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 (SIE) in elite alpine ski racing.

Methods: Data recorded in the Austrian Ski Federation's Injury Surveillance System were used to analyse the SIE 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 SIE occurred. Generalised Estimating Equation for Poisson Regressions were applied.

Results: The SIE 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 SIE 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 SIE 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 SIE has increased over the last two decades.