Actress Dies of Head Injury While Skiing – Helmet?

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To helm or not to helm?

To helm or not to helm?

Some things must be blogged. The tragic death of actress Natasha Richardson after falling and hitting her head on a beginner slope, as well as the death of Kathryn Miller Hess in Jackson, beg the questions. Do you wear a helmet while skiing? Should everyone? Are they really very effective? We’ve been around the block on this one before, but I’m wondering if anyone has any new thoughts on the matter.

For grist, a few factoids from the National Ski Areas Association:

-43% of skiers and snowboarders were wearing helmets last winter, compared to 25% five years earlier.

- Increased helmet use, however, has not reduced the number of ski resort fatalities. Perhaps this is because most “snowsport” helmets are wimpy foam hats that do little to protect in high speed impacts.

Also, this article from the New York Times gives good food for thought.

Oh esteemed commenters, your thoughts?

Comments

98 Responses to “Actress Dies of Head Injury While Skiing – Helmet?”

  1. Tucker March 19th, 2009 9:49 am

    I started wearing a helmet 5 years ago while skiing. And nothing happened all season. Until the last day, when I wiped out following my daughter down a race course. Bad fall (neck still injured to this day) as I was wearing a pack and fell down slope. Saw stars for a good 15 minutes after the fall.

    Now I wear one religiously. They’re warmer than hats (in New England, a very important consideration) and you just might need it one day.

    My wife needed hers this last weekend: a kid took her out standing in the lift line, knocked her knees out. Right over backwards, head into the snow. She was shaken up enough to not ski for the rest of the day, and had a big bump on her head for several days.

    My daughter (6 years old) slid into a tree earlier this season. She had a bruise on her jaw, and a bruise on her eyebrow, but the helmet took the brunt of the impact. She was sledded off by ski patrol, and all of us thought she was seriously injured. She walked out of the first aid station.

    I ski the trees a lot. I now wear a Giro full-face (Remedy Carbon S), and even though it’s not as comfortable, I finally got it because, hey, I used to ride a motorcycle. I wouldn’t ride a motorcycle as fast or as often as I ski w/out a full-face helmet. (And yes, the motorcycle helmet saved my noggin a bunch of times.) Why shouldn’t I take the same care while I’m skiing?

    Helmets are, no pun, a no-brainer.

    I read an article earlier about the possible causes of Mr. Richardson’s death. It’s not certain that a helmet might have saved her (she may have had a pre-exisiting condition), but it surely wouldn’t have hurt.

  2. Bill March 19th, 2009 9:54 am

    Need more details on your figures. Were the fatalities wearing helemets? Were they due to head trama? The majority of the recent death in our area, Lake Tahoe, have been due to avi and tree wells, where a helmet does one no good.

    I wear my brain bucket every time i go out. You wear a helmet mountain biking, rock climbing, motor biking, snow mobiling, why wouldn’t you do so skiing. These last few years I even drag my helmet into the back county. A couple of hours in the woods is not a place I want to have any head trama. If for nothing else, it provides courage and warmth for my head.

  3. Tucker March 19th, 2009 10:06 am

    National Ski Areas Association Helmet Fact sheet has the details:

    http://www.nsaa.org/nsaa/press/0809/helmet-safety.asp

    A lot of ski fatalities result from multiple injuries, not just head injuries. Also, people tend to act in a riskier fashion when they think they’re safer, so this may offset some of the safety gains associated w/ helmets.

  4. Lou March 19th, 2009 10:16 am

    Thanks Tucker.

    And meanwhile, knees continue to be destroyed at an alarming rate. Where is the outrage?

  5. mb March 19th, 2009 10:41 am

    Speaking of knees, I got a pair of knee bindings (http://www.kneebinding.com/) after seeing them on your site. Not the sexiest bindings, but after one ACL surgery they seemed like a good idea. I have been very happy with them so far.

  6. Cameron Millard March 19th, 2009 10:50 am

    As a ski patroller, I can say that helmets make a difference. Could be the difference between a bad concussion or a life-changing injury. I wear a helmet at work, and have started to in the backcountry as well. A helmet saved my life in a mountain-bike crash last summer, and skiing involves risk of collisions. A lot of patrollers still won’t wear them, but that is starting to change.

  7. Lou March 19th, 2009 11:09 am

    This reminds me of the Avalung debate. Helmets and Avalungs are so easy to buy and wear we just plain want them to work. But when I stand apart from the helmet issue, it seems to me that the numbers speak pretty loud. I mean, if almost half of skiers are wearing helmets, and the death rate of skiers has not been reduced, just how effective are these things? I certainly agree they can prevent scalp cuts as well as making hitting your head more comfortable, but in the kind of impact that really does damage, are they doing enough? Something makes me doubt…

    Look at it with a cold heart. My CAMP helmet has one inch of foam between me and whatever. How much protection can that one inch really provide? Sure, it looks like a helmet and it’s warm, but?

  8. Peter Banta March 19th, 2009 11:11 am

    The “no change in fatalaties” argument is a weak one, as you don’t only wear a helmet to prevent death. The stats now show that helmets reduce head injuries by as much as 50%. That’s a solid number that is hard to refute. At the very non-lethal-injury least, concussions suck, at the worst, you can live and be a vegetable for the rest of your days. If you ski or ride over 20 MPH, or spend any time in the trees, without a helmet, you are simply rolling 2 dice instead of 1 that you’ll stay 5 or under. Yes, I might roll a 6, too, but your odds are much worse.

    They are warm, comfortable, do not affect hearing much or at all, and yes, they do take getting used to a little, but I don’t notice mine at all any more. I feel a bit naked & exposed without now. And I definitely do not think they give you some sort of “helmet courage”. That is bunk. Nobody thinks that.

    Now, while I do think that everyone should wear them, I would not want to see it mandatory at resorts. If people want to chance cracking their own heads open, let them. But that’s the Libertarian in me pushing the personal freedom thing…

  9. Bill Bollinger March 19th, 2009 11:14 am

    I wear a helmet, but I wonder about the effectiveness.
    When I compare my ski helmet to my bike helmet it seems much harder and I wonder if it will compress enough to reduce the shock well.
    Bike helmets seem flimsy, but they are designed to crush on impact to absorb the energy and reduce the shock.

  10. Clyde March 19th, 2009 11:16 am

    Current ski helmet designs are totally ineffective for preventing concussion. People who have already had mild TBI (hence more susceptible to another) should wear a helmeted rated for multi-impacts (skateboard is one example) since they used softer foams better capable of decelerating the brain gradually. It’s a shame helmet designs are still so antiquated in terms of doing the job for which they are intended. But as stylish hats with nice vents and earphones, current helmets are great.

  11. Eric March 19th, 2009 11:20 am

    These deaths, as tragic as they are, are not reasons to wear a helmet. You wear a helmet b/c it is your best chance to reduce the effects of head trauma when skiing. It’s a bit like wearing an avalung, or a beacon, it doesn’t make you invincible, it just improves your chances. And arguably they (avalungs, beacons, helmuts) don’t improve your chances when you apply statistics.)

    What do these deaths do? Much like happened in cycling, parents will see these stories, and start making their kids wear helmets. In ten more years almost everyone will wear one, because they always have. (and their egos’ will be used to it)

  12. Sophie March 19th, 2009 11:46 am

    The helmet thing should be based on EXPERIENCE. Like most people who grew up on the French Riviera, I skied an average of 60 days per year since I was 3 years old. Yet, I’ve never had a bad fall (and have competed). I know what to risk and what not to. What I’ve observed though is this: MOST PEOPLE WHO SUFFER INJURIES ARE BEGINNING ADULTS!!!! Morality: skying should be started as a child and done a lot then and now. If not, then leave it alone! Starting as an adult is too dangerous. You will NEVER develop some things you need to be good, or even safe, such as elasticity of the knees (they absorb all the bumps while the rest of the body hardly moves when you go down straight), a strong lower back, and strong legs. If you haven’t started by age 8, never do it later.

