Helmet Use Associated With Reduced Risk of Head Injury for Skiers and Snowboarders

Skiing and Head Injury

Alpine skiers and snowboarders who wear a helmet have a reduced risk of head injury, according to a study in the February 22 issue of JAMA.

Alpine skiing and snowboarding are enjoyed by several hundred million people worldwide. However, the injury risk is high, and head injuries are common in alpine skiers and snowboarders, according to background information in the article. Head injury is the most frequent reason for hospital admission and the most common cause of death among skiers and snowboarders with an 8 percent fatality rate among those admitted to hospital with head injuries. Helmet use is typically not mandatory and usage is generally low among recreational skiers and snowboarders. Although using a helmet is assumed to reduce the risk of head injuries in alpine sports, this effect is not certain.

Steinar Sulheim, M.D., of the Norwegian School of Sport Sciences, Oslo, Norway, and colleagues examined the association between helmet use and risk of head injury among skiers and snowboarders. The study was conducted at 8 major Norwegian alpine resorts during the 2002 winter season, and involved 3,277 injured skiers and snowboarders and 2,992 noninjured case controls. The participants were interviewed at times most skiers used the main ski lift. The researchers obtained information regarding helmet use, injuries and other risk factors.

Of the 3,277 individuals with injuries, 578 (17.6 percent) had head injuries. The researchers found that "using a helmet was associated with a 60 percent reduction in the risk for head injury" when comparing skiers with head injuries with uninjured controls. Use of a helmet was also associated with a 57 percent reduced risk for a potentially severe head injury. The risk for head injury was 53 percent higher among snowboarders than for alpine skiers. There also was a trend toward a lower risk for neck injuries with helmet wear.

"Our analysis identified beginners, male sex, youth, and snowboarders as groups with increased risk of head injuries but also showed that the protective effect of helmet use is consistent across groups," the authors write. (JAMA. 2006;295:919-924)