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Do helmets help?

Evidence suggests that skiing helmets won’t reduce deaths


 

Do helmets help?Francis Graveline, owner of a ski boutique at Owl’s Head mountain resort southeast of Montreal, sold 21 helmets last Saturday, more than twice his normal tally. Credit the tragic death days earlier of Natasha Richardson after a minor skiing accident. “I’ve been saying over and over for five years that people should wear helmets and hardly anyone listened,” Graveline says. “Now a celebrity gets killed and everybody wants one.”

But does every skier really need one? It may not matter. Soon, governments across the country are likely to mandate them. On Tuesday, just days after Richardson’s death sparked concern over a lack of snow helmet norms here, the Canadian Standards Association said it would begin testing helmets for certification next month, using standards it’s been developing for two years. Health Canada said it would consider referencing those new CSA specs in the Hazardous Products Act, making them mandatory in all helmets made in Canada. And Liberal MP Hedy Fry ramped up efforts to fast-track a similar private member’s bill banning all non-CSA approved helmets in Canada.

Yet studies show mandatory helmet use would likely have very little impact on the rate of ski-related fatalities, which anyway are surprisingly low. Although national numbers don’t exist, between 1990 and 2008 only 39 people died on Quebec ski hills. A provincial coroner’s report there last year found that of the 26 skiing-related deaths between 1990 and 2004, just 14 were the result of head injuries—an average of one a year—and two of the deceased were actually wearing protective headgear. Fatal injuries in snow sports are generally rare—less than one in 1.5 million days of activity, according to one American report.

Such numbers suggest there’s little evidence that fewer skiers would die in a world of mandatory helmets, says Michael Schwartz, a University of Toronto neurosurgeon who sat on the CSA committee that put together the specs for cycling helmets. “There would be more helmets worn to save one person than would be the case with cycling,” he says. “Natasha Richardson, from what I can gather, was extremely unlucky.”

Indeed, sports injury expert Jasper Shealy, of the Rochester Institute of Technology, says that despite an increase in helmet-wearing in recent years, the rate of skiing and snowboarding fatalities has stayed constant. “We’ve reached the point where roughly half the population is wearing a helmet, but over that same period of time the death rate hasn’t changed one iota,” he says.

Helmets just don’t help in the catastrophic, speed-related accidents that lead to death, says Shealy. “If you are in a typical fatality scenario—hitting your head against a solid object at the speeds that we believe people typically die at—I don’t think a helmet’s going to make much difference.” Though Shealy encourages skiers to wear helmets, “the notion that you should wear one so it will protect your head if you hit a tree and keep you from dying is probably misplaced hope.”

And the number of Canadians wearing helmets on our ski slopes is rising in any case. In Canada, Jimmie Spencer, head of the Canada West Ski Areas Association, says that about 45 per cent of Canadian skiers now wear them. Among younger skiers the numbers are even higher. A mail-in survey of nine- and 10-year-old skiers conducted this year by the Canadian Ski Council found that of the 4,000 who responded, 92 per cent wear helmets. “I personally wouldn’t go on the hill without one,” says Ski Council president Colin Chedore.

Both Spencer and Chedore bristle at the notion of mandatory helmets. “It should be a question of the individual’s choice,” says Spencer, adding that “a lot of people believe if they put a helmet on their heads, then they are invincible. That simply is not the case.” Shealy puts it another way: “Ideally, wear a helmet. But ski as if you weren’t.”

With Martin Patriquin


 

Do helmets help?

  1. As I sat an discussed this article with my 11-year old son this morning, we both came to the conclusion that the reporter clearly does not have an understanding of safety-related issues that plague ski resorts. As a 20-year veteran of the ski patrol in British Columbia, I can personally attest to both the need for and importance of skiers and boarders wearing helmets, not through questionable statistical analysis, but through direct observation of hundreds of accident scenes.

    First of all, Mr. Kohler notes that “national numbers don’t exist”, and he goes on to quote stats from the province of Quebec. I wonder if he has skied in (or even visited) Alberta or British Columbia, where the terrain, sheer size of the resorts, and number of skier visits far exceeds the ski hills of eastern Canada. To make an assumption that helmets may not reduce deaths based on this minimal amount of data is irresponsible.

