Ski Helmets are not the Silver Bullet

February 9, 2010

accident

http://www.ottawacitizen.com/opinion/helmets+alone+reduce+serious+injuries/2539248/story.html

The Ottawa Citizen newspaper just published an article (reprinted in the Edmonton Journal and the Windsor Star) I wrote entitled, ‘Why ski helmets alone won’t reduce serious injuries.’ Here are a few excerpts:

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The highly publicized death of actress Natasha Richardson in 2009 after she fell while taking a lesson on a beginner’s slope at Mont Tremblant Ski Resort in Quebec put the ski helmet issue back into the spotlight. That she was not wearing a helmet triggered a national debate about legislating standards and making helmet use mandatory at ski hills.

Tragically, an 11-year-old girl died last week in a skiing accident at Calabogie Peaks Resort near Ottawa. She was wearing a helmet when she struck a tree. No doubt this sad incident will prompt another round of debate about safety and skiing.

The Canadian Medical Association Journal (CMAJ) published a paper earlier this month suggesting that helmets are effective in reducing the risk of head injury among skiers and snowboarders. The meta-analysis of 12 previous studies performed in Canada, the U.S., Japan, and Europe systematically reviewed the impact of helmet usage on skiers’ and snowboarders’ head injuries. The researchers found that the use of helmets significantly reduced the risk of head injury; the pooled analysis of the studies indicated that the risk was reduced by 35 per cent.

Advocates of helmets such as the authors of the CMAJ paper encourage their use as a means to reduce the risk of head injury, and go so far as to say that “helmets do work.” This is difficult to argue against but reliance upon such figures paints a deceiving picture.

[F]igures indicate that helmeted skiers go faster than non-helmeted skiers as they are hitting things harder thereby causing more severe injuries. Other studies have suggested that skier and boarder fatality rates are unaffected by helmet usage.

[The theory of risk homeostasis suggests that] a control measure designed to mitigate the risk in one area (such as helmets) is compensated by behaviour such as skiing faster, hucking bigger air, skiing in the trees or taking otherwise ill-advised chances which elevate the risk to its pre-existing level. It is admittedly difficult to say whether the skiers increased their risk-taking behaviour because they were wearing a helmet or they wore a helmet because they planned on taking greater risks.

What are we to make of these contradictory findings? In short, helmets are not the silver bullet to skier and boarder accidents. Helmets alone are not the answer and should be part of a comprehensive risk management program at ski hills which includes skiers and boarders not altering their behaviour or taking more risks just because they are wearing a helmet.

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The Canadian Medical Association Journal paper by Kelly Russell, Josh Christie and Brent E. Hagel is at http://www.cmaj.ca/cgi/content/abstract/cmaj.091080v1

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