Behavioral Risk Factors for Ski Injury: Problem Analysis as a Basis for Effective Health Education

Abstract

A problem analysis dealing with the importance of behavioral risk factors for ski injuries is based on the results of a case-control study conducted among Dutch skiers. In this study, cases (N = 572) were a sample of those who filed insurance claims for medical costs incurred as the result of a ski injury that prevented them from skiing for more than one day. Controls (N = 576) were a sample of uninjured skiers who filed insurance claims for nonmedical reasons. Not taking ski lessons appeared to be a risk factor among beginners (odds ratio [OR] = 2.5; etiologic fraction [EF] = 12%). Failure of bindings to release is associated with a higher risk (OR = 3.2) for lower extremity injury, indicating that optimal binding adjustment can have a substantial preventive effect. Surprisingly, binding adjustment in the Netherlands more often involved the use of a test device compared to the ski resorts involved. In the latter case, the injury risk was higher (OR = 1.6; EF = 17%). From our data and the available literature, it can be concluded that alcohol consumption is probably not an important risk factor for ski injury. Several findings from our study seem to indicate that risk underestimation may be a risk factor for ski injury, but further study is necessary on this point. Taken together, the empirical basis for behavioral risk factors other than those mentioned above is still rather weak and thus a restrictive policy with respect to health education for downhill skiers would seem appropriate.

Risk Factors Associated With Alpine Skiing Injuries In Children

“…2, 5-7, 15, 20, 26, 27 It has been suggested that the development of a tailormade prevention program aimed at younger children (12 years and younger) would significantly contribute to the reduction of skiing injuries among this age group. 4,23 Systematic planning of a skiing injury prevention program includes analyzing the magnitude of the problem and the behavioral risk factors, studying behavioral determinants, designing an optimal intervention, and implementing the intervention. 23 For most sports, there seems to be a strong need for further research on the origins and determinants of behavior before effective prevention can be implemented.…”

“…At least two studies suggest that the risk of injury for children is increased by not having received any formal ski lessons, 10,32 whereas other studies have reported no difference. 4,31 Shealy et al 33 concluded that the rapid skill acquisition through lessons when not coupled with much skiing experience was not sufficient for reducing the injury rate. Garrick and Requa 14 argued that skiers appear to be in a paradoxical situation whereby they can ski more safely if they are better skiers, but rapidly gaining that expertise through lessons may mean an increase, although probably temporary, in injuries.…”

Myths Concerning Alpine Skiing Injuries

“…In the majority of studies done in North America and Europe, skiing lessons did not decrease the risk of personal injury 3,4,18,20,30,34,58. From the earliest studies18,30,58 to the present,3,4,20,34 researchers have shown that lessons are not an effective method for reducing injury risk.…”

“…In the majority of studies done in North America and Europe, skiing lessons did not decrease the risk of personal injury. 3 , 4 , 18 , 20 , 30 , 34 , 58 From the earliest studies 18 , 30 , 58 to the present, 3 , 4 , 20 , 34 researchers have shown that lessons are not an effective method for reducing injury risk. In contrast, Ekeland and colleagues have reported that ski instruction in Norway was associated with fewer injuries, when comparing an injured population with an uninjured control group.…”