  13. Scott March 19th, 2009 11:48 am

    I’m a fan of helmets. They have saved me from injury on numerous occasions while doing backcountry motorcycle trips and while skiing. This is my experience, not based on any statistics. In my opinion, the beefier helmets increase injury prevention (some types) quite a bit more than the flimsy, lightweight foam.

  14. Sophie March 19th, 2009 11:50 am

    If I died skiing, I’d die doing what I love most. A helmet would ruin the entire experience for me. Why should I suffer because some idiots decide to go learn to ski at 40 years old? It’s too late! It’s like starting ballet at 50! You’ll never be double-jointed… why bother and make the ones who started at 3 suffer because of your selfishness?

  15. justin March 19th, 2009 11:59 am

    The very first time I wore a helmet a few years back I actually attempted to tackle a tree. The tree won. Fortunately as we were walking to the car my friend reminded me to grab my new helmet, because the impact left a large gash on the hard plastic shell of my helmet. Not so sure about my new this year helmet though, only time I’ve tested it I ended up with a massive neck stinger (and headache) on a fall that didn’t seem to be very hard. Granted every fall is different, but it feels like there needs to be some more interior padding as opposed to just a hard shell over some foam. If I could find something that had the plush interior of my Arai Signet I’d be stoked.

  16. Art March 19th, 2009 12:32 pm

    I took a fall a couple of weekends ago and went for a bit of a tumble that made me think twice about not wearing the helmet I had just purchased. I wore it last weekend and took a fall after losing my balance in some dense new snow. I slid downhill and smacked the back of my head into a small tree. It wasn’t much of an impact with the helmet. I’m sure it would have been very uncomfortable without the helmet, to say the least, and it will be on my head from now on.

    BTW, I usually run pretty hot and sweat a lot — I didn’t think a helmet would work for me at all, but I found it very comfortable doing laps (ear flaps removed, and wearing a light beanie). That was a pleasant surprise!

  17. Geof March 19th, 2009 12:32 pm

    The problem with the current helmets (not all) is they are not designed as a motorcycle type helmet. Meaning they are not rated to change the level of deceleration that occurs in blunt force trauma, significantly. In fact, some helmets can actually make it worse, depending on materials in use. Until the helmets have SERIOUS crash ratings applied, we will never know how effective they are or not. They would need to be tested in situations that are real world, which is tough to do. Running into a tree is one thing, bouncing your head off the snow is another. Snow has MANY variations in firmness, thus it would be nearly impossible to cover all possibilities.

    The accident mentioned is tragic, but it is entirely possible there were conditions already present within the brain to predispose her injury severity. In this type of situation, is it tough to call whether or not she would have had a similar result had she been wearing a helmet, to many factors to analyze. It is really easy to say “she should have been wearing a helmet” but we have no idea if it would have been a significant factor or not. Also, this type of injury is easily repaired if caught in time. Obviously in this situation that was not the case.

    I wear a helmet if I’m pushing the limits or the terrain is particularly nasty IE: rocky, cliffy etc… Generally, I don’t wear one on a day to day basis. I think the concept of a helmet is good, but until they become better, I think it’s simple mental security rather than significant actual protection from injuries such as this.

  18. Peter March 19th, 2009 12:58 pm

    I always wear a helmet skiing. I find myself skiing trees nearly every time out (both backcountry and resort), and a helmet does a better job protecting my head from low hanging branches than a hat. That’s reason enough for me to strap on the brain bucket. I know that it may not be golden shield to prevent any and all head injuries, but I doubt that having it on will increase my chances of injury.

  19. Andrew March 19th, 2009 1:00 pm

    I’ve owned a helmet for years, but I didn’t much care for wearing it. The helmet was hot an uncomfortable and I couldn’t hear anything anyone said. Last year my 4 year old daughter started skiing. To have her wear a helmet made total sense to me, but she wanted to know why daddy wasn’t wearing his helmet. So I went out and tried on a few newer helmets and found them to be much more comfortable, far better vented and I could hear people while wearing it. So I bought a new comfortable helmet and now wear it all the time. I don’t know if the helmet will make me safer while skiing and I don’t really care, what matters is I’m no longer a hypocrite in the eyes of my daughter.

  20. Rob March 19th, 2009 1:46 pm

    Sophie, if you die, well, …

    Being fed via a tube for decades is not something anyone could be looking forward to. But even on a day to day basis, I’m happy about the helmet, makes it very easy to go through sections with dense trees.

    Just like I got used to wearing a helmet when cycling, I got used to it when skiing.

  21. Colin March 19th, 2009 2:06 pm

    Sophie your two posts are almost completely BS. “If you haven’t started by age 8, never do it later.” I started skiing at 17, and while I’m not a professional, I wouldn’t say I’m a novice.

    Clyde, I was waiting for you to chime in, remembering several of your helmet rants on TTips years ago. That said, I wear a helmet for reasons like the following: http://www.tetongravity.com/forums/showpost.php?p=2313929&postcount=93

    I’m under no illusions that should I crash into a tree at high speed that a helmet will save my life (indeed, skier trauma death stats are similar to what they were before helmets became prevalent), but the stats show reduction in head trauma, overall, even with the wimpy ski helmets on the market. The death stats show decreases in head trauma as the primary cause of death, and attribute those deaths to other types of trauma. That link is, I think, a good example of reduction of head trauma. I got a Giro Remedy S Carbon (fullface) for Christmas, and that’s what I wear now.

  22. Alex March 19th, 2009 3:31 pm

    Ok speaking to Sophie’s comment regarding skiing as an adult (“skying should be started as a child and done a lot then and now. If not, then leave it alone! Starting as an adult is too dangerous. You will NEVER develop some things you need to be good, or even safe…..If you haven’t started by age 8, never do it later.”) That’s so obsurd. That’s probably the most ridiculous comment and doubt in the capabilities of the human body.

    Between my buddy and myself, in two years of skiing, we’ve gone from skiing beginner to advanced terrain, and skiing that terrain fluidly and safely. And when I say advanced terrain we’re talking Wasatch terrain as in Snowbird, Alta, Superior, etc.

    Yes I’m not “old” but starting to ski at 25 (now 27) hasn’t left me without an ability for balance or the ability to make a turn in trees or above a cliff band safely. And my buddy learning at 38 hasn’t left him void of the necessary attributes to keep him safe.

    With all this blabbering, all I’m getting at is that statement is absolutely erroneous in validity.

  23. Ryan March 19th, 2009 4:24 pm

    I heart my brain bucket!!!

    There is no good argument that I have heard against wearing helmets.

    People say that people take bigger risks which is baloney – risk takers are now wearing helmets.

    Mine is super comfy, warm, and dare I say stylish.

  24. Nick March 19th, 2009 4:48 pm

    Worst time to have this sort of debate is after a high profile incident. Just get too much irrelevant emotional spew (not too bad on this thread – yet, but try looking at TTips and TGR).

    Oh as a late starter at 27 I guess I had better give up, after 20 years without major incident, to keep Sophie happy.

  25. Gary March 19th, 2009 4:59 pm

    I have been wearing helmets for the past 8 years and now feel naked without it. My wife had a head injury skiing some years ago (before helmets) that scared the crap out of us, luckily it was just a scalp wound and there was no brain damage. We both wear “full” helmets and I’ve fallen a few times where I’m sure it has saved me from injury. Doesn’t feel good to whack your head on the base in any case, but probably 1/10 the problems. If the helmet fits well and tight, you’re distributing the impact over a much larger area than just the point of impact. Many cases cited over the years (Sonny Bono, Kennedy) involved impact with trees and pretty good speed. Helmet or not, hit a tree at 30mph or more and there’s a good chance it will be the last thing you see. Same goes with cliffs, rocks and tree wells. The more you hang it out there on the edge, the greater the chances something may go wrong with serious consequences. I skied more aggressive when I was 14 than I do now at 53, but always ski in control, which doesn’t mean I don’t ever fall. Personal choice, but for my noggin, I’ll take the helmet.

