Where did the story come from?

The British Medical Journal (BMJ) recently published an editorial drawing together the findings from several different studies on the use of helmets in skiing and snowboarding. When reporting on this discursive piece, BBC News included some risk-reduction figures, which were sourced from a recent review of studies conducted by researchers from the University of Calgary. It is this review that has been appraised in this Behind the Headlines article.
The study was published in the peer-reviewed Canadian Medical Association Journal. The authors report that their study received no external funding.
BBC News reported the issue well, giving the context provided in the BMJ’s editorial. However, it attributed the risk-reduction figures of 35% in adults and 59% in children under 13 to a study of ski helmets by the University of Innsbruck, whereas these figures came from a review conducted by researchers at the University of Calgary.

What kind of research was this?

This was a systematic review of studies that assessed head injuries in skiers and snowboarders. To gather studies, the reviewers searched through sources of research literature, including electronic databases of studies published up to 2008, conference proceedings and reference lists of other research. They only included studies that had a control group (a comparison group of uninjured people). This allowed them to assess the effect of wearing a helmet on the risk of head and neck injuries.

What did the research involve?

The studies included were cohort, case-control or case-crossover studies. Three researchers separately extracted data from each of the included studies to ensure that data were extracted appropriately. The data extracted included the study design, the characteristics of the participants and the study results. A statistical technique called meta-analysis was then used to combine the results of the studies. This gave a pooled estimate of the risk of head injury associated with not wearing a helmet while skiing or snowboarding.
When performing a meta-analysis, it is important to assess whether it is appropriate to pool the results of the included studies. One way to measure the appropriateness of pooling a set of results is to determine how different the studies are from one another through measuring a statistical property called “heterogeneity”. The researchers measured the heterogeneity, which allows us to have a sense of the robustness of the pooled estimate. They also performed analyses using only the high-quality studies and only the low-quality studies to determine what range of results might be plausible around their estimate.
While they initially identified 36 studies, the researchers included 12 studies in their analysis after applying their inclusion criteria. Ten were case-control studies, one was a case-control/case-crossover and one was a cohort study. In total, they pooled data from 9,829 participants who were wearing helmets and 36,735 who were not.
The researchers presented two different analyses of the studies, one assessing the effect of helmet use on the risk of head injury and a second reporting the effects on the risk of neck injury.

What were the basic results?

The review found that wearing a helmet reduced the risk of head injury by about 35-40%. This variation arose due to studies comparing skiers with head injury against different control groups, including uninjured people, or a mix of uninjured people and those who were injured but not with head or neck injuries. For example, skiers and snowboarders with a helmet were significantly less likely to have a head injury than injured and uninjured people without a helmet (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.55 to 0.79).
Helmet use was associated with a significant reduction of about 55% in potentially severe head trauma in the studies that assessed this outcome. In subgroup analyses, the researchers investigated the effect of helmet use in children under 13 and found that use reduced the risk of head injury by 59% (OR 0.41, 95% CI 0.28 to 0.62).
Six studies specifically looked at neck injury. Analysis of these studies showed no evidence of a reduction in the risk of neck injury using helmets. The researchers report that this was true in both adults and children.

How did the researchers interpret the results?

The researchers concluded that helmets reduce the risk of head injury among skiers and snowboarders but that there is no evidence of an increased risk of neck injury.

Conclusion

This systematic review and meta-analysis addressed the issue of helmet use for snow sports. It has several shortcomings, some of which the researchers discussed:
The studies were generally of only moderate quality, and many failed to adequately adjust for potential confounding factors, such as activity while being injured, jumping and participants’ age.
The control groups in the studies varied. For example, some studies compared uninjured people and others looked at people who were injured but not with a head or neck injury.
The definition of head injury varied across studies.
There was a lack of information about the quality or fit of the helmet. The researchers say that if poor-quality helmets or helmets that didn’t fit well were worn, the helmets’ potential to reduce head injury may have been underestimated.
Importantly, there were several differences between the various studies being pooled (high heterogeneity). This appears to be due to the different methods of the studies and the different way that samples were selected. This high heterogeneity means that we can be less confident in the results of this study. For these studies, the I² statistic (a measure of heterogeneity) was about 75%, which can be interpreted as the percentage of variation across study results that is due to heterogeneity rather than chance.
As they are not based on a population sample, it is impossible for case-control studies to calculate the absolute risk of a head or neck injury. While it appears that helmets reduce the risk of injury, the large relative risk reductions (35% and 60%) mask the fact that a head or neck injury is a rare event. The authors of this study report that the rate of head injury is about 0.09 per 1,000 outings. This means that if you went skiing or snowboarding 11,111 times, you would be likely to injure your head just once. For neck injuries, the rate is reported to be 0.46 per 1,000 outings, equating to going skiing or snowboarding 2,174 times and receiving one neck injury.

SOURCE: http://www.nhs.uk/news/2011/02February/Pages/head-injury-protection-ski-helmet.aspx

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1. Ski Helmets cut ski injuries by 35%: study
2. You are 35% safer with a ski helmet says study
3. Review of studies says ski helmets reduce head injuries

To wear or not to wear that is the question.

