In areas of North America where snow covered the ground for many months, a motorized means of transportation was a necessity to move supplies and people, and for emergencies. The first motorized sleds date to the 1920s with the first patent attributed to Carl Eliason of Sayner, Wisconsin in 1927. 26 During the next 30 years, additional development and refinement of the motorized sled continued. Joseph-Armand Bombardier introduced today’s modern snowmobile, the Ski Doo, in 1958. Since then, growth in the use of personal snowmobiles has refashioned the winter recreational sport scene. 26
Currently, 4 million snowmobiles are registered in the United States and Canada. Approximately 2.3 million owners consider snowmobiling a family sport. 10 More than 50% of the snowmobiles in the United States are registered in Michigan, Wisconsin, and Minnesota. 14 Each sled travels an average of 1100 miles per season over 225,000 miles of groomed trails, as compared with the automobile that averages 12,600 miles per year. 10 Each year, $9.4 billion is spent on the sport and snowmobiling has become a major component of the winter tourism dollar for the Snow Belt areas of North America. 10
In 1998, the economic impact on New York State was $476 million whereas in Michigan more than $1.3 billion was spent on snowmobile-related activity. 1
As the popularity of the sport has grown, so have the number of injuries and deaths. The modern snowmobile can reach speeds in excess of 90 mph. Stopping distances can be significant: at 15 mph, the stopping distance is 52 feet and at 45 mph, the stopping distance is 272 feet. 12 When reviewing injury and mortality data, speed, alcohol, and inexperience are a common theme. Most commonly, accidents occur when an operator loses control of a sled by either rolling over, hitting fixed objects, colliding with a motor vehicle or another sled, or by submersion in icy lakes.
Examination of snowmobile mortality data from the states and provinces of North America confirm that more than 200 people die each year from snowmobile-related accidents. An additional 14,000 people present to hospital emergency departments with snowmobile-related injuries. 14 Unfortunately, injury statistics reported by state agencies are understated significantly. With the popularity of snowmobiling increasing, these statistics on the number of injuries and deaths are expected to rise considerably.
The 3000 snowmobile clubs in North American actively promote safety and fun. These clubs usually have the responsibility for trail maintenance providing groomed trails free of obstacles, with signage and away from ice. Only 15% of accidents occur on groomed trails where 80% of the snowmobile riding takes place. 2
Injury and Mortality Data
Snowmobile fatality statistics, in contrast to injury data, are well-documented by the states and provinces of North America. Mortality reports include use of alcohol, speed, gender, age, and accident details. Estimated injury numbers are notably underreported because not every injured snowmobiler presents to a hospital emergency department or urgent care facility. The injury may go unrecorded because no care was sought or care was furnished in a physician’s office and therefore not reported to any governmental agency. In Wisconsin, statewide snowmobile injury statistics are not recorded. During the past 10 years, eight states and three Canadian provinces have recorded and reported injury and mortality data. Although the databases are not identical, some common threads are observed.
Alaska reported data from 1993 through 1994. Twenty-six people died and 238 people were admitted to a hospital, usually with lower extremity fractures. Fifty-eight percent of the injuries and deaths happened as a result of colliding with a fixed object. Of those deaths, where blood alcohol levels were recorded, 65% had a blood alcohol level greater than 0.1%. 23
The Center for Disease Control, in a weekly mortality bulletin, reported that between 1991 and 1996, 1355 snowmobile accidents causing 903 injuries and 39 deaths were recorded in the state of Maine. 6 The data confirmed that 86% of the injured were males. The mechanism of injury varied with 23% falling off the sled, 22% colliding with another sled, 15% hitting a tree, 14% colliding with a natural object, and 3% striking a motor vehicle.
Speed was involved in 80% of the accidents. Alcohol, when samples were taken, could be documented in 13% of accidents and in 41% of the fatalities. Of the injuries reported, 32% were fractures, 10% were lacerations, 4% were concussions, and 7% were contusions.
