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Helmets for Many Activities
10/18/2010 2:54:15 PM

Helmets for Many Activities


Equestrian Helmets
The equestrian community developed an ASTM standard in 1988 and it has unique characteristics related to horseback riding and horse sports. In particular, the hazard of being kicked by the horse is unique. If you ride in woods, the larger vents of the bicycle helmet are more likely to snag a branch, another hazard that increases because the rider position is higher on a horse than on a bicycle. As a result, ASTM has a specific equestrian standard, and the design of the helmet is for the impacts encountered in horseback riding. Although some riders do wear bicycle helmets for cost reasons, they can have much better protection with an equestrian helmet designed for their sport. It should meet the ASTM standard for equestrian helmets (F1163).

There is no law in the US that prohibits a merchant from selling equestrian helmets that do not meet any standard, so look for an ASTM F-1163 sticker. We do not recommend equestrian helmets for bicycle riding because the lab drop test on flat surfaces is done at only 1.8 meters rather than the 2.0 meter bicycle requirement. In addition, most equestrian helmets are not as well ventilated as most bike helmets for summer riding. Plantation, Florida, has a helmet ordinance requiring ASTM F1163 or its equestrian helmet equivalent as approved by the Chief of Police for age 16 and under. It took effect in 1999. New York State now has an equestrian helmet law as well for riders under 14. Its effective date was 1/5/00. It requires an ASTM helmet and also requires that a helmet be provided if you rent a horse from a horse rental service. For sources of information on equestrian helmets, see this message by Dru Malavase <http://www.bhsi.org/equest.htm> , an equestrian helmet expert.


Heel wheels - Wheeled Shoes
Heel wheels on kid's shoes (the most popular brands are from Heelys, Inc. and the Street Gliders strap-on type.) have raised some helmet questions. The Consumer Product Safety Commission recently said they contributed to about 1,600 emergency room visits in 2006, the first year of the fad. Since they are used on hard surfaces, and about half of the falls are to the rear, it would make sense to use a skating or skateboard helmet following the CPSC guidelines <http://www.cpsc.gov/CPSCPUB/PUBS/349.pdf> . But the kids are wearing the shoes for everyday use, not specifically for sport, and parents don't expect them to wear a helmet every time they wear the shoes. Further, they like the ability to walk and instantly convert to gliding, and a helmet gives away the secret. We don't know how to resolve that one. World Against Toys Causing Harm <http://www.toysafety.org/>  put them in its "2006 Ten Worst Toys" list. There is a published study by emergency room doctors in the journal Pediatrics <http://pediatrics.aappublications.org/cgi/reprint/119/6/e1294>  indicating that injuries severe enough to require an emergency room visit are a problem, 76% were outdoors, 70% were beginners, 84% were girls, 87% suffered broken wrists, arms and elbows, and 54% said they would keep using the shoes after recovery. None of their sample of 67 had a head injury. The Canadian Safety Council has issued a consumer alert <http://www.safety-council.org/info/child/heely.html>  advising the use of skateboarding protective gear, and avoiding use on roads, sidewalks, and wet surfaces. In short, we have seen very little practical advice for parents to date, but a Web search may turn up more.


Ice Skating
Parents are often concerned about children learning ice skating with no head protection. This study in the journal Pediatrics <http://pediatrics.aappublications.org/cgi/content/full/114/1/124>  indicates that the concern is well-placed, and recommends helmets for ice skating. The US Consumer Product Safety Commission recommends that ice skaters use bicycle, ski or skateboard helmets <http://www.cpsc.gov/cpscpub/pubs/349.pdf> . If you want to follow that recommendation, we would suggest that you look for a helmet certified to the ASTM Skateboard standard, F 1492, or even dual certified <http://www.bhsi.org/dualcert.htm>  to the skateboard and bicycle helmet standards. They have some multi-impact capability and more coverage in the rear than a bike helmet. If you already have a bike helmet, the recommendation includes that too. The rounder exteriors that we recommend for cycling on pavement are not important for ice skating, since the ice is smooth and the helmet will slide no matter what it has on the exterior. Ski helmets tend to be more expensive, but are also warmer, and the impact protection is similar. Most bike and ski helmets are single-impact only, and must be replaced if you hit them hard in a crash.