It is certainly not a new debate and the argument about whether to wear a ski helmet or if there should be any form of compulsion, and for which groups, has been going on for many years.

It is likely to continue too.

The researchers from the BMJ have studied a project by the University of Innsbruck in Austria that concludes injures go down by 35% for adults if they are wearing a helmet and 59% for children under 13.

The University does much work into the safety side of skiing and snowboarding. Here are details of another study into fitness.

The research into wearing a helmet concludes that “wearing a helmet seems to make sense to prevent head injuries in all age groups” and that “protecting the head with a helmet must be beneficial.”

One study found that 74% of head injuries happened when people hit their head on the snow, 10% in collisions with other skiers or snowboarders and 13% when they hit fixed objects like pylons, rocks or trees.

The researchers argue that a ski helmet should be included in ski hire packages.

It already is in many cases and in the same way you can order skis and/or boots a skier or snowboarder can also add a helmet to the list.

We have already reported on both sides of the debate by asking a mountain guide why he had chose to start wearing a ski helmet and a ski instructor and BASI Trainer why he chose to not to on most occasions.

One argument against any compulsion is that wearing a helmet makes people feel safer and more protected.

They could therefore ski faster and with less care.

A point raised in this interview we did with British skier, Mervyn Fletcher, shortly after he bought a helmet for the first time.

It is not a new interview and we recorded it for PlanetSKI in 2009 but the points raised remain valid.

PlanetSKI has just been in Vail in Coloroado where people are encouraged to wear helmets and all resort staff have to wear one when on duty.

A quick and totally unscientific count in one of the lift queues in Vail showed about 70% of all people wearing a helmet.

More popular in the USA

In Europe there is widespread compulsion for children, especially in Italy and Austria.

Many ski schools require children to wear a helmet during lessons.

But despite the rhetoric and extensive media coverage after a number of high-profile accidents there is no sign of widespread compulsion coming into force.

In Europe at least.

UPDATE…..

The director of the British Alpine Ski & Snowboard School, Hugh Monney, has read the above article and just sent us in his reaction. He is a BASI Trainer and highly respected in the ski industry.

We thought it worth publishing.

“I’ve just read the Planet Ski article, reviewing the findings of the BMJ article, on the benefits of using helmets when skiing. I’ve been wearing ski helmets for almost a decade now and many of my clients convert, when they hear the reasons.

What type of skier would benefit from wearing a helmet?The type that has a head that they’d like to protect, in the event of an unforseen accident.

I’ve heard stories of helmets being uncomfortable and reducing peripheral vision – that would a description of a helmet that fits poorly.The helmet i use is light, comfortable and has absolutely zero effect on peripheral vision, as you’ll see from the photo.

The BMJ article is reporting real science. It’s fine for individuals to have opinions that are at odds with the science – that’s an example of democracy in action.

It’s less than fine for ski professionals to profess those opinions, though. That’s an example of being mis-informed. ‘The research is in’, as they say.”

SOURCE: http://www.planetski.eu/news/2550

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1. Austria requires Ski Helmets for more now

Dr Gerhard Ruedl and colleagues from the Department of Sport Science at the University of Innsbruck in Austria say there is convincing evidence that ski helmets protect against head injury. They argue that one way to increase helmet use is to ensure that they can be easily hired or included in skiing packages.

The authors say that the debate about ski helmets has intensified after a few fatal skiing injuries in Europe and North America. On New Year’s Day in 2009 a politician wearing a helmet collided with a woman who was not wearing one. The politician survived but the woman did not. In March 2009, actress Natasha Richardson died after a traumatic head injury while skiing in Canada – she was not wearing helmet.

A recent study concluded that general head injury was reduced by 35% when ski helmets were used and this rose to 59% for children under 13. “Wearing a ski helmet seems to make sense to prevent head injuries in all age groups,” say the authors.

They acknowledge, however, that there are some arguments against helmets. There is a theory, they say, that helmet use may provide a false sense of security and result in riskier behaviour. One study found that helmet use is higher in more skilled skiers so perhaps “the use of a helmet is not necessarily associated with a higher level of risk taking but primarily with a higher level of skill” they suggest.

Ultimately the authors believe the evidence points to helmets having a protective effect and say that action needs to be taken to increase helmet use.
Provided by British Medical Journal

http://www.physorg.com/news/2011-02-skiers-helmets.html

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1. Health Matters: Helmet Usage and Snow Sports
2. Helmets protect skiers, snowboarders from head injury

When the alpine ski hills at Brookvale Provincial Ski Park opened recently, posters encouraging the use of helmets were featured prominently and officials with the P.E.I. Brain Injury Association were vocal in encouraging their use.

Wearing the headgear simply makes sense. According to Canadian Medical Association statistics released last February, helmets reduce risk of head injury among skiers and snowboarders by 35 per cent. Head injuries, the medical association says, account for 19 per cent of all injuries reported by ski patrols and emergency departments.

So why not adopt an injury prevention attitude when engaging in sports or other activities that involve a high risk of mishap? Players in many other sports — hockey, football, baseball, for example — all wear helmets for obvious reasons of protection. It’s just good policy for ski hills to promote their use and for skiers to voluntarily wear them.

