Related Experiment Video
Updated: Aug 20, 2026
A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Effectiveness of helmets in skiers and snowboarders: case-control and case crossover study
Brent E Hagel1, I Barry Pless, Claude Goulet
1Alberta Centre for Injury Control and Research, Department of Public Health Sciences, Faculty of Medicine and Dentistry, University of Alberta, 4075 RTF, 8308-114 Street, Edmonton, AB, Canada T6G 2E1. brent.hagel@ualberta.ca
Objective:
To determine the effect of helmets on the risk of head and neck injuries in skiers and snowboarders.
Design:
Matched case-control and case crossover study.
Setting:
19 ski areas in Quebec, Canada, November 2001 to April 2002.
Participants:
1082 skiers and snowboarders (cases) with head and neck injuries reported by the ski patrol and 3295 skiers and snowboarders (controls) with non-head or non-neck injuries matched to cases at each hill.
Main Outcome Measures:
Estimates of matched odds ratios for the effect of helmet use on the risk of any head or neck injury and for people requiring evacuation by ambulance.
Results:
The adjusted odds ratio for helmet use in participants with any head injury was 0.71 (95% confidence interval 0.55 to 0.92), indicating a 29% reduction in the risk of head injury. For participants who required evacuation by ambulance for head injuries, the adjusted odds ratio for helmet use was 0.44 (0.24 to 0.81). Similar results occurred with the case crossover design (odds ratio 0.43, 0.09 to 1.83). The adjusted odds ratio for helmet use for participants with any neck injury was 0.62 (0.33 to 1.19) and for participants who required evacuation by ambulance for neck injuries it was 1.29 (0.41 to 4.04).
Conclusions:
Helmets protect skiers and snowboarders against head injuries. We cannot rule out the possibility of an increased risk of neck injury with helmet use, but the estimates on which this assumption is based are imprecise.
Related Concept Videos
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
01:16Crossover Experiments
Crossover designs are performed even with smaller sample sizes since the samples can act as their controls. These are better than simple randomized trials since patients are exposed to all the treatments.