The debate on helmets for skiing and boarding, long an issue that the industry preferred to finesse rather than face, is reaching critical mass in the public arena. While helmets are required in most alpine competition, this use has not, until now, been mirrored in the skiing public. But, with a number of professional patrols opting for them and with many ski schools requiring helmets on kids, helmets have become one of the hotter accessory items. And they are likely to become hotter yet, what with Burton sanctifying the coolness of helmets for riders.
The following opinions by respected safety specialist, Norm Sothan are followed by counterpoint based on SAM’s interview with Dr. Jasper Shealy, of the Rochester Institute of Technology, who, together with Carl F. Ettlinger, are considered the leading experts in skiing traumatology. They are currently reviewing the proposed ASTM recreational ski and snowboard helmet standard to see what the implications might be from a traumatology perspective.
The presentation in these columns should not be viewed as a debate, as such, since neither Shealy nor Ettlinger consider themselves to be committed to either “side” of the issue, but rather to be searchers after the facts of an issue where there is still much to be learned.
Heads, You Win!
by Norm Sothan, Principal, Safety Services
Sam Weaver is eight years old and very much alive in Boulder, Colo. He is alive today because his parents and ski coach insisted that he wear a helmet while skiing.
Earlier this season, after a full day of strenuous skiing, Sam was heading for the base area via a road. Like many young tigers, he and his buddies were probably skiing faster than they should have been. Although he is a competent skier, Sam fell, went off the side of the road and smacked a tree head on. Knocked unconscious, Sam was airlifted to the hospital where he was evaluated and found to be free of any serious injury—he walked out of the hospital ready to ski again. Examining the helmet after the accident, it was apparent that the headgear had sustained and absorbed high impact forces.
The point of this tale is that the helmet took the impact forces; Sam’s head did not and possibly his life was saved.
Although the wearing of protective headgear by skiers and snowboarders is a subject that merits serious consideration, it has met with resistance. At the same time, bicyclists, rollerbladers, kayakers, river rafters, rock climbers, skydivers and most motorcyclists wear them as a matter of course. With the exception of motorcyclists and bike racers, even novice and intermediate skiers and riders move faster than participants in these sports. Some opponents of helmets try to defend their position by saying that there are no United States standards for ski helmets. This is currently true, but there are helmet standards in Europe and for FIS racers. Furthermore, the American National Standards Institute publishes standards for motorcycle headgear and construction hard hats. Acceptable standards for ski helmets in the U.S. are certainly possible. For now, however, not wearing a helmet because of the lack of formal standards seems like a poor excuse.
In researching this article, I came across two articles in which the authors expressed concern about small children wearing helmets. They wrote that adding the weight of a ski helmet to a not-fully-developed neck could exacerbate any head trauma by transferring the force to the cervical area of the neck via a pendulum effect. If true, this would be a genuine cause for concern.
According to Edward Becker, executive director of the Snell Memorial Foundation, one of the leading organizations in the field of head protection and head trauma, the wearing of helmets is “neck-injury neutral.” He also said there is no evidence reported by any organization in which the weight of a helmet contributed to increased neck injury among children or adults.
While the simple physics of helmet use supports the use of protective headgear in preventing head injuries, what about the human aspects of helmet wearing—i.e., comfort, warmth, appearance, vision, hearing, etc.? To answer this question, I thought first-hand experience would be the best source, so my wife and I tested some helmets. After wearing the headgear for several full days, the results were very favorable. For comfort, we discovered the emphasis must be placed on proper fit and when they fit, the helmets proved to be very comfortable and stayed in place better than traditional wool-knit hats. On days with temperatures in the 10-degree range, the helmets proved warm, although on a sunny 40-degree day, there was some scalp perspiration. But when an out-of-control skier caused my wife to do a head plant on a firmly packed steep slope, the damp hair was a small price to pay for the protection provided.
There is also a question about it being “cool” or “chic” to wear head protection. Apparently it is a lot “cooler” this season than in past seasons. According to Jeff Turner, the general manager of Boulder Ski Deals ski shop, sales of ski helmets more than doubled over last season. As more helmets are worn on the slopes, and if the U.S. Ski Team advocates their use, it will become the thing to do. One caveat is my concern that young skiers, who already think that they are immortal, will think that with head protection they are indestructible as well as immortal.
As to visual acuity, properly fitted helmets have no adverse affect on vision according to the 25 helmet wearers who were questioned for this article. When goggles are added to helmets, vision can be restricted, but this restriction is caused more by the goggles than the helmet.
Hearing acuity, however, may be slightly affected when wearing a helmet. Much depends on the brand, style, fit and one’s unhelmeted hearing ability. By trying different brands, models and styles, hearing problems might be alleviated.
Overall, opinions about helmets were positive among skiers, safety engineers, head-trauma experts, manufacturer’s representatives, sales personnel and, most importantly, my wife, who were interviewed for this article. (Note: For my research, I borrowed a Boeri Profi model helmet for my wife. It was a good idea, but proved costly because I was informed that my chances of returning it are “slim to none!” She loves it.)