Motorized Sports
Bicycle helmets are not designed to protect in the harder impacts a motorcyclist can achieve by hitting something at 55 MPH or more. There are good helmets designed for every motor sport, and no excuse to settle for the lesser protection of a bike helmet. Standard bicycle helmets do not protect the face (you can live just fine with a busted nose or split lip from a bicycle crash) or the jaw joint <http://www.bhsi.org/astmdocs/williams.htm> , which can transmit injurious force to the brain in a crash at motorized speeds. We believe that motor scooters require motorcycle helmets too, and would even include motorized bicycles. We have a page up on that subject <http://www.bhsi.org/powered.htm> . The US Consumer Product Safety Commission, on the other hand, recommends that users of low speed motor assisted vehicles use bicycle helmets. Here is a link to their recommendation <http://www.cpsc.gov/cpscpub/pubs/349.pdf> . But for "wheeled large motor" vehicles such as ATV's, dirt bikes, minibikes, motocrossing, karting mopeds and powered scooters they recommend DOT or Snell approved motorcycle helmets. New Zealand has a standard for All Terrain Vehicles <http://www.standards.co.nz/atv.html>  (ATV), but we don't know what it requires. The only comprehensive motorcycle helmet resource we know on the Web is The World Health Organization Helmet Initiative <http://www.whohelmets.org/> , WHO's effort to spread the word about helmets worldwide.


Pogo Stick Helmets
The sport pogo stick craze began in 2005 and the manufacturers all recommend wearing a helmet. We think that's good advice, but don't know what helmet to recommend, since the falls made possible by more powerful pogo sticks can easily exceed what a bicycle, Segway or even pole vault helmet is designed to protect you against. Ventilation and light weight seem necessary for comfort given the heavy exertion, up and down motion and low airflow. Any helmet will offer some protection, but we are reluctant to recommend one that is not designed for this sport.


Pole Vaulting Helmets
The 2002 death of Kevin Dare, a pole vaulter who fell back on the pole plant box and two other vaulters who died the same year raised the question of pole vaulting helmets. For some years promoters of the sport have been studying catastrophic injuries to recommend improvements, and their analysis indicates that expanding the landing pits, using padded collars on the pole plant box and other measures to improve the facilities, training and coaching techniques can probably prevent more injuries than the use of helmets. For the definitive pole vaulting safety site, see former World Record Holder and Olympic bronze medalist Jan Johnson's Skyjumpers <http://www.skyjumpers.com>  page, with articles on pole vault safety from a thorough study of pole vaulting injuries.

ASTM has revised its standard for pole vaulting pits, and both high school and college facilities should have been upgraded for the 2003 season. In the meantime, ASTM's helmet subcommittee established a task group to develop a standard for a pole vaulting helmet, but it has been quite a challenge. The height of the fall can be 18 feet, reaching a velocity of 23 MPH/39 KPH. Contrast that to a bicycle crash, where the closing speed of head and pavement is typically about 12 MPH/20 KPH. The energy to be managed by the helmet could be almost three times what a bicycle helmet can handle, and would exceed the capabilities of motorcycle helmets. To protect against a fall like that if the athlete is going to hit a hard surface, the helmet would have to be perhaps two or three inches thick, and the sport would become the mushroom heads vault. In addition, there is a problem with pole clearance if the helmet is too thick on the sides. The athletes will of course resist adding weight and a cumbersome helmet. More to the point, we always advise that where possible, removing the cause of the injury before the impact occurs makes more sense than putting on a helmet to avoid the consequences of faulty athletic facility design. The problem can be better addressed by changing the configuration of the pits and other equipment so that the jumper does not hit hard surfaces to begin with. The organizers of the sport have control of those elements, unlike the road environment where it is more difficult to control the elements of danger.

