Risk Factors Associated with Serious Ski Patrol-Reported Injuries Sustained by Skiers and Snowboarders in Snow-Parks and on Other Slopes

Article excerpt

ABSTRACT

Background: Over the past years, the rate of injuries sustained at the alpine ski hills in Québec significantly increased. This raises concern over a possible increase in risk of severe injuries associated with snow-park use. The main objective of this study was to examine the severity of injuries sustained by skiers and snowboarders in snow-parks compared with other slopes from 2001 to 2005.

Methods: A case-control study design was used. Subjects were injured skiers and snowboarders who reported to the ski patrol with an injury. Two sets of severely injured cases were defined based on the type of injury and ambulance evacuation. Injured controls were those who did not sustain severe injuries. 50,593 injury report forms were analyzed. A logistic regression analysis was performed to relate the severity of injury to the type of slope used when the injury occurred. All analyses were controlling for age, sex, skill level, helmet use, season, and type of activity.

Results: There was evidence to suggest that, for skiers (adjusted OR = 1.36; 95% CI: 1.21- 1.53) and snowboarders (adjusted OR = 1.14, 95% CI: 1.05-1.23), participation in a snow-park increased the risk of being evacuated by ambulance. Severe injuries in skiers were also more likely to occur in snow-parks, but snowboarders had similar risk of severe injury in snow-parks and on other slopes.

Conclusions: These results provide evidence that the type of activities performed in snow-parks may increase the risk of sustaining a severe injury compared with participation on other slopes.

MeSH terms: Athletic injuries; snow sports; skiing; case-control studies; risk factors

Alpine skiing and snowboarding are two of the most popular winter sports in québec (population 7.5 million), with an estimated 995,000 participants, 83 stations in operation, and 6 to 7 million visits registered every season.1 unfortunately, from 1995 to 2000, the rate of injury increased from 0.91 to 1.36 injuries per 1000 outings in québec.2 there was also a steady increase in the rate of injury with younger age (12-17 years).2

The increase in the rate of injuries coincides with an increase in the number of ski areas where snow-parks are available, suggesting an association between these areas and increased risk.2-4 snowparks are specific areas of the slopes where terrain is modified to accommodate acrobatic maneuvers. Modules such as rails, boxes, tables, jumps or half-pipes can be found in snow-parks. the objectives of this investigation were to examine the associations between some risk factors and serious injuries, and the body region injured by skiers and snowboarders in snow-parks compared with other slopes.

METHODS

Data source

All subjects of this study were injured skiers and snowboarders who reported to the ski patrol at a ski station in québec with an injury sustained in a snow-park or another slope during the seasons from 2001-2002 to 2004-2005. the methods used for data collection respected the dispositions of two provincial statutes.5,6

The injury data were based on ski patrol reports. in québec, a law requires that every individual undergo a structured program of first aid education to qualify for the ski patrol and that all ski hills complete a standard injury report form when ski patrollers are asked to treat an injury.6

The ski areas are also required to send their ski patrol injury reports to the québec Ministry of education, leisure, and sport. although this requirement has been in place since 1988,6 not all ski hills comply every year. For this reason, and because not all skiing and snowboarding injuries get reported to the ski patrol,7-9 the number of injury reports received will underestimate the total number of injuries sustained at the québec ski stations.

Definitions

Cases

Two sets of cases based on the severity of the injury were defined: 1) those who suffered from a severe injury classified according to the type and body region of injury based on the opinion of emergency clinicians, as defined in table i;10 2) those evacuated by ambulance (evacuation by ambulance or medical referral has been used in other studies using ski patrol injury report data to define potentially severe injuries11-14). …