ski_helmetFormula One champion Michael Schumacher’s tragic accident has reignited the debate on the dangers of skiing. Schumacher, who turned 45 this week, remains in an artificial coma after he hit a rock while skiing in the French resort of Meribel on Christmas Eve. His accident has prompted media attention to skier safety and, in particular, the effectiveness of helmets.

Though Schumacher was wearing a helmet at the time of his ski accident, he still suffered severe brain trauma. However, without a helmet the former race car driver would not have made it to the hospital alive.

But Schumacher’s injury also focused attention on an unsettling trend. Although 70 percent of all skiers and snowboarders in the United States are wearing helmets, nearly triple the number from 2003, there has been no reduction in the number of snow-sports fatalities or brain injuries, according to the National Ski Areas Association.

As the number of helmets has increased on the slopes, so has the number of head injuries. A Western Michigan University School of Medicine 2012 study on head injuries among skiers and snowboarders in the United States found that the number of head injuries increased 60 percent in a seven-year period, from 9,308 in 2004 to 14,947 in 2010, even as helmet use increased by an almost identical percentage over the same period. A March 2013 study by the University of Washington concluded that the number of snow-sports head injuries among youths increased 250 percent from 1996 to 2010.

This paradox is explained by experts by first pointing out that helmets cannot prevent serious head injuries like Schumacher’s. But perhaps of greater concern is the fact that more skiers and snowboarders are engaging in risky behaviors: skiing faster, jumping higher and going out of bounds.

This trend is supported by the profile of those skiers most seriously injured – experienced male skiers on moderate groomed runs are those at highest risk. Only one of ten skier deaths occur on green runs, and somewhat surprisingly, only 3.5 percent occur on double-black or expert trails. And 70 percent of snow-sports fatalities involve men in their late teens to late 30s, according to the ski area association. Head injuries remain the leading cause of deaths in skiing and snowboarding, with about 30 in the United States each year.

Some manufacturers are trying to make helmets safer by introducing technologies that better mitigate some of the forces that cause brain injuries. One such technology, the Multidirectional Impact Protection System, is designed to absorb the rotational forces that produce serious brain injuries.

And yet skiing is a relatively safe activity. There are about 200 million skiers and 70 million snowboarders worldwide. Alpine, or downhill, skiing has an injury rate of about two injuries for every 1,000 ski days. Snowboarders have an injury rate of about three to five injuries for every 1,000 days on the slope. Fatality rates are also relatively low, at about 0.71 deaths per million ski days and 0.46 deaths per million snowboard days.

The take-away message is that skiing is safe, but watch for risk-taking by others and wear a ski helmet. You will not be provided protection from all brain trauma, but it might protect you from a more severe brain injury.