ArticleFrontiers in public health2026
Associated factors, nonlinear risk patterns and effect heterogeneity of severe injuries in recreational skiers and snowboarders.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
Background: Severe injuries in recreational alpine skiing and snowboarding impose disproportionate clinical and societal burden. Evidence on modifiable countermeasures beyond helmets remains fragmented and may vary across risk profiles and exposure conditions. This study aimed to identify factors associated with severe injuries among recreational skiers and snowboarders, and to examine nonlinear dose-response relationships and effect modification by preventive practices. Methods: We conducted a retrospective cross-sectional injury-severity study of injured adult skiers and snowboarders treated at resort medical clinics and emergency departments at two ski resorts in Zhangjiakou, China, across three winter seasons from 2021 to 2024. Severe injury was defined as an injury severity score (ISS) above 15. We modeled severe injury conditional on injury using Firth-penalized logistic regression. Restricted cubic splines were applied for age, body mass index, temperature, and snow depth to assess nonlinear associations. Prespecified interaction blocks were tested using joint Wald tests with false discovery rate control, and scenario-standardized impact metrics were estimated with bootstrap uncertainty. Results: Among 2,369 injured participants, 339 (14.3%) sustained severe injuries. In fully adjusted models, knee protector use (OR = 0.57, Conclusion: Severe outcomes among injured snow-sport participants reflect interacting exposure intensity, environment, and modifiable practices. Findings support risk-stratified prevention and condition-aware resort safety operations.
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