A postal survey was carried out of the 90 most accessible climbing walls in England, Scotland and Wales to determine the incidence and nature of injuries requiring emergency treatment associated with their use. Over a two year period, representing 1.021 million visits to the 56 walls used by more than 30 climbers per week, 55 significant injuries were recorded. The rate of injury was not related to any identified design or safety feature of the walls, although upper limb injuries were proportionally more common in walls which provided thinner fixed landing mats rather than thicker, moveable crash mats. The overall rate of injury was very low and climbers seem to modify risk taking behaviour and thus compensate for the level of safety equipment available. It may be possible to reduce the injury rate further by providing seamless ground cover with matting of adequate energy absorbency.
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