Background: Outdoor adventure is inevitably linked to risks that lead to injuries, psychological distress, illnesses, and even fatalities. Gathering detailed information on such occurrences and their contributing factors is a valuable component of risk management in outdoor programs. This study investigated the occurrence of injuries, illnesses, evacuation profiles, non-medical concerns, and near-miss events in outdoor adventure practice in Kenya.

Methods: A mixed-methods approach involving quantitative and qualitative methods was used to collect data from 136 outdoor adventure practitioners in Kenya. Questionnaires, key informant interviews, focus group discussions, and desk reviews were employed to collect data.

Results: The majority of injuries and illnesses occur during mountaineering (39%) and hiking and navigation (25.7%) events. The most reported incidents were mountain sickness (25%) and musculoskeletal injuries consisting of fractures (30%), cuts and wounds (14.7%), blisters (12.5%), sprains and dislocations (12.5%), and muscle strains and pulls (8.8%). Out of the 128 reported evacuation incidences on Mt. Kenya, 95 were due to mountain sickness and10 due to falls. Combined age and sex of the climbers and the location/altitude on the mountain are predictors of the occurrence and the type of injury/illness on the mountain (x2 (10, n = 128) = 63.32, P < 0.001). However, only altitude significantly contributes to the model (P < 0.001). Reported near-miss incidences included flash floods, aggressive encounter with wildlife, getting lost for extended period, near falls and slips, and rolling-rock falls. Non-medical concerns reported included extreme anxiety, intoxication from drug and alcohol use, confrontation and fights, and disorientation.

Conclusions: There is evident incidence of injuries and illnesses of varying severity, with age, sex, and altitude reached being key predicting factors. Mitigating efforts and preventive measures should be employed as well as risk assessment and management to promote safety. The findings are vital to advise policy and practice and enhance awareness among practitioners and interested parties in Kenya and also in other destinations with similar conditions, terrains, and challenges.