Helmet availability at skiing and snowboarding rental shops: a survey of Colorado ski resort rental practices
Introduction
The recent high-profile deaths of Michael Kennedy and Sonny Bono, owing to traumatic brain injury (TBI) sustained in skiing accidents, has focused attention on skiing-related injuries. Review of the literature suggests that TBI is a significant source of morbidity and mortality related to skiing and snowboarding. Macnab and Cadman1 reported an incidence of injury of 2.91/1000 skier days, with 22% of 2092 injuries involving the head. Sherry2 reported an incidence of 3.8/1000 skier days, with 17% of 1850 injuries involving the head. Early studies suggested an even distribution of injury between the two sports, yet more recent studies suggested a higher incidence and severity of TBI in snowboarding.1, 3, 4, 5, 6, 7 Risk factors associated with sustaining a head injury are variable but appear to be male gender, youth, a low skill level, the use of rented equipment, and absence of helmet use.1, 8
The injuries are often severe. In one study,1 22% of the the head trauma was severe enough to cause loss of consciousness or clinical signs of concussion. TBI is common in children participating in snow sports, and constitutes 52% of severe injuries requiring hospitalization in this population.9 Injury patterns in people who required surgical treatment for TBI consisted of a depressed skull fracture, with associated cerebral contusion and hematoma in 84% of the cases.10 Moreover, head trauma is the leading cause of death in fatalities related to skiing and snowboarding. In most instances, a helmet was not utilized by any of the fatality victims.3, 11 These injury patterns suggest that helmet use would be effective in preventing TBI.1, 3, 4, 9, 10, 11
No effective treatment is currently available for reversal of TBI. Prevention is the most effective method of eliminating the sequelae of TBI.12 Helmets offer obvious preventive benefits and are advocated by many researchers.4, 5, 8, 10, 13 We believe that if helmet use is to become widespread, helmets should be considered part of the standard equipment for these sports and available to the entry-level snow sports enthusiast.
The purpose of this study was to gather information on the availability, cost, and prevalence of helmet rental to skiers and snowboarders at Colorado ski resorts.
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Materials and methods
Twenty-seven ski resorts in the state of Colorado were identified through the Ski Industry Association, Ski Country USA, and the Colorado State Department of Tourism. A one-page questionnaire was mailed to each resort equipment rental operation. The questionnaire was returned by mail or fax. If a response was not received by a certain date, an attempt was made via telephone to persuade a knowledgeable person at the operation to complete the survey.
The survey consisted of 16 questions pertaining
Results
The survey was mailed to 27 Colorado ski resorts. Twenty-six of the 27 resorts responded to the survey, for a 96.3% response rate. Eleven of the resorts required telephone follow-up to prompt completion of the survey. One resort did not complete the survey, so rental practice information was obtained by calling the rental shop directly. One resort declined to participate citing legal issues.
Two of the 26 resorts did not operate a rental facility; thus, 24 rental shops were analyzed. Five of the
Discussion
Over the past decade, rental facilities at Colorado resorts have begun to offer helmets for rent and have increased the number of helmets available. While helmets are not yet universally available at Colorado resort-run facilities, a follow-up phone survey of the resorts not previously offering helmets revealed that one of the five resorts has added helmet rentals, suggesting that the trend toward helmet rental slowly continues.
The survey revealed that there is little financial incentive for
Conclusions
The data acquired should represent a reasonable picture of helmet rental practices at Colorado ski resort-operated rental facilities. While helmet use is increasing, it has not yet become generally accepted. The increased information available about the risk of head injuries in skiing and snowboarding, high-profile deaths, and the effectiveness of helmets should contribute to the trend of increasing helmet rental and use.
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