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Effect of environmental conditions on injury rates at a Colorado ski resort
  1. Lauren A Pierpoint1,
  2. Zachary Y Kerr2,
  3. Gary Grunwald3,
  4. Morteza Khodaee4,
  5. Tessa Crume1,
  6. R. Dawn Comstock1
  1. 1 Epidemiology, University of Colorado Denver–Anschutz Medical Campus, Aurora, Colorado, USA
  2. 2 Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
  3. 3 Biostatistics and Informatics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
  4. 4 Family Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
  1. Correspondence to Dr Lauren A Pierpoint, Epidemiology, University of Colorado Denver–Anschutz Medical Campus, Aurora, CO 80045, USA; lauren.pierpoint{at}


Objective To determine the effect of daily environmental conditions on skiing and snowboarding-related injury rates.

Methods Injury information was collected from a mountainside clinic at a large Colorado ski resort for the 2012/2013 through 2016/2017 seasons. Daily environmental conditions including snowfall, snow base depth, temperature, open terrain and participant visits were obtained from historical resort records. Snowpack and visibility information were obtained for the 2013/2014 through 2014/2015 seasons and included in a subanalysis. Negative binomial regression was used to estimate injury rate ratios (IRRs) and 95% CIs.

Results The overall injury rate among skiers and snowboarders was 1.37 per 1000 participant visits during 2012/2013 through 2016/2017. After adjustment for other environmental covariates, injury rates were 22% higher (IRR=1.22, 95% CI 1.14 to 1.29) on days with <2.5 compared with ≥2.5 cm of snowfall, and 14% higher on days with average temperature in the highest quartile (≥−3.1°C) compared with the lowest (<−10.6°C; IRR=1.14, 95% CI 1.03 to 1.26). Rates decreased by 8% for every 25 cm increase in snow base depth (IRR=0.92, 95% CI 0.88 to 0.95). In a subanalysis of the 2013/2014 and 2014/2015 seasons including the same covariates plus snowpack and visibility, only snowpack remained significantly associated with injury rates. Rates were 71% higher on hardpack compared with powder days (IRR=1.71, 95% CI 1.18 to 2.49) and 36% higher on packed powder compared with powder days (IRR 1.36, 95% CI 1.12 to 1.64).

Conclusions Environmental conditions, particularly snowfall and snowpack, have a significant impact on injury rates. Injury prevention efforts should consider environmental factors to decrease injury rates in skiers and snowboarders.

  • epidemiology
  • recreation / sports
  • sports / leisure facility
  • environmental modification

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Colorado Multiple Institutional Review Board (No 13-1730).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.