  26. Pundy March 19th, 2009 5:00 pm

    I know first hand of a guy who drydocked at 5 mph while traversing a rocky slope, skiing in France. He high-sided and his head came to rest on a rock. He suffered pretty severe brain damage due to the accident. There is no doubt in anybody’s mind that a helmet would have saved him from this fate. I imagine most of the readers here read about Sam Bass’s (Skiing mag editor) crash last spring. Had he not been wearing a helmet, he likely would have suffered life ending head trauma. As Ryan just said, there is absolutely no good reason to not wear a helmet at this point. with all the models available there’s something for everyone.

  27. Lou March 19th, 2009 5:02 pm

    Nick, we truly do try to keep our level of discourse at functional levels, glad you noticed.

  28. Zachary Danyluk March 19th, 2009 5:23 pm

    I look at helmets skiing the same way I look at helmets when I ride my bike. It’s not going to do anything if I get hit by a car on the highway, I am road pizza either way. However, it will save me a pile of pain if I take a small or medium dive or plow into a tree.

    Toque replacement is a good point too.

  29. Peter Banta March 19th, 2009 5:31 pm

    Sophie’s silly posts are a perfect example of the illogical rationalization that you hear from folks resisting wearing helmets. If you don’t want to wear one, fine, but don’t try to justify it by cooking up absurd reasons & false supportive facts.

    It’s not like all of us who wear helmets never did the activites without them and can tell the difference. Truth is, there really aren’t any differences, but it does feel a little different on your head than a hat, and not having the wind blasting your ears all the time at speed is actually kind of nice. And while they can be hot, better ones have good venting & removable insulation and are fine into the 60′s are higher, and they are perfect in the teens, which is prime ski weather.

    I think there are more pros than cons, and the cons are inCONsequential.

  30. Clyde March 19th, 2009 5:43 pm

    Colin, my argument has never been that helmets are bad. Just that what is foisted onto the market aren’t good enough (but sold as if they were). The helmet Lou wears, the CAMP Pulse, is arguably the best currently available for BC since it is basically a climbing helmet with vents and earflaps for skiing. Until the media and public start insisting on real protection against mild TBI (concussions)–the major concern at resorts–we’ll still get the stylish choss offered now that meets minimum, poorly designed standards. Even a skull cap with no padding protects against the knocks like in your example. Protecting against major impacts beyond what the Pulse offers is probably pointless since then you get into the realm of torn aortas and other nastiness. Notice that ski helmet reviews never talk about protection–they may as well call them hat reviews.

  31. Lou March 19th, 2009 6:07 pm

    All, I’m with Clyde, I think everyone is way to trusting in that what’s sold as ski helmets offer adequate protection. Where is the leery consumer in all you guys? Don’t any of you ever wonder if your helmet is really providing all the protection you assume it is? And isn’t settling for something that only works at slower speeds settling for second best?

    Also, it doesn’t take much protection to ward off cuts and smaller bumps. Shoot, you can do that by stuffing a stocking cap with rags and sticking it on your head.

    Me, I’m a leery consumer when it comes to this stuff. I don’t disagree that existing ski helmets provide some modicum of protection, I’m just a skeptic.

  32. Jess Downing March 19th, 2009 6:28 pm

    Well, since my blog post got buried by this, figured I’d comment and give a female perspective that wasn’t completely negative. I’ve been wearing a helmet for over 10 years and like Gary said above, I feel naked w/o one. Although, the backcountry is one place I haven’t drug my helmet up to yet – but they places I generally go are void of rocks and cliffs and I always ski slower and more cautiously. Depending on the terrain, I’ve considered starting to strap it to my pack.

    As to the material/construction debate, there are helmets being developed that are less ‘hard’ and have a in-mold inside that conforms more to your head so the helmet is less of a brain bucket and more of a brain pillow (couldn’t think of a better simile)… Its hard to do real helmet reviews that can talk about protection as I’m sure most gear testers aren’t out to go hit a tree. It’s stories like Sam Bass’ that lay testament to the protection of the helmet (he was wearing a POC helmet BTW).

  33. Geof March 19th, 2009 6:30 pm

    So, in CLASSIC overreaction fashion, the resort were she was skiing is going to implement a manditory helmet move. What’s next? Manditory shovels, beacons, water bottles, tampons, toilet paper, compass, altimeter? PLEASE…

  34. Colin March 19th, 2009 6:30 pm

    Clyde and Lou,

    Very good points. Clyde, you might know, having done research in the area, are there design and material (or COST) limits to building significantly better ski helmets such that consumers should be demanding more? Can companies build a helmet that is as light as current offerings, while offering significantly more protection at similar cost? If so, then we *should* be asking for more. Do we need to revamp the testing standards so that companies build better helmets? I definitely agree that the industry projects this “helmets save lives” idea on the public, and that isn’t necessarily true.

  35. Randonnee March 19th, 2009 6:36 pm

    My helmet is a trade-off of weight and comfort. I own a heavier helmet than the one that I use when skiing I usually left behind the heavier helmet. Whatever the amount of protection, probably low speed or on a secondary impact, what I use is comfortable to wear all day up and down, sheds rain or snow, sheds tree limbs, and will be useful for low speed protection.

    At high speed, even with a great full-face helmet , with a fall a neck fracture may then occur unless then one wears that neck and back protector, etc. For that matter, if one is skiing at high speed and does not die from head or spinal injury, then one may incur a ruptured spleen, a lacerated liver, flail chest, blunt force trauma to the heart, pelvic fracture, femur fracture. I have treated all of these on the ski hill in the past and also now in the hospital. The lacerated liver on the beginner slope resulted in the death of a formerly healthy 17 year-old in minutes. I cared for a telemarker who had a full soda can in his parka breast parka, fell on a blue square piste, burst his spleen from the soda can trauma, had a splenectomy.

    Much like entering avalanche terrain, speed on skis may have potentially serious or fatal consequences whether or not one buys this or that gear.

  36. Lou March 19th, 2009 6:59 pm

    All, I should have placed a link in this post to Randonnee’s helmet guest blog. Check it out:
    http://www.wildsnow.com/1514/helmets-backcountry-skiing/

  37. Clyde March 19th, 2009 7:11 pm

    Colin, the foams exist but the good ones aren’t as cheap as the styrofoam (EPS) typically used. Despite the hype, in-mold construction is mostly about style, not performance. Manufacturers have zero incentive to deliver more protection because the cheap stuff passes standards (that are outdated but hard to change) and that’s good enough. This won’t change until consumers wise up.

    The only helmet I know of that is truly superior for resort skiing comes from Team Wendy (http://www.teamwendy.com/skihelmets/sportsindex.cfm). But they don’t have the marketing power of Giro, Smith, etc and do need to work on styling. Just about any skateboard helmet is superior to ski helmets for resort skiing. In the backcountry, a helmet that meets the climbing standards is the best choice.

  38. David P March 19th, 2009 7:40 pm

    I’m sorry, Lou, but this whole discussion is really of no value. Everyone is entitled to their opinion, but that does not mean those opinions are worth anything. Does anyone really think that the opinions, pro or con, expressed here have any validity? The only valid arguments are provided by objective examination of the DATA. Here are 3 studies that have some real data (like all clinical investigations, there are potential methodological flaws):

    Helmets do provide protection against the consequences of head injury:
    1. Hagel BE, Pless IB, Goulet C, Platt RW, Robitaille Y. Effectiveness of helmets in skiers and snowboarders: case-control and case crossover study. Bmj 2005;330:281.
    ABSTRACT:OBJECTIVE: To determine the effect of helmets on the risk of head and neck injuries in skiers and snowboarders. DESIGN: Matched case-control and case crossover study. SETTING: 19 ski areas in Quebec, Canada, November 2001 to April 2002. PARTICIPANTS: 1082 skiers and snowboarders (cases) with head and neck injuries reported by the ski patrol and 3295 skiers and snowboarders (controls) with non-head or non-neck injuries matched to cases at each hill. MAIN OUTCOME MEASURES: Estimates of matched odds ratios for the effect of helmet use on the risk of any head or neck injury and for people requiring evacuation by ambulance. RESULTS: The adjusted odds ratio for helmet use in participants with any head injury was 0.71 (95% confidence interval 0.55 to 0.92), indicating a 29% reduction in the risk of head injury. For participants who required evacuation by ambulance for head injuries, the adjusted odds ratio for helmet use was 0.44 (0.24 to 0.81). Similar results occurred with the case crossover design (odds ratio 0.43, 0.09 to 1.83). The adjusted odds ratio for helmet use for participants with any neck injury was 0.62 (0.33 to 1.19) and for participants who required evacuation by ambulance for neck injuries it was 1.29 (0.41 to 4.04). CONCLUSIONS: Helmets protect skiers and snowboarders against head injuries. We cannot rule out the possibility of an increased risk of neck injury with helmet use, but the estimates on which this assumption is based are imprecise.

