04 March 2013

Culture of Fear Meets Science on the Pistes

Gressoney La Trinité:  Orange
We got sent a link to a page from the Danish Consumer Council (Forbrugerrådet)about ski helmets. It was interesting reading because of a confusing mix of Culture of Fear (for profit) and the science of helmets. And much of it is a mirror of the rhetoric about bicycle helmets. Ski and bicycle helmets are even compared.

The article starts with the standard emotional propaganda in the first few lines:

Ski helmets can reduce the number of injuries by up to 60%, BUT roughly half of adults ski without head protection.
Would you ride 40 km/h on a scooter without a helmet? If you answer no, then why ski 60 km/h down a piste without a helmet?


Right there we can see the ideology shining bright. Go for the emotional juggler. Project fear and guilt onto the reader so that their perception is manipulated for the rest of the text.

Usually, the rest of the text continues in the same vein - you've all read this kind of stuff before. This article, however, embarrasses itself involuntarily.

According to statistics, head injuries are not the typical reason that a ski holiday ends up in a hospital. Concussions made up 9% of all reported injuries last season. This is a rise of 5-6% from the year before.

So... head injuries are not typical injuries. Um. Okay. But head injuries are up? From the season before last to last season, there was little dramatic increase in the number of helmet wearers, and yet head injuries are up? Boy, that sounds like Risk Compensation at play. Are people feeling protected so they go just a bit faster?

According to statistics from Denmark's Ski Union, the total number of injuries are two per 1000 ski days for skiiers. Head injuries make up about 15%. In other words, the risk of a head injury is one per 3000 ski days - or one head injury every 400 years if someone skiis for one week each year.


So I have to ski for 400 years? Personally, I've probably skied about 400-500 days in my life. While I love the thought of skiing for 400 years, I don't know many people who will.

The potentially dangerous brain injuries make up one injury for every 14,000 ski days and 94% of them are concussions.


Okay. This is rare information. Normally, the phrase "brain injury" is happily chucked around in the rhetoric without any differentiation in order to scare and confuse. Yes, a serious concussion can be life-threatening and dangerous. Most aren't. I've had several in my life. None whilst skiing or cycling, but hey, that's just me. This article that started out with a scary paragraph is turning out to be rather informative.

Snowboarders have a bit higher risk of head injury than alpine skiers and children under 18 have more than double the risk.

Does that mean kids have to ski for 200 years - before they're 18?
Skiis
The Helmet protects partially
Ski helmets aren't built to withstand direct impacts in speeds over 20 km/h. Measurements at several destinations have shown that the average speed on the easier pistes is around 30 km/h - and much higher on the medium and difficult pistes. If a head hits a tree, rock, other skiers or chairlift poles at high speeds, the helmet offers no protection.


Hang on... rewind to the first paragraph. I thought they were fingerpointedly telling me that I needed a ski helmet at 60 km/h. Now they're telling me that it won't really do anything for me. I'm so confused. Interestingly, as I'm sure you all know, the same limitations apply to bicycle helmets. No direct impacts and keep it under 20 km/h.

The helmet's benefits are limited to minor head lesions like scratches and cuts on the scalp and minor concussions.


Sounds like a bicycle helmet again. Actually, it sounds like something everyone should wear in the home and certainly in the car. But hey... they were throwing around all manner of confusing stats on "brain injuries" and concussions, weren't they? Again... I'm confused.

In all collisions, the helmet protects in glancing collisions and protects against getting hit by ski edges and other loose objects, just like it protects when your head hits a hard snow surface and when you tumble off a t-bar lift.

Which, we assume, means it protects against hitting your head against the cupboard door or if you slip in the shower. Or if you're out gardening. Good to know.

The Ski Union recommends helmets
The International Ski Union - FIS - recommended a couple of years ago that all skiiers and snowboarders use a helmet. FIS based their recommendation on a Norwegian study published in the Journal of the American Medical Association. The study showed that using a helmet reduces head injuries by 60%.


But isn't the FIS a sports organisation? You know, professionals going super fast in order to win medals? A far cry from Citizen Skiers. Kind of like the forms you have to fill out in America to ride through a park at low speeds. Based on this logic, why doesn't the company behind Formula 1 car racing recommend motorist helmets? FIS based their recommendations on one study. Were there others? What was the collective result of the different studies? Why base it on just one? Here the information dries up.

FIS also deals with cross-country skiing. You'd think that these athletes would be better off wearing helmets if they protect against tumbling onto the ground and getting a glancing blow by a ski or other object.

Also, is the FIS sponsored by a helmet company? Duh. Of course they are.

The helmet's strength is a compromise between strength and comfort. If ski and bicycle helmets had the same strength as motorcycle helmets, nobody would bother wearing them.

So a motorcycle helmet is better since a ski or bicycle helmet is just a question of comfort more than protection?

Every second adult skis without a helmet
Here in Denmark, experts used to only recommend helmets for kids and other risk groups like young men with an aggressive skiing style.
Denmark's Ski Union recommends helmet use, especially by kids and youths and if you participate in high-risk snow sport competitions and training in the snowboard park and off-piste, but the Ski Union doesn't support a helmet law.

