Health Care

Dartmouth-Hitchcock study finds ski helmets don’t guarantee protection

Skiers and snowboarders at Sugarbush ski resort last December. Photo by Mark Johnson/VTDigger

This story by Nora Doyle-Burr was published Dec. 1, 2019, in the Valley News.

Just as seatbelts can’t protect people from all injuries in car accidents, helmets cannot protect skiers and riders from all injuries on the slopes.

A new study published last month in the Journal of Trauma and Acute Care Surgery by researchers at Dartmouth-Hitchcock Medical Center found that helmeted skiers and riders are more likely to experience serious head injuries than those who aren’t wearing helmets. They also are more likely to hit a tree or fall from a jump.

“Even though you have a helmet on, (it) doesn’t provide you a shroud of invulnerability,” said the study’s lead author Dr. Eleah Porter, a surgical resident at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

Among the 721 injured skiers and riders included in the study who were evaluated by DHMC’s trauma service — general surgery, orthopedic surgery or neurosurgery — from November 2010 to April 2018, 65% were wearing helmets.

In a trend on par with national averages, the study found that during the study period, helmet use doubled from 43% to 81%.

But, despite the increase in helmet use, the rate of head injury did not change significantly, decreasing only slightly from 49% to 43%, the researchers found.

Helmeted patients at DHMC were more likely to have an intracranial hemorrhage, also known as a head bleed, but less likely to have skull fractures, cuts to the scalp and neck injuries than unhelmeted patients.

Because head bleeds are commonly caused by impact at high speed, the researchers said that their results “may suggest that helmet use promotes increased risk taking behavior,” such as skiing too fast or jumping off things.

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The findings struck Alan Beebe, a ski patroller at Quechee Lakes, by surprise.

“I … never thought that (people would look at a helmet) as a safety cushion, but maybe,” said Beebe, a former assistant fire chief in Hartford.

Beebe, a 52-year-old who also works as a paramedic for Fairlee-based Upper Valley Ambulance, said he has seen some “pretty good wrecks” over the years in which heads have bounced off the snow. Watching them, Beebe said he’s been glad the skiers have been wearing helmets.

Alan Beebe, a ski patroller at Quechee Lakes. Hartford Fire Department photo

Adam Pearce, whose brother Kevin was wearing a helmet when he sustained a career-ending traumatic brain injury in a snowboarding accident in 2009, said the D-H study highlights the fact that injuries can happen even with the proper safety equipment in place.

“The sad truth is that traumatic brain injury isn’t going away, so we feel a responsibility to be there for anyone who navigates this challenging journey,” Adam Pearce said in an emailed statement.

The Pearce brothers, who grew up in Norwich, co-founded the LoveYourBrain Foundation to support those with traumatic brain injuries to find healing through activities such as yoga and meditation.

The D-H researchers wrote in the study that their scope is limited because it focused only on one institution and only on patients with severe injuries. As a result, it “may underestimate the protective effect of helmets of injuries such as a concussion or loss of consciousness, which might otherwise trigger further medical evaluation.”

The researchers, who are all skiers, still wear helmets themselves and recommend that others do as well.

It would be “silly to take away from our study that helmets don’t help,” Porter said. “They protect against things that you can prevent with a helmet.”

But in addition to wearing helmets, the researchers also urge people to ski and ride on trails that match their skill levels.

People should be “aware of your abilities” and “ski in control,” said Dr. Andrew Crockett, a DHMC trauma surgeon, who also participated in the study.

The researchers said that further study is needed to determine whether and how other factors such as patients’ skiing or snowboarding skill levels, weather, trail density and terrain are related to the risk of head injuries.

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