A SLIPPERY SLOPE - Ski injuries decline, but fatalities hold steady

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Increased use of helmets and improvements in equipment have cut down on ski injuries. Reducing user error would make the sport even safer.

Shorter skis and helmets have helped decrease the rate of ski injuries over the last 10 years, but the average number of people who die on America's slopes every year has remained flat at about 40. Researchers say the nature of the fatal crashes makes it unlikely the deaths can be eliminated altogether.

According to the National Ski Areas Association, 25 skiers and 13 snowboarders died during the 2009-10 season out of 59.8 million skier/snowboarder days.

"It's a rare event, and it looks to me, based on our research, that this is something that is going to be very difficult to address because the deaths primarily are due to collisions with fixed objects, where somebody is going at a relatively high rate of speed," said Jasper Shealy, a professor emeritus at the Rochester Institute of Technology who has studied skiing and snowboarding injuries for 40 years.

Typically slope deaths involve males in their teens to late 40s who are intermediate or better skiers, wearing a helmet, and traveling at a high rate of speed when they lose control. Of the 38 who died last season, 30 were males.

"There's almost no margin for error. They hit a tree; and, unfortunately, they die," Shealy said, explaining that the forces generated by hitting a fixed object far outweigh the protection a helmet affords.

Despite high-profile cases such as that of actress Natasha Richardson, who died of head injuries after falling on a ski slope in 2009, the sport remains relatively safe.

For example, 900 Americans died bicycle riding; 3,600 drowned either swimming, playing in the water or falling in; and 39,000 died in motor vehicle crashes in 2008, while 46 died from lightning in 2007, according to the National Safety Council.

The best way to avoid injury on the slopes is to wear a helmet; ski or ride in control; be able to avoid objects and other skiers and snowboarders; and never test the effectiveness of the helmet, said Michael Berry, president of the National Ski Areas Association.

Skiers and riders also should follow what he calls a responsibility code, which includes stopping in safe places; looking uphill and yielding before going downhill or merging onto a trail; staying off closed trails; and knowing how to use lifts.

"For a sport that has the kind of adrenaline factor that skiing and snowboarding does, there isn't a corollary injury rate. ... I mean we're right down there with tennis," Berry said.

On paper, snowboarding appears to be more dangerous but less deadly. The injury rate is 50 to 70 percent higher than in skiing, Shealy said, which he suspects is because of the people doing it: Snowboarders tend to be young males.

While snowboarders get injured more often, the death rate is about one-third lower than in skiing. That snowboards don't release from the feet of the snowboarder is a likely explanation, Shealy said. When a rider falls, the edge of the snowboard drags on the snow and acts like a brake (reducing blunt force impact fatalities). But that also can cause fractures (increasing injuries), he said.

Overall, the rate of ski injuries has dropped by half since the late 1960s and early 1970s nationwide.

The broken lower legs of the 1970s are almost nonexistent, if a skier's binding is appropriately set, adjusted and well-maintained, Shealy said. The rate of midshaft tibial fractures has gone from a high of about 25 percent of ski injuries to about 1 percent.

"They were due to the failure of the ski to separate from a person at the appropriate time," he said.

In recent years, serious knee injuries, particularly ACL injuries, have declined by about 30 percent, the National Ski Areas Association said. The introduction of shorter skis is the likely reason.

"The mechanism is what we refer to as the 'phantom foot,' where it's the tail of the ski that exerts a force on the knee that the knee wasn't designed to accommodate. So as skis got shorter that lever arm got shorter and therefore less force," Shealy said.

In the last 10 years, head injuries have declined by 50 percent thanks to the increased use of helmets. But even though more than half of all skiers and snowboarders nationwide wear helmets, life-threatening head injuries such as skull fractures are still possible.

Behavior is the key, Berry said.

"People should wear helmets; they're important," he said. "But at the end of the day, they should ski and snowboard as though they were not wearing a helmet."

Reprinted with permission.