    2. Levy AS, Hawkes AP, Hemminger LM, Knight S. An analysis of head injuries among skiers and snowboarders. J Trauma 2002;53:695-704.
    ABSTRACT: BACKGROUND: Head injury is the leading cause of death and critical injury in skiing and snowboarding accidents. METHODS: Data relating to head injuries occurring on the ski slopes were collected from the trauma registry of a Level I trauma center located near a number of ski resorts. RESULTS: From 1982 to 1998, 350 skiers and snowboarders with head injuries were admitted to our Level I trauma center. Most of the injuries were mild, with Glasgow Coma Scale (GCS) scores of 13 to 15 in 81% and simple concussion in 69%. However, 14% of patients had severe brain injuries, with GCS scores of 3 to 8, and the overall mortality rate was 4%. Collision with a tree or other stationary object (skier-tree) was the mechanism of injury in 47% of patients; simple falls in 37%; collision with another skier (skier-skier) in 13%; and major falls in 3%. Skier-tree collision and major falls resulted in a higher percentage of severe injuries, with GCS scores of 3 to 8 in 24% and 20%, respectively, and mean Injury Severity Scores of 14 and 17, respectively. Mortality from skier-tree collision was 7.2%, compared with 1.6% in simple falls and no deaths from skier-skier collision or major falls. The risk of sustaining a head injury was 2.23 times greater for male subjects compared with female subjects, 2.81 times higher for skiers/boarders 35 years, and 3.04 times higher for snowboarders compared with skiers. CONCLUSION: Skier-tree collision was the most common mechanism for head injuries in patients admitted to our Level I trauma center, and resulted in the most severe injuries and the highest mortality rate. Because most traumatic brain injuries treated at our facility resulted from a direct impact mechanism, we believe that the use of helmets can reduce the incidence and severity of head injuries occurring on the ski slopes.

    Helmets do not appear to increase risky behavior:
    3. Hagel B, Pless IB, Goulet C, Platt R, Robitaille Y. The effect of helmet use on injury severity and crash circumstances in skiers and snowboarders. Accid Anal Prev 2005;37:103-8.
    ABSTRACT:The aim of this study was to examine the effect of helmet use on non-head-neck injury severity and crash circumstances in skiers and snowboarders. We used a matched case-control study over the November 2001 to April 2002 winter season. 3295 of 4667 injured skiers and snowboarders reporting to the ski patrol at 19 areas in Quebec with non-head, non-neck injuries agreed to participate. Cases included those evacuated by ambulance, admitted to hospital, with restriction of normal daily activities (NDAs) >6 days, with non-helmet equipment damage, fast self-reported speed, participating on a more difficult run than usual, and jumping-related injury. Controls were injured participants without severe injuries or high-energy crash circumstances and were matched to cases on ski area, activity, day, age, and sex. Conditional logistic regression was used to relate each outcome to helmet use. There was no evidence that helmet use increased the risk of severe injury or high-energy crash circumstances. The results suggest that helmet use in skiing and snowboarding is not associated with riskier activities that lead to non-head-neck injuries.

  39. Jim in the Midwest March 19th, 2009 7:49 pm

    The worst bell ringing I ever had was from a sidward fall on a glare ice intermediate slope. The thing that scared me the most was the the bell ringing started a day later, I didn’t even know I had hurt myself at the time of the fall. Since then I’ve worn a helmet.

    How many would stand on their concrete driveway and muster up the courage to fall backward or forward and use their skull to catch the fall? One doesn’t have to be moving on skis to hurt themselves if they fall on ice or hardpack. I understand the argument that my helmet probably isn’t as effective as I would like, but it increases one’s chances.

  40. Randonnee March 19th, 2009 7:56 pm

    That looks like some useful data David P. I was wondering, however, if you were able to get away from fulltime charm school to go accept that Nobel Prize?

    A lot of the discussion here has the potential to get folks thinking at a level that they embrace.

  41. Robie March 19th, 2009 8:00 pm

    In the early days of motocross somebody said “If you have a $10 head buy a $10 helmet” . Now as far a very severe hit a helmet isn’t going to help not even a good one. But what a helmet will do and has done for me is let me finish a day of skiing after a minor scuffle. I also find a top vent helmet will produce a vacum over the top of my goggles thus helping with fogging issues.

  42. Lou March 19th, 2009 8:03 pm

    David, thanks for the details, but did anyone here say that helmets didn’t prevent head injury? I don’t recall anyone writing that. We’re just questioning how effective they really are, as opposed to the common perception that they can do quite a bit to prevent injury.

    As for the theory that they increase risk behavior, yeah, jury is out on that and your study appears to refute it.

    Also, no one is arguing that head injury is not a leading cause of death! The problem is, from what I’m reading, the rate of death from skiing has not declined, but a ton of skiers are wearing helmets. I can see no other conclusion other than that helmets are not preventing death at enough of a level to make a difference! That’s radical! I really could care less about wearing a helmet to prevent my scalp from getting cut, or to keep my head warm. I want one that’ll keep me from getting killed from a head injury!

    Like I said above, it’s a no brainer (no pun intended) that helmets prevent some injuries. But to what extent! That’s not an opinion, it’s a question anyone who buys and wears the things should be asking.

    Sure, that question will not be definitively answered here but if enough people keep asking, perhaps that’ll make a difference.

  43. Nickel March 19th, 2009 8:04 pm

    I am an advocate of helmets. I am on ski patrol and have seen several instances where helmets have saved lives. I am aware that the “effective” tested range for helmet safety is only about 20 miles per hour. But last year there was an accident where a snowboarder hit a tree going roughly 45 miles per hour. To give you a sense of the mechanism of injury, when he hit the tree he had bilateral femur fractures and pelvis injuries and a punctured lung etc. So really bad injuries. His helmet was shattered. The snowboarder was in a coma for a few weeks and came out to rehabilitate and is currently fully recovered. The doctors said if it weren’t for the helmet he surely would have been dead.

    But to argue against that same point. I recognize a psychological contributer to this conflict also. Recently, I have stopped wearing a helmet as much. And I have found I ski less fast through the trees, and less fast and risky in general. So with that, wearing a helmet can give a false sense of safety. Wearing a helmet I ski more risky lines and faster through trees, etc. Where otherwise I wouldn’t ski if I were just wearing a hat. So yes, when I do hit a tree a helmet may save my life. But would I have skied so riskily without a helmet to get into the situation of crashing in the first place.

    But I rather just wear a helmet.

  44. brian March 19th, 2009 8:08 pm

    Not much to add here except to say…..Sophie, are you kidding me????? Those comments MUST be a joke! Very funny.

  45. dave downing March 19th, 2009 8:10 pm

    I’ve finally started taking my helmet into the BC semi-regularly. I’ve been wearing one at the resort for about 10 years now. I’m sick of hearing a lot of this discussion. If you want a guaranteed life saver, don’t go skiing and it won’t kill you. On the other hand, I have knocked myself out 100% less times since wearing a helmet, and have significant reduced or eliminated the effects of multiple concussions. These are facts. Also, helmets are warmer on nasty days. I HATE forgetting my helmet in the winter, it makes me cold. Anyway, wear a helmet if you want. Don’t wear one if you don’t want to.

