Role of Helmets in Mitigation of Head Injuries: Epidemiologic Study of Head Injuries to Skiers

摘要

Helmets have been proposed as a means of injury mitigation. Head injuries are of particular interest due to the potential for death or permanent cognitive impairment. The objective of this paper was to determine the degree that a recreational ski sports helmet can mitigate head injuries. The authors conducted a prospective epidemiological study of all medically significant skiing injuries at the Sugarbush Resort. All injuries were diagnosed and initially treated at a clinic at the base of the resort by orthopedic physicians. Various control group strategies were used to assess the characteristics of the population at risk. The numbers of resort visits by various sub-groups of the population were carefully audited. Controls consist of random assessments of the population at risk as well as equipment examinations and evaluations. During the time period of this study 07 seasons from the 1995/1996 season through the 2011/2012 season), within the population at risk, helmet usage increased from 8 to 84%. Our analysis began at the time that helmet usage became popular. We specifically focused on all injuries to the region of the head. For the 17 seasons of interest, the prevalence of all injuries to the head decreased from 8.4 to 6.8%; the prevalence of potentially serious head injuries (PSHI) declined from 4.2 to 3.0 %. The incidence of PSHI declined from 1 in 4200 days of activity to 1 in 11 000 days of activity; the incidence of any head injury declined from 1 in 8600 days of activity to 1 in 26 000 days of activity. Results of the study also stated that over this same time, the incidence of helmet usage increased from 8 to 84%. The average helmet use for the period of interest was 45%. Of the 10 observed skull fractures, only 1 was to a person wearing a helmet. Of 47 scalp lacerations, only 1 was to a person wearing a helmet. Helmets are mechanical devices that attenuate a finite amount of energy during a head impact. We observed that helmets offer very effective mitigation for head injuries such as skull fractures and scalp lacerations. Increased use of helmets was also associated with a significant reduction in potentially serious head injuries, as well as all head injuries.