Macnab A J, Smith T, Gagnon F A, Macnab M
Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Inj Prev. 2002 Dec;8(4):324-7. doi: 10.1136/ip.8.4.324.
To evaluate whether helmets increase the incidence and/or severity of cervical spine injury; decrease the incidence of head injury; and/or increase the incidence of collisions (as a reflection of adverse effects on peripheral vision and/or auditory acuity) among young skiers and snowboarders.
During one ski season (1998-99) at a world class ski resort, all young skiers and snowboarders (<13 years of age) presenting with head, face, or neck injury to the one central medical facility at the base of the mountain were identified. On presentation to the clinic, subjects or their parents completed a questionnaire reviewing their use of helmets and circumstances surrounding the injury event. Physicians documented the site and severity of injury, investigations, and disposition of each patient. Concurrently, counts were made at the entry to the ski area of the number of skiers and snowboarders wearing helmets.
Seventy children were evaluated at the clinic following ski/snowboard related head, neck, and face injuries. Fourteen did not require investigation or treatment. Of the remaining 56, 17 (30%) were wearing helmets and 39 (70%) were not. No serious neck injury occurred in either group. Using helmet-use data from the hill, among those under 13 years of age, failure to wear a helmet increased the risk of head, neck, or face injury (relative risk (RR) 2.24, 95% confidence interval (CI) 1.23 to 4.12). When corrected for activity, RR was 1.77 and 95% CI 0.98 to 3.19. There was no significant difference in the odds ratio for collisions. The two groups may have been different in terms of various relevant characteristics not evaluated. No separate analysis of catastrophic injuries was possible.
This study suggests that, in skiers and snowboarders under 13 years of age, helmet use does not increase the incidence of cervical spine injury and does reduce the incidence of head injury requiring investigation and/or treatment.
评估头盔是否会增加年轻滑雪者和单板滑雪者颈椎损伤的发生率和/或严重程度；是否会降低头部受伤的发生率；以及/或者是否会增加碰撞的发生率（作为对周边视力和/或听力产生不利影响的一种反映）。
在一个世界级滑雪胜地的一个滑雪季（1998 - 1999年）期间，识别出所有前往山脚下唯一一家中央医疗设施就诊、头部、面部或颈部受伤的年轻滑雪者和单板滑雪者（年龄小于13岁）。在就诊时，受试者或其父母填写一份问卷，回顾他们佩戴头盔的情况以及受伤事件的相关情况。医生记录每位患者的受伤部位和严重程度、检查情况及处置方式。同时，统计进入滑雪区域的佩戴头盔的滑雪者和单板滑雪者的数量。
70名儿童在因滑雪/单板滑雪相关的头部、颈部和面部受伤后到诊所接受评估。14名儿童无需检查或治疗。在其余56名儿童中，17名（30%）佩戴了头盔，39名（70%）未佩戴头盔。两组均未发生严重颈部损伤。利用来自滑雪场的头盔佩戴数据，在13岁以下人群中，未佩戴头盔会增加头部、颈部或面部受伤的风险（相对风险（RR）为2.24，95%置信区间（CI）为1.23至4.12）。校正活动因素后，RR为1.77，95%CI为0.98至3.19。碰撞的比值比无显著差异。两组在未评估的各种相关特征方面可能存在差异。无法对灾难性损伤进行单独分析。
本研究表明，对于13岁以下的滑雪者和单板滑雪者，佩戴头盔不会增加颈椎损伤的发生率，且确实会降低需要检查和/或治疗的头部受伤的发生率。
