To the Editor.
—A few years ago, Drs Shlim and Houston1 reported about the risk of death during trekking in Nepal. They calculated a death rate of 15 per 100 000 trekkers and indicated that trekking was safe. However, no comparisons were made. Avery et al2 compiled figures for mountaineers in England and Wales and calculated a death rate of 2.3 per 1 million days of exposure.2 This risk was 100 times greater than that of ball games and water sports. Using an estimated average of 14 days of exposure per trekker in Nepal, the risk is 11 deaths per 1 million days of exposure—almost five times greater than that indicated by Avery et al.Since 1986, nearly all fatalities during mountain sports in Austria have been recorded and analyzed by the Health Section of the Austrian Alpine Club. Based on 7 years of observation (1986 through