{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:45:49Z","timestamp":1777934749452,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The outdoor recreation industry in Texas has witnessed a large growth. There are no publications about the epidemiology of outdoor recreation injury and mortality in Texas. This work analyzes the Texas Parks and Wildlife Department (TPWD) outdoor injury reports to address this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed TPWD injury incident reports filed from July 2012 to April 2021. Statistical analysis included descriptive statistics, Wilcoxon Rank Sum test for continuous data, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      analysis for categorical data, Fisher exact test for small sample cross tables, and two multivariable logistic regression models for the effects of season, activity, and location on morbidity and mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 4882 outdoor recreational events, including injuries (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094401, 90.1%), mortalities (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009124, 2.5%), and search and rescue operations (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009357, 6.4%). The injury and mortality rates were 5.20 and 0.15 per 100\u2005000 visits, respectively. Activities preceding injury included hiking (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091112, 24.3%), walking\/running (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091078,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200923.6%), water sports (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009533, 11.6%), biking (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009393, 8.6%), and climbing (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009260, 5.7%). The most common injuries were skin-related (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091194, 27.1%), musculoskeletal (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009804, 18.3%), and heat injuries (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009393, 8.9%). Activities preceding mortality included water sports (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200952, 42.6%) and hiking (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200920, 16.4%). Injuries contributing to mortality included respiratory events and drowning (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200946, 37.41%), cardiac events (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200913, 10.5%), and heat injury (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20099, 7.3%). Most incidents occurred in Hill Country (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091170, 24.01%) and Prairies and Lakes (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091144, 23.48%) areas.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study evaluates outdoor recreational injuries in the state of Texas. It uncovers and summarizes important trends that may inform the development of prevention and education efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10806032251323500","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T21:29:50Z","timestamp":1742938190000},"page":"223-233","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Recreational Outdoor Injury and Mortality in Texas State Parks Between 2012 and 2021"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0542-8025","authenticated-orcid":false,"given":"Mohammad I.","family":"Hirzallah","sequence":"first","affiliation":[{"name":"Baylor College of Medicine"},{"name":"Baylor College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebubechi K.","family":"Adindu","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julliet C.","family":"Ogu","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania","family":"Allison","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Denver Health, Denver, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May","family":"Kamleh","sequence":"additional","affiliation":[{"name":"Patient-Centered Outcomes Research, ICON Clinical Research LLC, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Outdoor Foundation. 2023 Outdoor Participation Trends Report. https:\/\/oia.outdoorindustry.org\/resource\/2023-outdoor-participation-trends-report. Published 2023."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jort.2023.100641"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2018.06.030"},{"key":"e_1_3_2_5_2","volume-title":"Outdoor recreation satellite account, U.S. and states, 2022","author":"Rzeznik S","year":"2022","unstructured":"Rzeznik S, Washington P, O\u2019Connell C. Outdoor recreation satellite account, U.S. and states, 2022. Vol BEA 23\u201354; Bureau of Economic Analysis; 2022."},{"key":"e_1_3_2_6_2","unstructured":"Adams C. What is the most visited state park in Texas? Here\u2019s the top 10 countdown. KXAN. https:\/\/www.kxan.com\/news\/texas\/what-is-the-most-visited-state-park-in-texas-heres-the-top-10-countdown\/. Published 2023."},{"issue":"4","key":"e_1_3_2_7_2","first-page":"248","article-title":"Morbidity and mortality in the wilderness","volume":"168","author":"Montalvo R","year":"1998","unstructured":"Montalvo R, Wingard DL, Bracker M, Davidson TM. Morbidity and mortality in the wilderness. West J Med. 1998;168(4):248\u201354.","journal-title":"West J Med"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1580\/1080-6032(2004)015[0011:EOWSAR]2.0.CO;2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.112256"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1580\/1080-6032(2005)16[192:RIIWSN]2.0.CO;2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8305.2008.00235.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2013.01.009"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/10903120903564506"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1580\/07-WEME-OR-152.1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2013.04.004"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2010.08.001"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2021.11.010"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2018.07.004"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-023-00445-6"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052506"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.09.004"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000209402.40864.b2"}],"container-title":["Wilderness &amp; Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032251323500","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10806032251323500","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032251323500","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:32:24Z","timestamp":1777689144000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10806032251323500"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1177\/10806032251323500"],"URL":"https:\/\/doi.org\/10.1177\/10806032251323500","relation":{},"ISSN":["1080-6032","1545-1534"],"issn-type":[{"value":"1080-6032","type":"print"},{"value":"1545-1534","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,25]]}}}