So what about the role of government in this debate? Two years ago, the provincial government was reluctant to bring in legislation requiring the use of helmets because there was no Canadian Standards Association-approved helmet on the market. Which begs the question: where is Parliament in dealing with repeated requests over the years for legislation that would require helmet manufacturers to meet CSA approval? Such approval would give purchasers the assurance that the helmet they buy meets CSA standards. And with such helmets on the market, provincial governments might also be more inclined to bring in legislation making it mandatory for skiers and snowboarders to wear them.

In the meantime, skiers who do consider it important to wear protective headgear should buy helmets that have been certified in the U.S. or Europe. In fact, there’s nothing preventing the provincial government from making the wearing of those helmets mandatory for now. Governments have a responsibility to show leadership. Rather than waiting for other provinces to take the lead, the P.E.I. government has the opportunity here to chart a course that could inspire others to follow.

If concern for people’s welfare isn’t enough to motivate governments to legislate or regulate the making and wearing of helmets, then sheer economics should force them to act. Every head injury results in costs to the health care system, costs that could well be avoided by the simple precaution of wearing a helmet.

SOURCE: http://www.theguardian.pe.ca/Opinion/Editorials/2011-02-01/article-2188220/Wearing-a-helmet-a-sensible-choice-for-skiers/1

A bipartisan bill co-sponsored by Assemblyman Anthony M. Bucco, R-Boonton, is trying to change that. The bill, which was released from committee last week, would require anyone under the age of 18 to wear a helmet while skiing or snowboarding.

A recent study by Morristown Memorial Hospital said helmets would prevent up to 50 percent of injuries suffered by young skiers. It admitted that helmets would be unlikely to prevent injuries in high speed crashes. Fair enough. Seat belts are not going to save the driver 100 percent of the time either in high speed crashes, but that is not a reason not to wear seat belts.

The committee’s action was applauded by Barbara Geiger-Parker, the president and CEO of the Brain Injury Association of New Jersey. She commended the sponsors for their leadership in trying to prevent brain injuries and expressed hope that the bill would become law. We concur.

SOURCE: http://www.dailyrecord.com/article/20110124/OPINION01/110121066/1005/NEWS01/Ski+helmet+bill+should+become+law

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1. Assembly panel OKs ski helmet use bill in NJ
2. CA: Gaines & Neillo butt heads over ski helmet bill

On behalf of the National Ski Areas Association, I’d like to respond to the recent article on New West, “Why Ski Resorts Should Do More to Promote Helmets” by Allen Smith.

From our view, we’d argue that our member ski areas take extraordinary efforts season after season to promote the use of helmets. Millions of parents have visited the Lids on Kids website since its initial launch in 2002. The purpose of the website is to educate parents of the benefits and limitations of wearing a helmet and it includes tips such as determining the proper helmet fit. In addition, NSAA is continuing to advance its helmet safety initiative and has set an end goal of near universal helmet usage by those skiers and riders aged 17 and under by the 2012-13 season. Last season, 57 percent of skiers and snowboarders of all ages voluntarily wore helmets on the slopes, so we are confident that our goal to get kids helmeted is well within reach.

Furthermore, ski areas nationwide offer discounts on helmet purchases throughout the season, and particularly during National Safety Awareness Week. Many resorts host fun safety-themed competitions for their guests and employees, and offer a new helmet as the prize. Our National Kids Safety Poster Coloring Contest has been running for more than 10 seasons now, and each year we receive hundreds of posters from young skiers and riders across the country. The kids who create the winning posters receive a helmet as their prize.

There are currently no states in the U.S. that mandate the use of ski and snowboard helmets. Those efforts are being made in a few select states, but to date, there are no ski helmet laws in place. A little more research on Mr. Smith’s part would have revealed that ski areas nationwide are, in fact, making significant efforts to not only educate their guests on the benefits and limitations of helmets, but to promote the use of helmets.

Thank you for your interest in covering issues that the ski industry takes very seriously

Lids on Kids, which launched in 2002, is part of an initiative to get achieve near universal helmet usage by skiers 17 and younger by the 2012-13 season.

Troy Hawks is the managing editor of the NSAA Journal, a publication of the National Ski Areas Association based in Lakewood, CO.

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1. Why Ski Resorts Should Do More to Promote Helmets

By Allen Smith, 12-03-10

When it comes to drawing attention to controversies and debates, celebrities often succeed where industry experts fail. The unfortunate death on March 18, 2009, of actress Natasha Richardson is a good example. Ms. Richardson suffered what appeared to be a minor head injury while taking a beginning ski lesson at Mont Tremblant in Quebec, Canada. She died two days later in a New York City hospital as a result of hitting her head on the snow during a fall – the type of injury that helmets are designed to reduce.

Ms. Richardson’s death rekindled the efforts of Michelle Courchesne, the Quebec sports minister, in requiring mandatory helmet use at Quebec ski areas. The United States ski industry experienced its own wake-up call after the deaths of Sonny Bono and Michael Kennedy in 1998. Since then, a number of ski-related organizations have come out in favor of skiers wearing helmets, but few have gone as far as issuing mandates. Yet, the case for helmets is clear.

