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Dartmouth-Hitchcock Study Finds Ski Helmets Don't Prevent Severe Head Injuries

A person smiles wearing a ski helmet and goggles with a pair of skis over their shoulder.
Lisa Rathke
/
Associated Press
In this Nov. 26, 2019, photo skier Biff Stulgis stands at the base of Sugarbush Resort in Warren, Vt. A new study shows that wearing a helmet doesn't prevent severe head injuries in skiers and snowboarders.

A study authored by trauma surgeons at Dartmouth-Hitchcock Medical Center looks at the effect that wearing a helmet while skiing or snowboarding has on injuries. As one might expect, the research found that helmet use reduces some types of injury. It also found, however, that serious head injuries actually went up with helmet use.

Two of the study’s authors, surgeons Dr. Eleah Porter and Dr. Andrew Crockett, spoke to VPR’s Mitch Wertlieb about their research. They wanted to make one thing very clear off the bat.

“We just want to start by saying that we do endorse helmet use!” Porter said.

The research came about because they were finding anecdotally that despite a significant rise in the rate of helmet use in the region, they weren’t seeing a corresponding drop in trauma and head injuries. So, they decided to investigate the numbers more formally.

“What we found, like you said, was that helmets do protect against some injuries, which is great,” Porter said. “They protect against skull fractures and cervical spine injuries. But at the same time they have limitations. And in our population, which is severely injured patients who are evaluated by the [Dartmouth-Hitchcock] trauma center, we found that helmets are not protecting against more serious head injury, like intracranial hemorrhage or brain bleed.”

Where these results come from is another, more difficult question.

“The ‘why’ is a tough tough question to answer,” Crockett said. “Just looking at our numbers and anecdotally, the best solution is just that despite the use of helmets, in the patients that we’ve seen at our facility, they’ve received so much traumatic energy that the helmets hasn’t proven to be as effective as we would like.”

"... what we did find from our study is that patients who were helmeted were more likely getting into high energy impacts. So specifically, they were more likely to hit a tree, they were more likely to fall from great heights as compared to unhelmeted patients." — Dr. Eleah Porter, surgeon and study author

So, does this mean that skiers and snowboarders wearing helmets feel safer and engage in riskier behavior?

“I don’t think our data can specifically answer why this is happening.” Porter said. “But what we did find from our study is that patients who were helmeted were more likely getting into high energy impacts. So specifically, they were more likely to hit a tree, they were more likely to fall from great heights as compared to unhelmeted patients."

From that data, she added, one can form a hypothesis: "Perhaps patients who are getting into these major traumas and ending up in our center who are helmeted, perhaps they have a false sense of security when they’re wearing a helmet and they’re skiing more recklessly or outside of their capabilities."

Both Porter and Crockett said their future research will look into whether national data bear out their results, and what factors influence behavior that may lead to increased risk of injury.

They also said their research can serve as a reminder to first responders not to assume that a helmeted individual has not sustained a serious head injury.

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