helmet use in preventing injury in the alpine environoment
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Helmet Use in PreventingInjury in the Alpine
Environment
Advocacy Morning Report, Feb2010
Dr. Gleich, Dr. Zimbric
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Skiing is not new.http://history.fis-ski.com/
6300-5000 BC- Oldest (wood) skis found in Russia 1206 The Birkebeiners (Norway) rescued the 2-year-old
Prince Hakon Hakonson, heir to the throne, skiing over theDovre mountains from Lillehammer to Osterdalen.
1800s Ski troops fought in the war over Finland between
Sweden and Russia. 1812- Russian ski troops take on Napolean 1866- First ski school (Norway) 1860s First known ski competitions (Norway) 1908- First ski lift (Switzerland) 1928 Nordic skiing in winter olympics 1936 Alpine events in winter olympics 1959 First death in official Alpine championships causes FIS
to rule that helmets must be worn.
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Skiing is fun.
Avg 10 million US people skied > 1/yrfrom 1993-1997 (household survey,Nat. Sporting Goods Assoc.)
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Skiing can hurt.
84,200 ski-associated injuries in USEDs 1997 (Xiang 2004)
600,000 estimated total ski/boardinjuries per year in US (Cusimano2010)
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Ski/Snowboard InjuriesH Jiang et al. Downhill Skiing Injury Fatalities Among Children. Injury
Prevention 2004; 10:99-102
Fatal injuries at CO ski resorts 1980-2001
Info via death certificates
Total 149 fatalities assoc w/ downhill skiing
21/149 (14%)
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Helmets
First mandated in ski competitions 1959 2002 Lids on Kids (http://www.lidsonkids.org/home.asp)
Goal is to get kids to wear helmet but ski as though they are not
2008/09 National Ski Areas Association (NSAA) NationalDemographic Study (130,000 interviews of skiers and ridersnationwide), helmet usage among skiers and riders in the U.S.increased 12 percent over the previous season. 77% 65 32% 18-24 helmet usage increases with the skier's ability level: 26% beginners
wear helmets, 38 % of intermediates wear helmets while 55 % ofadvanced skiers and riders wear helmets.
In April 2009, Vail Resorts announced that from 2009/10, theywould require helmet use for all their employees on the snow
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Do helmets work?Russell et al. The effect of helmets on the risk of head and neck injuries
among skiers and snowboarders: a meta-analysis. CMAJ 2010
1st meta-analysis examining effect of helmets onhead & neckinjuries for skiers & snowboarders
Methods:
Search of electronic databases, conferences,
reference lists Head injury or head trauma
Helmet
Skiing or snowboarding
Studies included:
Used a control group
Compared skiers/snowboarders with & without helmets
Measured at least 1 objectively quantified outcome (headinjury or neck/cervical injury)
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Results: 10 case-control, 1 case-control/case-crossover,
& 1 cohort study included
Use of helmets by skiers/snowboarders significantly
reduced risk of head injury by 35% 2-5 of every 10 head injuries could be prevented
with use of ski/snowboard helmets
Pooled OR 0.65 (95% CI 0.55-0.79)
6 studies examined association betweenhelmet use and risk of neck injury
No significant increased risk of neck injury
Pooled OR 0.89 (95% CI 0.72-1.09)
Do helmets work?Russell et al. The effect of helmets on the risk of head and neck
injuries among skiers and snowboarders: a meta-analysis. CMAJ 2010
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Do helmets work?Russell et al. The effect of helmets on the risk of head and neck
injuries among skiers and snowboarders: a meta-analysis. CMAJ 2010
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Do helmets work?Russell et al. The effect of helmets on the risk of head and neck
injuries among skiers and snowboarders: a meta-analysis. CMAJ 2010
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Limitations: Moderate methodological quality of included
studies
Insufficient adjustment for potential confounders
5 studies required crude OR calculations
Different definitions of head injury
No examination of design, quality, or fit of
helmets If helmets were of poor quality or worn
incorrectly, effect of helmet would beunderestimated relative to their true potential
Do helmets work?Russell et al. The effect of helmets on the risk of head and neck
injuries among skiers and snowboarders: a meta-analysis. CMAJ 2010
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wHelmets
Provides false sense of security More aggressive/dangerous skiing
Faster speeds
Increased risk of injury to other parts ofbody
Evidence mixed Several studies showed increased risk-
taking among helmet users
Others showed helmet users were morecautious group
After adjustment, meta-analysis(Russell 2010) showed no relationbetween helmet use and injury orseverity of crash
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Barriers to Helmet UseFinnoff et al. Barriers to Bicycle Helmet Use. Pediatrics 2001; 108
Perception it doesnt help Perceived discomfort Coolness factor
Cost Availability Sizing
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Lids on Kids
Picabo Street"Over 300,000 Americans suffer brain injuries a year. Don't be astatistic, wear your helmet. During my career the doctors fixed my
body several times. Luckily I never hurt my head because you onlyget one chance with your brain. Wear a helmet.
Bode Miller"When I was little, 6-years old, I got my first helmet. I've never hada more trusty or invaluable piece of equipment. Now that I'm racingand helmets are a requirement, it seems like I never go skiingwithout one. They're warm and comfortable, and they can save yourlife if you have an unlucky slip. When you see the pictures of theracers these days, one of the coolest parts are the lids. Some of thedecorations are awesome.
Gretchen BleilerI wear a helmet when I'm riding a halfpipe because I would rathernot risk it. There are too many things that could go wrong, so whytake a chance? It just makes sense to protect your head.
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Advocacy in the works
Legislative Efforts: Several states consideredmandatory helmet laws for youth
MA, MI, NJ, NY
No laws passed yet
Insufficient public support No enforcement agency
Need to institute further education & incentiveprograms well-rounded approach allows
recognition of protective value of helmets Similar to mountain biking (80-90% helmet use rate,
Kronisch 2002).
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What Can We Do?
Letter to ski resorts
Encourage employees, ski patrol to wear helmets
Consider free helmet use w/ rentals
Consider free helmet use for ski schools
Coupons for helmet with season pass? Helmet design/decorating competition
Wear a helmet yourself
Compliment kids on helmets on slopes
Discuss in WCC Encourage fellow boarders/skiers to wear them
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Works Cited http://alhazan.com/gallery/career/sonny_ www.gawker.com http://www.nsaa.org/nsaa/press/08
09/helmet-safety.asp H Jiang et al. Downhill Skiing Injury
Fatalities Among Children. InjuryPrevention 2004; 10:99-102
Russell et al. The effect of helmetson the risk of head and neckinjuries among skiers andsnowboarders: a meta-analysis.
CMAJ 2010 Finnoff et al. Barriers to Bicycle
Helmet Use. Pediatrics 2001; 108 Kronisch et al. Mountain Biking
Injuries: An Update. Sports Med2002; 32
http://history.fis-ski.com/ Facebook stalker tool http://www.ski-injury.com/prevention/hel http://www.lidsonkids.org/home.asp http://news.dipag.it/photo-Bode-
Miller-in-action-0000016716.html
http://alhazan.com/gallery/career/sonny_bono_450http://www.gawker.com/http://history.fis-ski.com/http://www.ski-injury.com/prevention/helmethttp://www.lidsonkids.org/home.asphttp://www.lidsonkids.org/home.asphttp://www.ski-injury.com/prevention/helmethttp://history.fis-ski.com/http://www.gawker.com/http://alhazan.com/gallery/career/sonny_bono_450
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