The two studies that are often cited for head injury statistics are the American Medical Association’s 1997 report to the Council on Scientific Affairs titled ”Helmets for Recreational Skiing and Other Winter Sports in Children and Adolescents” and the U.S. Consumer Product Safety Commission’s study, ”Skiing Helmets – An Evaluation of the Potential to Reduce Head Injury” [pdf] published in 1999. Although their conclusions vary to some degree, both concur that, while the number of ski and snowboard injuries is declining, head injuries are on the rise. After studying 11,795 injuries over a 15-year period at Sugarbush Ski Resort in Vermont, the AMA concluded that 2.6 percent of all ski-related injuries resulted in some type of “potentially serious head injury” that included skull fractures, concussions, serious brain injuries and death. Calculated as incidences per 1,000 skier days, the researchers concluded that head injuries accounted for 0.07 injuries per 1,000 skier days. They went on to say that the majority of preventable head injuries occur in beginning and intermediate skiers at speeds less than 15 mph on relatively flat surfaces.

In 2008, Robert Williams, M.D., at Smugglers’ Notch Resort in Vermont, published a detailed study in Wilderness and Environmental Medicine addressing the risks associated with the speed of skiers and snowboarders riding in gladed areas and terrain parks. The study consisted of 39 subjects. Eighteen were professional ski patrolers, snowboarders, telemark and recreational alpine skiers riding in a controlled glade run. Twenty-one were skiers and snowboarders who performed maneuvers on terrain park rails. A trained observer measured the riders’ speed using a radar gun as they approached and exited the designated glade runs and while performing tricks on rails that were several feet above the surface of hardpacked snow. The results indicated that over 87 percent rode at speeds below 15 mph –speeds that are purported to put riders at the highest risk for incurring head injuries and benefit the most from helmet use. Williams also noted that 68 percent of the falls occurring in terrain parks were the result of “opposite edge phenomenon,” where riders experience a sudden and unexpected “frontside” or “backside” fall that is difficult to control.

Williams offers more intimate behavior of skiers and snowboarders and helmet use after studying the skiing and riding habits of 75,000 guests. His observations include the “Theory of Risk Compensation,” or the decisions of riders to take more risks because they’re wearing a helmet. Young riders often feel that helmets make them invincible.

Another reason why resorts are seeing an influx of head injuries is because the sport of skiing is changing. Responding to the demands of younger guests, resorts are building terrain parks with rails, jumps and super-halfpipes that tower 17 feet overhead. Ski manufacturers are promoting “double-tipped” skis that entice skiers into skiing backward with limited visibility. “A lot of the accidents we see these days are flooky,” says Williams. “They’re slow speed collisions with objects and people that never used to happen.”

In the backcountry, skiers and snowboarders may benefit from the extra protection derived from helmets when trapped in avalanches. A 2001 study published by Johnson, et al, found that, while most avalanche-related deaths were the result of asphyxiation, 61 percent of the victims died from “closed-head injuries” that the authors speculate could have been prevented.

If morbid statistics aren’t enough to convince the skiing public that wearing a helmet is a good idea, how do you get through to them? Education is one way. Saving people money is another. In conjunction with the Vermont Resort Industry, Smugglers’ Notch is on the forefront of educating the public on the use of helmets while skiing and snowboarding. “We’ve determined that we’re behind the times when it comes to marketing helmet use,” says Williams. “Part of our demographics indicates that women are not getting the message. There are no women role models when it comes to wearing helmets. As a result, we’re replacing some of the photos of men in our marketing material with women.”

After determining that more than 70 percent of local skiers wear helmets, Smugglers’ instituted the “Ski Like a Local – Wear a Helmet” campaign. The resort distributes “Ski Like a Local” stickers identifying wearers as cool locals – even if they don’t live in Vermont. “If we can design a positive campaign, we can make a difference,” says Williams. “There is literally no downside to wearing a helmet.”

The National Ski Areas Association sponsors the “Lids on Kids” program with a website that answers many commonly asked questions and features a NSAA Helmet Safety Fact Sheet, games and activities – everything you need to know about helmets. There’s also a link to the “Skier Responsibility Code.” The code highlights seven ways to reduce injuries by using common sense and demonstrating courtesy to other riders.

Specialty Sports Venture takes the time to educate every family member who rents equipment from one of its 140 stores. “We recommend wearing a helmet to all our customers,” says Chris Fitzgerald, SSV’s Rental Equipment Systems Manager. “If they decline, they must check a box on their rental agreement indicating that they were informed about the risks of skiing or riding without a helmet but elected not to rent one.” SSV also reviews its rental risk policy every year and invites its attorney and insurance representatives to speak to managers during training in the fall. Despite all their efforts, Fitzgerald laments that parents will typically insist that their kids wear a lid while eschewing helmets for themselves.

Probably the best way to reach the skiing public is to hit them where it counts – in their wallet. One popular resort in Finland offers substantial discounts on lift tickets and retail items for guests who wear helmets. Similar to “good driver” programs promoted by auto insurance companies, helmet wearers can actually save money while doing something good for themselves.

