Is it time for all skiers to wear helmets?

In a bid to decrease brain injuries from skiing and snowboarding accidents, experts in an editorial published in the British Medical Journal today are calling for more public awareness to promote ski helmets.

Dr Gerhard Ruedl and colleagues from the Department of Sport Science at the University of Innsbruck in Austria say there is convincing evidence that ski helmets protect against head injury. They argue that one way to increase helmet use is to ensure that they can be easily hired or included in skiing packages.

The authors say that the debate about ski helmets has intensified after a few fatal skiing injuries in Europe and North America. On New Year's Day in 2009 a politician wearing a helmet collided with a woman who was not wearing one. The politician survived but the woman did not. In March 2009, actress Natasha Richardson died after a traumatic head injury while skiing in Canada – she was not wearing helmet.

A recent study concluded that general head injury was reduced by 35% when ski helmets were used and this rose to 59% for children under 13. "Wearing a ski helmet seems to make sense to prevent head injuries in all age groups," say the authors.

They acknowledge, however, that there are some arguments against helmets. There is a theory, they say, that helmet use may provide a false sense of security and result in riskier behaviour. One study found that helmet use is higher in more skilled skiers so perhaps "the use of a helmet is not necessarily associated with a higher level of risk taking but primarily with a higher level of skill" they suggest.

Ultimately the authors believe the evidence points to helmets having a protective effect and say that action needs to be taken to increase helmet use.