Document Type : Review Article
Authors
1 Physical Education Department, Andisheh Jahrom Institute of Higher Education, Jahrom, Iran.
2 Department of Sports Management, National University of Skills, Malayer Boys' School, Malayer, Iran.
Abstract
Purpose: Extreme sport tourism has become a rapidly expanding segment of the global tourism industry, involving high-risk activities such as rafting, climbing, sky running, and canyoning. The objective of this review was to synthesize current scientific evidence on the physiological and organizational determinants of safety in extreme sport tourism and to present an integrated framework applicable to diverse adventure sport contexts. Method: A narrative review methodology was adopted. Peer-reviewed studies published between 2000 and 2025 were identified through PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar. Included studies addressed physiological stress responses, environmental exposure, guide competence, safety management systems, and emergency preparedness in extreme or adventure sport settings. Findings were thematically synthesized across physiological and organizational domains. Results: The review identified key physiological determinants of safety, including cardiovascular strain, hypoxic and respiratory stress, thermoregulatory imbalance, dehydration, neuromuscular fatigue, and neuroendocrine stress responses, all of which influence performance, cognition, and decision-making under extreme conditions. Organizational determinants included structured risk assessment, guide training and certification, equipment standards, communication systems, emergency response planning, and organizational safety culture. Evidence indicated that inadequate organizational control amplifies physiological risk and contributes to accident occurrence. Conclusion: Safety in extreme sport tourism requires an integrated, multidisciplinary approach aligning human physiological limits with organizational management to improve participant safety and support sustainable destination development.
Keywords
Main Subjects
Aragon-Carrasco, M., & Hughes, B. (2020). Adventure sport participation and perceived risk: A systematic review. Journal of Outdoor
Recreation and Tourism, 29, 100280. https://doi.org/10.1016/j.jort.2019.100280
Attarian, A. (2018). Risk management in outdoor and adventure programs. Journal of Experiential Education, 41(3), 279–295. https://doi.org/10.1177/1053825918778345
Backe, S., Ericson, L., & Janson, K. (2019). Physiological responses to multi-pitch rock climbing. International Journal of Sports
Physiology and Performance, 14(4), 490–496. https://doi.org/10.1123/ijspp.2018-0225 Baláž, V., & Williams, A. M. (2018). Tourism risk and uncertainty: Theoretical reflections. Tourism Management, 68, 306–318. https://doi.org/10.1016/j.tourman.2018.04.004
Bentley, T. A., & Page, S. J. (2008). A decade of injury monitoring in the New Zealand adventure tourism sector: A summary risk analysis. Tourism Management, 29(3), 421–434.
https://doi.org/10.1016/j.tourman.2007.05.003
Bonanno, G. A., Romero, S. A., & Klein, S. I. (2014). The temporal elements of psychological resilience: An integrative framework for the study of individuals, families, and communities.
Psychological Inquiry, 26(2), 139–169.
https://doi.org/10.1080/1047840X.2015.992677
Buckley, R. (2012). Rush as a key motivation in adventure tourism.
Tourism Management, 33(4), 961–970.
https://doi.org/10.1016/j.tourman.2011.10.002
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144.
https://doi.org/10.1016/j.annals.2018.10.005
Burtscher, M. (2004). Effects of living at higher altitudes on physical performance. International Journal of Sports Medicine, 25(6), 411–422. https://doi.org/10.1055/s-2004-821042
Casolo, A., Malgoyre, A., & Millet, G. P. (2020). Neuromuscular fatigue during mountain trail running races. Frontiers in Physiology, 11, 612. https://doi.org/10.3389/fphys.2020.00612
Cater, C. (2006). Playing with risk? Participant perceptions of risk and management implications in adventure tourism. Tourism
Management, 27(2), 317–325.
https://doi.org/10.1016/j.tourman.2004.10.005
Cohen, E., & Cohen, S. A. (2015). Beyond Eurocentrism in tourism:
A paradigm shift to mobilities. Tourism Recreation Research,
40(2), 157–168. https://doi.org/10.1080/02508281.2015.1039331
Collins, L., & Collins, D. (2012). Decision making and risk management in adventure sports coaching. Journal of Adventure
Education & Outdoor Learning, 12(1), 37–50.
https://doi.org/10.1080/14729679.2011.611283
Ewert, A., & Hollenhorst, S. (1989). Testing the adventure model: Empirical support for a model of risk recreation. Journal of Leisure Research, 21(2), 124–139.