Despite the fact that everyone agrees helmets save lives, there are very few organizations or resorts that require skiers, riders or their employees to wear helmets. As of 1997, the National Ski Patrol, the American Academy of Neurology, the American Academy of Orthopaedic Surgeons, the American Academy of Pediatrics, the American Academy of Emergency Medicine, the Brain Injury Association, the National Ski Areas Association and the United States Consumer Product Safety Commission all recommend, but do not mandate the use of helmets in children and adolescents. Many large ski resorts employ professional ski patrolers and guest service ambassadors who promote safety and cite riders who put other guests at risk by participating in risky behavior. Most recommend but few require employees and volunteers to wear helmets.

One trend-setting organization is the Keystone Ski Patrol in Summit County, Colorado. While patrolers are not required to wear helmets by their employer, helmet use is prevalent. A number of Keystone patrolers wear helmets because they were given them. One patroler was issued a helmet while working at another resort in Australia. Others were given lids two years ago from a generous grant by the local medical center. The rest of the helmet-wearing crew followed suit as a result of peer pressure and a decision that it just makes sense to protect themselves from the thousands of other skiers on the mountain.

Unlike the 20 states with helmet laws for motorcycle riders, it’s unlikely that resorts will require their guests and employees to wear helmets any time soon. They could educate skiers and riders by offering discounts on helmets, lift tickets and food and promoting the responsibility code. The rest is up to the individual.

http://www.newwest.net/snow_blog/article/why_ski_resorts_should_do_more_to_promote_helmets/C458/L41/

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1. RESPONSE: Ski Resorts Doing More to Promote Helmets
2. Doctors promote helmet use

Ski areas are busy preparing for the throngs of skiers and snowboarders. Assuming Mother Nature does her part, the conditions should be great.

But, while anticipating that adrenaline rush that one gets from zipping down the slopes, it is also appropriate to think about safety.

Skiing and snowboarding are fantastic sports — athletically challenging, exhilarating, and relaxing. But they can also be dangerous.

Fortunately, much less dangerous than they used to be. One of the reasons is the advancement in equipment that skiers and snowboarders now use.

The broken lower legs of the 1970s are almost nonexistent, if a skier’s binding is appropriately set, adjusted and well-maintained; and the rate of midshaft tibial fractures has gone from a high of about 25 percent of ski injuries to about 1 percent, according to an Associated Press article which appeared in Monday’s Citizen.

Another equipment-related reason is the growing use of safety helmets. Donning a helmet, coupled with skiing or riding in control, makes skiing as safe as playing tennis, according the article. However, because of the potential for high speeds, when something goes wrong on the slopes, the consequences can be disastrous, and occasionally — albeit rarely — fatal.

A ski helmet is not a guarantee against injury. But a helmet which is properly fitted and properly worn does significantly reduce the risk of brain and neck injuries, either of which can have serious, long-term consequences.

That is why helmet use needs to be zealously promoted.

Some may think that helmets are not cool. But just as parents insisted their young children hold their hand when crossing the street, even if their kids made a fuss, parents should insist that, if their children want to ski or snowboard, a good helmet is part of the outfit.

Ski areas, too, should take steps to promote helmet use. They can do this by ensuring that all ski and snowboard advertising and website images include people wearing helmets. They also can work to get well-known athletes to promote helmets.

Formal ski instruction programs also need to push to get students to wear helmets, just as driver’s education instructors insist their students buckle up during lessons.

What we’re talking about here is a culture shift so that wearing a ski helmet is accepted as a matter of common sense. For this to happen will require a commitment from all the stakeholders, national organizations, ski resorts, schools, parents and kids themselves.

Skiing, like any sport, will never be injury-free. But wearing a helmet is one way of making it safer yet for those who enjoy this wonderfully exciting sport.

http://www.citizen.com/apps/pbcs.dll/article?AID=/20101214/GJOPINION02/712149977/-1/CITNEWS08

HINT: Wear a Ski Helmet.

WEST MICHIGAN (NEWSCHANNEL 3) – As skiers begin digging out their winter clothes, one local program is aiming to make sure their heads are not only warm, but protected.

Dr. Mark Krinock is no stranger to ski trails.

“Skiing is actually one of my first loves,’ said Dr. Krinock. “You get this adrenaline going and all of a sudden you’re over the edge and you’re going down.”

While Krinock is passionate about the sport, as a neurosurgeon he also knows the dangers of taking a tumble.

“It can vary, anything from chronic headaches to dizziness, to have a nauseous type feeling, inability to concentrate,” said Dr. Krinock.

While head injury isn’t the most common injury from falls, it has the potential to do the most harm.

To lessen the impact of winter wipe-outs, Borgess Trauma Services sells ski and snowboard helmets for just $18 each. In 2009 they sold 750 of them.

“The helmets within skiing are made differently than the helmets you see in football or in motorcycles,” said Dr. Krinock.

The difference is in the design. Ski helmets have a thick, Styrofoam lining with a hard plastic shell that’s designed to break. That means the helmet takes the impact from a direct hit and distributes the force of injury wider, easing the impact on your brain.

“The type of padding you have here can actually decrease the force of injury twenty fold,” said Dr. Krinock.

Helmets should feel snug.

“The worst thing you can do with a ski helmet or a bike helmet is wear it too loose,” said Dr. Krinock.

The helmets are available in small, medium and large and come in a variety of colors. They can be purchased at Borgess Trauma Services Monday through Friday 8:00 am to 4:30 pm.

