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. 2002 Dec;8(4):324–327. doi: 10.1136/ip.8.4.324

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

A Macnab 1, T Smith 1, F Gagnon 1, M Macnab 1
PMCID: PMC1756587  PMID: 12460972

Abstract

Purpose: To evaluate whether helmets increase the incidence and/or severity of cervical spine injury; decrease the incidence of head injury; and/or increase the incidence of collisions (as a reflection of adverse effects on peripheral vision and/or auditory acuity) among young skiers and snowboarders.

Methods: During one ski season (1998–99) at a world class ski resort, all young skiers and snowboarders (<13 years of age) presenting with head, face, or neck injury to the one central medical facility at the base of the mountain were identified. On presentation to the clinic, subjects or their parents completed a questionnaire reviewing their use of helmets and circumstances surrounding the injury event. Physicians documented the site and severity of injury, investigations, and disposition of each patient. Concurrently, counts were made at the entry to the ski area of the number of skiers and snowboarders wearing helmets.

Results: Seventy children were evaluated at the clinic following ski/snowboard related head, neck, and face injuries. Fourteen did not require investigation or treatment. Of the remaining 56, 17 (30%) were wearing helmets and 39 (70%) were not. No serious neck injury occurred in either group. Using helmet-use data from the hill, among those under 13 years of age, failure to wear a helmet increased the risk of head, neck, or face injury (relative risk (RR) 2.24, 95% confidence interval (CI) 1.23 to 4.12). When corrected for activity, RR was 1.77 and 95% CI 0.98 to 3.19. There was no significant difference in the odds ratio for collisions. The two groups may have been different in terms of various relevant characteristics not evaluated. No separate analysis of catastrophic injuries was possible.

Conclusion: This study suggests that, in skiers and snowboarders under 13 years of age, helmet use does not increase the incidence of cervical spine injury and does reduce the incidence of head injury requiring investigation and/or treatment.

