Background Alpine skiing and snowboarding have a substantial risk of injuries, but precise risk factor estimates are limited.

Objective To determine the risk factors among skiers and snowboarders.

Study design Case-control study.

Methods Ski patrols reported cases (N=3277) in eight major Norwegian alpine resorts. Injury type and risk factors (age, gender, nationality, skill level, equipment, helmet use, ski school attendance, rented or own equipment) were recorded. An uninjured control group (N=2992) was obtained at the same resorts. A multivariate logistic regression analysis was used to assess the relationship between individual risk factors and risk of injury.

Results The overall injury risk was increased among beginners (OR 2.72; 2.12 to 3.47), children (OR 1.72; 1.41 to 2.13), adolescents (OR 2.16; 1.72 to 2.66) and non-Nordic skiers (OR 1.80; 1.37 to 2.36). Snowboarders had a higher overall injury risk than skiers (OR 2.11; 1.81 to 2.46). Alpine skiers (OR 2.65; 1.47 to 4.80), beginners (OR 2.50; 1.61 to 3.85), children (OR 11.1; 6.7 to 20.0) and adolescents (OR 4.17; 2.44 to 7.14) were prone to lower leg fractures. Knee injuries occurred more frequently among alpine skiers (OR 1.82; 1.39 to 2.38), females (OR 1.67; 1.38 to 2.03) and beginners (OR 3.13; 2.50 to 3.85). Males (OR 1.85; 1.45 to 2.38), telemark skiers (OR 1.70; 1.30 to 2.23), children (OR 2.22; 1.37 to 3.57) and adults (OR 1.64; 1.11 to 2.37) had an increased risk for shoulder injuries.

Conclusions Snowboarders, beginners, children and adolescents had an increased injury risk.