There are a number of manufacturers of skiing head protection—Boeri, Briko, Joffa, Headstrong and Reusch to name a few. Different helmets and styles seem to fit different sizes and shapes of heads, but most brands come with a fitting kit to help customize them. Prices run from about $90 to $350 for a racing-approved helmet with accessories. For professional skiers, the pro-price for a good helmet can be as low as $52.
My conclusion about helmets is that while all skiers should consider buying and wearing helmets when skiing, I don’t advocate that wearing helmets be made mandatory. In a bad fall, the prevention of injury to the head is really a “HEADS YOU WIN” situation.
Helmets—The Question Marks
by David Rowan, based on an interview with Dr. Jasper E. Shealy
Bottom line, says Jake Shealy, “Would a helmet be effective against head injuries? Absolutely! No doubt about it. But it’s not a panacea and it is most effective against minor injuries and least effective against serious injuries.”
Shealy wants everyone to approach the ski helmet issue with perspective supported by as much objective fact as possible. For instance, whereas about one-third of all serious bicycle injuries involve head trauma, that figure is only about 2.5 percent for ski injuries. (The breakdown is 2.4 percent concussions and 0.1 percent fractures, based on diagnosed injuries over a 22-year span at Sugarbush North in Vermont). That means, Shealy says, that we are talking about 4,000 “potentially serious” head injuries nationwide per year. Of these, 87 percent are “mild concussions,” he reports, meaning there was no memory loss, no amnesia, even temporary, and no long-term consequences. Another 11 percent are in the “mild-to-moderate” category, meaning some temporary amnesia, but where the general outcome is excellent. The balance of two percent represent “very serious” head injuries that result in permanent injury and/or death.
Zeroing in on those catastrophic accidents, Shealy can infer from a study of some 400 death certificates that 95 percent resulted from direct impact—two-thirds with a tree and two-thirds to the head. Would helmets have made a life-saving difference in these? Shealy believes, based on the “massive trauma involved,” the answer is “probably not.” He concedes, however, there could be some borderline cases.
The sort of helmet protection being considered for recreational use typically offers some protection up to 12 mph in direct contact, but limited protection in excess of that. There is much evidence that indicates the catastrophic direct impact of skiers with trees or fixed objects involves much higher speeds than this threshold.
Recapping, Shealy believes that use of helmets by recreational skiers “could be as effective as in bicycling,” with somewhere between a 60 and 80 percent injury reduction. “They could be extremely effective against minor injuries because most minor injuries result from glancing blows rather than from a direct hit. For those who take a direct hit,” Shealy cautions, “frankly this is where the helmet would be least effective.”
Shealy also wants those thinking about ski injuries to consider them from a wider perspective and through a public policy prism. Projecting (“very conservatively,” he says) the annual cost of keeping the skiing public helmeted, he comes up with the cost of $20,000 per injury prevented, which, he says, “is a fairly expensive solution to a fairly minor problem.” (He quickly adds, however, that the problem may not be minor to the person who has it!)
“If we’re going to spend substantial sums of money in accident prevention,” Shealy argues, “why not spend it so that it can work effectively against a much more serious problem?” Shealy points to ACL injuries, which account for one-third of all injuries today, of which more than one-half are serious. He contrasts the 33 percent ACL incidence with the 2.5 percent for head injuries, the vast majority of which are minor.
Norm Sothan’s opinions above touch on some other concerns over helmet usage, such as the potential for neck injury to small children caused by adding the weight of a ski helmet to a not fully developed neck. Says Dr. Shealy, “Seen from a biomechanical perspective, it seems quite possible that the use of helmets may well result in an increase in the number of potentially serious neck injuries for the smallest skiers.”
Both Shealy and Sothan have concerns that wearing helmets may give skiers and riders an unwarranted feeling of indestructibility, particularly the older adolescent and young adult males, i.e. 15 to 30 years of age—the ones that fatality statistics show are most likely to take advantage of any increase in safety with at least an equal increase in risk-taking behavior. In this they hit on something that safety experts are universally concerned about, studying and measuring it as “off-setting behavior.” There are studies that seem to show, for instance, that drivers with ABS braking systems, or motorcycle riders wearing helmets, assume a level of protection that apparently results in their driving or riding with greater abandon. The resulting accident and insurance statistics are not pretty, and could be explained, as a study on the subject summarized, that it “could be an outgrowth of helmeted riders tending to ride more recklessly in response to that added sense of security that a helmet provides.” An unwelcome, but real, paradox.
No one knows, of course, if skiers might react similarly. To what extent, Shealy wonders, was the behavior of young Sam Weaver in Norm Sothan’s piece encouraged by the use of a helmet that, in his case, apparently also saved his life?
There are other points of discussion, all raised by Sothan, which need to be studied: impaired hearing and its potential consequences. . .decreased peripheral vision and/or impaired vision from the fogging of goggles caused by overheating. Such concerns can presumably be met or mitigated by design and ingenuity.
And the fashion or cool index that Sothan raises is a real issue. If it suddenly becomes “So-o-o cool” to wear a ski helmet, the biomechanics of Shealy and Ettlinger, together with the reasonings of Sothan, could become roadkill on the highway of fashion. Already, helmet usage at some ski areas is reaching critical mass (over 25 percent?) to where it becomes routine.
It’s time the industry got up to speed on this issue.