    Secondly, helmets are not necessarily for the purpose of preventing death alone. I have taken many injured patrons off our mountains knowing full well that if they had not been wearing protective headgear, they would have been in far worse shape. Experts from universities can spout stats all day long, however it would be nice once in a while if reporters gained insight from those of us who actually face these situations on a daily basis.

    Lastly, as a parent, I want my children to take advantage of ANY equipment that might protect them in the event of a collision, fall, or other accident, no matter how small the risk may be. Therefore, I model that behaviour.

    In our family, we wear our helmets 100% of the time. That’s a statistic we can count on.

    Peter H.

    • Good on ya, mate.

    • Martin Patriquin and Maclean’s are bang on with this dose of reality. Peter H. on the other hand likes to talk emotionally and like most mainstream media, in anecdotes, and ignoring or trying to discredit sources used.

      Jasper Shealey and Vermont Safety Research have been extensively studying ski injuries in North America longer than anyone or any other organisation and have collect tonnes of data. The average skier in the U.S. (Canadians are faster) skis at almost 44 kph. The absolute best helmet standard on the other hand, Snell, protects the user at speeds up to only 22 kph. And only one helmet used to meet that standard, Leedom, but even this helmet manufacturer has dropped the standard.

      Maclean’s is correct, helmets do not prevents deaths on ski hills (laceration rates have dropped significantly since skiers started wearing helmets, skier deaths have actually gone up slightly…presumably because like in all sports, helmet wearers act more aggressively and feel more invincible)

      Thankfully skiing is a safe sport. The chance of dying from a head injury skiing (in the U.S.) is akin to being hit by lightning — twice.

      • Ian,

        I speak emotionally yes, because I see (and deal with) the carnage that academics only read about. Once again (and as David McCallum notes below), we’re not talking about preventing deaths alone. You quote some interesting numbers regarding skiing speeds, however in my experience the majority of serious accidents that we attend are not related to fast skiers, but to high-impact falls in the snowboard park and more alarmingly, collisions where the person standing still (or skiing slowly) tends to receive the worst injuries.

        You note that laceration-type injuries have been reduced significantly since skiers started wearing helmets. That alone is evidence enough for me to wear one. Have you ever seen a person bleeding out from a severe scalp laceration?

        My argument is not with the debatable fact that statistically, helmets may or may not prevent death. It’s with the fact that this conclusion may make people think twice about wearing a helmet period.

  2. Fascinating juxtaposition… Right next door to Ezra Levant’s screams of terror regarding an “insane” court order (“Enough’s Enough”, excerpted from his chronicle of rediculous legal procedings) we find Nicholas Kohler’s piece (“Do Helmets Help?”) which seems to suggest that ski helmets are useless because the evidence seems to be that they do not prevent deaths.

    What I find fascinating about this juxtaposition is the apparent insinuation that it would be yet another “insane” legal act if Canadians were forced to wear ski helmets. After all: they don’t prevent deaths.

    I am astounded by the total lack of consideration of anything other than death in relation to the ski helmet discussion. As if death is the only possible outcome of a ski-related accident, or that death is the only thing a helmet could address.

    As undesirable as death is, there is a whole range of other undesirable outcomes that ski helmets can and in fact do either prevent or reduce. Further, many of these injuries can be very serious, and very costly not only to those involved but also to the public health care system. Why isn’t this part of the discussion?

    To bolster the “no helmet laws” position, Jimmie Spencer, head of the Canada West Ski Areas Association, is quoted to say that “It should be a question of the individual’s choice.” (I could try to comment on why a ski area representative might have that opinion, but I don’t know anything about Mr. Spencer, so I will refrain.)

    As to individual choice, does the government have the right to impose restrictions that would both protect us and reduce costs? Seems to me that the answer would be pretty close to: “Duh!”

    Instead of supporting the editorial suggestion that helmet laws would be “insane” what this juxtaposition has done, in contrast, is to highlight how “rediculous” it is to try to massage reality to fit your chosen dogma.

    So, do helmets help? Nicholas: please go and actually answer the question, okay, and don’t come back until you have the full story.