They’re also available at the ski swaps at Timber Ridge and K-Wings Stadium.

“That’s great news,” San Agustin, 66, said with hope in his voice after learning the New Jersey Senate passed the bill 34-2 on Aug. 23.

Passage of the helmet law is an affair of the heart for the San Agustins, who started lobbying for it in 1989 after their 12-year-old daughter Nicole died on Feb. 21, 1988, in a skiing accident.

“If Nikki had been wearing a helmet, I’m sure she’d be around now,” San Agustin said. “And if she was taken to the proper trauma center immediately, she would again be here with us today.”

The bill will go to the State Assembly’s Tourism and Gaming Committee in early October and likely before the full Assembly for a vote by the end of October. It could be on the governor’s desk by the first day of winter, said Assemblywoman Grace Spencer, sponsor of the bill in the Assembly.

“It has bipartisan and industry support,” Spencer said, noting the bill in the past was opposed by the ski resort lobby for making the industry responsible for requiring youths to wear helmets and for establishing a protocol for the quick transport of injured skiers to trauma centers. The current bill places the responsibility on parents, guardians and supervising adults for having skiers and snowboarders under 18 wear helmets. It fines violators $25 on a first offense and up to $100 for additional offenses. It does not deal with the transport issue.

“Having gone through our experience, we felt that we needed to do something to avoid any similar tragedies,” San Agustin, a breast surgeon, said. “So what I did is I found out the majority of deaths and serious injuries of skiers were from head trauma. Hence there was an urgent need for skiers to protect themselves with proper helmets.”

State Sen. Anthony Bucco of Boonton repeatedly introduced the bill for about 10 years, only to see it defeated. He also thinks its time for passage has arrived.

“It’s a no-brainer that helmets are necessary,” Bucco says. “It’s for the protection of the kids, whether they’re beginners on a recreational slope or experienced on an advance slope. If you watched the last Winter Olympics, in every sport the competitors wore helmets, even in cross country skiing.”

Nicole San Agustin was on a class field trip with the Peck School of Morristown to the Hidden Valley Ski Resort near Great Gorge in Sussex County when her accident occurred. San Agustin and his wife were not skiers.

“When Nicole went on the school trip as a novice skier, we thought she would be throwing snowballs and playing in the snow in a very safe place. We had no idea how dangerous the sport is until we went down and saw the place where she had the accident.”

Nicole was skiing on a beginner slope with two classmates, when they accidentally wandered onto a more advanced slope made bumpy by snow moguls, her father recounted. The three slipped and fell. As Nicole started to get up from behind a mogul, she was struck in the head by the skis of an airborne skier.

“She immediately fell and was unconscious, indicating the severity of her injury,” San Agustin said. An ambulance took Nicole to a small hospital in Rockland County, N.Y., which didn’t have the surgical staff or diagnostic equipment to deal with her brain injury, San Agustin said. She died three days later.

“One of the things my wife and I believe in is that things happen for a reason,” San Agustin said. “When this bill becomes law, what it will mean to us is that Nikki would not have died in vain. If this law saves one life and prevents a family from experiencing what we have gone through over the years, them again she would not have died in vain.”

The fact that the pending bill does not deal with the transport issue is unfortunate, San Agustin said. But triage has improved since 1988 to help insure that injured skiers are swiftly taken to the right facility, he added. “And it appears we will have required ski helmets to protect children and teenagers,” he said. “That’s important.”

On Wednesday, the state senate passed SB880 by a 21-11 vote, and the assembly approved AB1652 by a 43-19 vote.

SB880 — introduced by Sen. Leland Yee, D-San Francisco — would require skiers and snowboarders under 18 to wear helmets at all California winter resorts; according to the bill, violators would be fined up to $25.

Heavenly Mountain Resort fully supports both bills and commended California legislators for spearheading the way to safer slopes, said spokesman Russ Pecoraro.

“We absolutely support the law and we think it’s a great way for California to show leadership,” said Pecoraro. “We think it’s a positive story to tell.”

Pecoraro said like many other resorts in the region, Heavenly has taken the initiative in safety planning by requiring all employees and those participating in their ski school to where helmets. As a resort, he said safety has always been the underlying priority.

“At Heavenly we’ve taken a leadership stance early on,” he said.

Pecoraro preferred not to speculate on what financial impacts the bills might raise for California ski resorts but reaffirmed safety as fundamental in the resort community.

Sean Kristl, marketing manager at Squaw Valley USA, said the resort supports helmet requirements, and it already requires the use of helmets by all race team members and ski school participants.

“As a ski resort we are safety-oriented,” Kristl said. “We’re supportive of any type of safety initiatives.”

Michael Gross, Squaw Valley’s risk manager, said he is familiar with both bills but is still reviewing their wording and fine print — especially that of the assembly bill — before offering the resort’s official stance.

Rachael Woods, public relations manager at Alpine Meadows and Homewood Mountain resorts, shared a similar stance, in that the resorts support the helmet bill but still need time to review AB1652 before an official comment can be made.

At Northstar-at-Tahoe Resort, Public Relation Manager Jessica Van Purnis said their resort willingly supports the state’s decision to use bicycle helmet legislation as the model for its ski helmet mandate for children under the age of 18.

