Abstract
Objective
Previous studies have evaluated helmet use and risk compensation in alpine skiing and snowboarding. The impact of previous concussion (PC) related to skiing/snowboarding injuries and subsequent helmet usage or subjective risk compensation behavior has not been explicitly studied. There is evidence that helmet use reduces head injury risk, but the effect on concussion risk is inconclusive. The purpose of this study is to determine whether risk compensation while skiing/snowboarding is correlated with a history of concussion and whether risk compensation with helmet use could be contributing to more concussions in skiers and snowboarders.
Methods
This was a descriptive cross-sectional survey of persons aged 18 to 65 years who were interviewed on the mountain during their ski/snowboarding day at Park City Mountain Resort (2014–2015 season). Participants completed a 24-question survey conducted by a single trained interviewer regarding helmet use, risk-taking behaviors, and subjective risk compensation while wearing a helmet.
Results
In all, 938 participants (305 women, 633 men) completed the survey, 75% of whom were skiers, 25% snowboarders; 672 of 938 participants (71%) reported always wearing a helmet. Regarding concussions, 168 of 938 (18%) reported a PC from skiing or snowboarding; of those, 40% were snowboarders. Among participants without terrain park use, 23% of snowboarders versus 10% of skiers reported PC (χ2 [1, n = 596] = 11.22, P = .001). Among participants who spent at least some time in a terrain park, 35% of snowboarders versus 23% of skiers reported PC (χ2 [1, n = 342] = 5.83, P = .016). Only 5% of those who reported a PC never wear a helmet. When comparing participants with PC and those without, participants with PC were more likely to subjectively compensate risk-taking behavior when wearing a helmet (odds ratio 1.94, 95% CI: 0.93 to 0.96, P = .001). However, subjective risk compensation did not correlate with answers to follow-up questions designed to specify risk compensation.
Conclusions
Our results suggest that, although persons with PC also report subjective risk compensation while wearing a helmet, this may affect terrain park use but may not affect their choices of terrain outside of the terrain park.