title: Changes in Skiing and Snowboarding Injury Epidemiology and Attitudes to Safety in Big Sky, Montana, USA: A Comparison of 2 Cross-sectional Studies in 1996 and 2013.
abstract: BACKGROUND
  Despite a risk of harm, the past 20 years have seen dramatically increased participation in snow sports such as skiing, and particularly, snowboarding. This period has also seen revolutions in piste maintenance and paradigm developments in the use of safety equipment. Consequently, the numbers and characteristics of injury may be very different from those traditionally quoted.
  
  
  OBJECTIVE
  To compare and evaluate the injury patterns among skiers and snowboarders in a North American ski resort in 1996 and 2013.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  Questionnaire-based cross-sectional studies were carried out independently in a North American ski resort between the dates of March 6 and April 11 in both 1996 and 2013. Demographic data and information about incident circumstances were collected from injured patients who visited the local on-site clinic. Data were compared statistically to assess for significant changes in injury characteristics between the 2 time periods.
  
  
  RESULTS
  The 1996 report consisted of 148 injured participants, and the 2013 study included 156 participants. Results from 2013 demonstrated significant increases in helmet use, the number of snowboarders injured, and shoulder injuries. Injury was also more likely in those aged 46 to 55 years, those never having had professional instruction, or those with rented equipment. Significant reductions were seen in those injured with other people close by and in the 36- to 45-year age group. Overall, the knee was the most commonly injured body part in both periods (1996: 31%, n = 38; 2013: 33%, n = 36), although upper limb injuries were predominant in snowboarders.
  
  
  CONCLUSIONS
  Snow sports injury characteristics of patients presenting to a ski resort medical clinic have changed between 1996 and 2013. These findings can be used to further inform safety recommendations and areas to target with further research.
authors.affiliation: University of Aberdeen Medical School, Aberdeen, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Patrick
authors.affiliation: University of Aberdeen Medical School, Aberdeen, UK. ; Emergency Department, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Jamie G
authors.initials: JG
authors.lastname: Cooper
authors.affiliation: Big Sky Medical Clinic, Big Sky Ski Resort, Big Sky, Montana, USA.
authors.forename: Jeff
authors.initials: J
authors.lastname: Daniels
keywords: skiing injuries; snow sports; snowboarding injuries