Alcohol use

Last month’s Bulletin article focused on surfing and its associated injuries. This month we are looking at a different type of surfing—car surfing. A disturbing trend has emerged over the last 20 years—individuals are standing on top of moving cars to replicate the act of surfing. The term “car surfing” arose in the mid-1980s and describes a risky, thrill-seeking activity that involves riding on the exterior of a moving motor vehicle while another individual drives.

The most recent analysis at a national level was conducted by the U.S. Centers for Disease Control and Prevention and  published in the October 17, 2008, issue of the organization’s Morbidity and Mortality Weekly Report. The review revealed 58 car surfing deaths and 41 nonfatal injuries from 1990 through August 2008. Most occurrences were in the south and midwest (75 percent); involved males (70 percent); and occurred in a younger population—with the 15-to-19-year-old age range representing the majority of these occurrences.*

What is the attraction to an activity that seems so intuitively dangerous? Numerous reality television shows glamorize “stunts” such as car surfing. The smartphone video camera has created transient stars out of the individuals involved in these foolish and dangerous acts. The more outrageous the activity, the greater the odds that the video will go viral. Literally thousands of videos on the Web involve car surfing. Some even depict a fatal outcome. The widespread availability of these videos, coupled with the invincible attitude of youth, can be a recipe for disaster.

Hospital discharge status

To examine the occurrence of car surfing injuries in the National Trauma Data Bank® (NTDB®) research dataset for 2010, medical admissions records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Specifically searched codes included external cause of injury E code E818.1 (other noncollision motor vehicle traffic incident or passenger injury that includes a fall, jump, or being accidentally pushed from motor vehicle while in motion).

A total of 1,542 records, including the subset of car surfing injuries, were uncovered. In all, 1,278 records contained a hospital discharge status, including 1,036 patients discharged to home, 134 to acute care/rehab, and 53 to skilled nursing facilities; 55 died. These patients were 58.6 percent male, on average 29.2 years of age, had an average hospital length of stay of 5.3 days, an intensive care unit length of stay of 4.8 days, an average injury severity score of 11.9, and were on the ventilator for an average of 5.8 days. A total of 812 were tested for alcohol, and 47 percent were found to have alcohol present (see Figures).

Anyone who has ridden a wave on the ocean knows how difficult surfing can be. One small break of the wave or a twist of the board will render the surfer off balance and send him or her flying. When car surfing, even at slow speeds a slight swerve of the wheel or bump in the road is enough to make riders lose their balance. Water is hard enough when hitting it head-on after falling off a surfboard, but concrete is far more unforgiving in a wipeout from the hood of a car.

Throughout the year, we will be highlighting data through brief reports in the Bulletin. The NTDB Annual Report 2011 is available on the ACS website as a PDF file and as a PowerPoint presentation at www.ntdb.org. In addition, information regarding how to obtain NTDB data for more detailed study is available on the website. To submit your trauma center’s data, contact Melanie L. Neal, Manager, NTDB .

Statistical support for this article has been provided by Chrystal Price, data analyst, NTDB.

*Morbidity and Mortality Weekly Report (MMWR). Injuries resulting from car surfing—United States, 1990–2008. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5741a2.htm. Accessed July 18, 2012.

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