Recreational Snow-Sports Injury Risk Factors and Countermeasures: A Meta-Analysis Review and Haddon Matrix Evaluation

Abstract

Background

Snow sports (alpine skiing/snowboarding) would benefit from easily implemented and cost-effective injury prevention countermeasures that are effective in reducing injury rate and severity.

Objective

For snow sports, to identify risk factors and to quantify evidence for effectiveness of injury prevention countermeasures.

Methods

Searches of electronic literature databases to February 2014 identified 98 articles focused on snow sports that met the inclusion criteria and were subsequently reviewed. Pooled odds ratios (ORs) with 90 % confidence intervals (CIs) and inferences (percentage likelihood of benefit/harm) were calculated using data from 55 studies using a spreadsheet for combining independent groups with a weighting factor based on quality rating scores for effects.

Results

More experienced skiers and snowboarders are more likely to sustain an injury as a result of jumps, while beginners sustain injuries primarily as a result of falls. Key risk factors that countermeasure interventions should focus on include, beginner skiers (OR 2.72; 90 % CI 2.15–3.44, 99 % most likely harmful), beginner snowboarders (OR 2.66; 90 % CI 2.08–3.40, 99 % harmful), skiers/snowboarders who rent snow equipment (OR 2.58; 90 % CI 1.98–3.37, 99 % harmful) and poor visibility due to inclement weather (OR 2.69; 90 % CI 1.43–5.07, 97 % harmful). Effective countermeasures include helmets for skiers/snowboarders to prevent head injuries (OR 0.58; 90 % CI 0.51–0.66, 99 % most likely beneficial), and wrist guards for snowboarders to prevent wrist injuries (OR 0.33; 90 % CI 0.23–0.47, 99 % beneficial).

Discussion

The review identified key risk factors for snow-sport injuries and evaluated the evidence for the effectiveness of existing injury prevention countermeasures in recreational (general public use of slopes, not racing) snow sports using a Haddon’s matrix conceptual framework for injury causation (host/snow-sport participant, agent/mechanism and environment/community).

Conclusion

Best evidence for the effectiveness of injury prevention countermeasures in recreational snow sports was for the use of helmets and wrist guards and to address low visibility issues via weather reports and signage.

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Acknowledgments

Patria Hume, Anna Lorimer, Peter Griffiths, Isaac Carlson, and Mike Lamont declare that there are no competing interests associated with the research contained within this manuscript. The research was funded by the New Zealand Accident Compensation Corporation (ACC) Injury Prevention Group, a service group of ACC, and the Sports Performance Research Institute New Zealand (SPRINZ) of the Auckland University of Technology. According to the definition given by the International Committee of Medical Journal Editors, the authors listed above qualify for authorship based on making one or more substantial contributions to the intellectual content of the manuscript.

The opinions expressed are those solely of the authors and do not necessarily reflect those of the ACC, New Zealand.

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Hume, P.A., Lorimer, A.V., Griffiths, P.C. et al. Recreational Snow-Sports Injury Risk Factors and Countermeasures: A Meta-Analysis Review and Haddon Matrix Evaluation. Sports Med 45, 1175–1190 (2015). https://doi.org/10.1007/s40279-015-0334-7

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Keywords

  • Injury Prevention
  • Injury Risk
  • Knee Brace
  • Injury Risk Factor
  • Wrist Guard