, we review reports of amusement park injuries in the medical literature and Consumer Product Safety Commission data on the overall risk of injury. We also discuss the physics and the physiologic effects of roller coasters that may influence the type and severity of injuries. Although the risk of injury is low, emergency physicians are advised to include participation on thrill rides as part of their history, particularly when evaluating patients presenting with neurologic symptoms. [Braksiek RJ, Roberts DJ. Amusement park injuries and deaths. Ann Emerg Med. January 2002;39:65-72.]

Introduction

The US Amusement and Theme Park Industry continues to grow in popularity. Amusement parks reported a record $9.1 billion in revenue during 1999. In 1999, the 450 fixed-site amusement parks in the United States accommodated approximately 309 million visitors from around the world.¹ Amusement parks owe their popularity, at least in part, to roller coasters, which date back to the 15th-century Russian mountains (Table 1).1, 2Roller coasters continue to set new height and speed records as engineers attempt to outdo each other by building the fastest, most thrilling ride in this increasingly competitive industry (Table 2).3, 4

Amusement park injuries and mishaps have long been considered newsworthy events, but stories have become more common in the last several years. A string of fatal amusement park accidents during a 6-day period in August of 1999 led many to question the safety of amusement park rides and prompted legislative attempts to regulate the industry. On August 22, 1999, a 12-year-old boy fell to his death after slipping through a harness during a 129-ft free fall on the Drop Zone Stunt Tower ride at Paramount’s Great America theme park in Santa Clara, CA. On August 23, 1999, a 20-year-old man fell to his death from the Shockwave stand-up-style roller coaster at Paramount’s Kings Dominion theme park in Doswell, VA. This particular roller coaster reaches a height of 95 ft and maximum speeds of 50 mph. Finally, on August 28, 1999, a 39-year-old woman and her 8-year-old daughter were killed when their roller coaster car slid backward down a 30-ft ascent and crashed into another car on the Wild Wonder ride at Gillian’s Wonderland Pier in Ocean City, NJ.⁴

Injuries and deaths in amusement parks are not restricted to roller coaster style rides. For example, a 21-year-old man was recently killed on a reverse-bungee catapult ride called the Rocket Launcher in Ontario, Canada. The ride consists of 2 steel towers with a bungee cord connected to each. The cords are stretched toward the ground, where they are attached to the rider’s safety harness and then released, catapulting the rider at high speeds into the air. Before the victim was launched into the air he was told by the “jumpmaster” to “hold out his arms and fly like Superman.” His harness became disengaged, and he launched 100 feet into the air, landing on pavement.⁴

A Journal of the American Medical Association article in 1985⁵ reported the death of a 14-year-old boy at a waterslide theme park in Utah. The boy was dangling from the side of a waterslide collecting pool when he was sucked into an underwater pipe (12.5 inches in diameter) that pumped water back up to the top of the slides. He traveled underwater 93 ft before becoming lodged in a 90-degree vertical bend in the pipe within the pump house. He was located after 15 minutes, but resuscitation efforts failed.

In this article, we review reports of amusement park injuries and fatalities that have been published in the medical literature. We also review amusement park injury and fatality data collected by the Consumer Product Safety Commission (CPSC). Finally, we review literature on the physics and the physiologic effects of roller coasters that may predispose healthy individuals to injury and make recommendations.

Section snippets

Injuries in the medical literature

A MEDLINE search of the medical literature with no limitations between 1966 and the second week of August 2001 revealed numerous amusement park injuries. These include corneal foreign bodies from bumper car collisions,6, 7 a pneumothorax resulting from “reversed” bungee jumping,⁸ a report of “roller coaster glaucoma” in a patient with Marfan’s syndrome,⁹ peritoneal dialysis catheter displacement after a roller coaster ride,¹⁰ and lately, more frequent reports of neurologic complications after

CPSC data

In July 2000, the CPSC issued a report on amusement park injuries, using emergency department reports compiled between 1993 and 1999. The data were collected from the 100 EDs in the United States that participate in the National Electronic Injury Surveillance System (NEISS). These 100 hospitals represent a stratified sample of the 5,388 US acute care hospitals with EDs and 6 or more inpatient beds. There are 5 strata in NEISS, 4 of which are stratified on the basis of annual ED visits (small,

Physiologic effects of roller coasters

Currently, industry officials and legislators are debating the physiologic safety of roller coaster rides. Some government officials and safety advocates believe that new technological advances and competition within the amusement industry have led to dangerously high G forces that may produce bodily harm. Unfortunately, few medical researchers have studied the specific physiologic effects of roller coaster rides on the human body. In addition, lack of G-force studies directed specifically at

Regulatory oversight

Current federal law subjects mobile amusement parks and carnivals to CPSC investigations. Jurisdiction over mobile parks was granted in July 1981. The CPSC was given the authority to investigate accidents, develop and enforce action plans to correct defects, and act as a national clearinghouse for accident and defect data. Fixed-site parks were to be included in this legislation but, after successful legal challenges from owners of large amusement parks, a “roller coaster loophole” was created.

