Context. - Despite the increased popularity of hot-air balloon flight, data on injuries and fatalities associated with hot-air balloon crashes are limited. Objective. - To determine factors associated with injury and death in hot-air balloon crashes. Design. - Retrospective review of data collected from reports and investigations by the Civil Aeronautics Board and the National Transportation Safety Board. Study Subjects. - Individuals involved in US hot-air balloon crashes from 1964 to 1995. Main Outcome Measures. - Total number of crashes and factors associated with fatality or serious injury. Results. - From 1964 to 1995, a total of 495 hot-air balloon crashes involving 1533 persons were reported and included 92 fatalities and 384 serious injuries. Pilot error or incapacitation was determined subjectively by crash investigators to contribute to 85.1% of the crashes. In univariate analysis, collision with the ground was the most significant predictor of a fatality or serious injury (P<.001), and power-line contact was the most significant predictor of fatality (P<.001). In multiple logistic regression, only the type of object struck by a balloon predicted a fatal crash or a fatality or serious injury. Conclusions. - Although a number of factors likely contribute to increased severity of hot-air balloon crashes, the object struck during a crash is most predictive of fatality or serious injury. Preventive efforts are needed to decrease future injuries.
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