The Law Enforcement Division of the Michigan Department of Natural Resources reviewed their snowmobile accident mortality data for the 2000 to 2001 season. During this season, 39 snowmobilers were fatally injured. Eighty-two percent of the accidents were the result of striking a fixed or moving object and alcohol was implicated in 56% of the fatalities. 22
Snowmobile accident reports have been reviewed from 1994 to 1999. Two thousand eight hundred fifty-one snowmobile accidents were reported, with 113 resulting in death (15 by drowning and 39 by striking a fixed object). Of all the accidents reported, 1231 were a collision with a fixed object, 738 were a collision with a moving object, 139 were submersions, and 267 were sled rollover. 20
Additional reporting on snowmobile accidents in Minnesota done by the Department of Natural Resources for 1999 through 2000, found that 315 snowmobile accidents were reported with 10 deaths. The causes for injury and deaths remained unchanged from prior data. 21
For 1988 through 1996, Beilman and associates 4 collected snowmobile injury data from three Minnesota trauma centers. Their review included 274 patients with an average age of 29 years. Helmets were used by 35% of the injured; alcohol was involved in 44%; and speed greater than 55 mph was involved in 26% of cases. Most injuries occurred by colliding with a fixed object, either a natural obstacle or manmade barrier.
Ten of these 274 patients died from injuries sustained in the snowmobile accident. The injuries included: 184 fractures, 92 serious head injuries, 88 facial fractures or soft tissue injuries of the head and neck, 80 chest injuries, 50 spine injuries, 41 abdominal injuries, and 31 pelvic fractures. Most of the injured had multisystem trauma. Beilman et al 4 concluded that snowmobile injuries were similar to those sustained in motorcycle accidents.
Newfoundland and Labrador
Hamdy et al 9 retrospectively reviewed the snowmobile accident experience in northern Newfoundland and Labrador. Hospital charts were reviewed on 310 patients injured from 1969 through 1986. Collisions or falling off the sled accounted for 57% of the accidents. Twenty-eight percent of the patients sustained head and neck trauma and an additional 43% of patients incurred lower extremity injuries. Only 10% of the accident victims were wearing helmets.
The Center for Disease Control reported that 165 nonfatal injuries and 12 deaths were recorded in New Hampshire from 1989 through 1992. Excessive speed and alcohol were recorded in 67% of these fatalities. 13
The office of Parks, Recreation and Historic Preservation in New York State reported 361 accidents during the 1998 through 1999 snowmobile season. 15 Accident data included: 157 sleds colliding with a fixed object; 50 sleds colliding with a moving object; eight submersions; and 50 snowmobiles overturning. Sixteen of the 17 deaths involved men between 20 and 40 years. Speed was involved in 11 fatalities and alcohol was involved in seven of those fatalities.
Of the 340 injuries sustained, there were 97 fractures or dislocations, 30 contusions, and 15 concussions reported.
A review of snowmobile-related trauma by James et al 11 at the University of North Dakota School of Medicine revealed that 88 people were admitted with snowmobile injuries. Nineteen percent of these snowmobile operators were younger than 16 years and most had multisystem trauma including 106 fractures. Three of the 88 people had fatal injuries. Again, causes attributed to the accidents were operator inexperience, use of alcohol, excessive speed, and driver carelessness.
In the province of Ontario from 1997 through 1998, 42 deaths occurred as a direct result of snowmobile accidents. 16 Death ensued from hitting a fixed object in 20 accidents, hitting a motor vehicle in four accidents, rolling over in two accidents, drowning in 11 accidents, hitting another sled in three accidents, striking a wire in one accident, and being struck by a falling tree in one accident. Most of the fatalities occurred in males younger than 30 years and excessive speed or problems with judgment were considered as the cause of the accident.
The 1999 through 2000 snowmobile season in Wisconsin had 200,000 registered sleds traveling on 25,000 miles of groomed trails. The Wisconsin Department of Natural Resources recorded 38 snowmobile deaths with 22 the result of a collision with a fixed object. In 23 of the 38 fatalities, excessive speed was identified as a significant cause of the accident. All the fatalities were in males and six males had excessive alcohol levels. 24 For the year 2000 through 2001, snowmobile accidents took the lives of 26 males (data current to March 14, 2001). Again, collision with a fixed object was the leading cause of death in 11 of the cases. 25 Unfortunately, Wisconsin does not keep statewide injury and accident data.