We would obviously recommend not using the older, smaller pits for vaulting. But a few states now require helmets for pole vaulting. If you do vault and want to wear a helmet, we would recommend one that meets the ASTM pole vaulting helmet standard, F 2400-06. Unfortunately that does not include the first purpose-designed pole vault helmet, sponsored by Kevin Dare's father and the Penn State Sports Department, now available from at least one online retailer <http://simpsonraceproducts.com/products/index.php?main_page=product_info&cPath=578_579&products_id=9146> , which is not certified to the pole vault standard, only to ASTM F1492 for skateboarding. But a newer Pro-Tec Pole Vault helmet does meet ASTM F2400, and is available online <http://www.onlinesports.com/pages/I,GIA-700241.html?srcid=frgl&utm_source=froogle&utm_medium=cpc&utm_term=GIA-700241&cm_mmc=Froogle-_-Products-_-PPC-_-GIA-700241>  for about $52 plus shipping.

Nothing on the market will protect you against the direct blow to the back of the head from sixteen feet onto an unpadded cement pole plant box, even a motorcycle helmet. In other situations a helmet may help, but cannot begin to approach the protection of additional pit and pole plant box padding. Helmets to avoid are those that do not meet any impact standard at all, and have no standards sticker inside, or a European EN standard for some unknown sport. Again, not one of these helmets can guarantee that you will not be injured. We recommend that you not vault at any facility that does not meet the new ASTM standard. You can find more info on upgrading pole vault landing pits on Jan Johnson's Web site <http://www.skyjumpers.com/articles/safetyupgrades.html> . A helmet is no substitute for a safe pit design!


Although you might think that a contact sport like rugby would require helmets, the players of the game have always had other ideas. They reject the use of layers of gear for body protection, including the head. This injury prevention study <http://ije.oxfordjournals.org/cgi/content/abstract/dyh346v1?ct>  concluded that the headgear rugby players had tried could reduce scalp injuries, but did nothing to prevent concussion. But an Australian study <http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=14751945&dopt=AbstractPlus>  that focused on improving the headgear used for rugby and Australian rules football found otherwise. The International Rugby Board awards rugby headgear the IRB Approval Mark if it meets its standards, including soft materials and thickness of less than 1cm. That rules out any impact protection.


Scooter Helmets
Push scooters suddenly became popular in 2000, so there is not much data on injuries yet. Anything that lets you travel fast on wheels on a very hard surface will involve crashes, and the hard surface indicates you should wear a helmet to preserve your brain. If cars are present that advice becomes critical. Scooter users probably can expect crash impacts similar to roller skaters and skateboarders. A NY Post reporter surveyed emergency rooms there in August of 2000 and was told that many scooter injuries are showing up now. In early September of 2000 the Consumer Product Safety Commission issued a press release <http://www.cpsc.gov/cpscpub/prerel/prhtml00/00178.html>  warning that scooter injuries were on the rise and recommending a bicycle helmet, knee pads and elbow pads. They have also put up some scooter injury data <http://www.cpsc.gov/pr/prscoot.html> . And in 2006 they issued a recommendation that bicycle helmets are fine for scooters and low powered motorized scooters <http://www.bhsi.org/up0603.htm> .

