• Bernhard Rainer, Christian Frimmel, Guenther Sumann, Hermann Brugger, Johann F Kinzl, and Wolfgang Lederer.
• Department of Anaesthesiology and Critical Care Medicine, Division of Psychosocial Medicine, Innsbruck Medical University, Innsbruck, Austria.
• Eur J Emerg Med. 2008 Feb 1; 15 (1): 43-7.

ObjectiveWe investigated whether frequency of avalanche accidents corresponds with the danger assessment given in avalanche hazard tables and with topographic factors of the avalanche origin.MethodsA retrospective review of official avalanche surveillance data and of medical reports from helicopter-based emergency medical systems was conducted.ResultsMost victims involved in avalanche accidents are ski tourers and off-piste skiers, about 90% are male, and age ranges from 10 to more than 70 years. Sixty-seven percent of accidents occurred when moderate and considerable danger was forecast. In 94.0% of accidents avalanches were triggered by victims themselves or by nearby recreationists; 32.6% of avalanche slides occurred on extremely steep slopes at gradients exceeding 40 degrees . Overall incidence of accidents before noon was 25.0%. Professional stand-by avalanche parties significantly contributed to rescuing avalanche victims, but the chance of survival is diminished when arrival was delayed. All patients who were able to free themselves from avalanche burial survived. Of those rescued by companions, 78.0% survived compared with only 10.0% of those rescued by organized rescue teams (P<0.001).ConclusionFrequency of avalanche emergencies associated with outdoor leisure activities does not correspond with the danger forecast in avalanche hazard bulletins. There is need of a modified and regionally adjusted grading that makes allowance for experience and individual behavior of recreationists going in for backcountry leisure activities.

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