A comparison of the previous state and provincial statistics on injuries and deaths related to snowmobile accidents shows many alarming similarities. Among these similarities are: (1) there are a significant number of accidents, injuries, and deaths for the number of miles a sled travels each year; (2) young males are more likely to be involved; (3) most injuries involve the head, neck, and musculoskeletal system; (4) the majority of accidents occur by either hitting a fixed object or colliding with another moving object; (5) operating the sleds under the influence of alcohol is directly related in many of the accidents and deaths; and (6) the use of excessive speed is another leading cause of accidents (Tables 1, 2).
Incredibly, children younger than 17 years sustain 12% of all snowmobile injuries. These injuries can occur when the child is a sled operator, a passenger, or a bystander. Most frequently, these children were the passenger, were not wearing a helmet, and were more likely to collide with another sled or motor vehicle. Many of these injuries can be ascribed to lack of experience or inappropriate risktaking by parents. 14
When reviewing off-road vehicle injuries in children, Pyper and Black 17 reported 70 snowmobile-related injuries in individuals from 2 to 17 years. These injuries had been caused by losing control of the sled, rollover, striking a fixed object, striking a motor vehicle or another sled. Fifteen accidents involved more than one person and five of the injured children were pedestrians.
The injuries recorded included: 43 upper extremity fractures, 59 lower extremity fractures, six spine fractures, six pelvic fractures, 49 head injuries, 10 chest injuries, six injuries to the genitourinary tract, and six abdominal injuries. Twenty-eight of the children had at least one associated injury, which is higher than for any other all-terrain vehicle accident. All three deaths in this series were related to head trauma. The Consumer Product Safety Commission’s database on children and snowmobiles contains information on 291 injuries and 75 deaths for 1990 through 1998. 18 A summary of the injuries noted involvement of the extremities in 49%, involvement of the head, neck, and face in 28%, contusion and abrasions in 31%; lacerations in 22%, fractures in 20%, and sprains in 14%.
Forty-three percent of the reported injuries happened on private property. Fatal injuries usually involved colliding with a fixed object and 67% of deaths occurred from head, neck, or facial injuries. The commission reported that many states have no age or helmet regulations regarding snowmobile use.
The American Academy of Pediatrics reviewed available snowmobile injury data from 1997 through 1998. 7 During that time, emergency department visits related to snowmobiling accidents were estimated to be greater than 10,000. Ten percent of these visits involved children younger than 15 years and 25% additional patients were between the ages of 15 and 24 years. Again, head trauma was the leading cause of death.
In 1988, long before their 1997 to 1998 snowmobile injury data, the American Academy of Pediatrics published a position statement on snowmobiling. 8 Their public stance was that snowmobiles were inappropriate for use by children and young adolescents, and that children younger than 16 years should not drive snowmobiles. They also recommended that riders older than 16 years be licensed and be required to wear a helmet.
Alcohol and Fatal Injuries
A favored social activity of some snowmobilers is visiting bars along the trail; predictably, some operators consume enough alcohol to exceed the legal limit. Excessive alcohol consumption is a major contributing factor to snowmobile accidents and fatalities. It is extremely difficult for law enforcement agencies to police this activity.
A review of snowmobile mortality data from across the United States and Canada revealed that alcohol is a significant factor: alcohol was involved in 65% of fatalities in Alaska, 41% of fatalities in Maine, 56% of fatalities in Michigan, 67% of fatalities in New Hampshire, 41% of fatalities in New York, and 10% of fatalities in Wisconsin.
Reviewing the Canadian experience from 1987 through 1992, Beirness et al 5 found 497 deaths with alcohol involved in 79% of these fatalities. Seventy percent of the documented fatalities were the result of striking a fixed object or going through the ice with a sled, suggesting significantly impaired judgment on the part of the operator.