Yes, you said that bit about every second adult up at the top. Just slapping in another guilt trip for good measure, are we? Interestingly, the Danish Ski Union has an entire page telling people how safe skiing is. "It's dangerous!... Uh... no it isn't..."

No law yet...
A law can be a reality in the future. Both in Italy and Austria children under 15 have to wear them. In Northern Europe there is no law, but many places let children use the lifts free if they're wearing a helmet. Therefore, it's rare to see a child without a ski helmet in Norway or Sweden.

And yet the children are transported helmetless in automobiles on winter roads without helmets. Odd logic.

Dealers that the Consumer Council have spoken with think that half of all adult skiers ski with head protection and for children the number is close to 100%. The reasons include the fact that the pistes are groomed for high speeds, so that even weaker skiers can ski faster. And many people traverse the busy pistes. Conditions that increase the risk of collision.

Traversing a piste? Isn't that just called skiing? And the risk of collision... the article told us all about that farther up.

Ski with care
Collisions on the pistes cannot be avoided if everyone wears protective gear, but by showing responsibility for yourself and others. Respect your technical level, be aware, adjust your speed to the conditions and keep your distance from other skiers.

THAT took us by surprise. We were totally expecting the whole article to end where it started, not with this sensible, rational advice.

While the article DID start out with the usual verbal diarrhea from the safety slash profit crowd, we are left wishing that all "advice" about skiing - or cycling - provided the reader with rational facts and statistics so that the individual was able to make up their own mind instead of merely being subjected to fear rants.

It's a hard slog at this point in our society, we know that. The Culture of Fear has a firm grip. Sitting in the café at a small Swedish ski resort - with five or six measly, ten turn pistes - an hour and a half from Copenhagen, I was amazed to see so many people sitting there with their jackets off and their backs protected with Terminator-like back shields, like they were characters in a wintry Call of Duty-Black Ops 2 level. Having bought into the fabricated gear myth presented to them at every turn.

What you can mine from this article is the fact that if you put a helmet on your kids when skiing - to get those free lift tickets - you can just use their bicycle helmet if they have one of those. Save some money right there. Just don't let them use them at the ice rink, because bicycle helmets (and ski helmets we figure) aren't allowed at some ice rinks... Yes. We're confused, too.

9 comments:

Unknown said...

I can't agree with the logic here (even though I am against any helmet laws for cyclists or skiers).

1. A modern helmet is the most comfortable headwear for a skier - it never gets wet, is windproof, holds your eyewear (goggles/sunglasses) well, is adjustable for temperature. Some models even have headphones.

2. Downhill skiing bears more injury-risk than cycling, and nobody advocates helmets for cross country skiing, which seems more similar to cycling.

3. Downhill skiing is a leisure activity, not regular means of transport, thus requesting to use helmets is not as much a nuisance as for cyclists.

4. A helmet can really protect from being hit by a T-bar skilift, which happens every now and then.

Nevertheless, the biggest danger on a skislope is the danger of being hit by another (bigger/heavier) skier, and a helmet offers almost no protection against that.

Didrik Hoag said...

@ unknown.
I don't think you grokked the logic actually. The whole article is about how helmets are be promoted with drama and guilt based on merely the *possibility* of a head injury, not the *probability*. If you take the position of possibility of a head injury then you have to also wear a helmet for all manner of activities. If you take the position of probability of head injury then you would not choose a helmet for skiing because the risk is so low. As it is with cycling and baking a cake.

What is so fascinating about the whole helmet thing in modern times is that it never came from a real need. Nobody sat around on their bicycles or at the ski lodge thinking, "Jesus, people are dropping dead left and right! Won't someone fix this problem?"

The whole helmet "debate" is either about making money or being morally correct. Just as some clergy wrote sermons in the early industrial revolution leading us to believe that being punctual was morally correct, so to have various entities written sermons on the moral correctness of helmet wearing. Odd creatures, humans.

Henry said...

"According to statistics from Denmark's Ski Union, the total number of injuries are two per 1000 ski days for skiiers. Head injuries make up about 15%. In other words, the risk of a head injury is one per 3000 ski days - or one head injury every 400 years if someone skiis for one week each year."

So I have to ski for 400 years?


No, that is not how probability works (and you ignored the phrase "if someone skiis for one week each year". If the probability of an injury is 1 per 500 ski days, you can still land that injury on your first day - you have an approximately 1 in 500 chance of it occurring. You have the same chance every day. Consider also that chance can be skewed higher earlier by your lower skill level, or skewed higher later by using more difficult pistes.

When that injury does occur, you have a 15% chance of it being a head injury. So, since you have skied for 500(?) days already, statistically you should have experienced about one injury, and there is about 15% chance it was a head injury. That chance actually seems pretty high, but then again, many people do not ski as much as you do. 400-500 days to me seems like a lot.

So yes, if you are skiing for one week a year then you should experience a head injury about every 400 years but consider that it could also happen on your first skiing day.

I share your position in being against skiing (and cycling) helmets, but please don't abuse / misunderstand statistics.