    • Today 100’s of thousands, in fact millions of people skied and did not suffer any kind of injury at all. The risk of injury in skiing is about a 1 in 50 year chance for the average skier. The risk of head injury even more remote; the risk of death from a skiing accident is miniscule. Meanwhile plenty of people die every year from drowning. Yet when I go the the lake, or the beach, or even the local pool, the vast majority of people do not wear life jackets! But so many drown year after year! Surely life jackets should be made mandatory. Or since most people who die in car crashes die from head injuries, surely helmets should be mandatory in cars. And there’s always injuries due tobacco and alcohol. So for anyone truly interested in directing limited resources to reduce the most pressing preventable injuries, making helmets mandatory for skiers should not be a priority. It’s fair to expect elected politicians to address the most pressing and damaging issues first.

      I have been a full time professional ski patroller since 1986 at 3 major ski resorts in western Canada. I have skied the equivalent of 200 years of 2 week ski vacations, and seen my fair share of carnage. It is my opinion that there has been a large increase in the number of blunt trauma injuries due to the increased speed and aggressiveness of helmeted skiers. I have not observed a decrease in head injuries in the 17 years of records I have kept. Meanwhile I have observed an increase in serious head, pelvic, spinal, neck, femur, and organ injuries, almost all sustained by helmeted skiers. Many have acknowledged taking risks they thought were mitigated because they were wearing helmets. There’s the “duh” moment, for me at least.

      As for those advocating mandatory helmets, where would you stop making safety accoutrements mandatory? How far into personal choice would you go? Mandatory condoms? Enforced dieting for obese kids? Should whitewater kayaking be banned, or mountain climbing, or maybe backcountry snowmobiling? Are you suggesting the government should impose restrictions on these activities and reduce costs? And if helmets were made mandatory, and no decrease–or worse, an increase– in injuries is observed, what then? Maybe seek more draconian measures–mandatory athletic body armor? Helmets on skiers should remain a personal choice, just like smoking, driving, swimming without a life jacket, eating junk food, and commenting on MacLean’s articles.

      As for the posts deriding the results of scientific research about helmets: Remember this: “facts are stubborn things.” Hopefully science will guide the politicians when they hear from the folks thinking that since they chose to wear helmets everyone else should be forced to make the same choice they did.

  3. Peter,

    Firstly, I think your assumption that the skiing out east gives ‘minimal’ data that isn’t useful is misleading. Do you know which resorts come second and third in skier visits after Whistler/Blackcomb? Tremblant and Blue Mountain! In terms of terrain, the west coast certainly has big areas for skiers to get lost in, and open faces that don’t exist avalanche danger etc…but it is consequently missing some of the dangers of east coast skiing. Primarily, I’m talking about fast cruisers where people bail out and end up wrapped around a tree. I patrolled a little bit at Blue Mountain, and had family friends who were long time veterans of the patrol, and I think it is really important to re-iterate a point made earlier- helmets don’t work at high impact speeds. I think eastern skiiers are more cognizant of this because unless you’e playing in the terrain park, thrill-seeking skiers have no other option othan than fast runs down steep icy hardpack, and consequently the deaths mourned tend to be from those.

    You also mention terrain park injuries. In terms of life threatening injuries I suspect we probably both have the same vision of responding to the call, and at first sight knowing radioing in a high priority ambulance code and calling for the trauma kits – because there is a jumper sprawled way beyond a big tabletop who didn’t get his jumping speed/landing angle right. Again though, in this case how relevant is the helmet going to be when you’re really worried about the spinal/broken femur/internal bleeding? Especially since most terrain parks with big elements have a fairly strict helmets only rule now?

    Now I certainly agree that helmets help prevent head injuries that don’t involve massive deceleration from high speed. Certainly it is more comfortable to somersault with a helmet on when you eject, and I’ve been glad of a helmet fairly often.

    The thing is that head injuries are still only a chunk of the pie, and tossing someone a helmet has a BIG impact on their perception of their own safety. As soon as someone puts on protective gear, they feel armoured against the dangers they face. Also, helmets restrict vision and hearing, which I have certainly found to promote the tunnel vision effect.

    One of the things that really bothers me is seeing skiers who make sure they borrow/rent a helmet in order to ensure their own safety- but fail to progress appropriately/take lessons. Another thing which bothers me If society wants to move in the direction of making skiing safer and/or preventing broken bones and joints, I think there is a strong argument to be made that enforcing a matchup between ability levels and terrain is more effective.