The number of snowmobile-related injuries and deaths per year constitutes a significant public health problem. Snowmobiling is uniquely dangerous for several reasons: first, a snowmobile can weight in excess of 600 pounds and travel at speeds exceeding 90 mph 14 and second, environmental conditions such as changing winter conditions, night riding, and exploration of strange territory can make a snowmobile trip challenging. Therefore, safety must be the snowmobiler’s main concern. Traditional rules of the trail include: the sled should be in proper working condition; the operator should have experience and have received adequate safety training; drivers and passengers should be clothed properly for winter exposure and be prepared for unforeseen problems; emergency equipment including a trail map, compass, flashlight, knife, matches, and sled repair tools should be carried at all times; snowmobilers should not travel alone; extreme caution should be used when crossing lakes or streams (at least 5 inches of ice thickness is necessary for a snowmobile); use reasonable speed and be vigilant for natural and manmade obstacles. Finally, there should be zero tolerance toward drinking and driving a snowmobile at all levels of governance.
Several states have developed training programs, similar to hunter safety courses, to educate the snowmobiler on proper use and safety. These programs initially are geared to the young rider with eventual plans to include all ages. The state of Minnesota has developed a program entitled Minnesota and Snowmobile Safety and You. 12 The program encompasses basic snowmobile responsibility, rules of the road, basic needs in cold weather, how to drive and transport a sled, maintenance, repair, and how to handle emergency situations. The second part of the course involves a snowmobile driving performance evaluation. New York also has instituted a course for young riders who need to be at least 10 years. Adolescents younger than 16 years who have not completed the New York State Youth Safety Riders Snowmobile Course cannot operate a snowmobile without direct adult supervision. This course also is offered on a voluntary basis to adults. Michigan also mandates that young people from the ages of 12 through 17 years cannot operate a snowmobile without direct adult supervision unless they have a safety certificate. In sharp contrast, Michigan allows children younger than 12 years to operate a snowmobile on their own property without adult supervision.
In response to the numerous fatalities related to speed, head injury, or alcohol, several states and provinces have legislated speed limits, mandatory helmet use, age limits for drivers, and zero tolerance regarding alcohol. Local snowmobile clubs have helped promote improved safety through education as The Safe Riders! You Make Snowmobiling Safer campaign (Table 3).
For a localized region, community based policing seems like a good approach to make snowmobiling safer. Sudbury, Ontario began a community-based program policing snowmobile activity in 1993. 19 From 1990 through 1992, 102 injuries, 87 hospital admissions, and 15 fatalities were recorded, all related to snowmobile accidents. From 1993 through 1995 a significant decrease in injuries (57), hospital admissions (53), and fatalities (four) were recorded.
Unfortunately, policing the 225,000 miles of groomed trails in North America is very labor-intensive and expensive. It is impractical to expect the present number of law enforcement officials from the departments of natural resources, parks, and recreation and sheriff’s departments to be able to patrol the snowmobile trail system in North America.
The logical choice to improve safety is through the local snowmobile clubs and government agencies, particularly through education. Government needs to consider issues such as mandatory helmet use, compulsory snowmobile safety education, age limitations, and stricter driving while intoxicated laws for snowmobilers. Unfortunately, there currently are not enough data to determine whether the existing rules, regulations, and safety courses will reduce the number of injuries and deaths. There also is an urgent need to collect more accurate injury data, to store it, and to allow law enforcement and safety groups access to that information (such as the National Highway Traffic Safety Administration). A review of future detailed injury and mortality statistics could determine the feasibility and success of current programs on snowmobile safety. Ultimately the responsibility lies with the snowmobiler keeping safety first and foremost; however, education at several levels would be helpful.
1. American Council of Snowmobile Associations: Economic Impact. http://www.snowmobileacsa.org/page.cfm/19/
2. American Council of Snowmobile Associations: Snowmobiling Safety. http://www.snowmobileacsa.org/page.cfm/141
3. American Council of Snowmobile Associations: State Laws and Rules. http://www.snowmobilecsa.org/page.cfm/17/
4. Beilman GJ, Brasel KJ, Dittrich K, et al: Risk factors and patterns of injury in snowmobile crashes. Wilderness Environmental Med 10:226–232, 1999.
