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Brian Mills, Jean Andrey, Sean Doherty, Brent Doberstein, and Jennifer Yessis


Emergency department visitation data were analyzed using a matched-pair, retrospective cohort method to estimate the effects of winter storms on fall-related injury risks for a midsized urban community in Ontario, Canada. Using a unique definition and classification of winter storm events and dry-weather control periods, relative risks of injury were estimated for total falls and two subcategories (same-level falls involving ice and snow; all other falls) across two storm event types (snowfall only; mixed precipitation). Winter storms were associated with 38% and 102% increases in the mean incidence of same-level falls involving ice and snow during snow events and freezing-rain events, respectively. The incidence of other types of falls was slightly but significantly less during snow events relative to dry-weather control periods. Findings suggest that walking is not safer than driving during winter storms, as same-level falls involving ice and snow accounted for 64% more of the injury burden than motor vehicle collisions. Significant reductions in mean relative risk estimates for fall-related injuries were apparent over the 2009–17 study period indicating possible long-term shifts in exposure, sensitivity, and/or risk-mitigating decisions, actions, and behavior. Consistent and significant effects of government-issued weather warning communications on risk outcomes were not found. Practitioners engaged in developing injury prevention strategies and related public risk messaging, in particular winter weather warnings and advisories, should place additional emphasis on falls and multimodal injury risks in communications related to winter storm hazards.

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