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A Heady Debate

A Heady Debate

Fitness
By Kellee Katagi
posted: 09/21/2000

Just a few years ago, a non-racer wearing a helmet on the slopes was about as rare as a snowboarder in Taos. Today, helmeted skiers—adults and children alike—can be seen at every resort in North America. Helmet sales are doubling every year, with more than 500,000 sold last season.

But even with helmets flying off store shelves, the percentage of skiers and boarders wearing them remains small; estimates hover around 5 percent. For many non-helmeted snowsliders, questions remain: Is the risk of head injury high enough to warrant wearing a helmet? Do they really work anyway? For some, the biggest question is still: Will a helmet make me look like a dork? The answers to these concerns are, respectively: maybe, usually and no.

Ski-industry officials have long been trumpeting the message that skiing is relatively safe. The odds of death or serious injury—such as paralyzation or severe head trauma—from skiing or snowboarding are less than two in a million, according to the National Ski Areas Association.

Skiing still puts your noggin at risk, however. Each year, between 12,000 and 16,000 skiers and boarders leave the slopes with head injuries, which account for about 14 percent of all snowsliding injuries, reports the U.S. Consumer Product Safety Commission. While the CPSC's definition of head injury includes neck strains, facial cuts and any other damage sustained from the neck up, agency officials estimate that nearly half of the injuries they studied occurred to an area of the head that would have been protected if the victim had been wearing a helmet.

The risk may be higher for some than others. If you're an experienced male skier or boarder between the ages of 15 and 30 who likes to cruise near the edges of intermediate trails, watch out, suggest the statistics—this group takes more than 70 percent of on-slope knocks to the head. "These are not random accidents," says the Rochester Institute of Technology's Jasper Shealy, who has been studying head injuries in skiing since the Seventies. "They are concentrated within a demographic group that is known for high-risk behavior."

When head banging occurs, helmets can do a lot to lessen the damage, contends Dr. Stewart Levy, a neurosurgeon at InterMountain Neurosurgery & Neuroscience, a division of St. Anthony's Central Hospital in Denver, Colo. The hospital is the likely destination for anyone who survives the first few hours of an on-slope head injury in Colorado's Grand or Summit counties, home of resorts such as Breckenridge, Copper Mountain and Winter Park.

Tired of seeing skiers come through the clinic with banged-up melons, Levy decided to analyze 395 on-slope head injuries treated at St. Anthony's. Of the five patients in the study who were wearing helmets, none had any lasting damage, even though they had experienced serious falls or collisions. Levy is convinced that the helmets dramatically reduced the severity of injury for those skiers and riders. He tells of one boarder who fell off a 40-foot cliff and cracked his helmet into two pieces. He was briefly knocked unconscious, had a seizure and was confused for several days. But he tested normal on both a CT scan and an MRI and went home with no permanent brain damage. "I believe he would have been dead or at least severely disabled without a helmet," Levy says.

But there are situations in which a helmet won't make a difference, Levy and other helmet advocates admit. If you go headfirst into a tree at 20 mph, a helmet isn't going to help much, says Randy Swart, director of the Bicycle Helmet Safety Institute and the first vice president of the American Society of Testing and Materials' snowsports helmet committee. "But most people hit the surface with something else first," he adds, "their chest or shoulder or arm—something that will absorb some of the impact before their head hits."

Some experts say that if you're skiing above 12 mph (slower than most people ski), a helmet won't help you in a crash. Ts conclusion is based on the way standards committees test helmets; the lids are placed on metal dummy heads and then anvils are dropped on them at different velocities. With most snowsports helmets, the headform shows some sign of impact when the weight is dropped at speeds above 12 to 14 mph. But the laboratory situation doesn't necessarily translate to an on-slope scenario.

"The speed of impact in a test doesn't replicate a real-life situation," Levy says. "We're not metal headforms running into solid steel anvils. A tree is hard, but not as hard as steel. Also, 'some sign of impact' isn't the same as a death blow."