Tuomas Palonen said...

You know that in Finland it's a law that you have to wear bicycle helmet when riding a bicycle but if you get caught there are no legal consequences? It's like it's "recommended" by law.

Recently there was a poll in my local newspaper if wearing a skiing helmet should be forced, and the results were 75 % for forcing the helmet. There recently was an incident where someone got severly injured, but I understood it was because the person in question was intentionally behaving dangerously on the slope.

Anyway I don't completely agree here. I snowboard every now and then and so does my friend. He has a helmet and I don't, but according to him the helmet makes the snowboarding much enjoyable, as the first commenter said on his first point. Problem in Finland is that most of the times all the slopes have more ice than snow which makes falling much more dangerous.

I do wear bicycle helmet and I admit it's little bit inconvenient, but the main reason I wear it is because most of the bicycling roads aren't made for bicycling and it's hazardous to slalom between cars and pedestrians.

What makes things interesting is that it's recommended by law and in case a car or a pedestrian bumps in your way you better wear helmet here, but there are no winter helmets for bicyclists even though bicycling in winter in here would kind of need that.

Comparing Finland and Denmark there are much less severe bicycling injuries in Denmark per capita even though almost no-one uses helmet there; the simple reason why is that Denmark has bicycling culture and infrastructure and Finland doesn't.

Erik Sandblom said...

@ Henry
What difference does it make when helmets only protect against scrapes and bruises anyway? It's like they're trying to sell a car while mentioning that NB, there is no engine in the car. Who would anyone buy a car without an engine?

Is it just me or are the helmet campaigns just getting dumber and dumber? It's like they're saying "wear this silly hat to scare away the monsters, even though we know it doesn't really scare away the monsters".

Let's start from the other end. Of all the people who have serious head injuries, how many were skiing or bicycling? Not very many! In fact I found that in Sweden, 30 000 (thirty thousand) people get a stroke every year, and it's one of the leading causes of disability among adults. Compare this to the 1300 (one thousand three hundred) people hospitalised for head injuries while cycling. They spend an average of 1,7 days in the hospital. Doesn't sound very serious to me. Consider further that one way to prevent a stroke is to get exercise such as skiing or cycling. Exercise also prevents a bunch of other common diseases.

Maybe they should give a medal to ALL the skiers!

http://sv.wikipedia.org/wiki/Cykelhjälm#Skadefrekvens
http://sv.wikipedia.org/wiki/Stroke#Riskfaktorer.2C_incidens_och_prognos

Fonant said...

If you want to make easy money, manufacture something that's very cheap to make in bulk (expanded polystyrene, for example) and ensure it's seen as an essential "safety" feature. Then you can sit back while the general population do all your marketing for you!

"Helmets" that provide very limited protection in a head impact are a scam, and it should be illegal to sell them without explaining clearly what their well-known limitations are.

If you want to wear a "hat" for comfort when skiing or bicycling, that's fine. But beware the shop trying to sell you a polystyrene "hat" as if it was a "helmet".

Snook said...

I agree with the first comment. A few more thoughts...

I think that skiing is more similar to mountain biking then cycling in the city.

I do not wear a helmet when I commute on bike but I do wear one every time I go trail riding or when skiing.

They are very different activities. I have been skiing for as long as I have been cycling (over 20 years). I haven't fallen on my city bike in years but I fall nearly every time I ski or mountain bike. Most falls are fairly low impact just when the helmet is helpful.

I grew up skiing in north Idaho and the skiing there is quite a bit different then in Sweden. Most of my skiing (and mountain biking) is not flying down the slopes at 60km/hr. I generally aim for more technical runs that require much slower speeds to navigate. If all I did was stay on piste I wouldn't wear a helmet. I prefer avoiding the piste whenever possible and frequently brush against tree limbs and such. I don't like getting scrapes and bruises on my head.

It's not just the young reckless men either. I still ski with my dad who has been skiing these same sorts of runs for 50 years.

Now, this may not be the way helmets are being marketed now but that is why I, and everyone I generally ski with wears helmets.

Henry said...

@Erik

Yeah, I said I agree with the no-helmet stance. Cycle helmets are pretty ridiculous

There is a much more balanced post on this topic here:
http://www.cyclehelmets.org/1139.html

I just don't like seeing misinterpretation of statistics.

SteveL said...

I got a ski helmet while living in the US because of all the things I do, skiing is the one that I fall off on the most, and have landed with my head on the ground. So far it's protected me from a couple of poll bashes, ski tip bashes when walking, and a sunburned bald patch.

But it adds one more thing to carry when skiing abroad -I've stopped taking it. It's different when you live near the mountains.

But even then, skiing in the trees is something made clear was not protected by helmets, especially as the main cause of death in trees is, apparently, getting stuck upside down in the soft powder round a tree and suffocating. This is why skiing with a partner in the trees is the best safety measure.

In Europe, the biggest hazard is other skiers; I don't know if helmets help there.

Why not start a ski-chic movement that wears retro-tweed and makes armoured skiers look victims of ski-wear vendors?