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Clayton T. Cowl, MD, MS; Michael P. Jones, PhD; Charles F. Lynch, MD; Nancy L. Sprince, MD, MPH; Craig Zwerling, MD, MPH; Lawrence J. Fuortes, MD, MS

JAMA. 1998;279:1011-1014.

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.

From the Mayo Clinic, Rochester, Minn (Dr Cowl), and the Injury Prevention Research Center, The University of Iowa, Iowa City (Drs Jones, Lynch, Sprince, Zwerling, and Fuortes).

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