But could donning a helmet have the opposite effect, giving skiers a false sense of security and causing them to ski more recklessly? Yes, contends Shealy of the Rochester Institute of Technology in Rochester, N.Y. "I call it the SUV mentality," he says. "Drivers of SUVs get in more accidents because they think they are in a personal tank. They have an exaggerated sense of what the vehicle can do." Levy disagrees, suggesting that a helmet is more comparable to a seat belt or airbag than a sport-utility vehicle because it's merely a protective device, not a preventive one. "With an SUV you have enhanced performance, and you feel like you can do more," Levy says. "SUVs are more analogous to shaped skis than to helmets."

Another concern Shealy has expressed about helmet use is the increased possibility of a neck injury, especially for young children. The argument goes as follows: A child's head is a much greater proportion of his body mass than an adult's head. Add a helmet, and the ratio is even larger. The higher the proportion the higher the potential for the neck to get bent or twisted during activity. While the argument is logical, the incidence of such accidents is so small that there isn't any evidence to support the theory. "This danger is a myth," Levy says. "Cervical spine injury in young children is extremely rare." Even when helmeted skiers do sustain neck injuries, it's unlikely that the helmet caused them, he adds. "Head injuries and spine injuries occur together. You hit your head, it flexes your neck—helmet or no helmet."

But forget statistics, forget scientific evidence—style and comfort are often the main barriers to skiers wearing helmets. Many think a helmet screams "geek;" others complain that a lid is too hot or that it muffles sound. But these barriers are beginning to crumble. "Psychologically, people are becoming more comfortable with helmets," says Bob Collins, store manager of a Christy Sports ski shop in Denver. "Fewer feel like it will make them look wimpy." In fact the image perception is starting to swing the other way, Collins suggests, especially among snowboarders. "It portrays a more extreme attitude," he explains. Helmets are increasingly user-friendly as well, with manufacturers offering better ventilation, lighter-weight materials, improved sightlines, removable liners, less obstruction to hearing and more style-conscious designs.

When buying a helmet, consider choosing one that has met established standards, such as the Central European Norm, the ASTM standard, which was finalized earlier this year, or two standards (one for racers) by the Snell Memorial Foundation in North Highlands, Calif. To meet one of these standards, a helmet must pass rigorous tests of stability, head coverage and impact protection. Head-coverage standards are relatively high for snowsports helmets, so some "shorty" or half-helmets may not meet them. Sorting through the various standards can be confusing. The important thing to remember is that choosing an approved helmet helps ensure that it will be effective when you need it to be.

While the public seems to be warming up to the idea of helmets, few people foresee a time that they are made mandatory on the slopes, at least universally. "There won't be any federal mandate," says Ken Giles, spokesman for the U.S. Consumer Product Safety Commission. "We just can't do that on a federal level. It would have to be done state by state or resort by resort. Right now we recommend wearing a helmet, but it's just that—a recommendation."

Most industry officials—including helmet advocates—agree that wearing a helmet should remain a decision people make for themselves. "There's no compelling reason not to wear a helmet," says Michael Berry, president of the National Ski Areas Association. "But people can and will reserve the right not to put one on. The statistics don't lead you to the conclusion that skiing is so fraught with risk that a helmet is absolutely necessary. Having said that, should you give serious consideration to wearing one? The answer is yes."

Health Hit
Helmets could prevent or reduce the severity of nearly 8,000 on-slope head injuries each year, says the Consumer Product Safety Commission.

By The Numbers
Colorado neurosurgeons studied 395 skiers and snowboarders with head injuries. They concluded that helmets may have prevented or reduced the severity of injury in many of these instances.Commission. "We just can't do that on a federal level. It would have to be done state by state or resort by resort. Right now we recommend wearing a helmet, but it's just that—a recommendation."

Most industry officials—including helmet advocates—agree that wearing a helmet should remain a decision people make for themselves. "There's no compelling reason not to wear a helmet," says Michael Berry, president of the National Ski Areas Association. "But people can and will reserve the right not to put one on. The statistics don't lead you to the conclusion that skiing is so fraught with risk that a helmet is absolutely necessary. Having said that, should you give serious consideration to wearing one? The answer is yes."

Health Hit
Helmets could prevent or reduce the severity of nearly 8,000 on-slope head injuries each year, says the Consumer Product Safety Commission.

By The Numbers
Colorado neurosurgeons studied 395 skiers and snowboarders with head injuries. They concluded that helmets may have prevented or reduced the severity of injury in many of these instances.

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