According to The Economic Burden of Injury in Canada 2009 report, all winter activities account for over 70,000 of unintentional injuries in Canada with nearly 1,400 resulting in partial and permanent disability. These serious injuries total $400 million in direct and indirect costs to Canadians.
An international review which included Canada concluded that head injuries are the most common cause of death among skiers and snowboarders. Traumatic brain injuries account for 50-88 per cent of the fatalities at ski resorts.1 Children account for 67 per cent of all ski related deaths.2 Research has demonstrated that ski and snowboard helmets are effective at preventing serious head injuries. It is estimated that approximately 35 per cent of all skiing and snowboarding head injuries could be prevented by simply wearing a helmet.3
An international review, which included Canada, concluded that head injuries are the most common cause of death among skiers and snowboarders. Traumatic brain injuries account for 50-88 per cent of the fatalities at ski resorts1 and 67 per cent of skier deaths in children.2 Head injuries comprise 3 -15 per cent of all injuries suffered by skiers and snowboarders.1
Novice skiers and snowboarders are most susceptible to injury; however novice snowboarders, in particular, are more likely to suffer severe head injuries.1 Children and adolescents experience more head and neck injuries than adults, which may be due to a number of factors unique to children. Children have immature muscles and bones that could result in more falls. They tire more quickly from physical activity. In addition, they often wear ill-fitting ski equipment due to their continued growth from one ski season to the next.4
Overall, head and spinal cord injuries are increasing.1 The majority of head injuries (83 per cent) are concussions. Concussions represent 9.6 per cent of injuries in skiers, 14.7 per cent of injuries in snowboarders and 5.7 per cent of injuries in snowbladers. For both skiers and snowboarders, traumatic brain injury is the leading cause of death.7 It is estimated that between 50 and 88 per cent of deaths can be related to traumatic brain injury.1
Several studies have demonstrated that ski and snow board helmets are effective at preventing head injuries.1 It is estimated that for every 10 people who wear a helmet, up to five may avoid head injuries.3 Studies also show that even at a speed of 19km/h, a ski helmet can minimize brain damage.1 Evidence also demonstrates that ski and snowboards helmet use did not increase the risk of neck injury.5
There is mixed evidence about the relationship between reported risk taking and helmet use. Some studies have shown no evidence between risk taking and helmet use. Other studies have shown that skiers who wear a helmet are more cautious.6, 8 Similar studies concerning cyclists and hockey players indicate that using a helmet or safety equipment does not lead to increased risk taking.9, 10
In order for helmets to protect adults and children properly, they must be correctly fitted and secured. Ski and snowboard helmets should rest two fingers width above the eyebrow and the helmet should be snug and comfortable, with only one finger width under the chinstrap. The helmet pads should touch the cheeks and the forehead, and the helmet back should not touch the nape of the neck. If wearing goggles, there should be little or no gap between the top of the goggles and the helmet. Most helmets come with fitting instructions. Please see our Wheeled Activities page for a video on helmet fitting.
If a helmet has been dropped or the wearer has been in a fall or collision while wearing the helmet, a new one should be purchased, even if it appears undamaged.
Using a second-hand helmet is not recommended. The accident history and the age of the helmet cannot be assured if the helmet had been previously used. A helmet that has been in a crash, or is over five years of age, should be replaced. Helmet plastics do not retain their integrity over time, and lose the ability to protect properly, even if they appear intact. In addition, older helmets may not meet current safety standards, or they may have missing or broken parts.
Helmets for sale in Canada should have certification from CE, Snell or ASTM. These are designed as single-impact helmets. In 2014, the Canadian Standards Association (CSA) released a new standard for a multi-impact ski and snowboard helmet. Visit their website to learn more.
Individuals who are motivated to participate in a particular activity do not appear to be deterred because of safety equipment requirements. Canadian research regarding mandatory bike helmet legislation demonstrates that children have not reduced their cycling activities as a result of helmet laws.11 Recreational hockey also requires helmet use and continues to be a popular Canadian winter sport.
Head injury is the leading cause of death for skiers and snowboarders, and it has been clearly demonstrated that legislation requiring cyclists to wear helmets has been effective in reducing head injuries.12
Developing mandatory helmet legislation involves a collaborative approach between ski hill operators and the government. A number of strategies could be developed. For example, chair lift use on alpine hills could become contingent on helmet use. Ski hill operators across Canada could implement a "no helmet; no lift ticket" policy. This could encourage wearing helmets on the hill to become standard practice.
1 Ackery A, Hagel BE, Provvidenza C, Tator CH. An international review of head and spinal cord injuries in alpine skiing and snowboarding. Inj Prev 2007;13(6):368-75.
2 Xiang H, Stallones L, Smith GA. Downhill skiing injury fatalities among children. Inj Prev 2004;10(2):99-102.
3 Russell K, Christie J, Hagel BE. The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis. CMAJ 2010;182(4):333-40.
4 Meyers MC, Laurent CM, Jr., Higgins RW, Skelly WA. Downhill ski injuries in children and adolescents. Sports Medicine 2007;37(6):485-99.
5 Hagel BE, Russell K, Goulet C, Nettel-Aguirre A, Pless IB. Helmet use and risk of neck injury in skiers and snowboarders. American Journal of Epidemiology 2010;171(10):1134-43.
6 Hagel BE, Pless IB, Goulet C, Platt R, Robitaille Y. The effect of helmet use on injury severity and crash circumstances in skiers and snowboarders. Accident Analysis & Prevention 2005;37(1):103-8.
7 Sulheim S, Holme I, Ekeland A, Bahr R. Helmet use and risk of head injuries in alpine skiers and snowboarders. JAMA 2006;295(8):919-24.
8 Scott MD, Buller DB, Andersen PA, Walkosz BJ, Voeks JH, Dignan MB, et al. Testing the risk compensation hypothesis for safety helmets in alpine skiing and snowboarding. Injury Prevention 2007;13(3):173-7.
9 Benson BW, Mohtadi NG, Rose MS, Meeuwisse WH. Head and neck injuries among ice hockey players wearing full face shields vs half face shields. JAMA 1999;282(24):2328-32.
10 Lardelli-Claret P, de Dios Luna-del-Castillo J, Jimenez-Moleon JJ, Garcia-Martin M, Bueno-Cavanillas A, Galvez-Vargas R. Risk compensation theory and voluntary helmet use by cyclists in Spain. Injury Prevention 2003;9(2):128-32.
11 Macpherson AK, Parkin PC, To TM. Mandatory helmet legislation and children's exposure to cycling. Injury Prevention 2001;7(3):228-30.
12 Macpherson AK, Spinks A. Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane Database of Systematic Reviews 2008(3):CD005401.