Recommendations

Although the current risk of injury, hospitalization, and death on amusement rides is extremely low, health care providers should be aware of a worrisome trend in the number and rate of amusement park injuries. CPSC statistics suggest that a statistically significant increase in amusement park ride injuries occurred between 1996 and 1999. Because of weak state oversight and the “roller coaster loophole,” the true number of amusement park injuries is probably much higher than that currently

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Cited by (40)

Approach to blunt, sharp, and transportation deaths
2022, Principles of Forensic Pathology: From Investigation to Certification
This chapter describes blunt and sharp injuries, including diagnostic features, proper terminology, and mechanisms of death. Lacerations, contusions, and abrasions are blunt injuries. They are caused by contact with a blunt surface/object, such as occurs in a fall to the pavement or a blow to the head with a baseball bat. Stabs and incised wounds (cuts, slashes) are sharp injuries caused by sharp objects such as knives and broken glass. Chop injuries are also discussed. The most common mechanism of death from sharp injuries is due to hemorrhage. Exsanguination is defined as the loss of enough blood to result in hypovolemic shock that progresses to inadequate perfusion of vital organs and death (generally, the rapid loss of 50% of blood volume is fatal). An average adult’s total blood volume is 70 mL/kg x body mass (kg). As such, the blood volume of a 70 kg adult would be roughly 5 L. Unique transportation injuries and investigative circumstances are also discussed.
Pulmonary contusion after bumper car collision: Case report and review of the literature
2018, Respiratory Medicine Case Reports
Thoracic trauma is a major source of morbi-mortality in injured children. Their pliable chest wall makes pulmonary contusion the most common chest injury. It is most often secondary to blunt trauma caused by traffic accidents. We report a case of severe chest trauma caused by a bumper car collision in an 8-years old girl. She sustained right lung contusion that led to complete atelectasis. After a week of supportive therapy, bronchoscopy removed a mucous plug from the main bronchus, resulting in significant clinical improvement. We aim to raise awareness of the risk of severe chest injuries during bumper car collisions.
Determining Participation Eligibility for Amusement Attractions
2015, Procedia Manufacturing
Amusement attraction participation eligibility requirements may be expressed in terms of age, height, weight, health condition, (dis)ability, and combinations of these, and potentially other criteria. Restrictive eligibility criteria can protect manufacturer and operator from liability for injury, since no guest could sustain injury without exposure to the ride. However, new forms of liability have emerged, through litigation under general human rights codes or specific regulations of the Americans with Disabilities Act. This paper describes and compares two approaches to more specifically determining participation eligibility for guests with disabilities and health conditions: the medical approach and the human factors engineering approach. Although many conditions are manifest in a range of severities, the medical approach will either impose the most restrictive eligibility on all guests with the same disability type, or require park personnel to make diagnostic determinations outside their expertise, and requires compilation of data about every disability and condition. The human factors engineering approach identifies functions to be performed by the guest to fulfill the ride experience. Clear description of functions and risks will enable guests to determine whether they are able to safely ride, in consultation with their own advisors. The approach to determining eligibility affects not only whether a particular guest can ride, but also operational practices that affect guests’ relationship with the park.
Three cases of cervicocephalic artery dissection in an amusement park
2014, Journal of Stroke and Cerebrovascular Diseases
About 20 cases of cerebrovascular accidents in amusement parks have been documented. However, only a few cases of amusement park stroke (APS) after roller coaster rides have been reported. Here, we present triggers of stroke, clinical characteristics, and the angiographic appearance of 3 consecutive patients of APS. Their clinical characteristics included young age, absence of atherosclerotic risk factors, and severe injuries. Serial changes in angiographic appearance led to the diagnosis of cervicocephalic artery dissection (CAD). Patients A and B were diagnosed with isolated middle cerebral artery (MCA) dissection, and patient C was diagnosed with internal carotid artery dissection involving MCA dissection. Running excitedly toward an attraction in patient A, a go-kart ride in patient B, and riding in an enhanced motion vehicle in patient C were considered as the likely triggers for APS. We had specific cases with APS associated with CAD, which can occur under diverse contexts other than roller coaster rides at amusement parks. Our findings suggest that the variable directions of the high gravitational forces induced by vehicle riding or running excitedly might injure the MCA or internal carotid artery, and thereby cause CAD in the amusement park.
Roller coaster-associated subarachnoid hemorrhage-report of 2 cases
2012, Journal of the Neurological Sciences
Citation Excerpt :
Head accelerations have been shown to range below biomechanical thresholds for traumatic parenchymal brain injury or tearing of bridging veins [4]. Nonetheless, there are a number of reports of subdural hematoma in roller coaster riders, including those that are young and healthy [2]. Altogether, we assume that during roller coaster rides, the combination of stress-induced increases in systemic blood pressure and transient increases in foot-to-head G forces may lead to transient shifting of blood to the brain and hence may be a possible cause of SAH.
The most common neurological injuries associated with roller coaster rides are subdural hematoma and cervical artery dissection. We report two cases of roller-coaster associated subarachnoid hemorrhage (SAH). A 40-year-old healthy man developed a strong, holocephalic headache during a roller coaster ride. SAH Hunt & Hess grade II and Fisher grade 3 was diagnosed. An underlying aneurysm of the anterior communicating artery was successfully treated with coil embolization. A 41-year-old female (smoker, otherwise healthy) experienced a sudden, strong headache and diplopia during a roller coaster ride. A perimesencephalic SAH (Hunt & Hess grade II, Fisher grade 3) was disclosed by a CT scan. No aneurysm was detected on angiography. Both patients were discharged without neurological disability. In conclusion, SAH is a rare but relevant differential diagnosis in cases of acute headache during roller coaster rides. Both aneurysmal and non-aneurysmal perimesencephalic SAH can occur. A combination of mechanical factors and excessive blood pressure rises in vulnerable persons is discussed.
Emergency Department Visits from a Local Amusement Park
2011, Journal of Emergency Medicine
Citation Excerpt :
Roller coaster and other amusement park rides also have been associated with pneumothorax, dislocated intraocular lens, partial hepatic amputation, corneal foreign body, and peritoneal dialysis catheter displacement (16–20). Braksiek and Roberts reported that the risk of being injured severely enough to require immediate medical attention on an amusement park ride was 1 in 124,000 rides, the risk of injury requiring hospitalization was > 1 in 15 million rides, and the risk of being fatally injured is 1 in 150 million rides (based on approximately 900 million rides per year) (21). From 1987 to 2002, there were an estimated 4.4 amusement park ride fatalities per year (mobile and fixed-site amusement park rides combined) (1).
Background: There are limited published data examining Emergency Department (ED) presentations associated with amusement parks, and even fewer data on presentations not associated with roller coaster rides. Study Objectives: To determine the spectrum of medical and traumatic presentations to two EDs from nearby amusement parks. Methods: A retrospective chart review of prospectively identified, enrolled, and surveyed patients was conducted at two EDs in Pennsylvania during the summer of 2006. Any patient presenting with a medical or traumatic complaint that occurred within 12 h of ED presentation and was associated with a visit to the local amusement park was prospectively identified and details of the visit were retrospectively reviewed. Results: There were a total of 325 discharge diagnoses for the 296 ED visits identified; 74% of discharge diagnoses were trauma related. The most common traumatic diagnoses were laceration (27%) and head injury or concussion (14%). The most common non-traumatic diagnosis was heat-related illness (24%). Twenty-nine percent of discharge diagnoses were directly associated with amusement park rides. Eighty-nine percent of patients were discharged home. There were no mortalities reported. Conclusion: The majority of ED visits from nearby amusement parks were benign and did not require hospitalization.

