title: Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study.
abstract: This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation (P < 0.001). The line of best fit showed an non-significant upward trend (P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders (P < 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults (P < 0.001); beginner/novices (P = 0.004); and snowboarders (P < 0.001), but helmet wearing was not associated with gender (P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.
authors.affiliation: University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
authors.forename: T J
authors.initials: TJ
authors.lastname: Dickson
authors.affiliation: University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Trathen
authors.affiliation: Faculty of Adventure, Culinary Arts and Tourism, Thompson Rivers University, Kamloops, BC, Canada.
authors.forename: F A
authors.initials: FA
authors.lastname: Terwiel
authors.affiliation: University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Waddington
authors.affiliation: University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Adams
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology* / Q000517:prevention & control; D002170:Canada / Q000453:epidemiology; D002648:Child; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D022125:Lacerations / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012737:Sex Factors; D012865:Skiing / Q000293:injuries* / Q000639:trends; D055815:Young Adult
keywords: Skiing; concussion; helmets; injury prevention; snowboarding