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"Most fatalities in US skiing involve skiers wearing helmets" - scientific study

 Poster: A snowHead
Poster: A snowHead
Research just released in the USA reveals that 58% of skiers killed were wearing helmets.

Dr Jasper Shealy - a prominent figure in ski injury research, who has contributed to long-term studies of trends in leg and upper body injuries - also reveals that helmeted skiers are more likely to experience serious head injuries than non-helmeted skiers.

In a study of skiers at Sugarbush Resort in Vermont, Shealy reported, "the use of helmets has increased from virtually zero prior to 1995 to approximately 30% today."

Over the same time period, Shealy added, the overall number of head injuries didn't change much, but their severity shifted.

"For nonhelmeted skiers, only 23 percent of all potentially serious head injuries are more serious than a mild concussion," Shealy wrote. "For helmeted skiers, 67 percent of their potentially serious head injuries are more severe than a mild concussion.

Dr Shealy concludes that skiers wearing helmets are most likely to be those taking risks. The research has been presented to the International Society for Safety in Skiing.

Shealy also points out trends in the use of helmets in cycling have not had the desired effect of reducing head injuries. He says "the U.S. Consumer Product Safety Commission has found to their dismay that as the use of helmets for bicyclists went from less than 18 percent in 1991 to 50 percent in 1998, the per capita rate of head injuries increased (not decreased) by 50 percent over the same period of time."

Despite this, Dr Shealy says that he personally opts to wear a cycle helmet. He does not wear a ski helmet.

This report by Craig Medred of Anchorage Daily News / The Inyo Register

More on this subject on Dr Jasper Shealy's website: www.lidsonkids.org
The article also quotes the UK ski injury website run by Dr Mike Langran: www.ski-injury.com

Do you wear a ski helmet? Is it possible that your increased feeling of security has also increased your risk-taking?
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 Obviously A snowHead isn't a real person
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Jesus, its tuesday so it must be helmets are dangerous day.

How many times is this gonna get dragged up. Helmets dont kill people, husbands coming home early kill people.

Find any topic involving any medical area and you will be able to find several articles of both sides of the story, each with nice percentages to hide the fact the sample size is doctored to give the slant required

wheres the yawn smilie?
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I wouldn't have quoted Dr Jasper Shealy if he wasn't one of the most internationally-respected experts on knee injury trends etc. You're making an allegation that a sample size has been doctored, which is potentially libellous.

Do you have knowledge to support that allegation?
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Did my comment refer direct;y to the esteemed gent in your latest cut and paste? No

My point rests about the focus of your findings, either side can be supported by flashy percentages in any argument. Research enough and you will support/disprove any theory.

Maybe discuss things instead of the usual legal action response to any challenge. Its called debate i believe

Besides this has been done to death. Get Willy wonka to tell me that wearing my ski helmet will kill me. It wont make a difference, I have worn a helmet for years and its saved me from a dent in the skull after an off piste fall onto a buried rock
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The figures quoted by DG show only that of skiers who have head injuries, those wearing helmets have a higher proprtion of serious injuries. They say nothing about the numbers involved nor about how many crashes in each group avoid head injury altogether. The study may include that information, of course.

The most likely reason for these figures to be misleading (which they may not be) is that there is a higher percentage of risk takers among those who wear helmets, not because they're wearing helmets but because they're risk takers. In other words, we don't know what the figures for the helmet wearers would have been had they not been wearing helmets. In the US, where helmet wearing is more common than in Europe, it is among young kids and teenagers that it is most common (from observation). I suspect that the sample size is small, making comparisons relatively insignificant.
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David Goldsmith wrote:
You're making an allegation that a sample size has been doctored, which is potentially libellous.

Do you have knowledge to support that allegation?
No, he didn't. What is potentially libellous is attributing motives, intent to others without justification. But we've been there before rolling eyes.

Does this latest survey discriminate between the different skiing practices of those who wear helmets and those who don't? The terrain skied, the % of off-piste to piste skiing, speed? The time spent skiing each season, each holiday, per individual?

If not then potential explanations for the stats you mention are not being taken into account.
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OK, firstly let's agree that a scientist who has contributed hugely to the understanding of injury trends in skiing should have his data respected, without accusations - or innuendo, if that's what kruked is now saying - that the data is "doctored".