Faull, A. L., & Guskiewicz, K. M. (2011). Cognitive function and recovery following physically demanding environments. Sports
Health, 3(4), 358–366.
https://doi.org/10.1177/1941738111403120
Furman, S., & Sibthorp, J. (2013). The development of judgment and decision-making in outdoor leaders. Journal of Experiential
Education, 36(1), 60–77.
https://doi.org/10.1177/1053825913481309
Galloway, S. D. R. (2012). Physiological challenges in cold water immersion and swift-water rescue. Wilderness & Environmental
Medicine, 23(4), 456–462.
https://doi.org/10.1016/j.wem.2012.06.002
Gstaettner, A. M., Rodger, K., & Lee, D. (2020). Visitor perspectives on risk management in adventure tourism. Journal of Outdoor
Recreation and Tourism, 30, 100283.
https://doi.org/10.1016/j.jort.2020.100283
Holyfield, L. (1997). Manufacturing adventure: The buying and selling of emotions in white-water rafting. Sociology of Sport Journal, 14(1), 1–24.
Jones, G., & Johnson, M. I. (2016). Cardiorespiratory responses to sustained climbing. European Journal of Sport Science, 16(1), 71–78. https://doi.org/10.1080/17461391.2014.987241
Kennedy, D. M., & Jackman, K. (2018). Risk communication in adventure tourism. Tourism Management Perspectives, 27, 133–
- https://doi.org/10.1016/j.tmp.2018.05.005
Muller, R., & Wadsworth, D. (2019). Weather-related risk in mountain sports. Meteorological Applications, 26(3), 451–460. https://doi.org/10.1002/met.1776
Page, S. J., Bentley, T. A., & Walker, L. (2005). Scoping the nature and extent of adventure tourism operations in New Zealand.
Journal of Travel Research, 44(2), 143–156.
https://doi.org/10.1177/0047287505276591
Queiroz, A. C., Silva, B. M., & Aidar, F. J. (2015). Physiological demands and safety considerations in canyoning. Journal of Human Kinetics, 47, 73–81. https://doi.org/10.1515/hukin-20150065
Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768 Schoffl, V., Morrison, A., Schwarz, U., Schöffl, I., & Küpper, T. (2010). Evaluation of injury and fatality risk in rock and ice climbing. British Journal of Sports Medicine, 44(7), 443–449. https://doi.org/10.1136/bjsm.2009.058537
Sperlich, B., & Holmberg, H. C. (2017). The responses of elite athletes to exercise: Wearable sensors and monitoring. Frontiers in Physiology, 8, 571. https://doi.org/10.3389/fphys.2017.00571 Swann, C., Piggott, D., Crust, L., Keegan, R., & Hemmings, B. (2018). Exploring the interactions between flow states and stress in extreme sports. Psychology of Sport and Exercise, 38, 28–36. https://doi.org/10.1016/j.psychsport.2018.05.003
Taylor, S., & Carter, R. (2019). Heat stress, hydration, and endurance performance. Frontiers in Sports and Active Living, 1, 38. https://doi.org/10.3389/fspor.2019.00038
Green, B. N., Johnson, C. D., & Adams, A. (2006). Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade. Journal of Chiropractic Medicine, 5(3), 101–117. https://doi.org/10.1016/S0899-3467(07)60142-6
Page, S. J., Bentley, T. A., & Walker, L. (2005). Tourist safety in natural adventure settings: An exploratory study of New Zealand operators. Journal of Travel Research, 44(2), 143–156. https://doi.org/10.1177/0047287505276591
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144.
