Skiing and snowboarding injury prevention

Question 1

What percentage of Canadians over age 12yo participate in alpine skiing, cross country skiing, or snowboarding?

Answer 1

~15%

Question 2

What percentage of nonfatal outdoor recreational injuries requiring emergency care are due to snowboarding?

Answer 2

25%

Question 3

What percentage of hospitalizations are due to skiing?

Answer 3

12.6%

Question 4

What percentages of hospitalizations are due to snowboarding?

Answer 4

11.3%

Question 5

What percentages of hospitalizations are due to hockey?

Answer 5

3.6%

Question 6

What are the second-leading cause of sport and recreation-related injury hospitalizations in Ontario?

Answer 6

Skiing and snowboarding
18% winter
10% spring

Question 7

What is the risk of injury for skiers and snowboarders?

Answer 7

2-4 per 1000 participant days

Question 8

What is the risk of injuries requiring referral to a tertiary trauma center?

Answer 8

0.06-0.07 per 1000 participant days

Question 9

What is the most common cause of death, serious injuries, and significant disabilities sustained while skiing and snowboarding?

Answer 9

Head injuries

Question 10

What is the most common mechanism of injury due to skiing?

Answer 10

Collisions with stationary object such as trees and lift poles

Question 11

What is the most common mechanism of injury due to snowboarding?

Answer 11

Falling

Question 12

What are risk factors for skiing and snowboarding injuries in children?

Answer 12

1. Age - children and youth
2. Male
3. Less experience
4. Increased injury severity with greater skill level
5. Deficient binding adjustment
6. Rented or borrowed equipment
7. Inadequate grooming of trials
8. Poor facility design features
9. Inappropriate policies i.e overcrowding

Question 13

What are prevention strategies for skiing and snowboarding injuries in children?

Answer 13

1. Helmet
2. Wrist guards
3. Formal instruction (inconsistent)
4. Ski area safety programs
5. Alpine Responsibility Code

Question 14

What is the Alpine Responsibility Code?

Answer 14

Beginners should:

1. Take lessons from a certified instructor
2. Never ski or snowboard alone
3. Maintain and check ski and snowboard equipment
4. Exercise and stretch before each day of skiing/snowboarding
5. Stay on marked trails
6. Follow the skiers/boarders responsibility code
7. Be alert to physical and environmental hazards
8. Wear appropriate gear including helmets
9. Ski and snowboard on hills that are within your ability and skill level
10. Quit before becoming too tired

Question 15

What should physicians provide as office-based anticipatory guidance?

Answer 15

1. Wear proper protective ski equipment, including a certified helmet and goggles, plus wrist guards for snowboarding;
2. Receive formal instruction, followed by a graduated exposure to more challenging terrain and conditions under the supervision of an experienced participant;
3. Become familiar with and adhere to the Alpine Responsibility Code;
4. Ensure a safe environment, including adequate supervision, terrain/runs and equipment appropriate to the child or youth’s age and ability;
5. Ensure proper fit and adjustment of equipment, particularly bindings; and
6. Understand the high risk of severe injury that comes with alcohol and/or drug use on the slopes.

Question 16

What are the CPS recommendations for governments?

Answer 16

Governments should develop policy/legislation making helmet use mandatory by all ages while skiing and snowboarding, with concurrent messaging to educate the public and resort operators about the indisputable importance of helmets in saving lives and preventing head injuries.

Question 17

What are the safety policies ski areas/resorts/snowparks should develop and enforce?

Answer 17

1. Make helmet use mandatory;
2. Improve helmet access at local ski facilities;
3. Establish industry standards for ski shops and resorts on binding adjustment;
4. Promote and enforce the Alpine Responsibility Code;
5. Ensure safe design and prevention-oriented maintenance programs for ski facilities; and
6. Promote safety awareness and education programs for participants, with consistent messaging and signage.

Question 18

What are the CPS recommendations regarding schools?

Answer 18

Schools should develop policies mandating proper equipment use, formal instruction, and appropriate supervision for school-related trips, clubs and competitions.

Question 19

What research should be supported?

Answer 19

1. Interventions to increase helmet and wrist guard use;
2. Effective snow sport helmets and related design development and standards;
3. Improved binding design (eg, multidirectional release), standards and optimal adjustment;
4. The roles of preseason conditioning and training;
5. The risk and profile of injuries at ski area terrain parks;
6. The evaluation of existing interventions, such as promoting the Alpine Responsibility Code and “Keep your Lid On,” to determine their effectiveness and improve uptake;
7. Ongoing surveillance of snow sports participation data for children, of emergency department, hospitalization, and mortality data for skiers and snowboarders, of protective equipment use, and of injuries due to ski/snowboard environments, such as falls in terrain parks and injuries related to ski lifts.