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Yet more evidence that helmets reduce head injuries

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Yet more evidence that helmets reduce head injuries

 Poster: A snowHead
Poster: A snowHead
New research has found that helmets clearly decrease the risk and severity of head injuries in skiing and snowboarding, and don't seem to increase the risk of neck injury, cervical spine injury, or risk compensation behaviour. The research involved analysing existing evidence on the efficacy of helmet use while taking part in snow sports. the researchers concluded that helmets are strongly recommended during recreational skiing and snowboarding.
...Citation: Haider AH et al. An evidence-based review: Efficacy of safety helmets in the reduction of head injuries in recreational skiers and snowboarders. J Trauma Acute Care Surg 2012;73:1340-7.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/23117389
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Excellent, el Hen.
In case anyone not familiar with grading of "evidence", a good explanation here: http://www.patient.co.uk/doctor/Different-Levels-of-Evidence-(Critical-Reading).htm
(sorry: don't know how to get all the link included - you'll need to copy and paste to get to the article)
So, the recommendation that all recreational skiers and snowboarders should wear safety helmets to reduce the incidence and severity of head injury is based on top level evidence - at least one randomised controlled trial. And the recommendation/observation that helmets do not increase risk compensation behaviour, neck injuries, or cervical spine injuries among skiers and snowboarders is based on at least one well designed study without randomisation.

Pretty well clears up the debate . . .
But I'm sure the usual arguments against will still be churned out in this thread.

You may be interested that the level of evidence supporting helmets is superior to many routine medical treatments.
British Medical Journal 1991

If interested, you might also read this: Testing Treatments: Better Research for Better Healthcare
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
And Essential Travel now insist that skiers and snowboarders wear helmets to be fully covered by their winter sports travel insurance policies.
See here: http://www.essentialtravel.co.uk/travelinsurance/use-your-head/index.asp and here: http://snowheads.com/ski-forum/viewtopic.php?t=92856#2131528
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 You need to Login to know who's really who.
You need to Login to know who's really who.
I've never really got involved in the ski-helmet debate before (although I know a vast amount about the cycle-helmet arguments). I'm a non-wearer but am pretty open minded about them.
Nice article here by Boris Johnson (and those words don't come easily to me!).
http://www.telegraph.co.uk/comment/columnists/borisjohnson/7289457/Wear-ski-helmets-by-all-means-but-Im-sticking-to-a-woolly-hat.html
The last time I was in A&E was because I walked into a post at a railway station. A pedestrian helmet would have prevented my concussion.
You could potentially save 700-800 lives per year in the UK if all motorists wore helmets.
So, wearing a helmet does undoubtedly bring safety benefits but perhaps we should be wearing them for most activities?
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Please please please can we have a helmet filter on this website, after posts by people asking if there's going to be great snow for the one miserable week a year they go skiing they are without doubt the most pointless of all posts.

You either want to wear a helmet or you don't, end of, its about free will and deciding what works for you.
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 You'll need to Register first of course.
You'll need to Register first of course.
adie wrote:
Please please please can we have a helmet filter on this website... you either want to wear a helmet or you don't, end of, its about free will ....


A bit like choosing NOT to read threads in which you have no interest, I guess rolling eyes
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Sure folk are free to make a decision, but I think there's some merit in making sure that the decision is made with the correct evidence.

If the evidence proves that "helmets saves lives" and they chose to ignore it, that's up to them.

