Background Niseko, which is located north of Japan, becomes a famous ski resort for the best powder snow called as ‘JAPOW’ or ‘NISEPOW’. As the number of backcountry skiing’s popularity increased, accidents related skiing also did in Niseko.

Objective The purpose was to show the effort for the safety of skiers in Niseko and how to prevent and decrease the number of ski accidents in Japan.

Design Cross-sectional study.

Setting Field of Niseko skiing resort.

Patients (or Participants) Skiers and snowboarders who played in Niseko were subjected in this study.

Interventions (or Assessment of Risk Factors) Interview survey was carried out in Niseko. We investigated the number of injuries in Niseko ski resort and the situation of severe ski accidents in Japan.

Main Outcome Measurements The type, part, and cause of injury and the effort for preventing accidents in Niseko ski resort.

Results About 50 severe backcountry skiing injuries occur every year in Japan, and 20 of them were fatal. Severe injuries means head injury, back injury and suffocation. During 1985 and 2000, there were 9 skiing fatalities in Niseko every year. All fatalities were caused by avalanches. 8 fatalities were backcountry skiing. These Niseko ski resorts prohibited out of bounds skiing (‘Niseko Rule’). The Niseko Rule was promulgated in 2001. No fatalities have occurred since 2001 for backcountry skiing. Only 20% of skiers wear helmets in Japan, however approximately over 60% people wear the helmet.

Conclusions The unique point of the Niseko Rule is that Niseko resorts and the local community respect the freedom of mountain users and place a strong emphasis on the sage usage of the mountain. Ski Patrol checks the conditions of each ski resort for the boundaries of the Niseko Rule. Niseko resorts are increasing the rate of wear the skiing helmets. It was influenced by foreign tourist. It will contribute to skiing safety.