Reference | Date of publication | Study design | Location | Activity* | Mechanism of injury† | Age (years)‡ | Gender data | Most relevant statistic¶ |
Xiang et al22 | 2004 | Retrospective study | Colorado, USA | Skiing | 2/3 of all deaths were collisions | 7–17 | N/A | 67% of all skier deaths in children resulted from TBI |
Ambach et al3 | 1992 | Retrospective study | Innsbruck, Austria | Skiing | N/A | N/A | N/A | Head injury is the most common cause of death from 1987–1990, in the 20–35 age group |
Genelin et al32 | 1994 | Retrospective study | Innsbruck, Austria | Both | Increasing speed and increasing deceleration | N/A | N/A | From 1982–1992 there was an increasing incidence of head injuries |
Heim et al4 | 1993 | Retrospective study | Davos, SUI | Both | N/A | N/A | N/A | Injuries are increasing, but head injuries are the same %, at 3–5%, of all injuries from 1974 to 1993 |
Hagel et al14 | 2004 | Retrospective survey | Quebec, Canada | Both | Most common mechanisms for both was falls/jumps, 7% collisions | N/A | M 1671 injuries F 1141 injuries | Rate of head and neck injuries is 50% higher in snowboarders than in skiers |
Xiang & Stallones21 | 2003 | Retrospective study (death certificates) | Colorado, USA | Skiing | 65% collisions with other skiers or stationary objects | 32 | M 81% F 19% | 42.5% of skier deaths were due to head trauma |
Bridges et al26 | 2003 | Prospective study | Quebec, Canada | Both and snowblading | Snowboarders: 21% snowparks, 17.6% jumps | N/A | N/A | Concussions represented 9.6% of all injuries in skiers, 14.7% in snowboarders, and 5.7% in snowbladers |
Levy et al12 | 2002 | Retrospective study (trauma registry) | Colorado, USA | Both | 61% collisions 37% falls | Snowboarders 21.5 Skiers 27.8 | M 272 F 78 | 87.5% of all skiing and snowboarding deaths were head injuries |
Nakaguchi & Tsutsumi40 | 2002 | Prospective study | Nagano, Japan | Snowboarding | 58% falls 21% jumping 21% collisions | 24 | M 30 injuries F 8 injuries | Predominant features of snowboarding head injuries included: falling backwards (68% of injuries), occipital impact (66% of injuries), and on a gentle or moderate ski slope (76% of injuries) |
Hentschel et al25 | 2001 | Retrospective study (trauma registry) | BC, Canada | Both | Most common mechanism for both was falls | Snowboarders 22 Skiers 32 | N/A | Head injury rate in skiers was 0.005 per 1000 participants Head injury rate in snowboarders was 0.004 per 1000 participants Snowboarders had a higher rate of severe brain injury |
Fukuda et al17 | 2001 | Prospective study | Nigita, Japan | Both | Falls most common in both jumps: 30% snowboarders 2.5% skiers | Snowboarders 22.2 Skiers 25.8 | M snowboarders 63% F snowboarders 37% M skiers 51% | 6.33 head injuries per 100 000 snowboarder days 1.03 head injuries per 100 000 skier days Snowboarder head injury rate was 6.1 times higher than skier head injury rate |
Levy & Smith19 | 2000 | Retrospective review | Colorado, USA | Both | N/A | N/A | N/A | Head injuries accounted for 28.0% of all injuries in skiers compared with 33.5% in snowboarders |
Nakaguchi et al23 | 1999 | Prospective study | Nagano, Japan | Both | Snowboarders had higher rates of falls when jumping | Snowboarders 23 Skiers 23 | M snowboarders 103 F snowboarders 40 M skiers 94 F skiers 64 | 6.5 head injuries per 100 000 snowboarder days 3.8 head injuries per 100 000 skier days |
Young & Niedfeltd8 | 1999 | Retrospective analysis | Wisconsin, USA | Snowboarding | N/A | N/A | N/A | 9.2% of all snowboarding injuries are to the head |
Deibert et al6 | 1998 | Retrospective analysis (database) | Vermont, USA | Skiing | N/A | Adolescents | N/A | Incidence of head injuries increased from 5.7% to 8.9% Frequency of concussions increased from 2.8% to 4.8% (comparing 1986–87 and 1993–94 ski seasons) |
Macnab & Cadman24 | 1996 | Prospective study | BC, Canada | Both | Wearing helmets: 48% falls, 10% collisions No helmets: 29% falls, 20% collisions | N/A | N/A | Head injuries accounted for 22% of all injuries Face injuries accounted for 17% of all injuries |
Furrer et al18 | 1995 | Retrospective analysis | Interlaken, Switzerland | Skiing | 66% falls | N/A | N/A | The number of most severe head injuries from 1984 to 1992 increased from 11.6% to 19.3% |
Myles et al15 | 1992 | Retrospective analysis (coroner’s office) | Alberta, Canada | Skiing | 48% falls 27% collisions | 23.8 | Ratio M/F, 3:1 | TBI involved in 88 of 145 deaths |
*Skiing, snowboarding, or both.
†Falls, jumps, or collisions. Collision percentages were the sum of all types of collisions (including skier and object collisions).
‡Average or total number injured.
¶Incidence, prevalence, increased risk %.
F, female; M, male; N/A, not available; TBI, traumatic brain injury.