Here are a few other articles you might like:

1. Gov. Brown vetoes ski helmet bill in CA
2. Another Bill in CA would require Ski Helmets for employees

New Jersey is also making great progress on their bill (S130). The legislation is very similar to the California bill and was passed with a staggering 33-2 vote. Once again, this bill is now waiting for approval from the State Assembly.

Both bills would require children 17 and under to wear a ski helmet while skiing on any California or New Jersey slopes. Fines will range from $25 for first offenses all the way up to $100 if caught again being unsafe. One of the finer points that we at SkiHelmets.org applaud in both of these bills is the fact that the penalties (fines) for non-compliance is not only for parent and legal guardians, but for any supervising adult, which we assume means schools, church groups, travel groups etc. There truly are No More Excuses in these two states (assuming that both bills will eventually pass).

This news is fantastic news in our opinion but it does make us ask some additional questions. For example, who were the 20 people who opposed the vote in California? Did they fall prey to the lobbyists from Ski Associations? Do they not want to make skiing and snowboarding a safer sport? We know that there is massive debate on the safety of ski helmets, but in the end it has never been proven that Ski Helmets are not as safe and we have seen countless reports demonstrating that Ski helmets are safer in many situations. We know that ski helmets are not going to prevent fatalities on the slopes. Skiing and Snowboarding are dangerous. It’s a fact. Just like driving a car. The idea of not wearing a helmet to us is about a absurd as driving a race car without a seat belt. It’s just plain stupid. (please feel free to comment away below, we know there will be LOTS of opinions on that last statement.)

We are curious to know what kind of accommodations will be made for people that are not able to wear a ski helmet. While there may not be many, we have seen heads that are honestly too large to fit in even the biggest ski helmet as well as people that have medical issues (like cochlear implants) that prevent wearing ski helmets. So far, we have not seen those issues addressed in these bills though we are sure it will come up in the news eventually.

Additionally, we are very curious as to why states like Colorado have not taken such bold and progressive action. When we think of skiing, our minds immediately move to Colorado and their rich powder days and crisp blue skies. Why has Colorado been so quiet about this movement? It might be time to write your senators if you live in CO and ask them why they are waiting so long to take action. Colorado should be leading this charge, it’s a shame they haven’t jumped in this game yet.

Congratulations to both California and New Jersey for your progressive and public safety focused efforts. We applaud you from SkiHelmets.org.

The 1st Senate District in which they are running contains the largest single concentration of the state’s ski slopes and the ski industry has endorsed the measure, Senate Bill 880, which would require helmets for those 17 years old and younger.

Gaines, of Roseville, spoke for and joined most Democrats in voting for the measure, Senate Bill 880, while Niello, of Fair Oaks, denounced and joined other Republicans in voting against it. The final vote was 41-20, returning the measure, authored by Democratic Sen. Leland Yee of San Francisco, to the Senate for final action.

The two are rivals in a Nov. 2 special election to fill the seat of Cox, who died last month. If no one receives an outright majority, the top Republican vote-getter will face a Democratic candidate in a Jan. 4 runoff.

The district has a strong Republican registration and former Assemblywoman Barbara Alby is also weighing whether to enter the race. Ken Cooley, the mayor of Rancho Cordova, is likely to be the Democratic candidate in the runoff, if one occurs.

PHOTO CREDIT: Shaun White competes during the snowboard slopestyle portion of the Alli Dew Tour on Feb. 20, 2009, at Northstar Resort in Truckee. (Photo by Jed Jacobsohn/ Getty Images)

Here are a few other articles you might like:

1. Heavenly Supporting the Ski Helmet Bill

Last week, the California legislature advanced a bill that could make helmets mandatory for junior skiers. The bill would require all skiers and snowboarders under age 18 to wear helmets, but doesn’t place the enforcement burden on parents. Instead, Sacramento Assemblyman Dave Jones’ bill looks to ski resorts for compliance. The bill also requires “all California ski resorts to report every injury and fatality on the slopes, coordinate with other resorts to adopt standardized safety signs and equipment, prepare annual safety plans and make all that information available to the public,” according to an Associated Press story.

Doing what we can to encourage young skiers and snowboarders to protect their developing brains is, pardon the pun, a no-brainer. After all, states require parents to strap small children into safety seats in motor vehicles, and California law already requires kids under 18 to wear helmets when they’re riding bicycles. The government has decided that they need to play a role in overseeing children’s safety on the slopes, and California has decided to take the lead. Most parents already make sure their children wear helmets. According to a study done by the National Ski Areas Association, 77 percent of children 9 years old or younger and 66 percent of children between 10 and 14 wear ski helmets.

While the intention is admirable, asking ski resorts to take on the role of helmet police is ridiculous. What if a kid decides to strap his helmet to his backpack and not wear it? Are ski patrollers going to be forced to chase down teenagers who aren’t wearing helmets? Suddenly, it’s no longer a parental responsibility, but a responsibilty of the business operator.The impracticalities of enforcement hasn’t escaped notice of the California Ski Industry Association which voiced their opposition to the proposal and has pointed out its an invitation to lawsuits.