  46. FernieBoy March 19th, 2009 8:14 pm

    The scariest thing for me is the lack of sound safety engineering going into the helmets our kids want to put on their head. Let’s face it, our kids are going for looks and as a result, the helmets being marketed to our young ones are designed more with fashion in mind than safety. A lot of parents assume all of these products offer ample protection….. they’re just happy to get a helmet their kid is willing to strap on. In Canada, something like 90% of skiers/ boarders under 18 are wearing helmets. Which is great but this popularity is driven more by the fashion factor rather than safety. The industry has done a good job of making helmet wearing cool and I commend it for that….. now that we know what kids want, lets start building them (helmets) to protect better. As for adult helmet wearing. I agree with previous posters….. I’ve yet to hear one good argument against it. And lets remember, no matter how prevalent helmet use becomes, there will always be skiing fatalities due to head trauma. Peace. And Sophie, you’re on crack…… any healthy adult can learn to ski…. go for it.

  47. Nickel March 19th, 2009 8:25 pm

    well said Dave

  48. Bar Barrique March 19th, 2009 8:38 pm

    I do not wear a helmet, and, while it may be possible that wearing one may marginally be of some benefit while skiing, the same argument could be made for wearing one at all times. Every day we take risks; driving in a car, or taking a bath. The odds of injury are with us at all times. Whether or not wearing a helmet is a prudent idea is a personal decision.

    Bar

  49. Randonnee March 19th, 2009 8:52 pm

    There is a significant number of head injuries seen in middle-aged to elderly adults from simple falls while walking or jogging. I have said, perhaps in jest, after treating these that sometime after age 65 I will just wear a helmet all of the time!

    : ) }

  50. Mark Worley March 20th, 2009 5:47 am

    Tip: Try wearing a helmet without the annoying ear flaps and just put a hat between your and the helmet. Hearing and comfort issue solved. Works for me.

  51. Steve March 20th, 2009 7:12 am

    The data show that helmets don’t reduce skier deaths. OK, what appears to be lacking is the ability to measure the number of injuries that were prevented by the increased helmet use. I have a totally non-scientific gut feeling that there are a number of those “near-misses”. My kids and I wear helmets, mostly as protection against the out-of-control teenage snowboarders like the one who bounced his board off my daughter’s skull or the other one who took out the person waiting in the lift line. After reading this thread, I’ll probably have my daughter use her climbing helmet instead of buying the next size ski helmet.

  52. Randonnee March 20th, 2009 8:18 am

    Data may be used to support helmet use, or not. That is the nature of data. All of us instinctively know that a helmet offers some degree of protection. I imagine that releasable ski bindings have not been shown to reduce death while skiing, but we would not ski without them. Yea, some of those other type skiers do, I am aware. As far as not discounting helmet use because it would only prevent injury and not high-speed caused death is a dubious standard if compared to the example of the use of releasable bindings.

  53. Tucker March 20th, 2009 9:02 am

    Clyde, Team Wendy helmets are all sold out.

  54. Mike Stone March 20th, 2009 9:14 am

    Meanwhile, in Spain a 31 year-old man who no-one has ever heard of – outside of his family and friends – died yesterday from injuries sustained when an instructor on a snowboard crashed into him last week-end.
    I am not hearing any fuss about negligent snowboarders though I am pleased to say that the instructor could be charged with manslaughter.
    Nearer the topic in hand, there are facts and opinions galore on the subject of helmets and safety. It is your job as a consenting adult to weigh up the pros and cons and decide what is best for you and act on that decision. No more laws.
    If Sophie wants to die on a mountain it is up to her – as long as she does not wantonly take someone else out in the process. Dave Downing, on the other hand, seems to be a dangerous man to be anywhere near. In 15 years of ski-touring I have not even suffered a headache and I do not wear a helmet (he has his experiences, I have mine).
    BTW here is a reference for the Spanish incident – in Catalan: http://www.diariandorra.ad/noticies/view.php?ID=10769

  55. PerH March 20th, 2009 9:28 am

    I find it highly irresponsible to try to downplay the importance of wearing a helmet whenever skiing, BC or resort. It is not a good argument to simply measure the number of fatalities, as the equipment we use today has done a lot to alter the speed and location of average skiers.
    My friends and I do between 50 to 70 BC days per season and we all wear helmets, always! So does almost everybody I meet in the mountains in Norway.
    Modern skiing helmets should follow standards that test helmets for multiple hits and in cold and warm conditions.
    I wear a helmet to prevent unnecessary injury from getting your ski or snowboard in your head, hitting a branch, or falling on ice or hardpack snow. I wear a helmet because it makes sense when I ski in places where there is a risk of avalanche, or where there are other skiers. My helmet is not going to save me from getting buried and killed from lack of oxygen, but it may save my head if I get dragged over rocks.
    To me, and most of my skiing friends, a helmet is as natural part of our BC equipment as a beacon, probe, and shovel! Never without it. I use a Sweet Trooper Half Cut helmet.

  56. hunter March 20th, 2009 10:49 am

    I wear an extra thick sumo wrestling suit with a full downhill mountain biking body-armor kit and bubble wrap underneath, an air force military grade fighter jet helmet with attached c-collar and movement limiting halo, extra stout knee braces that attach to my boots and have a speed measuring device that automatically engages my ski brakes if I exceed 15 mph that is backed up with a drag chute that deploys if I exceed 25 mph and I find it “highly irresponsible” that anyone would downplay the use of this equipment at the very minimum for safe skiing.

    Yeah, yeah, I jest, but what’s it going to come to? If you want to wear a helmet, do so, but don’t think that they should be mandatory for everyone. In the 40 years (maybe 2500 days total) I’ve been skiing, I’ve only had one head injury that only required 2 stitches, and that was when I was 11. I do own a helmet but only wear it when I’m ski mountaineering in serious terrain or planning on spending some time in the half pipe. Normally I don’t wear it and don’t like it. If, in the future, I sustain a head injury, so be it, that is a risk that I am willing to take with the full understanding of the consequences and full knowledge of my skills, abilities and limitations. If you want to be safe, don’t ski; or leave home for that matter.

  57. Peter Banta March 20th, 2009 11:25 am

    I don’t think anyone was calling for mandatory helmets here, just the usual political over-reactions in PQ since it is big news right now.

    I would like to add that I think the stats on injury reduction, which are already impressive on their own, are most likely much higher than those cited?

    Why do I think so?

    Because these deductions were all based on known accident info, culled from ski patrol reports of REPORTED accidents. And so leave out MANY unreported.

    How many of us have had a fall and whacked our head on the ground, or a tree/branch, shook it off and kept skiing and/or went home? Probably 99.9%.

    And how many stopped by Ski Patrol on the way out to say, “Hey, I fell and hit my head earlier, but I am fine. Just wanted you to know.” & filled out a report? None.

    So, if you can show a mathematically sound method to demonstrate that head injuries were reduced using only the info from the more serious, reported injuries, then one can safely assume that in truth reduction rates are even higher when one factors in ALL head injuries that were likely to have occured.

    And while these things are not made to the standards of motor-sport helmets, one should not fully discount how much energy can be displaced by styrofoam.

    Take a piece of it and lay it on the ground.

    Now take your forehead and head butt the piece of styrofoam with moderate force. Probably didn’t hurt too much, did it? It compresses and distributes force.

    Now remove the styrofoam and repeat with same force onto the bare ground.

    Now how did that feel?

    Hello? Are you OK? How many fingers am I holding up?

    Please wear a helmet. If not for you, do it for someone who cares about you.

  58. Dave N. March 20th, 2009 12:40 pm

    Like others here, my only concern is possible mandatory enforcement of a helmet law. The right to choose should be foremost in our already over-regulated world. A smarter populace thru education and good upbringing would vastly improve our world as opposed to more rules/regulations. Walking around in fear of every possible activity leading to death is exactly one of the things Thoreau was concerned about: “when I had come to die Discover that I had not lived” (partial quote.)

