The question is not whether there's a growing problem with tree stand accidents across Pennsylvania.

The answer to that is a pretty obvious yes.

It's what, if anything, to do about it.

One Pennsylvania Game Commissioner, at least, has an idea.

It might be time to require hunters in tree stands on state game lands to use a safety harness, said commissioner Michael Mitrick of York County. He's thinking of introducing such a regulation.

If adopted by the full commission board, his proposal, which is still under development, wouldn't necessarily go into effect right away. Perhaps hunters should be educated about the need for harnesses a bit first, with implementation of the rule to follow a year or so later, he said.

By then, maybe the Department of Conservation and Natural Resources would follow suit on its state park and forest lands, he added.

“I can't see how any reasonable hunter would be opposed to that,” Mitrick said.

The commission can't mandate tree stand harness use on any properties other than game lands. Only state lawmakers could take things beyond that.

Such a rule would be uncommon even, though.

Only one other state, Alabama, has a mandatory tree stand harness rule, and it applies only to lands owned by the Department of Conservation and Natural Resources.

But there's talk in at least a few states about following suit as tree stand accidents are a growing problem.

That's certainly the case in Pennsylvania.

Joseph Smith is a doctor in the intensive care unit at Geisinger Medical Center. He's also the chief author of the only study looking at tree stand accidents in Pennsylvania.

In a recent presentation to Game Commissioners, Smith said he looked at every known tree stand accident in Pennsylvania between 1987 and 2015. Information came from medical records collected by the Pennsylvania Trauma System Foundation.

The records — all anonymous — count only falls that occurred on a legal hunting day or on the day preceding a legal hunting day, such as the Sunday before opening day of deer season. They document 1,109 tree stand accidents, he said.

If the scope of that search was expanded to include all accidents between Sept. 1 and Feb. 28 of each year, there were another 162 victims, Smith said.

“So we would have basically over 1,200 people that have fallen out of tree stands,” he said.

And that might be a minimum.

“Those are the ones that sought treatment at an accredited medical center. We don't have any estimate of those who fell and didn't receive treatment,” Smith said.

That's likely a lot, said Andy Hueser, hunter education specialist for the commission.

“At best, this is a very, very conservative estimate of the actual number of falls that are out there,” he said.

Ninety-three percent of those who fell were not wearing a safety harness, Smith said. That resulted in lots of serious injuries.

“In trauma care, injury care, there is this thing we call the ‘golden hour.' That is, if you get somebody from a serious injury to medical care within that hour, their chances of having a better outcome is better,” Smith said.

That's not how things work for most tree stand fall victims, though.

Only 7 percent of hunters got help that soon. But 24 percent had to wait six hours of longer to get treatment, he said.

As a result, more than half of fall victims needed surgery. A quarter ended up in intensive care.

And for many, that was just a start.

“Twenty-four percent of these victims did end up with some long-term disability,” Smith said.

One percent of fall victims died in the hospital, “but we have no clue how many died at the scene,” Smith said.

“If they're not seen in any emergency room or trauma center, we have no way of knowing what this number really is.”

The problem is getting worse, too.

The rate at which accidents are occurring — defined as falls per 100,000 hunters — has increased consistently since 1987, Smith said. By comparison, the trend in shooting-related accidents is going the other way. Those numbers are dropping.

The “take-home message,” said Smith — who's fallen from tree stands twice himself — is that the commission needs to do more.

“We really don't know what the full extent of the problem is. And I think you need better information. You need some active surveillance,” Smith said.

Mandated reporting of tree stand falls — meaning, requiring hospitals to report tree stand accidents to the commission — is probably something that needs to happen, Hueser said. The majority of states already require that.

And “more states are coming on board all the time,” Hueser said. New York is joining the list this year, for example, he said.

That's not something the commission can require on its own, though.

“Mandatory reporting is probably going to require legislation,” said Tom Grohol, a deputy executive director with the commission.

The commission should ask lawmakers to tackle that, said board president Brian Hoover of Chester County.

“We certainly know that we have an issue with tree stands,” he said.

Bob Frye is the everybodyadventures.com editor. Reach him at 412-216-0193 or bfrye@535mediallc.com.