Helmet death ignited by misconception and famous personalities

Neither is an effective way to deal with risk management issues

A big debate has started over helmets. The debate is fueled by two things. First is the death of Natasha Richardson. The second is a misconception of the value of helmets in skiing.

The public relations surrounding the death of a famous person from a head injury always triggers a helmet debate. However, the debate seems inane when the head injury that caused the fatality of Natasha Richards would not have been protected by a helmet. Natasha Richards died of a rotation injury that no helmet would have prevented.

Second is the misconception about helmets. Helmets don’t stop fatalities. Helmets may stop head injuries in non-fatal ski/board accidents.

The debate is hot in Jackson Hole because of a fatality caused by a head injury by a ski patroller at the resort. While performing her duties as a patroller, she suffered a head injury in an out of bounds couloirs.OSHA and the state fined Jackson Hole Ski Resort for not having the patroller wear a helmet. However,by most accounts, a helmet would not have protected the fatality. See Jackson death spurs helmetdebate.

Vail Resorts and Intrawest have both published new helmet policies for guests and have in the past or have added requirements for employees when working within the past seven months. See Intrawest ski resorts increasing helmet use and Vail Resorts Makes Helmets Mandatory for Employees in 2009-2010 Winter Season.

The misconception is the biggest problems. Studies show that helmets do not reduce fatalities. Skiers and boarders who suffer a collision or an injury sufficient to cause a death while skiing or boarding die of some other issue.

See the following studies: Do helmets reduce fatalities or merely alter the Patterns of Death by Shealy, Jasper E., Johnson, Robert J., and Ettlinger, Carl F. Skiing Trauma and Safety, 17^th Volume 2009 and Head injuries in Snowboarding: Evaluating the Protective Rule, Scher, Iriving, Richards, Darrin, and Carhart, Michael, Skiing Trauma and Safety, 16^th Volume, 2008.

Helmets do prevent head injuries. Most noticeably in, terrain park injuries and backward snowboarder falls, possibly in skier v skier (or skier v. boarder or boarder v. boarder) collisions. See the above studies.

For other articles about ski resorts and helmets see: Whistler Blackcomb mandates helmet use by youth instructors, Jackson death spurs helmet debate.

What does all of this mean? If you ski and snowboard wear a helmet…..or not. Do not expect a helmet to save your life, it will only prevent head injuries.

Helmets do not increase risk of a neck injury when skiing

How this contradicts claims made by injured skiers, let’s hope the study wins.

The Canadian Medical Association Journal released a study The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis. he study showed that there was no increased risk to a skier or snowboarder when wearing helmets.

The study was only a review of electronic databases,
conference proceedings and reference lists. It would be nice to see a study using testing to show the forces on a head using a helmet. However, either way, the fear of using a helmet based on a neck injury appears to be minimal.

Several claims have been made that helmets have caused neck injuries in small or petite children with older style heavy helmets.

To see an article about the study see SportsOneSource Canadian Study Finds Ski Helmets Don’t Increase Risk of Neck Injury.


 
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Website dedicated to Tree Wells

Tree Wells in and out of bounds are responsible for several deaths each year.

Now there is a website that talks about tree wells, how to stay out of them and what to do if you are caught in one.

See http://www.treewelldeepsnowsafety.com/

Correction by an author I quote. THANKS! Myths of skiing injuries debunked by physician’s study.

Dr. Carl Ettlinger read my review of his study Myths Concerning Alpine Skiing Injuries, that I wrote about in Myths of skiing injuries debunked by physician’s study. After 20 years in the ski business, I missed several issues and wanted to correct them and to thank Dr. Ettlinger for his help.

Mr. Moss,

Thank you for the kind words regarding our Myths article. However, you inadvertently helped to perpetuate another myth–that skiing ability=Skier Type.

3) “All you need know is your DIN (release indicator value) number and you can adjust your bindings.” There are four different factors used to determine the correct DIN, height, weight, skiing ability and boot sole length. Even knowing these may not be enough because how the boot fits into the binding is also critical.

4) “Toe and heel pieces must be set to the same Release Indicator Value or the bindings won’t function right.” No, see study 3 above.

Skier Type selection is a means by which a skier can balance the overall risk of injury–injury due to inadvertent release versus injury due to failure of the binding to release. Skiing Ability is not a factor in the Release Value Selection process.

It is also important to note that the Release Indicator Value from the binding manufacturer’s chart is termed the Initial Indicator Value in ASTM/ISO standards and in all instructions from the binding manufacturer. In other words, it is the starting point. Following inspection by a properly trained technician using a ski binding testing device (that meets ASTM/ISO standards) readjustment of one or more of the binding components may be required resulting in four Final Indicator Values. In some cases the Final Indicator Values could each be different from the Initial Value. There is also the possibility that the test results may reveal a defect that can only be resolved by the replacement of the component or the entire binding system.

Regards,

Carl Ettlinger

Again Thanks!


 

Myths of skiing injuries debunked by physician’s study.

Myths of skiing injuries debunked by physician’s study.

The vivid images of wrecks disasters and injuries from the sport media are not real.

An article Doctor seeks to debunk skiing myths looks at a study published by Dr. Robert Johnson in the November/December issue of Sports Health. The study was titled Myths Concerning Alpine Skiing Injuries and authored by Robert J. Johnson, MD, Carl F. Ettlinger, Ettlinger, Ettlinger, MS and Jasper E. Shealy, PhD.

The results of this study even caught me off guard, and I have been studying the ski industry for more than twenty years. The study looked at twelve common myths in the industry.