https://doi.org/10.1016/j.annals.2018.10.005
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144.
https://doi.org/10.1016/j.annals.2018.10.005
Burtscher, M. (2004). Effects of living at higher altitudes on physical performance. International Journal of Sports Medicine, 25(6), 411–422. https://doi.org/10.1055/s-2004-821042
Casolo, A., Malgoyre, A., & Millet, G. P. (2020). Neuromuscular fatigue during mountain trail running races. Frontiers in Physiology, 11, 612. https://doi.org/10.3389/fphys.2020.00612
Galloway, S. D. R. (2012). Physiological challenges in cold-water immersion and swift-water rescue. Wilderness & Environmental
Medicine, 23(4), 456–462.
https://doi.org/10.1016/j.wem.2012.06.002
Page, S. J., Bentley, T. A., & Walker, L. (2005). Tourist safety in natural adventure settings: An exploratory study of New Zealand operators. Journal of Travel Research, 44(2), 143–156.
https://doi.org/10.1177/0047287505276591
Schoffl, V., Morrison, A., Schwarz, U., Schöffl, I., & Küpper, T. (2010). Evaluation of injury and fatality risk in rock and ice climbing. British Journal of Sports Medicine, 44(7), 443–449.
https://doi.org/10.1136/bjsm.2009.058537
Swann, C., Piggott, D., Crust, L., Keegan, R., & Hemmings, B. (2018). Exploring the interactions between flow states and stress in extreme sports. Psychology of Sport and Exercise, 38, 28–36. https://doi.org/10.1016/j.psychsport.2018.05.003
Taylor, S., & Carter, R. (2019). Heat stress, hydration, and endurance performance. Frontiers in Sports and Active Living, 1, 38. https://doi.org/10.3389/fspor.2019.00038
Attarian, A. (2018). Risk management in outdoor and adventure programs. Human Kinetics.
Bentley, T. A., & Page, S. J. (2008). A decade of injury monitoring in the New Zealand adventure tourism sector: A summary risk analysis. Tourism Management, 29(3), 421–434. https://doi.org/10.1016/j.tourman.2007.05.003
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144. https://doi.org/10.1016/j.annals.2018.10.005
Collins, L., & Collins, D. (2012). Decision making and risk management in adventure sports coaching. Journal of Adventure Education & Outdoor Learning, 12(1), 37–50.
https://doi.org/10.1080/14729679.2011.611283
Furman, S., & Sibthorp, J. (2013). The development of judgment and decision-making in outdoor leaders. Journal of Experiential
Education, 36(1), 60–77.
https://doi.org/10.1177/1053825913481309
Page, S. J., Bentley, T. A., & Walker, L. (2005). Tourist safety in natural adventure settings: An exploratory study of New Zealand operators. Journal of Travel Research, 44(2), 143–156. https://doi.org/10.1177/0047287505276591
Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768
Spence, H., & Anderson, D. (2021). Crisis management and emergency preparedness in adventure tourism. Tourism
Management, 83, 104237.
https://doi.org/10.1016/j.tourman.2020.104237
Attarian, A. (2018). Risk management in outdoor and adventure programs. Human Kinetics.
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144.
https://doi.org/10.1016/j.annals.2018.10.005
Burtscher, M. (2004). Effects of living at higher altitudes on physical performance. International Journal of Sports Medicine, 25(6), 411–422. https://doi.org/10.1055/s-2004-821042
Casolo, A., Malgoyre, A., & Millet, G. P. (2020). Neuromuscular fatigue during mountain trail running races. Frontiers in Physiology, 11, 612. https://doi.org/10.3389/fphys.2020.00612
Page, S. J., Bentley, T. A., & Walker, L. (2005). Tourist safety in natural adventure settings: An exploratory study of New Zealand operators. Journal of Travel Research, 44(2), 143–156. https://doi.org/10.1177/0047287505276591
Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768 Schoffl, V., Morrison, A., Schwarz, U., Schöffl, I., & Küpper, T. (2010). Evaluation of injury and fatality risk in rock and ice climbing. British Journal of Sports Medicine, 44(7), 443–449. https://doi.org/10.1136/bjsm.2009.058537
Taylor, S., & Carter, R. (2019). Heat stress, hydration, and endurance performance. Frontiers in Sports and Active Living, 1, 38. https://doi.org/10.3389/fspor.2019.00038
Bentley, T. A., & Page, S. J. (2008). A decade of injury monitoring in the New Zealand adventure tourism sector: A summary risk analysis. Tourism Management, 29(3), 421–434.
