Collisions against obstacles (CAOs) on ski areas account for a large proportion of deaths of skiers and snowboarders but are poorly documented. We aimed to characterize the risk factors and injuries of CAOs and to compare occurrences of CAOs with 2 control groups.

Between 2015 and 2019 in France, data were collected on the injured population by ski area doctors and ski patrollers. Systematic counts were also made to describe the noninjured population on ski slopes. Cases (CAOs injured: 3391 victims) were compared with 2 controls (non-CAOs injured: 198,302 victims and the noninjured population: 121,227 people). Crude and adjusted logistic regressions were performed (P<0.05).

Males, highly skilled participants, skiers, and people aged <26 y had higher risks of being injured after a CAO than a non-CAO. Moreover, CAOs more frequently occurred off-slopes and on very easy slopes; lifts were more often involved. Injuries to the head and neck and trunk were more likely to occur after CAOs than non-CAOs. Medical helicopters were more often used for CAOs than non-CAOs. Compared with the noninjured population, no age, sex, or sport group appeared clearly at risk of CAOs.

Typical victims of CAOs are males, skiers, young people, and highly skilled participants. This population was previously identified for moving fast on the slopes and having risk-seeking behavior, putting them at risk of high-energy accidents. There is a need for adequate prevention, such as awareness campaigns, and protection, such as individual device and padding on obstacles, that focus on protecting against injuries to the head, neck, and trunk.