Key Points - Between the seasons 1997 and 2020, the seasonal incidence of severe in-competition injury events (SIEcomp) per 1000 runs increased by a factor of 2.67 for elite alpine ski racers and 3.53 for the subgroup of World Cup racers. - The overall incidence of SIEcomp per 1000 runs was 1.48 (95% CI 1.26-1.73); in downhill it was 2.75 (95% CI 2.18-3.47), in super-G 1.94 (95% CI 1.30-2.88), in giant slalom 1.40 (95% CI 1.06-1.85), and in slalom 0.64 (95% CI 0.43-0.96). - Despite the introduction of many preventive measures—particularly in FIS Alpine Ski World Cup competitions—our results revealed a still rising risk of SIEcomp, calling for further efforts by all stakeholders (i.e. ski federations, equipment suppliers, researchers) to search for causes for the ongoing incidence increase and develop effective measures for injury prevention.
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