If, however they had seen some misleading information to suggest the opposite and chose to NOT wear a helmet based on that, but WOULD wear a helmet if they had been aware of the real evidence, then is it not worth ensuring the correct facts are available so that decision can be informed, and not misinformed?
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
I do find it interesting that threads about off-piste skiing are full of people (rightly) talking about the dangers of heuristic-based decision making, and yet threads about helmets are full of people making those same errors.
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
Back to the subject of Helmets - I work for a commercial sponsor and 3 years ago we were tasked with getting a Helmet manufacturer Insured before the sponsorship was going to get off the ground. No walk in the park by any means... but to assist we had a couple of great 'studies' which wed hoped would encourage the nervous insurers that we'd approached, and which I duly produced with a flourush once the subject of 'liability' and 'efficacy' was mentioned.
Imagine my disappointment when I was trumped by an Insurance Companies very own risk management report which came up with some interesting and at the time, unwanted facts.
Bearing in mind the report was from 2002-4 , and sample from 6 european locations and males/females into ability categories
Unsurprisingly Adult males 18-26 came out worse - they were 20 times more likely to be involved in a prang than all the female groups put together.
Statistically (at the time when the helmet wearing fratenity was outnumbered 30/70) a non-helmet wearer was 80% more likely to be involved in a collision with a wearer - read that how you choose, and this document finished by concluding that whilst kids up to the age of 14 who had learnt to ski with helmets there was no evidence of such issues unlike first time wearers in any group who were susceptible to a serious injury rending collision because of the presumed invincibility that the helmet bestowed.
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 Ski the Net with snowHeads
Ski the Net with snowHeads
Jonpim wrote:
Excellent, el Hen.
In case anyone not familiar with grading of "evidence", a good explanation here: http://www.patient.co.uk/doctor/Different-Levels-of-Evidence-(Critical-Reading).htm
(sorry: don't know how to get all the link included - you'll need to copy and paste to get to the article)
So, the recommendation that all recreational skiers and snowboarders should wear safety helmets to reduce the incidence and severity of head injury is based on top level evidence - at least one randomised controlled trial. And the recommendation/observation that helmets do not increase risk compensation behaviour, neck injuries, or cervical spine injuries among skiers and snowboarders is based on at least one well designed study without randomisation.

Pretty well clears up


Hmm. Maybe you've read the full paper. I can see the abstract only
Quote:
The PubMed, Cochrane Library, and EMBASE databases were searched using the search string helmet OR head protective devices AND (skiing OR snowboarding OR skier OR snowboarder) for articles on human participants of all ages published between January 1980 and April 2011. The search yielded 83, 0, and 96 results in PubMed, Cochrane Library, and EMBASE, respectively. Studies published in English describing the analysis of original data on helmet use in relation to outcomes of interest, including death, head injury, severity of head injury, neck or cervical spine injury, and risk compensation behavior, were selected. Sixteen published studies met a priori inclusion criteria and were reviewed in detail by authors.

Care to translate that?
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
I think that means that 16 from 179 people who crashed into a tree were saved by their helmet. The other 163 where just lucky.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Quote:

I think that means that 16 from 179 people who crashed into a tree were saved by their helmet



No. They found 179 studies, of which sixteen met their criteria to be included in the analysis.
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
From: Sports helmets now and in the future : British Journal of Sports Medicine : 2011;45:1258-1265 doi:10.1136/bjsports-2011-090509

Quote:
Alpine sports
A recent systematic review based on 12 studies on recreational
skiers/snowboarders concluded that skiers and snowboarders
with a helmet were significantly less likely than those without
a helmet to have a head injury
(OR 0.65, 95% CI 0.55–0.79), and
that there was no evidence of an increased risk of neck injury.


and some meta research : The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis.
http://www.ncbi.nlm.nih.gov/pubmed/20123800

Quote:
BACKGROUND:
The prevention of head injuries in alpine activities has focused on helmets. However, no systematic review has examined the effect of helmets on head and neck injuries among skiers and snowboarders.
METHODS:
We searched electronic databases, conference proceedings and reference lists using a combination of the key words "head injury or head trauma," "helmet" and "skiing or snowboarding." We included studies that used a control group; compared skiers or snowboarders with and without helmets; and measured at least one objectively quantified outcome (e.g., head injury, and neck or cervical injury).
RESULTS:
We included 10 case-control, 1 case-control/case-crossover and 1 cohort study in our analysis. The pooled odds ratio (OR) indicated that skiers and snowboarders with a helmet were significantly less likely than those without a helmet to have a head injury (OR 0.65, 95% confidence interval [CI] 0.55-0.79). The result was similar for studies that used controls without an injury (OR 0.61, 95% CI 0.36-0.92), those that used controls with an injury other than a head or neck injury (OR 0.63, 95% CI 0.52-0.80) and studies that included children under the age of 13 years (OR 0.41, 95% CI 0.27-0.59). Helmets were not associated with an increased risk of neck injury (OR 0.89, 95% CI 0.72-1.09).
INTERPRETATION:
Our findings show that helmets reduce the risk of head injury among skiers and snowboarders with no evidence of an increased risk of neck injury.
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 You know it makes sense.
You know it makes sense.
I tend not to trust these studies and especially not insurance studies which always seem to be biased towards the doomsday end of the rational scale.