https://doi.org/10.1016/j.tourman.2007.05.003
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144.
https://doi.org/10.1016/j.annals.2018.10.005
Burtscher, M. (2004). Effects of living at higher altitudes on physical performance. International Journal of Sports Medicine, 25(6), 411–422. https://doi.org/10.1055/s-2004-821042
Page, S. J., Bentley, T. A., & Walker, L. (2005). Tourist safety in natural adventure settings: An exploratory study of New Zealand operators. Journal of Travel Research, 44(2), 143–156. https://doi.org/10.1177/0047287505276591
Bentley, T. A., & Page, S. J. (2008). A decade of injury monitoring in the New Zealand adventure tourism sector: A summary risk analysis. Tourism Management, 29(3), 421–434.
https://doi.org/10.1016/j.tourman.2007.05.003
Buckley, R. (2012). Rush as a key motivation in skilled adventure tourism: Resolving the risk recreation paradox. Tourism
Management, 33(4), 961–970.
https://doi.org/10.1016/j.tourman.2011.10.002
Buckley, R. (2018). Adventure tourism: A global analysis. Annals of
Tourism Research, 73, 130–144.
https://doi.org/10.1016/j.annals.2018.10.005
Burtscher, M. (2004). Effects of living at higher altitudes on physical performance. International Journal of Sports Medicine, 25(6), 411–422. https://doi.org/10.1055/s-2004-821042
Casolo, A., Malgoyre, A., & Millet, G. P. (2020). Neuromuscular fatigue during mountain trail running races. Frontiers in Physiology, 11, 612. https://doi.org/10.3389/fphys.2020.00612
Cater, C. (2006). Playing with risk? Participant perceptions of risk and management implications in adventure tourism. Tourism
Management, 27(2), 317–325.
https://doi.org/10.1016/j.tourman.2004.10.005
Dickson, T. J., & Huyton, J. (2008). Customer service, employee welfare and safety in adventure tourism. Managing Leisure, 13(1), 1–17. https://doi.org/10.1080/13606710701847898
Furman, S., & Sibthorp, J. (2013). The development of judgment and decision-making in outdoor leaders. Journal of Experiential
Education, 36(1), 60–77.
https://doi.org/10.1177/1053825913481309
Page, S. J., Bentley, T. A., & Walker, L. (2005). Tourist safety in natural adventure settings: An exploratory study of New Zealand operators. Journal of Travel Research, 44(2), 143–156. https://doi.org/10.1177/0047287505276591
Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768 Rickly, J. M. (2017). “I’m doing something!”: Exploring wellbeing and meaning in adventure tourism. Tourism Management, 59, 315–325. https://doi.org/10.1016/j.tourman.2016.09.007 Schoffl, V., Morrison, A., Schwarz, U., Schöffl, I., & Küpper, T. (2010). Evaluation of injury and fatality risk in rock and ice climbing. British Journal of Sports Medicine, 44(7), 443–449.
https://doi.org/10.1136/bjsm.2009.058537
Swann, C., Piggott, D., Crust, L., Keegan, R., & Hemmings, B. (2018). Exploring the interactions between flow states and stress in extreme sports. Psychology of Sport and Exercise, 38, 28–36. https://doi.org/10.1016/j.psychsport.2018.05.003
Taylor, S., & Carter, R. (2019). Heat stress, hydration, and endurance performance. Frontiers in Sports and Active Living, 1, 38. https://doi.org/10.3389/fspor.2019.00038