The number of practitioners is rising worldwide: e.g., in Germany, it increased by 9.6% from 2014 to 2018 and by a further 10.9% (from 14.9 to 16.6 million people) between 20. In the European Alps, it has recently been estimated that there are approximately 18.7 million mountain bikers (locals and visitors). It is an Olympic sport and a very common recreational activity, especially in the mountains during the summer season. Mountain biking (MTB) is characterized by cycling off-road, often over rough terrain, using specially designed bikes. These results should be considered for future preventive strategies in recreational mountain-biking. Factors such as male sex in general, above average age and uphill riding for non-traumatic accidents, as well as downhill riding for traumatic events, seem to be associated with fatalities during recreational mountain-biking in the Austrian Alps. Throughout the examined period, the absolute number of fatalities slightly increased, whereas the mortality index (proportion of deaths/accidented victims) did not (mean value: 1.34 ± 0.56%). Mountain-bikers fatally accidented for non-traumatic reasons frequently belonged to older age classes ( p = 0.05) and mostly (73.6%) died during the ascent, whereas traumatic events mainly (70.0%) happened during the descent ( p < 0.001). Of those, 54.6% died due to a non-traumatic (mostly cardio-vascular) and 41.2% due to a traumatic event. In total, 97 fatalities (1 woman) with a mean age of 55.6 ± 13.9 years were recorded by the Austrian Alpine Police. For this purpose, a retrospective study based on Austrian institutional documentation from 2006 to 2021 was conducted. Therefore, the aim of the present study was to investigate the characteristics of fatal accidents as well as resulting dead victims during recreational mountain-biking in the Austrian Alps over the past 16 years. Despite recreational mountain-biking’s growing popularity worldwide, the literature on mortality in this leisure sporting activity is scarce.
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