If there is statistical evidence that contradicts the data that Shealy has collected, let's see it. No one's trying to play the propaganda game here.

PG, until we see Shealy's full study (don't know if it's published yet. This is normally done by the ASTM (American Society of Testing of Materials) your questions have to hang in the air. But the evidence suggests (suggests) that helmets are not contributing to a reduction in fatalities.

If one reads the article (which seems a very carefully written and balanced piece of writing) it seems to imply, because of the obvious doubts, that high-risk skiers are equipping themselves with helmets but suffering an ongoing risk of fatality because helmets can't protect from the shock to the brain of hitting a tree or rock at a significant velocity.
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how many of these pointless "studys" do we need to understand the phrase correlation does not imply causation ?

young males on snowboards wear baggy pants
young males on snowboards are more likely to have accidents
Baggy pants cause snowboard accidents
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So far I have not bought, or worn, a ski helmet. I have been tempted to do so, but I have found no conclusive evidence that it does save life or serious injury (though I concede it could save a scalp scrape when skiing through trees). Nor am I persuaded by those who think I should just accept I should wear a helmet, because everyone else has "moved on" Toofy Grin . I hope the decision on whether or not to wear a helmet remains a personal one.


Last edited by You'll get to see more forums and be part of the best ski club on the net. on Tue 31-01-06 11:51; edited 1 time in total
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I wasn't going to get involved ...... wink Like PG says without the report, and the details it may have ( splitting out different types of skiers etc) its difficult to read anything into some tof the quoted stats. The Anchorage Daily News report does seem fairly well writen and informed - no obvious journo howlers, and the thing that I take most from it, is that the increase in helmet use ( from 0% to 30% in the US) has not impacted the head injury rates - they have increased! SO if helmets had not been introduced would we have a much bigger increase in injuries? I don't know, but there is something underneath this - a big increase in riskier, more dangerous skiing? Are half pipes really that bad? ( they have appeared in the last decade or so) Has there been such a big increase in off-piste, tree skiing etc???? I honestly don't know - and these are genuine questions. Then you get to the part of the article where there is a quote about most fatalities occuring on groomed blue runs! What on earth is going on here?
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David Goldsmith wrote:
...If one reads the article (which seems a very carefully written and balanced piece of writing) it seems to imply, because of the obvious doubts, that high-risk skiers are equipping themselves with helmets but suffering an ongoing risk of fatality because helmets can't protect from the shock to the brain of hitting a tree or rock at a significant velocity.

In which case the only significant conclusion that can be drawn is that there is a force of impact beyond which the helmet can no longer protect, a fact which surely was blatantly obvious before this study.
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I think what may be significant about this study is that it's an early step in collection of authoritative data. The use of helmets in skiing is very recent.

Much of what's been discussed about helmets up to now has been based on purely subjective thought. The more data the better.
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kruked, you cynic, and hooray for that. Surveys are commissioned with the end result in mind: usually, that's to advance a political position or to publish findings which keep the researchers swimming in more cash to carry out research. Based on no research evidence at all, my view is that if head injuries are more likely when wearing a helmet then it's because of over confidence on behalf of the skier, a presumption that they are now protected against injury. The same phenomenon was seen following the compulsory wearing of seat belts in cars: drivers thought they were safer and more protected, they drove more recklessly and the accident rate increased.

So, Dr Jasper Shealy is 'a prominent figure in ski injury research'. I don't doubt his motives include the aim of advancing knowledge and helping to make skiing a safer pastime. But it should always be borne in mind that the day Dr Jasper Shealy reports "skiing is now completely safe" is the day his grant money dries up.
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 You know it makes sense.
You know it makes sense.
Purely anecdotal I know, but just I'm back from a trip with 16 blokes, 2 of whom wore helmets for the first time this year. Both of those wearing helmets took greater risks than they did last few years (general concensus). One hit a car with his head stopping too late and skiing too fast towards a car park at the bottom of the piste, the second fell over and banged his head on a lamp post walking home. Both of them also missed shouted warnings about hazards elsewhere on the piste.
The research above firms up the conclusion I have already reached that helmets for free skiing make no sense, but may be useful in the park where speeds are generally lower, or for walking home at the end of the day or a night on the town. I do however wear a helmet when cycling (can of worms not really worth visiting in this thread)
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I'll put my oar in here:

My friends recently bought me a bike helmet which I am now wearing for my cycle to work - personally I think it is probably pointless as the accident on road I envisage is a high speed collision with a car for which the helmet is most unlikely to save me, and which is hopefully very unlikely to happen.
However I have been planning on do some more serious mountainbiking, here I think a helmet will be usefull as I'm much more likely to have low speed falls where the helmet may well save me from serious injury. But there is also the increased probabilty of a high speed collision with an imovable object like a tree where again the helmet probably won't save me. I whaven't done this more serious mountain biking upto now cos I haven't had a helmet. So wearing a helmet is going to make/allow me to take more risks.

