Acute on-snow severe injury events in elite alpine ski racing from 1997 to 2019: the Injury Surveillance System of the Austrian Ski Federation.

OBJECTIVES: The study aimed to (1) determine the incidence and gender-specific risk ratio of acute on-snow severe injury events (SIE) in elite alpine ski racing, (2) examine the development of SIE over 22 seasons, and (3) analyse SIE with respect to the severely injured body parts and structures. METHODS: Data recorded in the Austrian Ski Federation's Injury Surveillance System over 22 seasons were analysed. The Austrian Ski Team consists of four groups: Team National (n=477), Team A (n=444), Team B (n=696) and Team C (n=608). Team National and Team A comprised World Cup, Team B European Cup and Team C junior alpine ski racers. Simple and multiple Poisson regressions were calculated. RESULTS: The SIE incidence was 15.7 (95% CI 14.2 to 17.5) per 100 skier seasons. ACL injury events accounted for 70.8% of severe knee injury events and 48.6% of SIE. The incidence of severe ACL injury events was 7.6 (95% CI 6.6 to 8.9). Female World Cup alpine ski racers had a 1.65 times (95% CI 1.02 to 2.69) higher risk of severe ACL injury events than their male counterparts. CONCLUSION: The incidence of acute on-snow SIE in World Cup alpine ski racing was higher than previously reported. Despite various prevention efforts, the average seasonal incidence of SIE in World and European Cup alpine ski racers has grown from approximately 11 in 1997 to 23 in 2019; thus with roughly one more injured athlete every second season.

In-Competition Severe Injury Events in Elite Alpine Ski Racing from 1997 to 2020: The Case of the Austrian Ski Team.

BACKGROUND: To increase safety in elite alpine ski racing Injury Surveillance Systems were implemented and preventive measures introduced. However, studies analysing the change in athletes' injury risk by controlling for their exposure are still scarce. OBJECTIVES: This study aimed to describe and analyse the risk of in-competition severe injury events (SIEcomp) in elite alpine ski racing. METHODS: Data recorded in the Austrian Ski Federation's Injury Surveillance System were used to analyse the SIEcomp incidence. Information on athletes' competition exposure was obtained from the official website of the International Ski Federation. In 23 seasons, 2333 skier seasons were recorded for the Austrian Ski Team. Within a total of 114,531 runs 169 SIEcomp occurred. Generalised Estimating Equation for Poisson Regressions were applied. RESULTS: The SIEcomp incidence per 1000 runs was 1.48 [95% confidence interval (CI) 1.26-1.73] for elite alpine ski racers and 2.21 (95% CI 1.79-2.75) for the subgroup of World Cup racers. A significant sex difference was detected for the subgroup of junior racers with a higher risk for female athletes [risk ratio (RR): 2.97, 95% CI 1.46-6.05]. Between the seasons of 1997 and 2020, the seasonal SIEcomp incidence increased by a factor of 2.67 for elite alpine ski racers and 3.53 for World Cup racers. Downhill (2.75, 95% CI 2.18-3.47) had the highest SIEcomp incidence, followed by super-G (1.94, 95% CI 1.30-2.88), giant slalom (1.40, 95% CI 1.06-1.85), and slalom (0.64, 95% CI 0.43-0.96). CONCLUSION: Although many preventive measures have been implemented in elite alpine ski racing, the risk of SIEcomp has increased over the last two decades.

Did injury incidence in alpine ski racing change after equipment regulations? An evaluation based on the injury surveillance system of the Austrian Ski Federation.

OBJECTIVES: To assess the effects of alpine competition equipment regulations from 2003, 2007 and 2012 on severe injury incidence. DESIGN: Case study METHOD: Data originated from records of the injury surveillance system of the Austrian Ski Federation. Injuries from the seasons 2001-2017 were divided in four periods between the equipment regulations. For comparison of consecutive periods, risk ratios (RR = later period / preceding period) with 95% CI were calculated. Total severe injury events, events with severe knee injuries, and events with severe ACL injuries were separately investigated. RESULTS: A significant increase of total severe injury incidence was found after the equipment regulation in 2003 (RR1.52, 95% CI 1.00-2.31). None of the other comparisons revealed significance (p<0.05) or statistical trends (p<0.1). Only the minority (40%) of the RR showed a reduction in the injury incidence of the Austrian Ski Team (lowest RR 0.78). 60% of the RR increased after the regulations (highest RR 1.63). CONCLUSIONS: Even though statistical uncertainties remain, our findings allow the conclusion, that the implemented equipment regulations did not cause a noticeable reduction of injuries. The three analysed equipment regulations were not appropriate or were counteracted by other factors.