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US call for mandatory skiing helmets

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7126.167l (Published 17 January 1998) Cite this as: BMJ 1998;316:167
  1. Deborah Josefson
  1. San Francisco

    The recent skiing related deaths of celebrities Michael Kennedy and Sonny Bono within the same week has led to renewed calls for the use of skiing helmets to be made compulsory.

    Last month a resolution at the American Medical Association's annual meeting called for mandatory use of skiing helmets by children and adolescents. At the time, however, the association's council on scientific affairs concluded that there was insufficient evidence to support the resolution. Dr Carolyn Ferree, chairwoman of the council, said that the recent deaths would prompt the association to re-examine the issue and possibly to press for legislation requiring both children and adults to wear helmets.

    In its report the association estimated that 135 000 skiing accidents occur in the United States every year, of which 3537, or 2.6%, are potentially serious head injuries. Most head injuries are the result of the skier hitting a stationary object, and most of the deaths occur when the skier is travelling at speeds greater than or equal to 32 km per hour. Therefore, for a skiing helmet to reduce serious head injuries it would have to withstand great velocities.

    In contrast with cycling helmets, no standards exist on the optimal biomechanics for skiing helmets. Moreover, no epidemiological data exist on the degree of protection afforded by currently available skiing helmets. This lack of data was a prime reason for the American Medical Association's failure to recommend mandatory use of helmets last month.

    The National Ski Areas Association said that skiing was far safer than many other sports. Tim White, director of education for the association, said: ‘The people who are generally severely injured or suffer fatalities are the risk takers in our communities-the same risk takers that suffer injuries in other sports such as bicycling and boating.’

    Evidence exists, however, that a move by industry would reduce serious injury. In the 1970s the manufacturers of skiing equipment radically reduced the incidence of broken legs by developing quick release bindings, and the number of accidents was also reduced by the development of ski brakes, which prevent ‘run away ski’ injuries.

    Figure1

    Most head injuries are the result of the skier hitting a stationary object KEN GRAHAM/IMPACT

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