INTRODUCTION: Alpine skiing and snowboarding have become the most popular winter sports world-wide. About 8 million skiers and snow boarders alone visit the Austrian Alps annually and complete more than 500 million ski lift transports. Although the annual death risk (0.7 deaths per 100.000 skiers) and the injury risk (2-4 injured persons per 1000 skier days) are low, the total number is high because of the huge population at risk (1,2). More than 90 % of all accidents are caused by a fall not induced by other skiers. Only little Information is available about causes for falling. Thus, the main goal of the study was the identification of risk factors responsible for falls during downhill skiing and snowboarding. METHODS: To obtain representative data on the frequency and conditions of falls, inquiries were carried out on 5 occasions during one winter season in 5 ski areas in Austria. About 2000 skiers and snowboarders were interviewed by a standardized questionnaire. Less than 1 % refused to answer the inquiry. Data were collected on demographic characteristics, environmental conditions, and the number of preceding falls on the day of the inquiry. Conditional logistic-regression analysis was used to estimate adjusted odds ratios (OR) and their 95 % confidence intervals (Cl) for fall outcome in skiers and snowboarders. The final regression model included age, gender, regular physical activity, smoking, alcohol consumption on the skiing day, skiing skills, types of preferred slopes, preferred velocity of skiing, altitude, snow and weather conditions. RESULTS: A total of 1607 downhill skiers and 373 snowboarders were recorded. 29 % of the skiers and 71 % of the snowboarders reported at least 1 fall. The preceding duration of skiing on the day of the inquiry was about 3 hours for skiers and snowboarders as well. Logistic-regression analysis revealed that altitude above 2000 m (OR: 1.6; Cl: 1.2-2.2), poor skiing skills (1.5; 1.2-1.9), alcohol consumption (1.4; 1.1-1.9), smoking (1.4; 1.1-1.8), high speed skiing (1.4; 1.1-1.8), soft snow conditions (1.3; 1.0-1.7), and age (0.8; 0.7-0.8) were predictive for fall outcome during downhill skiing. The variables alcohol consumption (3.7; 1.8-7.7), high speed boarding (1.8; 1.1-2.9), and age (0.6; 0.4-0.8) were predictive for fall outcome during snow boarding. DISCUSSION: Although a fall does not mean injury, falls are the overwhelming causes for injuries during skiing and snowboarding (1,2). Therefore, the reduction of the incidence of falling would mean reduction of injuries. Our findings demonstrate that some easy modifiable factors would markedly reduce the frequency of falls and likely also the frequency of injuries. For both, downhill skiers and snowboarders the most important factors are alcohol consumption and high speed skiing.
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