5. Beirness DJ, Mayhew DR, Simpson HM: Alcohol Involvement in Snowmobile Fatalities in Canada. Schaffer Library of Drug Policy. http://www.druglibrary.org/schaffer/misc/driving/s30p5.htm
6. Centers for Disease Control Morbidity and Mortality Weekly Report: Injuries and Deaths Associated With Use of Snowmobiles: Maine 1991–1996. Maine Department of Inland Fisheries and Wildlife and Maine Office of Chief Medical Examiner. http://molecularmedicine.medscape.com/govtnt/CDC/MMWR/1997/Jan/4.4601.1.htm
7. CNN.com: American Academy of Pediatrics calls for snowmobile restrictions. http://cgi.cnn.com/2000/HEALTH/children/11/07/snowmobile.guidelines
8. Frankenfield G: Avoidable Injuries Continue in Wintersports. WebMD Medical News. http://my.webmd.com/content/article/1728.55464
9. Hamdy CR, Dhir A, Cameron B, Jones H, Fitzgerald GW: Snowmobile injuries in northern Newfoundland and Labrador: A 18 year review. J Trauma 28:1232–1237, 1988.
10. International Snowmobile Manufacturers Association: Snowmobiling Fact Book. http://www.snowmobile.org/t_trails.htm
11. James EC, Lenz JO, Swenson WM, et al: Snowmobile trauma: An eleven-year experience. Am Surg 57:349–353, 1991.
12. Mills HD, Koosman VW, Hammer MA: Minnesota Snowmobile Safety and You: State of Minnesota Department of Natural Resources. Seattle, Outdoor Empire Publishing Inc 1999.
13. Morbidity and Mortality Weekly Report: Injuries Associated with use of Snowmobiles in New Hampshire 1989–92. State of New Hampshire Department of Fish and Game and New Hampshire Department of Health and Human Services. http://epbiwww.cwru.edu/MMWR/vo144/mm4401.htm
14. National Children’s Center for Rural and Agricultural Health and Safety. Snowmobiles and youth: Selected Facts. http://research.marshfieldclinic.org/children/Resources/Snowmobile/FactSheet.html
15. New York State Snowmobile Accident Statistics 1998–1999 Program Year. Albany, NY, Office of Parks, Recreation, Historic Preservation New York State 1999.
16. Ontario Snowmobile Fatalities 1997–1998. http://www.cyberbeach.net/~stop/9798.htm
17. Pyper JA, Black B: Orthopaedic injuries in children associated with the use of off-road vehicles. J Bone Joint Surg 70A:275–284, 1988.
18. Rice MR, Alvanos L, Kenney B: Snowmobile injuries and deaths in children: Review of national injury data and state legislation. Pediatrics 105:615–619, 2000.
19. Rowe BH, Therrien SA, Bretzlaf JA, et al: The effect of community-based police surveillance program on snowmobile injuries and deaths. Canadian J Public Health 89:57–61, 1998.
20. Snowmobile Accident Report 1994–95 thru 1998–99. St Paul, Minnesota Department of Natural Resources 2000.
21. Snowmobile Accident Report 1999–2000. St Paul, Minnesota Department of Natural Resources 2000.
22. Snowmobile Program Report for 2000–2001 Season. Michigan Department of Natural Resources Law Enforcement Division. http://www.michigansnowmobiling.com
23. State of Alaska Epidemiology Bulletin: Snowmobile Injuries in Alaska, 1993–1994. http://www.epi.hss.state.ak.us/bulletins/docs/b1997_13.htm
24. Wisconsin Snowmobile Fatality Summary 1999– 2000. Wisconsin Department of National Resources. http://www.dnr.state.wi.us/org/es/enforcement/safety/snowstats.htm
25. Wisconsin Snowmobile Fatality Summary 2000. Wisconsin Department of Natural Resources. http://www.dnr.state.wi.us/org/es/enforcement/safety/snowstats.htm
26. Yukon/NWT/Nunavut: Joseph-Armand Bombardier the Father of Snowmobiling. http://canadafarnorth.about.com/aboutcanada/canadafarnor
Maureen A. Finnegan, MD—Guest Editor