Original article

Are there risk factors in alpine skiing? A controlled multicentre survey of 1278 skiers

Rebecca Maria Hasler¹, Simon Dubler², Lorin Benneker^3,*, Simeon Berov⁴, Jonathan Spycher⁴, Dominik Heim⁵, Heinz Zimmermann⁶, Aristomenis Konstantinos Exadaktylos¹

¹ Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland;
² Department of Emergency Medicine, Inselspital Bern, Switzerland;
³ Department of Orthopedica Surgery, Inselspital Bern, Switzerland;
⁴ Department of Orthopedic Surgery, Spital Interlaken, Switzerland;
⁵ Department of Surgery, Spital Frutigen, Switzerland;
⁶ Department of Emergency Medicine, Switzerland

Correspondence to: Lorin M Benneker, Department for Orthopaedic Surgery, Inselspital, University of Bern, Frreiburgstrasse, Bern, 3010, Switzerland; lorin.benneker{at}insel.ch

Accepted 30 September 2009

Objectives: Analyse risk factors in alpine skiing.

Design: A controlled multicentre survey of injured and non-injured alpine skiers. SETTING: One tertiary and two secondary trauma centres in Bern, Switzerland.

Patients and methods: All injured skiers admitted from November 2007 - April 2008 were analysed with a completed questionnaire incorporating 15 parameters. The same questionnaire was distributed to non-injured controls. Multiple logistic regression was performed. Patterns of combined risk factors were calculated by inference trees. A total of 782 patients and 496 controls were interviewed.

Results: Parameters significant for the patients: High readiness for risk (p=0.0365,OR 1.84,CI 1.04–3.27), low readiness for speed (p=0.0008,OR 0.29,CI 0.14–0.60), no aggressive behaviour on slopes (p<0.0001,OR 0.19,CI 0.09-0.37), new skiing equipment (p=0.0228,OR 59,CI 0.37–0.93), warm-up performed (p=0.0015,OR 1.79,CI 1.25–2.57), old snow compared to fresh snow (p=0.0155,OR 0.31,CI 0.12–0.80), old snow compared to artificial snow (p=0.0037,OR 0.21,CI 0.07–0.60), powder snow compared to slush snow (p=0.0035,OR 0.25,CI 0.10–0.63), drug consumption (p=0.0044,OR 5.92,CI 1.74–20.11) and alcohol abstinence (p<0.0001,OR 0.14,CI 0.05–0.34). Three groups at risk were detected: (1) warm-up 3-12min., VASspeed >4 and bad weather/visibility, (2) VASspeed 4-7, icy slopes and not wearing a helmet, (3) warm-up >12min. and new skiing equipment.

Conclusions: Low speed, high readiness for risk, new skiing equipment, old and powder snow as well as drug consumption are significant risk factors when skiing. Future work should aim at more precise identification of specific groups at risk and at developing recommendations, e.g. a snow-weather index at valley stations.

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