ISSW 24 Speed Dating Round Three: Avalanche Airbags

ISSW 24 presenter Dr. Chris van Tilburg asks the question: Should Avalanche Airbags be Mandatory?

We’ll continue our ISSW speed dating. Here’s round three.

In this episode of ISSW speed dating, we focus on a presentation by Dr. Christopher van Tilburg titled “Should Airbags be Standard Safety Equipment for Professionals and Recreationalists?” The author is no stranger to the airbag or no-airbag debate. In 2021, Van Tilburg penned a piece for Outside on the topic, and he is involved with the mountain rescue community and past airbag research.

For now, the standard and required safety tools to teach or participate in an avalanche class are the three staples: Beacon, shovel, and probe. Airbags are not a formal part of the safety tool arsenal. Here’s an extended excerpt from his recent paper to reinforce his point. 

“The three main North American avalanche organizations—American Avalanche Association (A3), Canadian Avalanche Association (CAA), and American Institute for Avalanche Research and Education (AIARE)—have no formal recommendation for airbag use on their websites or in their publications, as confirmed by published information, websites, and personal communication with the three agencies. For A3 airbags are part of the core curriculum for only one course titled Avalanche Rescue; this is one of five courses that range from basic to advanced. For AIARE, airbags are considered ‘additional safety equipment’ in their 2021 student manual. In the CAA 2016 risk handbook, airbags are mentioned only once in discussion of risk statistics.”

Van Tilburg also presented a poster about his query. (See below.) It summarizes the paper’s key findings. On it, Van Tilburg repeats what we have heard before, that avalanche transceivers and airbags have roughly the same benefit regarding mortality reduction. This is not the first time we’ve heard or read this finding. Nonetheless, reading that data point makes us think.

We transcribed Van Tilburg’s presentation, which ran roughly 10 minutes—it is also published below. Yet, before we get there, the presentation was followed by a short Q & A. An audience member asked an excellent question. 

Question: In terms of the beginning of the production of transceivers to when they were required by professionals, have airbags already gone beyond that timeline?”

Van Tilburg’s Response: That’s a great question. I don’t know the answer to that, but I know that when I worked on the Wilderness Medical Society Practice Guidelines, we did look at things like seat belts in cars in the US. It took a long time for those to be adopted, even though the data showed they were extremely effective at saving lives. But I don’t know, your question is valid. Is this just the normal cycle of a safety device—that it takes a decade or more to be settled as mandatory? 

Van Tilburg’s remarks are transcribed below with light editing for clarity.

This is a study published last year that basically shows how airbags reduce mortality, or reduce our risks of death, somewhere between eight and 20%. That’s pretty good, but it’s not as good as the recreationalist might think, but it does reduce our risk of death by preventing burial. 

We don’t have any data on whether airbags reduce our risk of trauma. Trauma is about 25 to maybe 30% of all avalanche fatalities. If you have a 170-liter balloon covering your head, it may work pretty well to protect you against trauma, but we don’t have any data. We have just one study that suggests that if you have an airbag that deflates after burial, it may prevent asphyxia by giving your head room to move and creating an air pocket. Okay, so we know that airbags are effective. We don’t know exactly how much, but we think it’s between an 8% and 20% reduction in mortality, a reduction in the chance of death. 

How do transceivers look? Transceivers are almost the same, a 15% reduction in your chance of death if you have a transceiver. If you’re a recreationalist and you go buy a transceiver, it’s not really all that good at saving your life, right? We all know that. 

However, this data is outdated, because all of the transceiver data we have for mortality reduction is based on old transceivers, so we don’t really know, although it seems like these new transceivers are fabulous. They have marking function, digital processing, and multiple antennas, but we don’t know how much better they work than old transceivers, in part because we have a new problem, and that’s electromagnetic interference. 

The point here is that transceivers and airbags probably work about the same to save our lives. So, the question that I investigated is, why are they optional? It’s a similar phenomenon that when we look at teaching snow pit analysis in recreational avalanche courses, we teach it in a lot of level ones and almost all level twos in North America, but we don’t have any data that suggests that snow pit analysis saves lives at the recreational level. 

We do know that CPR in avalanches saves lives, but we don’t teach CPR in level one or Level Two avalanche courses, generally. So it’s just an interesting problem that we could address. 

In my paper, which you can read, I did postulate on potential barriers for universal adoption. One is that everybody says they’re too heavy, but really, as a professional, unpaid professional, the question isn’t, is the airbag too heavy? The question is, if I have a limited amount of weight, what am I going to take? A liter and a half of water weighs the same as a modern airbag, right? 1.5 kilos. So, if you’re choosing to take water over an airbag, that’s a choice that the individual is making. It’s not the airbag’s fault for being too heavy. 

There’s some discussion, as airbags are expensive, they are. However, we know of some anecdotal evidence that professionals are given an airbag for free for work, yet they don’t take it on their days off. We also know, particularly in America, which is a consumer-based society, we know that people have to buy the latest and greatest equipment regardless of cost. 

There is a little bit of a training burden. To properly train with an airbag, you need to practice deploying it while you’re tumbling down a mountain, not just in your garage. There’s not much of an availability issue anymore, except for probably some regions around the world. But generally, we have airbags available. 

There’s some speculation that if you live in a community where people don’t embrace airbag use, then you’re likely not to use it. Or, if you live if all of your touring buddies have airbags, you’re maybe more likely to buy one. 

There’s also been a couple of papers on risk tolerance with airbags that may or may not be valid. But we know that risk tolerance with airbags and with transceivers is an issue. We know risk tolerance with helmets is an issue. 

The one thing I’m interested in is the lack of a professional recommendation. So here is an avalanche that happened in 2022 in Oregon. [Points to projected image of an avalanche.] I took this picture about three minutes after the avalanche. It was skier-triggered. Nobody was hurt. This was a guided trip—four guides and assistant guides without airbags, 10clients, seven of whom had airbags. Here’s a picture of a guided trip in 2024 just this April. We experienced two skier-triggered avalanches in three days, the 12 clients all had airbags. The three guides didn’t have airbags. 

Here are the North American groups that teach avalanches. [American Avalanche Association (A3), Canadian Avalanche Association (CAA), and American Institute for Avalanche Research and Education (AIARE).] I just looked on the websites to see what was available to consumers, but there’s really almost no support for airbags for the North American group. I think the American Institute for Avalanche Research and Education says it’s additional safety equipment. ICAR, the International Commission for Alpine Rescue, has a very outdated guideline on airbags. The textbook for the diploma in mountain medicine—sponsored by UIAA, ICAR, and the International Society of Mountain Medicine—has nothing on airbags. It was published in 2015

Editor’s Note: at the conclusion of his talk, van Tilburg referenced another article, linked here, on which he is the first author. The paper is titled “Wilderness Medical Society Clinical Practice Guidelines for Prevention and Management of Avalanche and Non-avalanche Snow Burial Accidents: 2024 Update.”