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Can a Helmet Save Your Life?

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Dr. Stewart Levy says a properly constructed and fitted helmet can significantly reduce the probability of brain injury. Dr. Levy says helmets can reduce the risk of brain injury by 75%.

skiing

Dr. Stewart Levy, a Denver-based neurosurgeon and father of two, helped launch a successful helmet-loaner program in Colorado called "It Ain't Brain Surgery." His studies have found that helmets can reduce the risk of brain injury by 75%.

"It's important for anyone to use a helmet when they ski or snowboard -- not just kids," he says. "It's more devastating to a family when a parent gets a brain injury, because the parent is the breadwinner or caretaker or both, it's very disturbing to see families on the slopes with their kids in helmets but Mom and Dad aren't wearing them. It's upsetting, disturbing and hypocritical as well."

Why should people wear helmets while engaged in activities? "There is always the risk of a brain injury when you are in any high speed sport, no matter how good of an athlete you are," he says. "There's always a chance you could fall or hit your head. At the same time, I'm an avid skier, so I'm not telling people to stop skiing. Just take a reasonable precaution and wear a helmet."

He says a helmet is not going to decrease the chance you're in an accident, but it will significantly reduce your odds of a brain injury. "Even if you do get a brain injury, it will reduce the severity of the injury," he says. "We've seen a lot of examples of that. We don't see the people whose injuries are completely prevented, obviously, because they don't make it to the hospital. But every season, we continue to see serious brain injuries that could have been prevented or reduced by simply wearing a helmet."

He says just like you strap your kid into a car seat or buckle your seatbelt every time you get into a car, wearing a helmet when you bike ride, ski, snowboard, roller blade, or skateboard should be automatic. "It's a no brainer," Dr. Levy says.

When an unhelmeted child or adult falls and hits their head, Dr. Levy says they can sustain injuries ranging from a mild concussion, hemorrhage, epidural or subdural hematoma, to a massive brain injury that results in coma or death.

How is the damage different if one is wearing a helmet? "Even if you do get an injury, the severity is likely to be reduced," Dr. Levy explains. "We see very few injuries that cause bleeding in the brain if the patient was wearing a helmet. And I have never personally treated a patient who died if they were wearing a helmet at the time of their injury."

What happened in Natasha Richardson's case? "It's possible she sustained a skull fracture," he says. "If the fracture tore an artery, then the artery would bleed, and over time, an epidural hematoma would develop and press on the brain, causing more and more pressure. Helmets are best for preventing skull fractures in a fall and preventing epidural hematomas. A helmet would have had a high probability of preventing an injury like this."

Why aren't helmets mandatory? "The ski industry is complex -- and helmet laws have been losing traction over time," Dr. Levy says. "Motorcycle helmets laws have been repealed in state after state. The ski industry is worried that if they pass a helmet law in their state, college students will just go to other states where they don't have to wear a helmet, and the resorts will lose money."

On the bright side, however, he says there is no doubt that helmet use on the slopes has increased. "It's gone from essentially zero percent when we launched our program in 1997 to about 50 percent now," he says. "Of course, we'd like it to be higher. We still unfortunately see injuries every year of people who are not wearing helmets. High-profile cases like this one and Sonny Bono are tragic, but they do help to get the word out about the importance of wearing helmets."

So, the next time you head out the door to ride, ski, or rollerblade, check your ego at the door and wear a helmet -- it could save your life.

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48 comments so far | Post a comment now
HelmetFan March 18, 2009, 11:01 PM

Nothing aggravates me more than seeing a helmeted kid biking with a bare-headed parent. Mom, Dad? You head splits just as easily as your kid’s….and then you leave your kid with a brain-damaged parent. Stop the hypocrisy!

Tom March 19, 2009, 6:19 AM

This is one sided rubbish. No doubt wearing a helmet is safer for you and your children on the slopes but this article takes it too far - the ” I have never personally treated a patient who died if they were wearing a helmet at the time of their injury” is a ridiculous statement - most fatalities on the ski hill involve adults/children wearing helmets skiing recklessly.

As for the zero percent statistic in 1997 - yet more rubbish, I was a young racer out in Canada in 1997, and we all wore helmets, and it was very common in the tourist ski school.

Yes please do wear a helmet, but lets not get caught up in hysteria or ignore statistics that show most serious accidents involve skiers/boarders wearing helmets.

The torsional stiffness of relatively soft modern skis allow intermediate skiers to travel at twice the speed they could a decade ago - they still can’t manoeuver, stop, or change direction any quicker - teach people to know their limits, and equip themselves to be as safe as possible.

You would be safer driving your car with a helmet on, it doesn’t mean you do it. I know skiing is different, but it is also different to biking where you fall from a perched position therefore greatly increasing the chance of head injury.