You will find that the stats mentioned in DGs origanal post can probably be explained by this. People who wear helmets do more dangerous things.

On the sking front I had never thought about wearing a helmet, but I was at an avalanche awareness course at Glenmore recently and one comment was that burials were actually quite rare in Scotland (there were none last year), because the depth of snow is often not great. What was more likely was injury due being bashed off terrain as you are tumbled about by said avalanche. So I'm starting to think that a helmet might be worth it for touring. (though avioding being avalanched would be even better)
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 Poster: A snowHead
Poster: A snowHead
It appears that this "study" has not been peer-reviewed or published, but has somehow found its way into the public domain (presumably through a press-release).

This is a trend that is becoming ever more common among members of the medical (particularly) science fraternity.

I for one, speaking as a (non-medical) scientist am extremely unwilling to place any credence on such reports until they have been fully and professionally appraised by the specialist community.

Frequently such press-releases are motivated by the need to obtain funding for further research, and try to do so by raising the profile of a particular subject area with the general public in order to leverage a grant application. Alternatively, there may be other commercial motives (where the investigator has a direct financial interest in the adoption of a new treatment, therapy or product).

I am not saying that this is the case in this instance. It is equally possible (and I'd like to think) that Dr. Shealy has a genuine concern about the incidence of head injuries and believes that any publicity on this matter may help to reduce that incidence. However, until the evidence is properly tested, I'll remain unconvinced.

Declaration of interest: I wear a helmet.
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A hell of a lot of reading but this link covers most. I'm sure most of you would have already seen it.
http://www.ski-injury.com/helmet.htm
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Acacia, I'm not sure how you deduce that Dr Shealy's research hasn't been peer-reviewed or published. The article suggests that the opposite may be true. The key data is quoted from the International Society for Skiing Safety. This may have evolved from the International Symposium on Skiing Safety (ISSS) which - unless things have changed - convenes the world's leading ski injury researchers every few years.

What I know about Dr Shealy is that most of his research has been been conducted via the University of Vermont, with Dr Robert Johnson and Carl Ettlinger, and that their research on anterior cruciate ligament (ACL) knee injuries has been some of the most influential in understanding the mechanism of those injuries. Their studies of injury trends at Sugarbush are the world's longest running - about 30 years now.
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This is also from the ski-injury website and is a far more upto date study.

More recently in February 2005, Hagel and colleagues from Canada published a case-control study in the British Medical Journal comparing 1082 skiers and snowboarders with head or neck injuries with 3295 skiers/boarders without head or neck injuries. They found that wearing a helmet reduced the risk of a head injury overall by 29%. For those who required ambulance transport, wearing a helmet reduced the risk of head injury by 56%. 693 people had head injuries - 69,7% of which were cases of concussion. Those with head injuries were more likely to have been injured as the result of a collision or jump. They found no associations between wearing a helmet and the occurrence of neck injuries.
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Fine if you don't want to wear a helmet don't. If you've personally assessed the risks & believe that yes you could well hit a rock, tree, icy slope etc then do. Personally I don't really care about the study because unless you've taken a helmet wearing group and a non-helmet wearing group of the same ability, risk aversion/personality, skiing the same slopes in identical conditions then my view is you may not be comparing like with like. There is a huge amount of self selection going on in the helmet wearing population - many individuals who choose to wear helmets do so precisely becuase they know they will have falls whereas non -helmet wearers may have estimated their chances of falls are low.

Oh and well done Craig Medred for balanced well-considered journalism rolling eyes :

"But small children and beginners aren't the people you usually see in helmets. Instead, they are usually worn by extreme or racer wannabees, often 'boarding out of control, often skiing too fast in congested areas, often playing in places where they mistakenly believe the helmet will save their life if they hit a tree."
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David Goldsmith wrote:
Dr Shealy concludes that skiers wearing helmets are most likely to be those taking risks.


