Factors associated with injuries occurring aboard vessels in Alaska: differences between residents and nonresidents.

BACKGROUND Over the past decade, visitors to Alaska have spent increasing amounts of time engaged in water-based recreational activities aboard vessels of various sizes. Serious vessel-related injuries to travelers in Alaska involve not only medical care from unfamiliar health care providers and facilities but also entail the loss of vacation time and the need for injured travelers to return to their homes under less than optimal traveling conditions. METHODS This study employed a retrospective, case-comparison analysis to identify differences in factors associated with recreational injuries acquired aboard watercraft that resulted in hospitalizations of residents and nonresidents of Alaska during 1991 to 2000. Tests of proportions were conducted to elucidate differences in demographic characteristics and injury precursors between the two subgroups. Specific injury outcomes were then tested for significance using odds ratios. RESULTS Alaska residents and nonresidents demonstrated significant differences for both demographic factors and factors describing events leading to injuries, and for injury outcomes. Nonresidents were more likely to be 65 years or older, female, and aboard cruise ships when injuries occurred. Nonresidents were more likely to suffer fracture injuries, to suffer injuries with Abbreviated Injury Scores greater than 2, to experience posthospital discharges to sites other than their homes, and to experience postinjury disabilities. CONCLUSIONS Alaska residents and nonresidents in this study showed significant differences in demographics, precipitating events, and injury outcomes. The findings lend support for targeted safety promotion programs.