  59. Jeremy March 20th, 2009 1:22 pm

    I bought my first helmet 8 years ago, and my second one 10 days later. The story of the first helmet runs like this:

    While traversing along the top of a cliff in trees at Whistler, my downhill ski caught in a tree root buried beneath the snow surface and I fell backwards down the cliff. I fell about 60 feet, and did 3 backward somersaults. Each time my head hit the cliff (once for each somersault) I thought “Good thing I’m wearing the helmet .” I landed conscious, if bruised and banged up, but with no damage to my head. I was able to walk away.

    Putting this in perspective – the helmet had deep gouges down one side, and the foam interior was cracked in two places from the impacts. The fall took place about half an hour before the lifts closed, and my friends were ahead of me. I’m not sure they’d have found me that quickly if I hadn’t been able to make my own way out, and I wouldn’t like to have spent the night or the evening out. I landed in deep snow from which I was able to extricate myself – if I was unconscious when I landed … well, you get the picture.

    I’m a capable skier, I wasn’t skiing even close to fast, and I don’t think I could have second guessed the tree root and its effects. That first helmet made a big difference, and I have worn a helmet since.

  60. Colin March 20th, 2009 2:01 pm

    Dave N., I for one am NOT concerned about a mandatory helmet law. At least, I’m not concerned aobut one for 18+ year-olds. If bicycle helmets aren’t mandatory, then it’s highly unlikely that ski helmets could be made so, except maybe for children (which would not necessarily be a bad thing, in my opinion).

  61. Lou March 20th, 2009 2:42 pm

    Wow, good thread you guys! Just got back from doing a classic descent of a 14er with son Louie, and look what’s been happening at good ol’ WildSnow!

    Those Team Wendy helmets look like the ticket. Louie’s helmet has too many years on it, so we’re going to upgrade to Team Wendy. Too bad they’re out of stock. But they say they’ve got some new models coming out… perhaps we can do the WildSnow treatment on one!

  62. dave downing March 20th, 2009 3:23 pm

    @Mike Stone said “Dave Downing, on the other hand, seems to be a dangerous man to be anywhere near.”

    I am SO taking that as a compliment :)

  63. Rob March 20th, 2009 4:02 pm

    Personally, I use my CAMP climbing helmet for skiing. It’s a lot better ventilated, which is a big issue in the backcountry, and I feel that that it will do a better job reducing an impact with its flexible suspension than my ski helmet which is metal, hard and thick plastic, and relatively hard foam. While I am willing from time to time to ski in bound without a helmet, not only am I increasingly of the opinion that one should always wear them, I have long held that they are absolutely necessary in the back country.

    As to moral hazard, I believe moral hazard is as real in ski helmets as in every other piece of protective equipment ever made. On the other hand, bikers, climbers, motorcyclists, and pretty much everyone else has had this argument and concluded that they should probably wear helmets. I don’t see skiers being different.

  64. Sean March 20th, 2009 6:00 pm

    1) I really like Jeremy’s story as a good practical example.

    2) Anyone who is reacting to the notion of a mandatory helmet law needs to realize that such isn’t the tenor of the comments here; instead the mention arose in the context of a ski resort considering that as a rule. So if you don’t like the proposed rule, get angry with that resort. Not people in here, who aren’t asking for a mandatory helmet rule.

    3) Peter Banta mentioned people not reporting things. I can say from experience that I did that very thing last season. I was doing a tree-lined traverse to sidecountry, alone. Ducked for a branch, but didn’t duck enough. Next thing I knew I felt a solid hit to the noggin, vision blacked out for a second, and when I could see, there was blood streaming from my nose. My helmet had pushed my goggles frame down hard against the bridge of my nose, causing not only a bloody nose, but also a gash on the outside of the nose. I didn’t report it to ski patrol, I just finished my run after the nosebleed stopped, went to my truck, and drove home.

    I am a MTB rider and a skier, and I wear a helmet in both activities. From past MTB accidents, I know that the force of my head collision just mentioned would have been disastrous if I hadn’t been wearing a helmet. At the very least I’d have had a nasty gash atop my noggin.

    I don’t care if anyone refuses to wear a helmet. I don’t want to see helmets made mandatory. So don’t imagine that I’m telling you you have to wear one. Just read my comment as what it is… a tale of my experience.

  65. Lou March 20th, 2009 6:58 pm

    The thing is, folks who have accidents that exceed the capabilities of their helmet to protect them are not telling survival stories. They are either dead or in a vegetative state. We should all be aware of that painful bias in the excellent testimonies above!

    Don’t get me wrong, helmets do protect and it’s great hearing the stories. But any person with a shred of logic has to acknowledge that we’re getting a mighty skewed picture of the protection helmets provide. (And yes, I did wear mine today…)

  66. Lou March 20th, 2009 7:00 pm

    I’ll second that emotion about Downing (grin), especially when he’s skiing backwards.

  67. Ruth March 20th, 2009 8:28 pm

    I recently came across your blog and have been reading along. I thought I would leave my first comment. I don’t know what to say except that I have enjoyed reading. Nice blog!

    Ruth

  68. wendy March 21st, 2009 1:31 pm

    Helmet or no, it is prompt medical care that would have prevented Richardson’s death.

    If you’ve lived to be over the age of 30 it’s likely you’ve cracked yourself in the head once or twice, doing any number of activities, risky sports aside. A simple fall in the home could have resulted in the injury that Richardson suffered.

    Accidents are just that, so of course injury from them is not entirely preventable. People dying from their own stupidity is really natural selection at work.

    Because life is such risky business, just to be safe, I suggest we wear helmets at all times.

  69. Dan March 21st, 2009 2:36 pm

    It’s as simple as this:

    Individuals adverse to the wearing of helmets are as naive as those who think car seat belts are unnecessary.

    You can’t beat physics…but helmets can sure improve your odds.

  70. Geof March 21st, 2009 4:06 pm

    To the folks wearing climbing helmets thinking it might make a difference…

    Climbing helmets do one thing and one thing only, help prevent a rock from taking you out. They do NOTHING to prevent head injury in a fall. Wearing one while skiing is just added weight to your head… Take a look at ALL the literature provided on climbing helmets. They were never meant to be an impact absorbing (from a fall) device.

  71. Randonnee March 21st, 2009 5:20 pm

    Geof said, “Climbing helmets do one thing and one thing only, help prevent a rock from taking you out. They do NOTHING to prevent head injury in a fall.”

    That is a bit of obvious overstatement, don’t you think? When one looks at climbing helmets at online retailers the following is commonly stated, “Meets all UIAA and CE specifications for shock and energy absorption, conical impact, security of retention straps and ventilation standards.” Clearly there is a standard for fall protection as well as “conical impact.”

    My Grivel Mont Blanc helmet is designed for ice-climbing/ climbing. It is so light that I actually take it along ski touring- I wear it on the up and the down. I was drawn to the nice coverage of the temples, and the cool graphics on the shell. As a Patroller I noted that skiers whacked their temples and incurred head injury in even some easy falls on blue-diamond runs. So, my helmet covers the front of my head well, that is the area I would expect to impact first in a ski fall, especially since I would be reflexively tucking in my chin. Climbing helmets usually have energy-absorbing materials, thus your hyperbole leads me to state the obvious…we all know that climbing helmets offer some degree of worthwhile protection in a ski fall, even without seeing that it meets some standard.

    Anyone, what exactly are these UIAA standards? My quick search using the UIAA etc. standards just returned more ads for climbing helmets.

  72. Njord March 21st, 2009 8:22 pm

    I wrap my head in bubble wrapping and duct tape. All I can say is: “So far, so good!”.

    Njord

  73. Jon March 21st, 2009 8:54 pm

    “Climbing helmets do one thing and one thing only, help prevent a rock from taking you out. They do NOTHING to prevent head injury in a fall.”

