title: Helmets for skiing and snowboarding: who is using them and why.
abstract: BACKGROUND
  In Canada, winter sports injuries are responsible for significant health care burden, with estimates of $400 million in direct and indirect annual health care costs. For ski-related injuries, helmets have been shown to provide significant protection. Current common practice in Canada, including the Province of Nova Scotia, is to leave the decision of whether to wear a helmet to the individual. The purposes of this study were to document skiers' and snowboarders' use of helmets and to isolate factors associated with helmet use and nonuse.
  
  
  METHODS
  A mixed methods approach was used to collect data during a 2-month period at the province's three ski hills. Naturalistic observations documented helmet use and falls, whereas interviews identified factors influencing helmet use or nonuse.
  
  
  RESULTS
  Helmets were used by most skiers (74%) and snowboarders (72%); the use varied significantly between ski hills, ranging from 69% to 79%. Females were more likely to wear helmets compare with males (80% vs. 70%). The highest rates of use were found among 4-year-old to 12-year-old children, with helmet use declining as age increases. Qualitative data revealed that helmet users were most influenced by the protective benefits of helmets (77%), personal choice (46%), family (44%), and rules (44%), while non-helmet users cited personal choice (29%), comfort (26%), rules (14%), and cost (11%) as reasons for nonuse.
  
  
  CONCLUSIONS
  More than 25% of skiers and snowboarders remain at increased risk of a serious brain injury by not wearing a helmet. Changes in regulations may be required to ensure widespread use of helmets on ski hills.
  
  
  METHODS
  Prognostic study, level II.
authors: Division of Neurosurgery, Dalhousie University, Nova Scotia, Canada.
authors: Lynne
authors: L
authors: Fenerty
authors: Ginette
authors: G
authors: Thibault-Halman
authors: Beth S
authors: BS
authors: Bruce
authors: Jacob
authors: J
authors: Landry
authors: Julian
authors: J
authors: Young
authors: Simon
authors: S
authors: Walling
authors: David B
authors: DB
authors: Clarke
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D012865:Skiing / Q000293:injuries*; D055815:Young Adult