    A good example is how a typical group of middle school kids react. Typical aggresive risk-taking skier of that age is going to percieve his helmet as a license to go fast, despite limited control ability. Forcing lessons, where an instructor will spend at least 50% of the time demanding that the daredevils in the group slow down and learn to turn, and the other 50% of the time working on stance and balance with the other kids so that they won’t end up on a sled with a broken tib/fib/wrist etc is extremely valuable. Especially since any good instructor will talk with students who are likely to overstep their abilites and give them a good graphic picture of a serious injury and the looming possiblity of death. Same goes for adults & lessons too.

    I guess my take on the ‘whole helmets should be mandatory’ can be summed up in a few points:
    -Most deaths won’t be prevented by helmet use
    -cutting down the accident rate should be done by forcing people to stay in control, not forcing them to wear armour so they’re less likely to injure themselves on one part of their body.

    • All good points (I’m happy to someone agree with me that helmets are a good thing), except the conversation keeps coming back to preventing death, which we all seem to agree is only ONE aspect of this discussion (and my original post).

      As for your last point, with 6000+ skiers on a mountain at one time, it is an impossible task to successfully monitor and control speeders and risk-takers, not that we don’t make a very conscientious effort). Helmets are another matter. We CAN require them before people board a lift. No additional resources required.

      I neglected to mention earlier that I do speak from experience here (not only as a patroller but as an accident victim). Last season I suffered a fall at Blackcomb as a result of a binding that was improperly locked in. After a few somersaults, I slid on my back and head first down a steep incline. My head bounced off a few rocks but I was fortunate enough to escape with relatively minor injuries (mild concussion etc.) Had I not been wearing a lid, I can GUARANTEE you that I would have suffered a skull fracture at a minimum, possibly much worse. Could I have died? Maybe. Could I have been incapacitated, lost my ability to work, communicate with my family, live a healthy and active lifestyle? Good chance.

      Your mileage may vary. My original post was quite simply to point out that suggesting helmets aren’t worth wearing is irresponsible. I stand by that.

  4. The article is by far the best article I’ve come across on the Helmet Debate.Helmet use is increasing on its own .Why legislate something that is happening naturally ? Lift serviced skiing injuries/deaths are extremely low . If someone is interested in reducing pain and suffering wht tackle much more dangerous activities like driving automobiles or swimming as previous comments rightly claim ?

    I find it interesting that Peter H. feels safer wearing a helmet .He could easily reduce his chance of injury by putting his ski on properly ( not a very safe move for a ski patroller). I am a lifelong hard core expert skiier who avoids injury by skiing under control and taking responsibility for my actions at all times.I don’t need to wear a helmet to make me a safer skiier . Accident aoidance is much safer .Taking away personal freedoms is not the solution .

    • Good grief. You find it “interesting” that I feel safer wearing a helmet? And yes, in 41 years of skiing, I had one instance where my binding was improperly locked in, and a simple error (which could happen to anyone) happened to have a serious consequence. I am puzzled by a comment such as “I don’t need to wear a helmet to make me a safer skier”. I would assume that you would wear one when you road cycle, mountain bike, or parachute, but then again, your “personal freedom” seems to come before common sense.

      But back to my point, which is continuously being misinterpreted. I really don’t care if helmet use is legislated or not. My issue is with suggesting that wearing a piece of safety equipment is not helpful when it clearly is. We should be setting examples for kids by taking steps to equip ourselves properly, along with providing proper education and training. Surely there can’t be a valid argument against that.

  5. Yes, helmets can lessen the severity of some low impacts in skiing, but skiing simply isn’t a dangerous sport for head injuries (any kind of head injuries) when you compare it with skating, hockey, cycling, toboganning…parachuting….

    Are you seriously comparing parchuting with skiing?

    For every head injury in skiing, there are about 20 in cycling — and more than 100 in tobogganning. Where are the mandatory-toboggan-helmet-legislation threads?

    Why are so many skiers determined to promote to the world our sport as a death sport — and ignore all the stats that show it’s relatively much safer than so many other sports?

    Where’s the knee-injury bandwagon?

    • [quote] Yes, helmets can lessen the severity of some low impacts in skiing [/unquote]

      No more questions your honour.

      • [quote] Good on ya, mate.

  6. I appreciate the concern which is been rose. The things need to be
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    everyone.The initiative taken for the concern is very serious and need an
    attention of every one. This is the concern which exists in the
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  7. I don't know why people would not want to wear a helmet in the first place. With the technology that today's helmets have they barely feel like they are on your head. Also, saying they will not at least reduce the likely hood of deaths is a bit much.

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