    Friend of mine just took a 15 foot whipper flipping upside down because the rope was around his leg, slamming into the rock with mostly his head. He complained about his elbow and never said anything about his head, and his helmet could take the same hit again. When you take into fact the rotational forces that come with a typical upside down climbing fall you are probably getting at least similar speeds to moderate ski crashes. Rocks are rocks regardless of whether your trusting your quiver or your rack,

  74. John Gloor March 22nd, 2009 7:11 am

    I think it is important to note that not all climbing helmets are the same. For years, the helmets were basically suspension hard hats, with no energy absorbing foam. The new helmet style is more akin to a bike helmet and probably can help with falls. I am not sure of any ANSI or SNELL testing for velocity impacts for the new foam helmets, but it would seem like there should be some. It is noted on a sticker on the inside of the helmet. If Geof was thinking of the hard hat style, he is correct as far as official testing for speed impacts goes

  75. Dave N. March 22nd, 2009 8:10 am

    Colin, I don’t lose sleep over possible regs either, but have notice the proliferation of reactionary comments on other Richardson newvines calling for mandatory helmet enforcement… Just putting it out there for all to mull over.

  76. Seth March 22nd, 2009 8:43 am

    Sorry if i am being redundant here but it seems very important to me to point out the dangers of conflating the issues of death rate of skiers and helmet usage. i ski predominately in the east and the mountain I ski at averages about 1-2 deaths a year. typically though these involve someone cutting their leg with their edge in a nasty fall (and then bleeding to death) or some kind of blunt trauma to the chest (resulting in internal bleeding or other life-threatening injuries). Unfortunately, there are many ways to die skiing and trying to somehow question the efficacy of helmets through the fact that the death rate hasn’t dropped is logically inconsistent. there of course are concerns about what a helmet can really do to help you in a high-speed, head-on collision. in reality a helmet is most effective for low-speed falls on hard snow or ice. if helmet wearers somehow think that the plastic and foam egg-shell on their head is going to protect them from serious head trauma while bombing down a rock-strewn slope at mach 2 then they may need to reevaluate. unfortunately a helmet may well have minimized some of the harm to Natasha Richardson judging from the accident description. in short, if you want to judge what effect helmets are having, you’ll have to look at the rate of head injuries in ski accidents broken down by mechanism of injury (if such data exists). otherwise, we’re just going to be stuck with anecdotal evidence. just be reasonable with expectations for helmets. they won’t save you if you’re skiing fast or hit something really hard. common sense tells this. however, if you lose your balance momentarily standing on an ice sheet and whip your head onto the ice by accident, a helmet may well prevent a concussion or other serious injury, or at the very least minimize the harm.

  77. Lou March 22nd, 2009 9:08 am

    Seth, if helmets provided much in the way of protection, and almost half of skiers used them, shouldn’t there be at least an itsy bitsy teeny weeny drop in death rate, as some deaths must be from head trauma? It might be illogical to make a god out of the skier death rate when it comes to helmets, but it would seem equally illogical to explain it away.

  78. Randonnee March 22nd, 2009 9:18 am

    When one disease or mechanism is cured or lessened, deaths occur by another. In this example of helmet use, behavior and speed are the issue, therefore even if the head is protected another mechanism of injury causes death if speed/ force is involved.

    Conversely, there is increasing avalanche education, more and more expensive gadgets for avalanche “safety”, yet has all of that affected death by avalanche? Again, chosen behavior, the result of choosing to enter avalanche terrain compared to the hazard evaluation is the key. Likewise with helmets- if I ski in control at a moderate speed, a helmet may very well prevent my accidental death. If I ski fast, I had better get it right and stay in control- or die. Much like the decision to enter avalanche terrain.

  79. Dave March 23rd, 2009 11:41 am

    The Natasha Richardson thing is sad. More of an important lesson to medical providers than anything else. Accidents happen just like this to the famous and ordinary all the time.

    I knew Kathryn, but not well. Total rockstar. Patroller at the village and all-around mountain badass. I cannot rationalize not wearing a helmet any longer. I spent several seasons at the Alta Medical Clinic and work in the Emergency Department at a local hospital. There is no doubt that helmets work. No doubt.

    I’ve been shopping for a helmet this week. It is time.

  80. Mike Stone March 23rd, 2009 1:58 pm

    @Dave Downing: You’re welcome. Now why did I think that might be your response?
    Let me know if you ever come to the Pyrenees so I can arrange a beach holiday for myself. (I hate beaches)

  81. Dave March 23rd, 2009 3:50 pm

    It’s interesting that statistics always focus on fatalities. Someone probably already commented about this but how many people lose a bunch of brain cells and end up in the hospital for a day without a helmet who might have been up and skiing a moment later if they had a helmet? If a helmet will keep me from ruining my family vacation and also might save my life in the rare case of hitting rocks or trees, it seems worth the trouble.

    My wife took a fall on her bike way back and the helmet had a dent in the foam. Seems like she would have had a bad headache or concussion with the helmet but with it, she got up and rode away.

    Dave

  82. powderjunky March 23rd, 2009 3:54 pm

    Everyone is forgetting the number one reason to wear a helmet is to protect yourself against people banging the safety bar on your noodle or being whacked by your partners diagonal carry while he/she is trying to pass you on the bootpack :)

  83. Jerry March 24th, 2009 1:02 pm

    Lou – you are enough of an engineer to understand the simplicity of your position – you are asking the question wrong. In the population of deaths, there are literally more variables than events. Think about grooming technology, equipment, crowding, artificial snow, trail layout, etc. All these factors and more contribute to skiing deaths and they are not integrated into your “model”. Quite simply, unless we can isolate the effect of helmets none of us can know the real effects. Helmets are only one variable in a very long regression equation; the effect may be so small they simply don’t show up in the equation. On the other hand, what, as skiers, can we control in the equation? We can’t control many of the important factors but we can decide to minimize risk by wearing a decent helmet. Seems to me the conservative approach is to isolate what you can and hope for the best.

    As a patrol and one who has read the available medical literature the evidence is conclusive. Keep in mind much of the med literature is not as well done as it could be in a controlled experimental design but the basic findings are clear – wear a helmet.

  84. Seth March 29th, 2009 9:54 am

    Lou,
    Hey, sorry for the late response. I understand your question regarding death rate and helmet usage (meaning that there should at least be some reduction) but that speaks to exactly what I was talking about before. Let me try to clarify my admittedly rambling previous post. My point was simply that helmet usage will be unlikely to show any effect on the death rate because the utility of a helmet in a fall of sufficient force to cause serious injury or death is minimal. For example, if you crash at 44-55 mph bombing down a groomer run here in the east and hit a lift tower with your head, it won’t matter whether you’re wearing a helmet or not. The helmet will not be able to provide any meaningful protection against such a fall. Thus, with or without a helmet, death is likely to occur. My problem with the “cult of the helmet” is that people think that they are the silver bullet to increasing safety while skiing, yet they fail to recognize the very limited utility of helmets in violent crashes. Basically, it is ironic but true that something that people believe will protect them in a bad crash is unlikely to do much of anything. Where helmets are useful is if you catch an edge at low speed and bounce your head off an icy patch or if you collide with an out of control skier at relatively slow speeds. As has probably been pointed out in better ways by previous commenters, helmets can reduce the rate of injury among skiers or lessen the severity of injuries for a certain subset of accidents (low-speed, low-force collisions mainly). Thus, the better data to look at would be rates of head injury over the last 10 years combined with severity of injury and see whether there has been a drop in that. Bottom line, you can’t trust a helmet to do much of anything for your if you’re a super aggressive skier who pushes the envelope (except keep your head warm on freezing days which is important here in the east). Finally, I think one point that would support your argument is that if helmets are useful in slow speed crashes, then wouldn’t we see a drop in the fatality rates due to helmet usage because they would prevent against accidents just like Natasha Richardson’s. However, I think the problem with such an argument is that Natasha Richardson’s accident strongly resembles the kind of statistical outlier would have little effect on national fatality numbers. This is further compounded by the fact that national fatality numbers conflate all mechanisms of death into one number, not just head injuries, making it difficult if not impossible to draw any meaningful conclusions based on that data. But I digress….. Thanks for the forum for debate though. I think that even if people disagree it is good to at least hear the issues.

