Accident prevention on ski slopes - Perceptions of safety and knowledge of existing rules

Effectiveness of an injury prevention video on risky behaviours in youth snow sports: A randomized controlled trial

Objectives

Ski and snowboard-related injuries are common among Canadian youth. Analyzing the role of risky behaviours that contribute to injury risk is essential for gaining an understanding of injury prevention opportunities. The objective was to determine if rates of risky behaviour seen at the ski hill were lower for children and adolescents exposed to an educational injury prevention video.

Methods

This single-blinded cluster randomized controlled trial included students (ages 7-16) from 18 Calgary schools who were enrolled in novice levelled school-sanctioned ski and snowboard programs. Consenting schools were randomly assigned to the intervention or control. The control group followed standard preparation including watching a general ski hill orientation video that was created by the ski hill. The intervention group viewed the intervention video focussed on injury prevention. The Risky Behaviour and Actions Assessment Tool was used by blinded research assistants to observe and record students' risky behaviours at an Alberta ski hill.

Results

In total, 407 observations estimated the rate of risky behaviour. The overall rate of risky behaviour was 23.31/100 person runs in the control group and 22.95/100 person runs in the intervention group. The most commonly observed risky behaviours in both groups were skiing too close to other skiers/snowboarders and near collision with an object/person.

Conclusions

Both groups showed similar rates of risky behaviour and demonstrated the same most common type of behaviour. Practical applications: future work should focus on mitigating common risky behaviours.

Incidence of alpine skiing and snowboarding injuries

BACKGROUND

The incidence of injuries on alpine ski slopes have been assessed using various methods. A decline in injury rate has been observed throughout the literature; however, the actual incidence remains unclear. The purpose of this study was therefore to evaluate the incidence of skiing and snowboarding injuries using large-sample data from an entire geographic state.

METHODS

Data on alpine injuries over the course of five winter seasons between 2017 and 2022 were prospectively collected from the emergency service dispatch center of Tyrol (Austria). The incidence of injuries was assessed in relation to the number of skier days, which was obtained from the chamber of commerce.

RESULTS

A total of 43,283 cases were identified, and a total of 98.1 Mio skier days were registered during the inclusion period of our study, resulting in an overall incidence of 0.44 injuries per 1,000 skier days. This is significantly less than reported from previous studies. From 2017/18 to 2021/22 there was a slight increase in injuries per 1000 skier days with an exception only for the COVID-19 related season 2020/21.

CONCLUSION

Our study showed a significant reduction in the incidence of alpine skiing and snowboarding injuries in comparison with previous studies and should be considered a benchmark for future studies. Long-term studies on the efficacy of safety gear, as well as the influence of ski patrol and air-borne rescues on patient outcome are warranted.

Managing Accident Prevention in Ski Resorts: Participants' Actual Velocities in Slow Zones

Velocity is one of the main factors affecting the kinematic of snow sports' accidents and the severity of resulting injuries. The aims of the present study were to measure the actual maximum velocities attained by a sample of snow sports participants in slow zones, to compare them to the recommended velocity limits and to assess whether their velocities were in any way related to their personal characteristics and to environmental conditions. Data were drawn from a sample of 1023 recreational skiers and snowboarders during the 2021-2022 winter season at four ski resorts located in the Spanish Pyrenees. Maximum velocity measurements were taken by the authors with a radar speed gun whose precision had been previously validated. Bivariate analysis tests were used to compare the influence that personal characteristics and environmental conditions had on the participants' maximum velocities. Furthermore, a multivariate analysis was performed. The binary logistic regression was used to distinguish the categories of personal and environmental factors that have the highest probabilities of impact on different segments of velocity. As generally accepted, probability values were two-tailed, and values of 0.05 or less were regarded as statistically significant. Participants' mean measured maximum velocity (±SD) was 51.61 (±16.14) km/h. A vast majority of the participants in this study traveled in slow zones at actual maximum velocities well over the recommended limits. Multivariate analysis showed that modality and both environmental conditions (visibility and snow quality) were highly significant and can be used to explain the chances of an increase in velocity in slow zones. Further research is needed to investigate causal relationships between skiers and snowboarders' accidents, injuries and disrespect for velocity limits.

Emergency Service Assistance for Injuries on Alpine Ski Slopes: A Cross-Sectional Study

OBJECTIVES

Injuries on alpine ski slopes have been described in cohorts of a reasonable sample size, but constant improvements in safety gear, increased use of airborne rescue, and safety measures during the coronavirus disease 2019 (COVID-19) pandemic mandate re-evaluation. Therefore, the purpose of this study was to evaluate skiing and snowboarding injuries, effectiveness of airborne rescue, and impact of the COVID-19 pandemic on a large sample size.

METHODS

Data on alpine injuries were prospectively collected from the state emergency services dispatch center in the state of Tyrol (Austria). A total of 10,143 patients were identified, with an average age of 33.5 years (SD = 20.36). The ski patrol was involved in 8,606 cases (84.9%) and some patients (n = 1,536; 15.1%) required helicopter rescue.

