Ski helmets: are they preventing injuries of recreational alpine skiers? – An evidence based review

Sa？etak Alpine skiing is a popular sport with growing number of recreational skiers involved. It is also a sport associated with injuries, among which head injuries are especially dangerous while they can increase morbidity and lead to mortality of skiers. Mentioned are potentially preventable by ski helmets. Although use of ski helmets among recreational skiers is on a constant rise, the number of ski-associated head injuries is not following the decreasing trend at the same pace, thus leaving the issue of ski helmet an open polemics among skiing society. The aim of this review was to compare the pro’s and con’s for helmets to reduce the risk of head injury. Relevant literature search included PubMed, EMBASE and Cochrane Library during years 2000-2018, with additional manual search of all extracted articles. Included were articles examining role of ski helmet during recreational skiing. Both those arguing for helmets and those against. Included were only original articles, in English and with peer review. Excluded were review articles and those investigating the role of helmet during ski racing. The author searched and graded all articles with special attention put on study design, included population and the role on potential preventive/hazardous role of ski helmets. Mentioned data was categorized in order to make the synthesis easier. In the end, 17 studies were included in final analysis. Meta analysis could not be performed due to missing data. Moreover, there were no published randomized studies, which are not performed due to ethical reasons. Ski helmets have an important role in the prevention of ski injuries, especially in children and young recreational skiers. There is a falling trend of injuries correlating with use of ski helmets, but unfortunately not a significant reduction in mortality. The potential explanation for the mentioned is in more risk taking behavior and skiing in snow parks