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Safety First When It Comes To Ski Helmets

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By Deborah Frazier
Scripps Howard News Service

To Dr. Stewart Levy, a Denver neurosurgeon, it's a "brain bucket." To an increasing number of skiers and snowboarders, it's a helmet. But to many of those who have worn it and crashed, it's a lifesaver. It's also Levy's passion. Helmets, he says, reduce brain injuries on the ski slopes by 42 percent, a statistic he believes in so firmly that over the years he's handed out hundreds to Colorado skiers and boarders.

"For the first time ever, we have evidence that helmets reduce the incidence and severity of brain injuries in skiers and boarders," said Levy, who has tracked 261 head injury cases at St. Anthony Central Hospital in Denver. When ski area clinics throughout Colorado see severe head injury cases, they invariably helicopter them to St. Anthony. About 10 people die each year in accidents at Colorado ski areas, and head injuries cause 87.5 percent of the fatalities, he said. In his study, no skier or boarder who suffered a fatality was wearing a helmet, he said.

The results support Levy's previous research on 395 patients at the hospital's InterMountain Neurosurgery and Neuroscience clinic. There, he has studied brain injuries from skiing for nearly 10 years. "In over 400 skiers and snowboarders with head injuries serious enough to warrant transfer and admission to our level one trauma center, only five were wearing helmets," Levy said. Those five had mild injuries and made full recoveries, he said.

In Colorado and throughout the nation, the ski industry generally has remained mum about the effectiveness of helmets and has declined to endorse the safety measure. "Helmets may not prevent every injury, but they have mitigated potentially fatal or disabling head injuries into fully recoverable injuries," said Levy, who spoke recently at the Neurosurgeons of the Rockies' conference in Vail.

In the study, he also found that:

• People wearing helmets were less likely to have other serious injuries.

• Helmets have not caused an increase in other injuries, so the headgear isn't creating a false sense of security spurring skiers or boarders to speed down the slopes.

• Males were 2.23 times more likely to sustain brain injuries.

• Brain injuries occurred nearly three times as often in skiers and boarders under 35 years old.

• Among non-helmet users, snowboarders sustained brain damage at three times the rate of skiers.

Last season, Levy's researchers surveyed helmet use at Colorado ski areas and found that about 18 percent of all skiers or boarders wore helmets. He estimated that the headgear prevented up to 15 brain injuries and deaths. And, he said, helmet use was up to 25 percent this year in Colorado, which he believes will mean fewer deaths and severe brain injuries. "If wearing a helmet prevents only one death, it's worth it," he said.

An earlier and smaller study by the American Association of Orthopedic Surgeons concluded that helmet use in recreational skiing and boarding should be encouraged and possibly mandated. "Bicycle helmet use has resulted in a 70 percent reduction of severe brain injury among cyclists," the association said in December 2000. "Helmet use is mandated for ice hockey, alpine ski racing and other competitive winter sports." The national Consumer Product Safety Council also has endorsed wearing helmets on the slopes. But Colorado Ski Country USA, the industry lobbying group, and the National Ski Areas Association, the national ski group, aren't ready to endorse helmet use. "It is up to personal choice," said Kristin Rust of Colorado Ski Country.

"People should consider using a helmet, but it's more important what is in your head than what is on your head," said Stacy Gardner of National Ski Areas. Some ski town doctors haven't waited for an industry endorsement or research results. Five years ago, Dr. Tom Moore, a pediatrician in Crested Butte, started outfitting local children with helmets, for free. "It is what I think is my obligation not to just take care of people when they're sick, but to improve their safety," he said. "Lots of kids wear helmets to bike, but they go lots faster skiing than on their bikes." When he hands out helmets in classrooms, Moore takes a cantaloupe, a helmet and a bat. He asks a student to smash the helmet-covered cantaloupe. The cantaloupe survives. Then, he removes the helmet for a second try. The spewed seeds and fractured fruit make the point, he said. Last year, one of his patients, a snowboarder, was wearing a helmet he got from Moore when he hit a tree. The boarder suffered only a concussion. Sometimes Moore's helmets come back to him, usually from youngsters who return them dented, scraped and cracked from use. "I just imagine what would have happened without the helmet," he said.

Thomas Noyes, 42, of Boulder didn't need a research project to learn the value of his helmet. Two weeks ago, Noyes was skiing the fresh powder on an expert run at the Eldora ski area. He lifted off a snow-covered boulder, thinking it was just a pile of snow, and caught his ski. He flipped, face first, into rocks. "The rocks compressed the plastic of the helmet, pried it open and then smeared the plastic backward," said Noyes, who is at the Craig Rehabilitation Center in Denver for spinal injuries. "I'm one of the 42 percent where helmets save lives," Noyes said. "If you look at my helmet, it's obvious."

(Contact Deborah Frazier of the Rocky Mountain News at www.rockymountainnews.com.)