Scene: Group of teenagers popping of a ramp 100m of piste, all are only insured for 'on-piste', one decides to go for his/her first back flip - looses it and takes out a friend who has taken their helmet off lower down the slope. Crashee's 'board, nose and arm are totalled. Insurance report 'Yeah, like, I was just cruisng down dis piste den I stopped for Jules and Pete - 'cos dey is too slow, like - then this ol' skiier fook just totally tromped on me when I was doing nuffin' and then just pelted off, like, down the slope. He took out me ride, me nose and me wing, innit. I swear doz ol' skiier dudes should all be banned or road tested, like, cos' dey is all blind 'n dat. 'Course I was wearing my lid - wot do you take me for, fool?!?' All his little m8's swear it happened that way (especially the one that trashed him), cue new board + comp and it gets written into insurance data as fact.

The thing that has always freaked me out a bit with helmets is that if you catch them on something in a crash then you are much more likley to do yourself a serious injury(read: broken neck). And I can attest to the fact that it seems to make teenage boys much less attentive to their surroundings. I am not small and the ones in the helmets seem to have been markedly less able to see me - to their detriment - on more than one occasion. You swing across me with cliff to my right when I'm going at speed and I can assure you evasion techniques with your safety as a paramount focus are the last thing on my mind - you'll need the helmet. Never seems to happen with those who are lid-less, tho'.
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Be interesting to know the event rate so can work out nnt.
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 Poster: A snowHead
Poster: A snowHead
Thanks, I'll chase that link up and see if there's anything new there.


Neil Neige wrote:
..So, wearing a helmet does undoubtedly bring safety benefits but perhaps we should be wearing them for most activities?

Good question.

A few more:
- Wearing a helmet in a car would save more lives. Why wear helmets at resorts, but not driving to them?
- Why don't snow sports people wear full-face helmets?
- What's the effect of the large increase in helmet usage in American ski resorts on serious and fatal accidents?
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Oh, so it's *not* "new research", it's not "yet more evidence" of anything. It's a review of existing literature. So no new data, no "New research", no "Yet more evidence".

Really you have to read the paper:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831705/
I don't know the field or the journal. These guys seem to have done more than one of these with basically the same text in them, for example:
http://www.cmaj.ca/content/182/4/333.full.pdf+html (published in 2010 with a bit more detail).
Odd.

If you read the text they're significantly more moderate in their claims than these headlines. I'm finding it hard to see any significant difference in this stuff - it looks to me like they're just trying to crank up their publication record. How are academics scored in Canada?


It's odd that increased helmet usage has not caused a significant reduction in serious injury or death rates at US resorts, but it's certainly pumped a lot of money into the business, so what's not to like?
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Well, with regards to why don't we wear helmets for everything, the answer is fairly simple.
Relative risk and risk abeyance. Or to put it another way, if you want to never be involved in an incident where a helmet could help you, never leave your house. If you do some kind of activity where theoretically you could plough your head into something unyielding, a helmet becomes a more attractive option the higher the risk of it happening is.

Cyclists wear helmets because their risk of being involved in an accident is higher than that of your average pedestrian.
Snow sports enthusiasts wear helmets (or not, as the case may be) because their chance of coming a cropper by slamming into something/someone at high speed is much higher than that of your average couch potato.

There is also a particular human behavior (which I cant for the life of me remember the proper name of) which indicates that even if the chance of something negative occurring remains constant, the longer it does not occur for, the less likely people treat it. So if (for example) the risk of having your house burgled is 1% per day, but it does not happen for a year, the owner believes that his risk is less than 1% and stops locking his door. However, his risk is exactly the same as it has always been, but his experience of no burglaries discounts his perception of the risk. I'm sure you can draw this metaphor back to skiing. Just because you haven't had a serious accident while skiing, doesn't mean you wont.

Boris Johnson in a nutshell appears to be. "Helmets are for wimps. And I am a MANLY man. Ive been skiing without a helmet for 35 years and by God, that should be enough for any man."
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 You need to Login to know who's really who.
You need to Login to know who's really who.
zanarchist wrote:

There is also a particular human behavior (which I cant for the life of me remember the proper name of) which indicates that even if the chance of something negative occurring remains constant, the longer it does not occur for, the less likely people treat it.


We tend to refer to this as inurement in the risk management trade, but it's just a fancy word for desensitization.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
18 bites...erm replies and counting!