View all citing articles on Scopus

^*: Address for reprints: Robert J. Braksiek, MD, Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415; 612-347-5683,fax 612-904-4241; E-mail [email protected].

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ConceptsAmusement park injuries and deaths*

Abstract

Introduction

Section snippets

Injuries in the medical literature

CPSC data

Physiologic effects of roller coasters

Regulatory oversight

Recommendations

Lancet

Lancet

Am J Med

Lancet

International Association of Amusement Parks and Attractions Web Site

History of roller coasters

Record holders report

Amusement Park Injury Database

Fatality at a waterslide amusement park: Utah

JAMA

Corneal foreign bodies: sparks from bumper-car rides

N Engl J Med

Incidence and risk factors for eye injuries sustained at fairs: metal particles in the eye after a ride of dodg’em cars [Dutch]

Ned Tijdschr Geneeskd

Pneumothorax after “reversed” bungee jump [Danish]

Ugeskr Laeger

“Roller coaster glaucoma:” an unusual complication of Marfan’s syndrome

Eye

CAPD catheter malposition during a roller coaster ride

Perit Dial Int

Roller coaster headache and subdural hematoma

Neurology

Stroke after roller coaster–induced carotid compression

JAMA

Traumatic pericallosal aneurysm in a patient with no major trauma

J Neurosurg

A roller-coaster headache: case report

J Trauma

Concepts
Amusement park injuries and deaths*