  85. Christian C. March 30th, 2009 11:54 am

    I just came across this study on the “Speeds Associated with Skiing and Snowboarding” 2007) their input on helmet effectiveness is worth noting.

    (Excerpts from abstract)

    The protective effect of a ski helmet is diminished at the high speeds a skier or snowboarder can potentially obtain on an open slope.

    Many skiers and snowboarders frequent nontraditional terrain such as gladed areas and terrain parks. Since these areas contain numerous physical obstacles, we hypothesized that skiers and snowboarders would traverse these areas at speeds slow enough to expect a significant protective effect from a helmet.

    In 79% of the cases in gladed terrain and 94% of the instances in the terrain park, observed speeds were less than 15 mph. Skiers and snowboarders navigate nontraditional terrain at speeds slower than on open slopes. At the observed velocities, a helmet would be expected to provide significant help in diminishing the occurrence of TBI.

    full article:
    http://www.allenpress.com/pdf/weme_18_205_102_105.pdf

  86. Megan March 31st, 2009 10:58 pm

    I ski to be free. It is everyone’s choice how they ski and what they wear. The mountains should be the place where we are free!!! Not wearing a helmet endangers no one else life but your own. FREEDOM OF CHOICE is my vote.

  87. Dave April 1st, 2009 7:38 am

    next topic, helmets v. global warming!

  88. Gray April 10th, 2009 4:16 pm

    Lou,

    Another question?
    Are we talking about the number of deaths or the death rate?

    If we are talking about the number of deaths not decreasing this is not that surprising. Skiing and snowboarding are becoming increasingly popular. Therefore more people are participating which leads to a higher probability of accident or death. If we are talking about the rate, ie the number of deaths caused by head trauma per a set number of winter-sports enthusiast, increasing then we should be looking at the effectiveness of the helmets.

    Another question to look at is what is considered cool. It used to be that only Olympic ski jumpers would consider jumping the heights that are now common place. Helmets may give a feeling of “invincibility” causing more people to do crazy things. However we need to look at the activities that are getting all the attention. We are becoming a society that is fueled by adrenaline, and to keep the same level of interest higher and higher levels of adrenaline are needed. How many ski movies are showing huge drops and descents in front of avalanches? How many of us go so we can have that adrenaline rush? Then how many of us go out and try something similar to what we have seen?

    Helmets might be a part of the issue. Another part is what risks are we willing to take so we can get our adrenaline fix. Or what are we willing to do to “feel alive.”

    This is a personal question one which we have to come up with the answer to ourself. I am not saying the media are at fault for producing movies that feed off adrenaline. Nor am I saying that helmets are not an important part of the equation. We need to take responsibility and make the choices that we are willing to live with.

    If wearing a helmet helps you feel comfortable with the activities you are choosing then by all means wear a helmet. Just don’t expect it to solve all the problems and accidents.

  89. Jim Moss April 12th, 2009 12:21 pm

    Interesting comments but many are based on myth rather than reality.

    1.

  90. Jim Moss April 12th, 2009 12:27 pm

    Interesting comments but many are based on urban myth as much as anything. (1.) a helmet would not have saved the actress. (2.) According to media reports there have been 4 inbounds fatalities this year due to head injuries. However further investigation usual proves that incorrect for the actual cause of death in skiing. In the past 4 years no death has been reported due to head injuries. Fatalities are usually due to “blunt force trauma” (torn ascending aorta). (3.) Wearing a helmet without a mouth guard is the same as wearing Tupperware on your head, worthless. (http://rec-law.blogspot.com/2008/02/helmet-manufacture-understands-issues.html) (4.) Risk Homeostasis usually mitigates the use of a helmet for single person accidents. (http://psyc.queensu.ca/target/) (5.) Modern ski helmet standards are out of date and based on a throw away design. You hit hard on your helmet, you should throw it away. (http://rec-law.blogspot.com/2008/03/new-idea-that-makes-sense-in-helmets.html).

  91. Lou April 13th, 2009 7:22 am

    Hi Jim, looks like a glitch bit your comment. Sorry about that. Appreciate you giving it a shot. With any blog, if you write a lengthy comment always do it on your local computer first (in your word processing software, or Windows Notepad, or whatever), then copy/paste in the blog comment field. That way if the server has a glitch at the moment you click “submit” for you comment, and it gets lunched, you can try it a second time. ‘best, Lou

  92. Lou April 13th, 2009 7:42 am

    Indeed, stick some bubble wrap in a Tupperware bowl, stick it on your head, instant ski helmet! I agree that’s about all most ski helmets are the equivalent of.

  93. Jamoke October 5th, 2009 9:39 pm

    :angry: SOPHIE :alien: Your comments are so immature. I started skiing at age 48 seven yrs ago. Skiing is 1,000 miles away but I’ve gone every year since. I’m an advanced level skier and will retire to a ski area next year. I’m looking for a helmet right now so I don’t bang heads with people like you on the slopes. :sideways:
    Expanded polystyrene (EPS) aka styrofoam has been determined the best material to deccelerate head impacts. Unhelmeted motorcyclists have died in low speed collisions their body otherwise would’ve survived except they hit their head on something. There is no room in the skull for the brain to swell.

  94. Wyatt November 26th, 2009 8:18 pm

    Coming in late here, but this is a good discussion.

    I’m glad I read this because I’ve been shopping for a ski helmet but I’ve held off pending more research since I’ve noticed some have disclaimers saying they aren’t certified against this and that (basically saying they’re just for looks).

    I’m thinkin about wearing my hockey helmet since those are designed for higher impacts and multiple types of impacts (pucks, sticks, elbows, high speed headfirst slamming into solid objects, etc . Plus I already have one so I don’t need to buy something else. The downsides are weight, warmth (I’d wear a thin cap under it), and they don’t work with my goggles. For resort skiing I’ll probably do it. I’m on the fence for AT stuff. Thoughts?

  95. Rob May 15th, 2010 1:08 pm

    Great discussion!

  96. Trev Marsden February 13th, 2011 8:42 am

    I have just returned from Austria after a weeks skiing in Zell um see. My holiday was cut short by three days after I was swept from behind on a wide open slope by two young snow boarders racing each other. The first of the impact I remember is the immense shock going through my head as the rear left of my cranium impacted the hard packed snow….I was not wearing a helmet! I suffered whiplash injuries to my neck and concussion, as well as fractured ribs. I was escorted off the mountain and taken to the local hospital were I was admitted for 24 hours and underwent xrays intravenal painkillers and constant hourly observations. Whilst I was in hospital I was pretty shook up because my neck muscles felt very painful and I felt very tired and confused.
    Had I been wearing a helmet I believe I would have still sustained some injury but not to the extent I suffered. The helmet would have provided vital space between my head and the snow and would have limited the whiplash to my neck. I’m not sure the foam inside many helmets would have overly protected my head too much but you have to remember the energy would have also been disipated around the helmet and not solely through the head as was the case with me. Its been 10 days since my accident and my whiplash is under control and my concussion is starting to ease off. I would certainly advocate the use of wearing a helmet and will in future always wear one and I am currently researching the internet to find out the most robust helmet out there. I count myself as lucky, I am physically strong and i believe this has helped me but this accident came out of the blue and I for one did not think it could happen. More the fool me!!

  97. Lou February 13th, 2011 9:00 am

    Trev, really sorry to hear that and yes, helmets are perhaps a requirement now for skiing inbounds due to insanity of other skiers and riders. BUT, are we not missing something? Should skiers and riders be hitting each other with what I believe is now alarming frequency?

  98. Les December 15th, 2011 9:26 am

    I have skiied most of my life, I’m almost 50 and never crashed as hard as I did yesterday. I’m an excellent skiier and rarely ever fall and at most have sat on my butt a couple of times. I started wearing a helmet last year and loved it most because it keeps my head so warm. I never dreamed it would actually save my head until yesterday when I haf a wicked fall that threw me up in the air landing on my head on ice. My helmet broke in one part and cracked in two others spots. I am thankful I only have a mild concussion rather than serious head trauma. Never thought it would happen to me but it did! I will always wear a helmet from now on!!!

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