I'm not sure where the controversy is here. This conclusion seems so obvious from the figures quoted as to be trite

As DG reports it, Shealy is NOT saying that just because someone chooses to wear a helmet, their appetite for risk changes. He is saying that helmet wearers are more likely to take risks - they may very well have been risk takers before they got their helmet
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I wear a helmet because I believe that it makes sense for me to do so. It hasn't yet saved me from injury in about 15 weeks of skiing (and I hope that it never has to) but that doesn't mean that it won't at some point in the future.

As it happens, I wear a helmet when riding my mountain bike - I have done many more hours on the bike than on skis and (inevitably) a couple of years ago that helmet did pay for itself in a low speed impact which wrecked my shoulder but broke the cycle helmet rather than my head.

I wouldn't say that I take more risks because I wear a helmet but, more likely (and as Arno suggests above), perhaps I take more risks in the first place.
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David Goldsmith wrote:


Despite this, Dr Shealy says that he personally opts to wear a cycle helmet. He does not wear a ski helmet.



He should do, I've seen him ski, he's rubbish.
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Quote:

He should do, I've seen him ski, he's rubbish

Presumably he's even worse at cycling if he chooses to wear a helmet for that?
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Does wearing your helmet affect how well you hear what's going on around you (as Martin Nicholas - possibly - implies)?
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Quote:

Does wearing your helmet affect how well you hear what's going on around you

Yes - but no more so than a hat.
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DavidS, I recently bought a helment (principally for slalom training). I tried it for the first time on Saturday and the loss of awareness of what was going on around me was immense, so I took it off except when going through the gates. I could still hear people talking at me, but got none of the audible clues from around me. In particular I couldn't hear the noise my skis made on the plastic, which I appear to find a huge help and source of feedback on how I'm skiing. Now admittedly this is a fairly enclosed race helmet (with sides down to the angle of the jaw), and so will probably cut off more sound that some of the more open helmets people use for freeride skiing, but I could not disagree with Caspar's comment (immediately above) more. I personally would find myself feeling far less secure on the slopes without being able to hear the swish or chatter of skiers coming behind me, falls of snow released by skiers above etc..

I have had many falls on the snow, and have never hurt my head in a way that a helmet would have ameliorated (and regular helmet wearers tell me that the effects of whiplash are greater when wearing a helmet). I do not wear a helmet when free-skiing, and currently see no advantage in doing so. I do ski off piste a lot, but I not do big cliff jumps; I do ski in trees from time to time, but never so fast that a helmet would be required to save me from injury - I think you are far more in need of goggles for eye protection in such circumstances.
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I wear a Giro 9.9, which has removable fabric ear flaps. I don't find that the flaps make much difference to what I can hear (but my hearing is not great anyway).
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 You know it makes sense.
You know it makes sense.
Caspar,

He's toilet at bike riding as well, wobbles all over the place.
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GrahamN,

Obviously this is your choice, but I have had a number of falls from my bike, both my and other people's fault. At the moment, I have received no head injuries that a helmet would have ameloriaet, amleiorir, amreotit, sorry, stopped hurting, but I still wear one.

I don't hear as well with a helmet on skis as without one, but when I am free skiing in an area it tends to be such that you ski individually and watch each other, certainly not one above another unless one is stopped and looking up.

I'm probably lucky because wearing a helmet really doesn't bother me and I have become used to it over three years. I'm just surprised how many scratches it has at the end of a big tree day.
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GrahamN, Perhaps it's a different perspective - I have worn a helmet when riding motorbikes for over 20 years and so am very used to it. Wearing a lightweight ski helmet is virtually nothing by comparison. When comparing reduction in sound to that experienced when wearing a hat, I guess it would depend on the type of hat.

I don't do anything extreme on skis but figure that a bit of protection can't hurt in that most dangerous of places - a busy piste. As it happens, my brother started wearing a helmet last year and it has already paid for itself this year when he experienced an impromptu 'launch' and relatively low speed impact as a result. He was very glad of the helmet.
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Quote:

I recently bought a helment (principally for slalom training). I tried it for the first time on Saturday and the loss of awareness of what was going on around me was immense

Depends on the helmet. As a non-wearer I recently tried a full shell race-style Salomon helmet to see if I could get on with it:- it didn't seem any different to wearing a fleecey hat pulled down over the ears. It was no hotter than the fleece hat either - I was pleasantly surprised, and am now seriously considering buying a lid.