I will always make my kids wear a helmet whilst skiing, I will set a good example and do the same - but they will also be taught to respect the mountain and never take safety for granted.

Pierre Forget March 19, 2009, 4:24 PM

Twenty years ago, I was a ski patrol at the local mountain in St-Donat, Quebec, and I was probably one of the first ski patrol, if not the first, to wear a helmet. People would look at me with a funny face, but I didn’t mind. My head is more important.

Now the paradox : go to any decent ski station and use vintage skis and vintage ski bindings. As soon as you will try to get on the chairlift, the attendant will stop you and say you can’t get up with non secure ski bindings. They will tell you that newer types of ski bindings are mandatory to protect your legs and ankles. And they won’t let you up, because of insurance liability.

Why are your ankles and legs so well protected and not your head? What is more important? Your head or your ankles and legs? If they have insurance liability for legs and ankles, why not with your head?

Not to go back on safety, but you can live with a broken ankle, but you may not live with a broken skull…

Linda March 19, 2009, 6:15 PM

Interesting point that Tom made. I figured most fatalities were caused by reckless skiing/snowboarding, but I didn’t realize that they were wearing helmets too. A helmet only goes so far though. It won’t protect your head if you’re going extremely fast and hit something hard. And hopefully if you’re a beginner who’s not confident with stopping and changing directions yet, you won’t fly down an intermediate slope and risk yourself getting killed. As I said in another post, some of the beginner slopes are steep enough that you can go pretty fast. Heck, I snowboarded down a beginner slope without stopping and was scared to death at how fast I was going. It’s always better to wear a helmet. After all, you’re going pretty fast.

trixie  March 21, 2009, 9:14 PM

Every one should wear a helmet. that goes for any sport that you know you need a helmet. Use your good sence and wear the thing no matter what!

Stewart Levy March 22, 2009, 9:16 PM

I would like to address Tom’s comments above. He is correct that there are still fatalities among skiers and snowboarders wearing helmets. Approximately half of those in fatal accidents in recent years were wearing a helmet. The quote in the article is still true (“I have never personally treated a patient who died if they were wearing a helmet at the time of their injury.”), but that is only part of story and the discussion I had with the author. I also commented that I am aware of helmeted fatalities. Also note that the young males are the most likely to wear helmets and have been the most at risk for injury and death since a long time before recreational skiers started wearing helmets. Therefore, helmet use among those fatally injured may be skewed. To analyze it accurately one would need to know the age, gender and ability of all the fatally injured, and then the helmet use rate among those population groups in order to calculate an odds ratio. For example, if 80% of males between 16 and 25 wear helmets in general, and 40% of males fatally injured in that age group were wearing a helmet at the time of their injury, then that would imply that helmets reduce the risk of fatality by 50%. If there had been no effect, we would expect 80% of them to be helmeted at the time of injury. Unfortunately, these statistics are very difficult to obtain in the USA.

I’m very glad to hear that you have been wearing a helmet since before 1997. Our helmet counts on the slopes started in 1997, and we found that less than 1% of recreational skiers were wearing helmets at that time; thus the comment “essentially zero”. I am well aware that racers have been wearing helmets for much longer.

Finally, I couldn’t agree with you more that the most important aspect in skier safety is for participants to know their abilities and limits and to stay within them and stay in control. A helmet will not prevent all injuries and is not a license to ski recklessly. As the NSAA has said “wear a helmet, but ski as if you’re not”

A. Stewart Levy, MD
Chief of Neurosurgery and Neurotrauma
St. Anthony Central Hospital
Denver, CO

Richard Keatinge March 23, 2009, 3:49 AM


There is evidence that helmeted skiers tend to go faster.(Shealy, Jasper E.; Johnson, Robert J. (July 2005). “How Fast Do Winter Sports Participants Travel on Alpine Slopes?”. Journal of ASTM International (JAI) 2 (7): 8 p. doi:10.1520/JAI12092. Retrieved on 2009-03-19.)

“There is no evidence they reduce fatalities,” said Dr. Jasper Shealy, a professor from Rochester Institute of Technology who has been studying skiing and snowboarding injuries for more than 30 years. “We are up to 40 percent usage but there has been no change in fatalities in a 10-year period.” (Fletcher Doyle (4 March 2008). “Use your head on the ski slopes”. The Buffalo News. Retrieved on 2009-03-19.
And Shealy, Jasper E.; Johnson, Robert J.; Ettlinger, Carl F. (November 2008). “Do Helmets Reduce Fatalities or Merely Alter the Patterns of Death?”. Journal of ASTM International (JAI) 5 (10): 4 p. doi:10.1520/JAI101504. Retrieved on 2009-03-19.)
If I ever go skiing I might wear a helmet, but I wouldn’t presume to advise anyone else on whether they should.

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The more padding a person wears the more risks they will take and the less liky the new protection will help.

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