title: Effect of trail design and grooming on the incidence of injuries at alpine ski areas.
abstract: OBJECTIVE
  To identify the conditions at certain sites on slopes known as black spots for injury.
  
  
  METHODS
  In the Hafjell and Voss alpine ski areas in Norway, 1410 skiing injuries were recorded from December 1990 through the 1996 season. In Hafjell, 183 of these injuries were plotted on an area map during the two first seasons. Similarly, in Voss, 214 injuries were plotted on an area map for two seasons. During the last three seasons in Hafjell, 835 ski injuries were related to 6712 snow grooming hours and 6,829,084 lift journeys.
  
  
  RESULTS
  The mean injury rate was 2.2 injuries per 1000 skier days, and the mean injury severity score (ISS) was 3.1. Accumulations of injuries at three sites (black spots) were recorded on the Hafjell area map. These injuries represented 40% of all injuries in the alpine area (p<0.05). Seven injury accumulation sites were recorded on the alpine area map of Voss, representing 22% of the total injuries (p>0.05). Grooming of the slopes was rated poor for the 49% of injuries that occurred at the sites of injury concentration and significantly different (27%) from injuries that occurred at random in Hafjell. The corresponding values in Voss were 50% and 25% respectively. Grooming hours appeared to be inversely proportional to the number of injuries: R = -0.99 (p<0.02). The mean ISS declined significantly in Hafjell over the observation period (p<0.001).
  
  
  CONCLUSIONS
  Inappropriate trail design and slope grooming seem to result in an accumulation of injuries at certain sites. Modification in construction and maintenance of the courses may reduce the number of injuries and mean ISS.
authors.affiliation: Orthopaedic Surgery and Sports Medicine, Voss, Norway. kjell.arne.bergstrom@c2i.net
authors.forename: K A
authors.initials: KA
authors.lastname: Bergstrøm
authors.forename: A
authors.initials: A
authors.lastname: Ekeland
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004779:Environment Design / Q000592:standards*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D012865:Skiing / Q000293:injuries*; D015599:Trauma Severity Indices