RESULTS

A total of 10,143 patients were identified from the dataset of the emergency dispatch center. The most frequently injured region was the knee (30.2%), and it was followed by the shoulder (12.9%), the lower leg (9.5%), and the head/skull (9.5%).

CONCLUSION

The present findings indicate that the most frequent site of injuries on alpine slopes is the knee, and life-threatening injuries are rare. Airborne rescue is very time-effective, however clinical studies with patient follow-up should be emphasized to determine the impact of airborne rescue on patient outcome. The present findings indicate that the duration of all rescue operations has been prolonged as a result of the introduction of safety measures during the COVID-19 pandemic.

Managing risk in ski resorts: Environmental factors affecting actual and estimated speed on signposted groomed slopes in a cohort of adult recreational alpine skiers

BACKGROUND

Certain weather conditions are clearly harmful, increasing the risk of injury of winter sports participants substantially. The objective of this study was to investigate actual speeds of skiers on signposted groomed slopes and to measure their skill to accurately estimate them with regard to environmental conditions such as visibility, sky cover, snow quality, wind and temperature.

METHODS

The data were obtained from a sample of 421 adult recreational skiers taking ski courses. The Pearson correlation coefficient was used to explore the relationship between actual and estimated speed for all participants. Multiple linear regression analysis was used to measure the effect of environmental conditions on both the skiers' actual speeds and their errors of estimation. Values of 0.05 or less were considered to indicate statistical significance.

RESULTS

The Pearson correlation coefficient between estimated and actual speed was 0.90 (P < 0.001). Skiers underestimated their actual speed on average by 13.06 km/h or 24.1%. Visibility, quality of snow and wind speed were shown to significantly affect both actual maximum speed and estimated speed. Good visibility, grippy snow and calm wind were associated with both the highest actual maximum speed and the lowest ability to estimate it.

CONCLUSION

Certain environmental conditions are associated with the actual speed at which skiers travel and with their ability to estimate it. Visibility, quality of snow and wind speed seem to influence both actual speed and the ability to estimate it while sky cover and temperature do not. A reinforced understanding of skiing speed on signposted groomed slopes is useful to gain insight into crashes and the mechanisms of resulting injuries, to evaluate means of protection and to devise successful prevention policies in ski resorts.

Injury prevention: Individual factors affecting adult recreational snowboarders' actual and estimated speeds on regular slopes

Speed is a main factor affecting the kinematic of snow-sports accidents and the degree of severity of the resulting injuries. The aim of this study was to measure on-slope actual maximum speeds of snowboarders and to assess their ability to accurately them with regard to individual factors such as gender, skill level, age and risk-taking behaviour and actual maximum speed. The data were obtained from a sample of 312 (67% male, 33% female) adult recreational snowboarders taking lessons in one of the major resorts in the Spanish Pyrenees. The Pearson correlation coefficient was used to investigate the relationship between maximal measured actual speed and estimated speed for all participants. Multiple linear regression analysis was used to estimate the impact of individual factors on both the snowboarders' actual maximum speed and their error of estimation. The Pearson correlation coefficient between estimated and actual maximum speed was 0.52 (P < 0.001) for all participants. They underestimated their actual maximum speed on average by 10.05 km/h or 28.62%. All assessed factors were shown to significantly affect the snowboarders' actual maximum speed. However, gender, skill level, age and actual maximum speed were shown to significantly affect the snowboarders' error of estimation, while risk-taking behavior did not. Gender, skill level, age and risk-taking behaviour are associated with the actual maximum speed at which snowboarders ride, while the same individual factors, except for risk-taking behaviour, and their snowboarding speed seem to affect the ability to estimate actual maximum speeds in adult recreational snowboarders. The ability to estimate actual speed accurately is an important factor to avoid accidents on ski slopes and, therefore, having snowboarders informed about the benefits of speed self-awareness is a key matter for prevention purposes.

Snowboarders' Knowledge of the FIS Rules for Conduct on Ski Slopes

The objective of the present study is to assess snowboarders’ general perceptions of safety and knowledge of existing rules and both active and passive knowledge of the International Ski Federation (FIS) regulations in order to contribute to defining target groups for specific educational interventions in the field of injury prevention. Data were drawn from random interviews conducted with 918 snowboarders during the 2017–2018 winter season at five ski resorts located in the Spanish Pyrenees. To collect the data, a questionnaire assessing personal characteristics (gender, age, origin, and self-reported skill), general perception of safety, general request for rules, and knowledge of existing rules was used. Pearson’s Chi-squared tests were performed to compare characteristics between groups. The study revealed, for accident prevention purposes, a concerning lack of general knowledge of existing rules. Risk-inducing situations that could result in severe injuries were largely assessed incorrectly. The appropriate intuitive behavior increases with age and experience: youths and beginners are less able to implement the FIS rules than older and more experienced snowboarders. Stakeholders, such as parents, ski resorts, clubs or schools, should direct educational efforts at high-risk groups. Further research is needed to determine the causal relation between snowboard-related injuries and disregard of FIS rules.