If there is a small increase in possible whiplash from wearing a helmet, I am sure it is vastly outweighed by the impact benefits. It would be interesting to know how much the average human head weighs, and see what difference wearing a helmet makes to the mass your neck muscles have to deal with.
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A couple of questions to think about;

If you had to whack your head against a rock (as you might, say, when skiing and you fall over) and you had a choice between wearing or not wearing a helmet which would you choose?

Why do all ski racers wear helmets?

Would you let your child ride a bike without wearing a helmet? If not then how can you justify not having them wear one to ski?

As has been mentioned already this has been well and truly done before so I'm staying out of it from now on.

snowHead
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On a personal note I know if I wore one I would be tempted to believe in the myth it would protect me from all ills. Cliff jumping would cease to be a teptation and become a frequent (at least until death) activity and the snowpark would be terrorised by optimistic Kaiser-flying.

Ban them before I buy one.
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mjg wrote:
......Why do all ski racers wear helmets?


FIS rule, I believe.

Quote:
Would you let your child ride a bike without wearing a helmet? If not then how can you justify not having them wear one to ski?


The case for children wearing a helmet seems rather stronger than the case for adults doing so.
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I've worn a helmet for a number of seasons (prompted by injuries to another skier after non planned excursion of piste).

So far its not had to save me due to a head impact when I've fallen (just lucky so far I guess). Its saved me from a bump on the head when safety bars have been pulled down a bit quick. Never noticed any adverse effect on my neck when I've fallen either.

In terms of comfort I've not found it any hotter than when I use to wear a hat. Not really noticed any particular difference in what I can hear (still aware of other skier/boarders). What does surprise me is how soon you forget your wearing a helmet due to the low weight.

As a plus on very cold windy days combined with face mask its extremely effective at keeping the worst of the weather out.

Any helmet (cycle/motorbike/ski) is unlikely to save your life in a very serious accident but just might save you from a disabling injury in other cases.

If we look at every day life all sorts of delicate items are packed in protective materials and no one doubts the effectiveness of these measures. Is it hard to believe that a helmet will be a benefit?

Anyway I'm happy to wear mine and if you don't want to wear one thats fine.
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My mate just gashed his forehead on ice boarding last week. Not wearing a lid and now a nice cut. A first week learner though so falls were common.
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As a recently retired Ski Patroller I've seen many accidents. To get the most out of a helmet do the following. Wear it and ski as if you were not wearing it. If you ever get to Sugarbush drop in to the Aid Room and check it out. If you ever are injured this is the place to be.
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Someone was killed coming off the side of Tete Ronde in VT last week - hit his head on a rock and that was it. Made me think seriously about buying a helmet.

Went out today in warm sunshine and was glad to be relieved of my hat - thank goodness I wasn't wearing a helmet.

I don't think there's a right or wrong answer here - but a helmet can't be a bad move if you're wandering off into dodgy terrain.
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Quote:


If there is a small increase in possible whiplash from wearing a helmet, I am sure it is vastly outweighed by the impact benefits

my own experience suggests this is right. i bashed my head very hard at Milton Keynes, catching back edge of snowboard (should have been on front edge). My head smacked the snow incredibly hard. Helmets were compulsory for the lesson, thank goodness. I did have a very stiff neck for a few days, but nothing lasting, and I'm sure it would have been worse without. Another anecdote: wore helmet to ski today for good reason that couldn't find the right hat at last minute. A very wobbly beginner snowboarder knocked me flying off a chair lift and his knee smacked me hard in my helmeted head, which suffered no damage. His knee was sore though. And I don't blame him, I can't get off lifts very well on a snowboard either. So I was glad I had worn it. The statistics quoted at outset of this thread are no doubt 100% accurate but they can't tell us whether it makes sense to wear a helmet. Comparing helmet wearers to non helmet wearers is to compare apples and pears. Nothing in the report suggests that, OTHER THINGS BEING EQUAL, you are more likely to be injured wearing a helmet.
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