Ramanpong J.CHIA-PIN YUChiang, Po-NengPo-NengChiangMING-JER TSAI2020-11-022020-11-02202016188667https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084859083&doi=10.1016%2fj.ufug.2020.126710&partnerID=40&md5=f5ab398ee1ebe5c6e1ef0d64c661e417https://scholars.lib.ntu.edu.tw/handle/123456789/518868Participating in forest recreation activities sometimes involves risks that result in illnesses and/or injuries. One important risk factor is participants’ preexisting medical conditions, which may lead to illness incidents. Little has been studied about the relationship between participants’ illnesses and their preexisting medical conditions, and, from a risk management perspective, that is crucial information with which to identify vulnerable groups for preventing incidents. Finding answers can help the site managers of Xitou Nature Education Area (XNEA) in Taiwan (R.O.C.) in risk management planning. Therefore, we retrospectively analyzed emergency medical service records between July 2012 and June 2018 that included each patient's age, sex, date, time, preexisting health conditions, and illness contracted. Of the 276 patients assessed, 56.2% were female. More than half (55.4%) had preexisting medical conditions. The most common symptom was dizziness (47.8%). Most health-related events occurred in the morning and during summer months. Elderly visitors (?60 years) were the most vulnerable to illness. More men than women encountered syncope. Participants with high blood pressure had a higher risk of dizziness, respiratory problems, and syncope. Individuals with diabetes were vulnerable to weakness. Visitors with cardiac-related problems were likely to have chest pain or tightness in their chest. Preexisting medical conditions constitute an inherent risk in visitors, and this association with the occurrence of illness during forest recreation confirmed higher risks in specific patient groups. This epidemiological study describes the characteristics of illnesses and identifies the at-risk groups to facilitate future risk management planning for forest recreation in XNEA. ? 2020 Elsevier GmbH[SDGs]SDG3disease incidence; epidemiology; public health; risk assessment; risk factor; spatiotemporal analysis; suburban area; urban forestry; Taiwanjournal article10.1016/j.ufug.2020.126710572168248252-s2.0-85084859083