How about taking California’s law a step further? I didn’t imagine it would happen so quickly, but New York Assemblyman Felix Ortiz hasn’t hesitated, apparently feeling that it’s in society’s best interest to legislate adult helmet usage. He’s proposing that New York state require ALL skiers and snowboarders, including adults, to wear helmets while on the slopes. Ortiz doesn’t ski or snowboard, but he sure is concerned about the safety of adults who choose to take part in this risky activity. Ortiz has developing quite the reputation in New York. Earlier this month, he proposed a bill that would have banned all forms of salt from the preparation and cooking of restaurant food.

Once upon a time (about 30 years ago), no one wore ski helmets except for downhill racers. Skiers who launched the freestyle movement with inverted aerials in the 1970s didn’t wear helmets. In 1984, Phil and Steve Mahre wore ski hats while winning Olympic medals in slalom. When I purchased my first ski pass at Jackson Hole Mountain Resort in 1996, the only helmets visible in the tram line were worn by kids. Over time, helmet design improved and there was a shift in public opinion. Now, helmetless skiers like myself are in the minority, amazingly without any government intervention at all.

Ortiz’ legislation isn’t addressing some massive public health crisis­. According to the National Ski Areas Association, there were 39 fatalities and 44 serious injuries to skiers and snowboarders each season over the past 10 years. Both injury and fatality rates are less than 1 per million skier or snowboarder visits. It’s wonderful to want to protect children, but I don’t envision the California law wll have significant impacts if enacted, except for raising the sky-high liability insurance rates ski areas pay even higher.

I do own a helmet and strap it on periodically. I started wearing it when I learned to snowboard, because the type of falls I was taking frequently involved me smashing into the snow headfirst. I wear a helmet when I’m ski mountaineering to protect me from falling rocks or ice chunks, or when descending a route where a fall would likely result in an uncontrollable slide that would involve pinballing off of rocks. I won’t argue the scientists and physicians who point out the benefits of helmets, and I encourage anyone concerned about safety to choose to wear one.

The majority of the time I’m resort or backcountry skiing, I choose to go helmet free, as I have for the more than 30 years I’ve spent on skis. I accept the risk of skiing in trees, just as I accept the risk of skiing slopes that have the potential of avalanching. Skiing symbolizes freedom to me, and I want to continue to have the right to decide whether I need head protection when I’m on the slopes. In states like Wyoming or Montana, I doubt a law like this will ever be forced down my throat. In California, it may only be a matter of time before someone like Felix Ortiz is forcing adults to strap on helmets. I have no idea if New York’s legislature will decide it needs to take the lead in extending the nanny state concept to the ski slopes, but I hope not.

Here are a few other articles you might like:

1. Ski Safety Legislation Moves Forward Again in CA
2. Ortiz (NY) pushes ski helmet mandate
3. OPINION: Ski helmet bill should become law

Some experts are calling for a mandatory helmet law, one year after the death of British actress Natasha Richardson following a ski lesson at Mont-Tremblant.

Richardson, the wife of actor Liam Neeson, was taken off of life support and died last March 19th, two days after she hit her head during the beginner lesson.

She was not wearing a helmet.

While her death was shocking at the time, trauma experts say there are 200 to 250 cases of brain injury a year in Quebec.

And while helmet-use on ski slopes is up, experts including neuropsychologist Dr. Alain Ptito want governments to make them mandatory.

“It seems obvious to me,” Ptito told CTV’s Caroline Van Vlaardingen.

“It seems obvious to me that if you’re going at a certain speed and there is a risk of impact — the obvious thing is to protect yourself as best you can.”

Dr. Ptito, who works at the Montreal Neurological Institute, has been studying the effects of head injuries on memory and the thought process.

He has scanned the brains of athletes with and without head injuries to compare their brain function.

“What we see is the more severe the symptoms, the less the activation patterns.”

Financial costs

He said that the effects can last months and even years and that if public safety doesn’t prompt governments to act, politicians should be motivated by the financial costs.

“If the government wants to save money I think they should make (helmets) mandatory because it’s very expensive to treat a head injury,” said Ptito.

Think First, a Quebec group that promotes brain-injury awareness, says it could cost $8.2 million to care for a healthy 20-year-old who’s unable to work after a head injury.

Stats

Quebec ski hill operators say helmet use on the province’s slopes has grown from just over 10 per cent to close to 80 per cent over the past decade.

But that still means one in four skiers and boarders aren’t wearing them.

Human cost

Benoit Ballard knows first-hand the effect that head injuries can have on quality of life.

On April 15, 1999, Ballard was snowboarding down a beginner’s run called Cameron’s Trail at Lake Louise, Alta. when something happened.

“They said I was screaming . . . ‘cause I hit my head very hard on the ice, I guess,” said Ballard, 31.

He was not wearing a helmet.

Ballard spent the next 40 days in a coma and he awoke with only limited use of his left side.

He can move his right hand but it takes effort to open the left. The toes on his left side are always in a curled position.

“Every step I take from morning ‘till night, I have to think of the step I’m going to take,” he says “That’s my life.”

Ballard spends several hours a day in a rehab centre. He says he’s lucky to be alive but still has regrets.

“I’d give anything I have just to go back on April 15th because I’d be wearing a helmet, that’s for sure.”