Mortality in Different Mountain Sports Activities Primarily Practiced in the Winter Season—A Narrative Review

Abstract

Annually, millions of people engage in mountain sports activities all over the world. These activities are associated with health benefits, but concurrently with a risk for injury and death. Knowledge on death rates is considered important for the categorization of high-risk sports in literature and for the development of effective preventive measures. The death risk has been reported to vary across different mountain sports primarily practiced in the summer season. To complete the spectrum, the aim of the present review is to compare mortality rates across different mountain sports activities primarily practiced in winter. A comprehensive literature search was performed on the death risk (mortality) during such activities, i.e., alpine (downhill) skiing, snowboarding, cross-country skiing, ski touring, and sledging. With the exception of ski touring (4.4 deaths per 1 million exposure days), the mortality risk was low across different winter sports, with small activity-specific variation (0.3–0.8 deaths per 1 million exposure days). Traumatic (e.g., falls) and non-traumatic (e.g., cardiac death) incidents and avalanche burial in ski tourers were the predominant causes of death. Preventive measures include the improvement of sport-specific skills and fitness, the use of protective gear, well-targeted and intensive training programs concerning avalanche hazards, and sports-medical counseling for elderly and those with pre-existing diseases.

Editorial on the Special Issue on “Mountain Sports Activities: Injuries and Prevention”

“…Thus, the prevention of such events is of utmost importance. Four studies (two reviews and two original papers) focused on available data on the death risk when performing mountain sports primarily practiced during the winter [ 1 , 2 ] or the summer season [ 3 , 4 ]. With the exception of ski touring the death risk turned out to be low across different winter sports (0.3–0.8 deaths per 1 million exposure days).…”

“…Traumatic events like falls were predominant causes in climbers and downhill skiers, avalanche burial and/or high-altitude illness in ski tourers and in high-altitude climbers, and non-traumatic events like sudden cardiac death in sports with high participation of older individuals (downhill and cross-country skiing, and hiking). Whereas insufficient mountaineering skills and/or preparation, and overestimation of their own capabilities were considered as major reasons for traumatic deaths, avalanche burial, and high-altitude illness, lack of physical fitness and pre-existing diseases seem to be associated with non-traumatic (cardiovascular) deaths [ 1 , 3 ]. Unfortunately, information on the number of persons at risk, on environmental conditions, and on individual characteristics associated with the accident/emergency are often lacking, but would be important for proper risk calculations.…”

Mountain Rescue in Non-Profit Organizations: Interdisciplinary Research Spectrum in Mountain Tourism

“…M. Niedermeier, H. Gatterer, E. Pocecco and co-authors stated on the basis of comprehensive preliminary literature research that the main causes of death during alpine (downhill) skiing, snowboard, cross-country skiing, ski tourism and sledging were traumatic incidents (fall with fracture) and non-traumatic incidents (heart stroke) as well as avalanche suffocation. In their opinion, preventive measures should include improving sports skills and fitness, the use of protective equipment, information technologies, well-targeted and intensive training programs on avalanche threats and, last but not least, sports and medical counseling (Niedermeier, Gatterer, Pocecco, Frühauf, Faulhaber, Menz, Burtscher, Posch, Ruedl, and Burtscher, 2019).…”

Sudden Cardiac Death Risk in Downhill Skiers and Mountain Hikers and Specific Prevention Strategies

“…Mountain sports possess inherent risks due to objective hazards like rock and ice falls, avalanches, lightnings, etc. but also related to subjective reasons like inflated self-esteem, insufficient sport-specific skills and/or physical fitness [ 5 , 6 ]. For instance, the level of individual physical fitness needs to be much higher for uphill walking in the mountains, often with heavy boots and additional load (rucksack), compared to level hiking [ 7 ].…”

“…However, the large proportion of SCDs contributing to the total number of deaths during mountain sports is somewhat surprising [ 9 ]. Indeed, 50% of all deaths during downhill skiing and mountain hiking are SCDs, unfavorably impacting the risk-benefit ratio of these activities [ 5 , 6 ]. Appropriate preventive measures are urgently needed to reduce risk of SCD and to optimize beneficial effects of exercise when skiing and/or hiking in the mountains.…”