Injury Prevention: Freestylers' Awareness of FIS Code of Conduct for Snow Parks

The objectives of the present study were to assess general perceptions of safety in snow parks (SPs), general knowledge of rules existence, and both active and passive awareness of the International Ski Federation (FIS) rules contained in its Code of Conduct for SPs in order to define target groups for injury prevention-specific education interventions. Data were drawn from 436 freestylers randomly interviewed. The study was conducted during the 2018-2019 winter season in the SP of a major winter resort located in the Spanish Pyrenees. A questionnaire assessing personal data (gender, age, gear used, self-reported skill, and frequency of use), general perceptions on safety, general request for rules, and awareness of existing rules in SPs was developed. Chi-square goodness-of-fit tests were used to compare characteristics between groups. It was revealed, for accident prevention purposes, a concerning general lack of knowledge of existing rules in SPs (63% of participants ignored them). Risk-inducing situations that could result in severe injuries, such as familiarity with the right progression in choosing features and/or stunts or with safety equipment, were largely assessed incorrectly (94% and 70% of participants, respectively). Appropriate intuitive behavior increases with experience: youths and beginners are less able to implement FIS rules than more experienced freestylers.

Stimulating injury-preventive behaviour in sports: the systematic development of two interventions

Background

In addition to the beneficial health effects of being active, sports are also associated with a risk of sustaining injuries. To avoid the occurrence of sports injuries, preventive measures can be applied. The aim of the current article is to provide insight into the systematic developmental process of two evidence-based interventions designed to stimulate injury-preventive behaviour in runners and skiers, in which Intervention Mapping (IM) and Knowledge Transfer Scheme (KTS) are used as developmental protocols. However, the ultimate steps in the process are adjusted to meet requirements of the intervention and the target group.

Methods

Using a three-step process, we developed two interventions to stimulate injury-preventive behaviour in runners and skiers. Sports participants, sports experts and behaviour experts contributed throughout steps two and three of the developmental process.

Results

In step one we started with a problem statement in which we used information about the number and the burden of running-related and skiing-related injuries in the Netherlands. In step two, in-depth research was performed using four research strategies. During this step we tried to answer the following question: Which preventive measures or actions should be executed to prevent what injuries by whom, and how should we do that? A desk research/systematic review of the literature, expert meetings, target user surveys, and target user focus group meetings were conducted. In step three of product development, both interventions were developed. During the developmental process, co-creation sessions with target users were held. Before finalizing the interventions, pre-tests of the interventions were performed with target users.

Conclusions

Through a three-step approach, we developed two interventions to stimulate injury-preventive behaviour in runners and skiers. To develop an intervention that fits the needs of the target population, and will be used by them, it is necessary to involve this population as soon and as much as possible. Several steps in the IM and KTS protocols have thus been adjusted in order to establish an optimal fit between intervention and target group.

Snow groomer vehicle-related fatality: an illustrative case study of the importance of medicolegal involvement

This article describes and discusses an unusual case of an accidental death of a 29-year-old female snowboarder. A snow-grooming vehicle had run over her body after she accidentally fell down during a training ride. According to the official statement, the victim was probably under the influence of alcohol or drugs, and the snowboarder caused the accident because she did not respect the safety restrictions and collided with the snow vehicle. However, forensic pathologists offered different conclusions to the police to place the responsibility of the accident by observing the characteristics of the injuries and analyzing the autopsy results. Autopsy findings led to the suspicion that the injuries on her body were a consequence of running over of the vehicle without any modifications caused by hitting. A title and abstract review of recent articles worldwide over the past 2 decades indicates that there have been no case reports that have focused on snow groomer vehicle-related fatality with a description of the characteristics of the injuries. This case study particularly focuses on wound morphology caused by an uncommon mechanism that might help forensic practitioners.

The +1245g/t polymorphisms in the collagen type I alpha 1 (col1a1) gene in polish skiers with anterior cruciate ligament injury

Objectives

The aim of this study was to examine the association of +1245G/T polymorphisms in the COL1A1 gene with ACL ruptures in Polish male recreational skiers in a case-control study.

Methods

A total of 138 male recreational skiers with surgically diagnosed primary ACL ruptures, all of whom qualified for ligament reconstruction, were recruited for this study. The control group comprised 183 apparently healthy male skiers with a comparable level of exposure to ACL injury, none of whom had any self-reported history of ligament or tendon injury. DNA samples extracted from the oral epithelial cells were genotyped for the +1245G/T polymorphisms using real-time PCR method.

Results

Genotype distributions among cases and controls conformed to Hardy-Weinberg equilibrium (p = 0.2469 and p = 0.33, respectively). There was a significant difference in the genotype distribution between skiers and controls (p = 0.045, Fisher's exact test). There was no statistical difference in allele distribution: OR 1.43 (0.91-2.25), p = 0.101 (two-sided Fisher's exact test).

Conclusions

The risk of ACL ruptures was around 1.43 times lower in carriers of a minor allele G as compared to carriers of the allele T.