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Selected References

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  1. Chow T. K., Corbett S. W., Farstad D. J. Spectrum of injuries from snowboarding. J Trauma. 1996 Aug;41(2):321–325. doi: 10.1097/00005373-199608000-00021. [DOI] [PubMed] [Google Scholar]
  2. Floyd T. Alpine skiing, snowboarding, and spinal trauma. Arch Orthop Trauma Surg. 2001 Sep;121(8):433–436. doi: 10.1007/s004020100267. [DOI] [PubMed] [Google Scholar]
  3. Friermood T. G., Messner D. G., Brugman J. L., Brennan R. Save the trees: a comparative review of skier-tree collisions. J Orthop Trauma. 1994;8(2):116–118. [PubMed] [Google Scholar]
  4. Fukuda O., Takaba M., Saito T., Endo S. Head injuries in snowboarders compared with head injuries in skiers. A prospective analysis of 1076 patients from 1994 to 1999 in Niigata, Japan. Am J Sports Med. 2001 Jul-Aug;29(4):437–440. doi: 10.1177/03635465010290040901. [DOI] [PubMed] [Google Scholar]
  5. Furrer M., Erhart S., Frutiger A., Bereiter H., Leutenegger A., Rüedi T. Severe skiing injuries: a retrospective analysis of 361 patients including mechanism of trauma, severity of injury, and mortality. J Trauma. 1995 Oct;39(4):737–741. doi: 10.1097/00005373-199510000-00024. [DOI] [PubMed] [Google Scholar]
  6. Goulet C., Régnier G., Grimard G., Valois P., Villeneuve P. Risk factors associated with alpine skiing injuries in children. A case-control study. Am J Sports Med. 1999 Sep-Oct;27(5):644–650. doi: 10.1177/03635465990270051701. [DOI] [PubMed] [Google Scholar]
  7. Hagel B. E., Meeuwisse W. H., Mohtadi N. G., Fick G. H. Skiing and snowboarding injuries in the children and adolescents of Southern Alberta. Clin J Sport Med. 1999 Jan;9(1):9–17. doi: 10.1097/00042752-199901000-00003. [DOI] [PubMed] [Google Scholar]
  8. Hennessey Theresa, Morgan Steven J., Elliot J. Paul, Offner Patrick J., Ferrari James D. Helmet availability at skiing and snowboarding rental shops. a survey of Colorado ski resort rental practices. Am J Prev Med. 2002 Feb;22(2):110–112. doi: 10.1016/s0749-3797(01)00411-1. [DOI] [PubMed] [Google Scholar]
  9. Hunter R. E. Skiing injuries. Am J Sports Med. 1999 May-Jun;27(3):381–389. doi: 10.1177/03635465990270032101. [DOI] [PubMed] [Google Scholar]
  10. Josefson D. US scientist plans human cloning clinic. BMJ. 1998 Jan 17;316(7126):167–167. doi: 10.1136/bmj.316.7126.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kip P., Hunter R. E. Cervical spinal fractures in Alpine skiers. Orthopedics. 1995 Aug;18(8):737–741. doi: 10.3928/0147-7447-19950801-08. [DOI] [PubMed] [Google Scholar]
  12. Kok G., Bouter L. M. On the importance of planned health education. Prevention of ski injury as an example. Am J Sports Med. 1990 Nov-Dec;18(6):600–605. doi: 10.1177/036354659001800608. [DOI] [PubMed] [Google Scholar]
  13. Konrad C. J., Fieber T. S., Schuepfer G. K., Gerber H. R. Are fractures of the base of the skull influenced by the mass of the protective helmet? A retrospective study in fatally injured motorcyclists. J Trauma. 1996 Nov;41(5):854–858. doi: 10.1097/00005373-199611000-00016. [DOI] [PubMed] [Google Scholar]
  14. Koo D. W., Fish W. W. Spinal cord injury and snowboarding--the British Columbia experience. J Spinal Cord Med. 1999 Winter;22(4):246–251. doi: 10.1080/10790268.1999.11719577. [DOI] [PubMed] [Google Scholar]
  15. Kopjar B., Wickizer T. M. Age gradient in the cost-effectiveness of bicycle helmets. Prev Med. 2000 May;30(5):401–406. doi: 10.1006/pmed.2000.0645. [DOI] [PubMed] [Google Scholar]
  16. Levy A. S., Smith R. H. Neurologic injuries in skiers and snowboarders. Semin Neurol. 2000;20(2):233–245. doi: 10.1055/s-2000-9833. [DOI] [PubMed] [Google Scholar]
  17. Macnab A. J., Cadman R. Demographics of alpine skiing and snowboarding injury: lessons for prevention programs. Inj Prev. 1996 Dec;2(4):286–289. doi: 10.1136/ip.2.4.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Myles S. T., Mohtadi N. G., Schnittker J. Injuries to the nervous system and spine in downhill skiing. Can J Surg. 1992 Dec;35(6):643–648. [PubMed] [Google Scholar]
  19. Oh S., Schmid U. D. Kindliche Kopfverletzungen beim Skifahren und ihre optimale Prophylaxe. Z Kinderchir. 1983 Apr;38(2):66–72. doi: 10.1055/s-2008-1059941. [DOI] [PubMed] [Google Scholar]
  20. Partrick D. A., Bensard D. D., Moore E. E., Calkins C. M., Karrer F. M. Cervical spine trauma in the injured child: a tragic injury with potential for salvageable functional outcome,. J Pediatr Surg. 2000 Nov;35(11):1571–1575. doi: 10.1053/jpsu.2000.18313. [DOI] [PubMed] [Google Scholar]
  21. Prall J. A., Winston K. R., Brennan R. Severe snowboarding injuries. Injury. 1995 Oct;26(8):539–542. doi: 10.1016/0020-1383(95)00085-n. [DOI] [PubMed] [Google Scholar]
  22. Sacco D. E., Sartorelli D. H., Vane D. W. Evaluation of alpine skiing and snowboarding injury in a northeastern state. J Trauma. 1998 Apr;44(4):654–659. doi: 10.1097/00005373-199804000-00016. [DOI] [PubMed] [Google Scholar]

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