Millions of people engage in mountain sports activities worldwide. Although leisure-time physical activity is associated with significant health benefits, mountain sports activities also bear an inherent risk for injury and death. However, death risk may vary across various types of mountain sports activities. Epidemiological data represent an important basis for the development of preventive measures. Therefore, the aim of this review is to compare mortality rates and potential risk factors across different (summer) mountain sports activities. A comprehensive literature search was performed on the death risk (mortality) in mountain sports, primarily practiced during the summer season, i.e., mountain hiking, mountain biking, paragliding, trekking, rock, ice and high-altitude climbing. It was found that the death risk varies considerably between different summer mountain sports. Mortality during hiking, trekking and biking in the mountains was lower compared to that during paragliding, or during rock, ice or high-altitude climbing. Traumatic deaths were more common in activities primarily performed by young adults, whereas the number of deaths resulting from cardiovascular diseases was higher in activities preferred by the elderly such as hiking and trekking. Preventive efforts must consider the diversity of mountain sports activities including differences in risk factors and practitioners and may more particularly focus on high-risk activities and high-risk individuals.

Annually, millions of people engage in mountain sports activities all over the world. These activities are associated with health benefits, but concurrently with a risk for injury and death. Knowledge on death rates is considered important for the categorization of high-risk sports in literature and for the development of effective preventive measures. The death risk has been reported to vary across different mountain sports primarily practiced in the summer season. To complete the spectrum, the aim of the present review is to compare mortality rates across different mountain sports activities primarily practiced in winter. A comprehensive literature search was performed on the death risk (mortality) during such activities, i.e., alpine (downhill) skiing, snowboarding, cross-country skiing, ski touring, and sledging. With the exception of ski touring (4.4 deaths per 1 million exposure days), the mortality risk was low across different winter sports, with small activity-specific variation (0.3–0.8 deaths per 1 million exposure days). Traumatic (e.g., falls) and non-traumatic (e.g., cardiac death) incidents and avalanche burial in ski tourers were the predominant causes of death. Preventive measures include the improvement of sport-specific skills and fitness, the use of protective gear, well-targeted and intensive training programs concerning avalanche hazards, and sports-medical counseling for elderly and those with pre-existing diseases.

The present project compared acute hypoxia-induced changes in lactate thresholds (methods according to Mader, Dickhuth and Cheng) with changes in high-intensity endurance performance. Six healthy and well-trained volunteers conducted graded cycle ergometer tests in normoxia and in acute normobaric hypoxia (simulated altitude 3000 m) to determine power output at three lactate thresholds (P_Mader, P_Dickhuth, P_Cheng). Subsequently, participants performed two maximal 30-min cycling time trials in normoxia (test 1 for habituation) and one in normobaric hypoxia to determine mean power output (P_mean). P_Mader, P_Dickhuth and P_Cheng decreased significantly from normoxia to hypoxia by 18.9 ± 9.6%, 18.4 ± 7.3%, and 11.5 ± 6.0%, whereas P_mean decreased by only 8.3 ± 1.6%. Correlation analyses revealed strong and significant correlations between P_mean and P_Mader (r = 0.935), P_Dickhuth (r = 0.931) and P_Cheng (r = 0.977) in normoxia and partly weaker significant correlations between P_mean and P_Mader (r = 0.941), P_Dickhuth (r = 0.869) and P_Cheng (r = 0.887) in hypoxia. P_Mader and P_Cheng did not significantly differ from P_mean (p = 0.867 and p = 0.784) in normoxia, whereas this was only the case for P_Cheng (p = 0.284) in hypoxia. Although investigated in a small and select sample, the results suggest a cautious application of lactate thresholds for exercise intensity prescription in hypoxia.

This study aims to evaluate the agreement in maximum oxygen consumption ($\dot{\mathrm{V}}$O₂max) between a running protocol and a ski mountaineering (SKIMO) protocol. Eighteen (eleven males, seven females) ski mountaineers (age: 25 ± 3 years) participated in the study. $\dot{\mathrm{V}}$O₂max, maximum heart rate (HRmax), and maximum blood lactate concentration (BLAmax) were determined in an incremental uphill running test and an incremental SKIMO-equipment-specific test. $\dot{\mathrm{V}}$O₂max did not differ between the SKIMO and uphill running protocols (p = 0.927; mean difference –0.07 ± 3.3 mL/min/kg), nor did HRmax (p = 0.587, mean difference –0.7 ± 5.1 bpm). A significant correlation was found between $\dot{\mathrm{V}}$O₂max SKIMO and $\dot{\mathrm{V}}$O₂max running (p ≤ 0.001; ICC = 0.862 (95% CI: 0.670−0.946)). The coefficient of variation was 4.4% (95% CI: 3.3−6.5). BLAmax was significantly lower for SKIMO compared to running (12.0 ± 14.1%; p = 0.002). This study demonstrates that $\dot{\mathrm{V}}$O₂max determined with a traditional uphill running protocol demonstrates good agreement with an equipment-specific SKIMO protocol.