Wearing helmets to ski and snowboard helps reduce the risk of head injury without increasing the risk of neck injury, Canadian researchers say.

Helmet use reduced the risk of head injuries among skiers and snowboarders by 35 per cent, a review of 12 studies published in Monday's issue of the Canadian Medical Association Journal found.

Helmet use reduced the risk of head injuries among skiers and snowboarders by 35 per cent, researchers found. (Peter McCabe/Canadian Press)

Traumatic brain injury is the leading cause of death and serious injury among skiers and snowboarders, the researchers said. Estimates from several countries suggest head injuries account for up to 19 per cent and neck injuries for up to four cent of all injuries reported by ski patrols and emergency departments.

But between two and five out of every 10 head injuries could be prevented by wearing helmets, the reviewers concluded.

"The use of helmets significantly protects against head injuries among skiers and snowboarders," Brent Hagel of the departments of pediatrics and community health sciences at the University of Calgary and his co-authors concluded.

Wearing a helmet reduces the risk of head injury regardless of age and to both backcountry and prepared ski runs. But one study had raised a concern that helmets may increase the risk of neck injury, particularly among children because of their greater head-to-body ratio compared with adults.

Neck risk discounted

The results of the individual and combined studies from Canada, the U.S., Japan and Europe showed no major link between helmet use and increased risk of neck injury, according to the study published Monday.

"When we look at models like the bicycle helmet legislation that's been implemented in a number of provincial jurisdictions across Canada and, really, all over the world, I think it's probably moving in that direction," said Hagel.

"But from an epidemiologic point of view, I think that helmets reduce the risk of head injuries and we encourage their use."

More rigorous research is needed to determine which types of helmets provide the best protection, and head gear is not a panacea, Hagel added.

Canadian standard in the works

The highly publicized death of actress Natasha Richardson after a fall at a ski resort in Quebec last March added to the debate over whether helmets should be mandatory for the winter sports, as they are for children in some European countries.

Mandatory helmet use would require helmet safety standards. The Canadian Standards Association (CSA) tests helmets for alpine skiing and snowboarding and has developed such a standard. This certification is voluntary, and no manufacturers have applied to receive it, said Anthony Toderian, a spokesman for CSA in Montreal.

"There may be product out there that meets European and American standards," said Toderian. "There's currently no product out there that meets the CSA standard, and there's also product available out on the market that doesn't meet any standards whatsoever."

The CSA standard calls for multiple-impact testing of alpine skiing and snowboard helmets. (Courtesy CSA)

Unlike the U.S. and European standards, the CSA standard calls for multiple-impact testing, which means a helmet that passes the test may remain functional after it has suffered a blow as long as it is not damaged. The CSA standard also requires an independent lab — rather than the manufacturer — to test and certify the helmets.

Health Canada requires certification of hockey helmets and is reviewing comments on establishing a similar standard for the sale of ski and snowboard helmets, a spokesperson for the department said.

There is demand for certified helmets, said John Tustian, director of operations at the Lakeridge Resort in Uxbridge, northeast of Toronto.

Some other ski operators have opposed mandatory helmet use, saying they would have to police their guests, including foreigners who might not be aware of the requirements, and would face costs from providing helmet rentals.

On the slopes at Lakeridge, snowboarder David Bonder said he thinks helmets are a good idea.

"I wear when I dirt-bike," said Bonder, adding that he started donning a helmet after breaking a few bones dirt-biking, but he does think he takes more risks when he's wearing one. "Why wouldn't I wear one here?"

Fellow snowboarder Jed Johnston agreed, saying he didn't wear a helmet for about 10 years, but now thinks it’s a good idea because it "keeps people out of the hospital."