1) “Skiing is among the most dangerous activities.” The fatality rate makes it safer than driving a car and slightly more dangerous than riding a bicycle per million hours of exposure.

2) “Broken legs have been traded for blown-out knees.” Knee injuries increasing and broken legs decreasing in skiing occurred at different times and are not related. See number 11 below for an interesting twist on this issue.

3) “All you need know is your DIN (release indicator value) number and you can adjust your bindings.” There are four different factors used to determine the correct DIN, height, weight, skiing ability and boot sole length. Even knowing these may not be enough because how the boot fits into the binding is also critical.

4) “Toe and heel pieces must be set to the same Release Indicator Value or the bindings won’t function right.” No, see study 3 above.

5) “Formal ski instruction will make you safer. This is not true. However, every ski resort in the US argues with this result. Personally, I would have disagreed with this study if a ski lesson taught you how to fall, however, now I am confused based on study 9 below.

6) “The shorter the ski, the less torque is applied to the leg in a fall. Therefore, short skis don’t need release bindings.” There is a 3 to 20–fold increase in broken ankles and tibias from using short skis. You should use releasable bindings on these skis also.

7) “Young bones bend rather than break, so there’s no point spending a lot of money on children’s equipment.” Children have the highest risk to equipment related injuries so properly functioning equipment is critical for them.

8) “When buying boots for children, leave plenty of room for fast-growing feet.” If a child’s boot does not foot there is an increased chance of a lower leg fracture. I think this is common sense.

9) “If you think you’re going to fall, just relax and let it happen.” This always seemed to work for me, however the study indicates differently. You should fall however, you should assume the position of a parachutist landing and tense your muscles and joints to stiffen and protect them.

10) “Exercise is the best way to avoid skiing-related injuries.” This is going to mess up consumer magazines that constantly have articles on getting in shape for skiing. This does not mean that being in shape will not be a better skiing experience, it just will not change your chance of injury.

11) “Tighter standards that mandate lower release setting will reduce the risk of an ACL injury.” This has been known in the industry for years and is one of the common misconceptions in the industry. Knee injuries are not related to your binding releasing or how your binding releases.

12) “Buying new ski equipment is safer than renting.” Rental equipment is maintained. After skiing for ten days and driving to the slopes with your skis on top of your car if you do not have your skis and bindings checked you have a greater risk of an injury.

Robert J. Johnson, MD, Carl F. Ettlinger, MS and Jasper E. Shealy, PhD, are well known in the ski industry for their research into skiing industry injuries. Johnson and Shealy are the editors of the ASTM Skiing Trauma and Safety 17^th Volume, which is the standard of ski industry research.

Skiing/Boarding Helmets and what is the correct message

Journalist now days can write, but they have forgotten had to understand what they are writing. Bloggers, like myself, can get away with murder. Helmets are a big topic on the web, and I have written about them before. More information over the debate about ski helmets: Ski Helmets ineffective crashes were the wear is going faster than 12 miles per hour, Mixed emotions, but a lot of, I told you so are some of the articles I’ve written for this blog, and I have even indorsed a helmet A new idea that makes sense in helmets: the Bern Hard Hat

However, I have seen so much garbage lately it is starting to be a pain.
So let’s put some facts down.

Helmets may prevent head injuries. There are not many arguments here. The number one reason I can see to wear a helmet is that idiots put the comfort/safety/footrest bar down without letting other people on the lift know. The bar comes down and whacks you in the head.

Helmets will save your life. This is crap. There is no research to support this statement. See Shealy, Jasper E., Johnson, Robert J., and Ettlinger, Carl F., Do Helmets Reduce Fatalities or Merely Alter the Patterns of Death?, Skiing Trauma and Safety 17^th International Symposium, Journal of ASTM International Vol. 5 No. 10, “Skiing Helmets” and Evaluation of the Potential to Reduce Head Injury,” US Consumer Product Safety Commission, Washington, DC, 20207, Jan 1999. The main point of this research is even though helmet used has increased dramatically; fatalities have stayed the same or increased.


If Natasha Richardson had been wearing, a helmet, she would still be alive. The jury is out on this, but one who understands the issues (physicians) has said yes a helmet would have saved her life. See Could a Helmet Have Saved Natasha Richardson? Doc Wild Weighs In and Would a Helmet Have Saved Richardson? Maybe Not


A helmet will increase your chances of an injury. Some research supports this argument. The basis is risk homeostasis, which says that when humans feel safe they take greater Wearing a helmet makes you feel safe. Therefore, you may ski faster. See the research above.


People die of head injuries skiing. No if you hit a tree hard enough or fast enough to cause a head injury that will kill you, you are going to die of something. During the 2008-09 skis, season three fatalities were reported to people wearing helmets and they all died of blunt force trauma. Two people reportedly died of head injuries, one reporting head and other injuries and the other was not substantiated as coming from a source. All reports of fatalities from corner’s or physicians reported the cause of death as blunt force trauma or asphyxiation.

Wearing a helmet increases your risk to injury because you cannot here. With more skiers on the slopes, there is a greater chance of injury from not hearing an approaching rider. I have no idea and I cannot find any research about this subject. If this is true and it may be, then earphones and helmets may both lead to injuries.

I am telling you to not wear a helmet. NO! I am telling you to understand why you are choosing to wear a helmet. I am telling you that there is some evidence that says you may increase your chance of an injury and some research that shows that it may decrease your chance of an injury. There is no evidence that a helmet will keep you from dying. If you choose to wear a helmet, do so with an understanding of the risk of wearing and of not wearing a helmet.