Effect of helmet wear on the incidence of head/face and cervical spine injuries in young skiers and snowboarders

Abstract

Purpose: To evaluate whether helmets increase the incidence and/or severity of cervical spine injury; decrease the incidence of head injury; and/or increase the incidence of collisions (as a reflection of adverse effects on peripheral vision and/or auditory acuity) among young skiers and snowboarders. Methods: During one ski season (1998-99) at a world class ski resort, all young skiers and snowboarders (<13 years of age) presenting with head, face, or neck injury to the one central medical facility at the base of the mountain were identified. On presentation to the clinic, subjects or their parents completed a questionnaire reviewing their use of helmets and circumstances surrounding the injury event. Physicians documented the site and severity of injury, investigations, and disposition of each patient. Concurrently, counts were made at the entry to the ski area of the number of skiers and snowboarders wearing helmets. Results: Seventy children were evaluated at the clinic following ski/snowboard related head, neck, and face injuries. Fourteen did not require investigation or treatment. Of the remaining 56, 17 (30%) were wearing helmets and 39 (70%) were not. No serious neck injury occurred in either group. Using helmet-use data from the hill, among those under 13 years of age, failure to wear a helmet increased the risk of head, neck, or face injury (relative risk (RR) 2.24, 95% confidence interval (CI) 1.23 to 4.12). When corrected for activity, RR was 1.77 and 95% CI 0.98 to 3.19. There was no significant difference in the odds ratio for collisions. The two groups may have been different in terms of various relevant characteristics not evaluated. No separate analysis of catastrophic injuries was possible. Conclusion: This study suggests that, in skiers and snowboarders under 13 years of age, helmet use does not increase the incidence of cervical spine injury and does reduce the incidence of head injury requiring investigation and/or treatment.H ead, neck, and spinal cord injuries are the most costly sports injuries, both in terms of care costs and humanitarian costs. Reported incidences of head injury among skiers and snowboarders vary widely, depending on the location, age group, the specific sport, the source of the data (ski patrol, local clinic, emergency department, tertiary care neurology unit), and the quality of the denominator data, but overall, there are about 15 head injuries per million visits.

Characteristics of Helmet or Knit Cap Use in Head Injury of Snowboarders -Analysis of 1,190 Consecutive Patients-

“…13) Wearing a helmet is effective for preventing head injuries in skiers and snowboarders. 13,17) We obtained the same finding.…”

“…13) Wearing a helmet is effective for preventing head injuries in skiers and snowboarders. 13,17) We obtained the same finding. Head wear including a helmet or knit cap protected against serious head injuries on jumping, but whether helmet use prevents injuries in snowboarders is still controversial.…”

“…Recently, helmet use was reported to clearly reduce the incidence of head injury in snowboarding. 13,17) However, the usefulness of helmets in skiing and snowboarding is still controversial. 7,8,10,11,14,16) The present study evaluated the efficacy of helmet or knit cap use for protection against serious head injuries, based on 1,190 snowboarders who presented with head injury.…”

ECSS Position Statement 2009: Prevention of acute sports injuries

“…A meta-analysis, based on five wellconducted case-control studies on pedal cycle helmets in transport and recreation, have confirmed that helmets provide a 63Á88% reduction in the risk of head, brain, and severe brain injury for cyclists of all ages (Thompson, Rivara, & Thompson, 2000). In recreational skiing and snowboarding, there is solid evidence to show that using a helmet is associated with a 22Á60% reduction in head injury rates (Hagel, 2005;Macnab, Smith, Gagnon, & Macnab, 2002;Sulheim, Holme, Ekeland, & Bahr, 2006). Thus, it is strongly recommended that recreational skiers and snowboarders wear helmets.…”

Improving bicycle safety: The role of paediatricians and family physicians

“…Counter-examples also exist. For example, the introduction of helmets in snowboarding has resulted in reduced head injuries but no concomitant increase in neck injuries as would result if helmeted snowboarders took greater degrees of risk (27). A recent study examined 23,000 cyclists involved in traffic crashes and found that committing a speed-related infraction was not associated with the frequency of helmet use (28).…”