Personal and environmental factors in relation to injury risk in downhill skiing.

A case-control study was conducted among Dutch downhill skiers. This article presents data on the circumstances of the accident leading to injury and on personal and environmental risk factors for both cases (n = 572) and controls (n = 576). Most accidents (84%) happened on the pistes and ski lifts were involved in about 6% of them. Bad condition of the ski run (30%) and lost balance (24%) were the direct causes most frequently mentioned. Risk seemed to be constant for particular days and moments of the day. Injury risk for the individual appeared to rise with increasing duration of exposure, although very small durations had an elevated risk as well. A relatively low risk was observed for skiers who reported to be only moderately rested (OR = 0.4) and for those who admitted a certain fear of having a ski accident (OR = 0.6). A relatively high risk was observed for the presence of icy spots (OR = 1.4), while poor visibility (OR = 0.4), the presence of clouds (OR = 0.5), and perceived coldness (OR = 0.5) were associated with a relatively low injury risk. No recommendations for prevention can be based on these results. Most factors mentioned are not open to manipulation and further quantification should involve prospective study designs and independent measurements of these factors.