19 now Toofy Grin
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 You'll need to Register first of course.
You'll need to Register first of course.
gatecrasher - 20. I wouldn't consider getting on a motorbike without a full face helmet, gloves, boots with titanium inserts and a large piece of cow-skin covering my entire body. For track days add a back protector. There aren't really any downsides with this kit (possibly slightly reduced visibility........, and looking like a Power Ranger.......) Fairly much every time you come off a motorbike, better gear will give you a better chance of survival with less injuries. With bicycle and ski helmets, there are times when they could cause worse injuries, many times when they won't make a difference, and a few times where they will actually be of benefit. Maybe the difference is down to the quality of what you are wearing along with usability. My leathers cost about a grand. I could fall off at 200 MPH on sandpaper and be OK. Boots - 400 quid. I have had a bus drive over my leg and suffered no injuries. Lid - 800 quid. If I hit something hard enough to get a brain injury through it, it probably won't matter, as my head will already have come off. This stuff is all tailored to saving a motorcyclist in a crash, while allowing maximum manoeuvrability and usability while riding. Difficult to walk in though. With a ski helmet, fall over at any speed on piste with a normal helmet on and you quickly find that your chin strap is providing most of your braking. Sure it will help if you hit something solid, but that is a no brainer (scuse the pun)
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Quote:

helmets do not increase risk compensation behaviour

Coblers!
I know for a fact that I take more risks when I am wearing protective equipment, and take more care when I am not, I'm sure many don't but I'm sure I'm not that much of an oddball.
I don't wear a helmet because I really really hate wearing anything on my head when skiing and would avoid using facilities that insist that I do.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Thornyhill,
Quote:

looking like a Power Ranger


Which one are you?
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
Thornyhill wrote:
and looking like a Power Ranger



Stick a GoPro on top and that changes to Telly-Tubbie
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 Ski the Net with snowHeads
Ski the Net with snowHeads
Research schmesearch!!!
All you need is sense..... If you're in an environment where you could get a brick to your head (see tree, hardpack, ice, other skier/boarder etc)... You ARE better off wearing a helmet... to argue the point is to say "NO, I disagree... lets do a study where i stand here in a helmet first, you hit me in the head with a brick... then I'll take the helmet off and hit me in the head with the same brick again... I BET I wont get hurt more without the helmet!!!"..... Duh!

If you don't want to wear a helmet.. don't wear the damn thing... don't try to justify it with ridiculous statements like "oh but i might get a neck injury"... what?! Do you think NOT wearing a helmet makes your neck immune to injury?!.... please!

POSSIBILITY:...
I'd imagine any 'real world' evidence "proving" that helmet wearers had higher incidence of neck injury may well have been from serious incidents where they may well have not survived were it not for the helmet...
I doubt they even check for neck injury on a corpse with a smashed in skull and if they do it probably wont be listed as the cause of death!
...

SUMMARY: Helmets, wear it, or don't wear it,.... you don't need to justify NOT wearing one, it's your skull, your choice (currently), but to argue that it's safer is foolish...
...
p.s. Anyone wanting to argue against the validity of my opening example, feel free. I'll happily bring a helmet for you to wear and a test brick to the Vodka party! Very Happy
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
But can wearing a ski helmet protect you from crucifixion?

Jesus at Whitefish Mountain Resort, northwest Montana:
http://i.dailymail.co.uk/i/pix/2012/11/29/article-2240169-1641B442000005DC-477_634x471.jp
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Comedy Goldsmith wrote:
But can wearing a ski helmet protect you from crucifixion?

Jesus at Whitefish Mountain Resort, northwest Montana:
http://i.dailymail.co.uk/i/pix/2012/11/29/article-2240169-1641B442000005DC-477_634x471.jpg
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
[Second posting above has working link]
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 You know it makes sense.
You know it makes sense.
Comedy Goldsmith wrote:
But can wearing a ski helmet protect you from crucifixion?

Jesus at Whitefish Mountain Resort, northwest Montana:
http://i.dailymail.co.uk/i/pix/2012/11/29/article-2240169-1641B442000005DC-477_634x471.jp


Only if you can tuck your hands and feet into the subject headgear!!!!!
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
This issue was clarified for me when my wife with no helmet on fell off a T-bar, was skied over, knocked herself out and lost her short turn memory for a while. If she had a helmet on at the time, it would have been a minor mishap, but she ended up on a drip in a hospital corridor. We now both wear helmets, you soon get use to it, and other skiers now look really vunerable without one, with a head "perched" on shoulders. I skied for over 10 year without a helmet before this. But, skiing is all about controlled risk, so if you want to risk it and it doesn't damage me, go for it.
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 Poster: A snowHead
Poster: A snowHead
gardyco wrote:
and lost her short turn memory for a while.


GS skis would have solved that problem for her.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Good - well spotted!
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