The numbers of scooter riders' visits to emergency rooms were very low compared to the half million American bicyclists who end up there, but still cause for concern since there are not that many scooters out there yet. The advice was very similar to CPSC's findings on roller skate injuries <http://www.bhsi.org/skatcpsc.htm>  back in 1997. In October press reports said that twelve communities in the US had adopted or were considering laws to require helmets for scooter users, including laws already adopted in Medford, NJ; Raleigh, NC; Milton, WA, and San Francisco, CA. In addition, Elizabeth, NJ now has a law, and there is are bills pending to adopt a statewide law in New Jersey, New York and Pennsylvania. There are lots of helmets available that will be adequate for scooter protection, particularly since roller skate helmets and bicycle helmets are designed to an identical ASTM standard. (The CPSC standard does not actually cover roller skating, or scooters. It is limited to bicycle helmets.) For more info, see our comments on skating helmets below. In one of its 2000 issues the Journal of the American Medical Association published an article on scooter injuries <http://jama.ama-assn.org/cgi/content/extract/285/1/36?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=scooter+injuries&searchid=1104710042166_2890&stored_search=&FIRSTINDEX=0&journalcode=jama> . Then in December of 2000 the Centers for Disease Control issued a statement, indicating that the rapid rise in the rate of scooter injuries was more alarming than the actual number <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4949a2.htm> . They noted two scooter deaths, one from a head injury and the other from being hit by a car. Next CPSC got into the act again in August of 2001 with a recommendation that users of motorized scooters use bicycle helmets <http://www.cpsc.gov/cpscpub/prerel/prhtml01/01222.html> . Their 2007 statistics show that there were nearly 50,000 emergency room-treated injuries involving unpowered scooters in 2007, and more than 80 per cent of them were to children younger than 15. In addition to wearing a helmet, CPSC recommends elbow and knee pads when riding a scooter. For those who are promoting scooter safety, Toys R Us has a pamphlet titled "Scooter Safety Tips for Riders." It's weighted toward what to buy, but it is a nice full color pamphlet, and all the riders have helmets on. And here is a scary scooter crash story <http://www.bhsi.org/taylor.htm>  where the child was not wearing her helmet.


Segway Helmets
The Segway is a motorized scooter-like device with two wheels and gyroscopes to keep it upright. The rider stands upright about six inches higher than the ground. It is designed to go 14 mph or more on level ground. We would not use a Segway without a helmet, which is our standard advice for anything that moves at considerable speed on pavement without protection for the operator. Although helmets for bicycles would work at that speed and height of the head above the ground, there is a specific ASTM standard for Segway helmets, F 2416. No manufacturers are making helmets to that standard yet, however. Segway recommends a multi-impact helmet due to concerns about helmets being bashed around in the trunk of a car with one of their machines. The closest thing to an F 2416 helmet now available would be a dual certified skate style helmet <http://www.bhsi.org/dualcert.htm> , certified to the ASTM F-1492 Skateboard standard as well as the CPSC bike helmet standard. The bicycle certification means it would perform well in the initial hard impact, and because it has a hard shell it should withstand being carried in a trunk with a Segway. In mid-2003 President Bush was photographed trying to mount a Segway, tennis racket in hand and no helmet. He fell off but luckily caught himself before hitting the ground. Apparently he had neglected to turn the machine on, so the gyroscopes were not energized. In 2006 the Consumer Product Safety Commission issued a recommendation that bicycle helmets are fine for low powered scooters <http://www.bhsi.org/up0603.htm> , apparently including the Segway.


Skating Helmets
Over the years, the skating community using inline or quad skates for normal recreational and competitive activities has settled mostly on bicycle helmets as the best thing on the market for their activity. There are now some helmets which purport to be designed for skating. The main difference is more coverage in the rear.

The International In-line Skating Association <http://www.iisa.org/>  was one of the organizations that persuaded ASTM to extend its F 1447 bicycle helmet standard to skating. So ASTM considers bicycle helmets adequate for roller skating. So does the Consumer Product Safety Commission in this pamphlet <http://www.bhsi.org/up0603.htm> . The ASTM standard does not cover trick or freestyle skating and skateboarding, where frequent crashes require a multi-impact helmet. See skateboard helmets below <http://www.bhsi.org/other.htm#skateboard> .

The ASTM standard does cover roller racing, since the falls are very similar to bike races, and bike helmets have almost eliminated deaths in US Cycling Federation/USA Cycling races since they were required in 1986. In either sport the initial impact with the pavement is the only life-threatening moment, even if those drafting behind may run you over in their attempt to remain upright and in the race.

Skaters have other safety equipment needs, including wrist braces and knee pads. For more on skating injuries, The IISA has put up an impressive page of skating injury statistics <http://www.iisa.org/resources/safety.htm> . The IISA has a page on helmet laws for skating <http://www.iisa.org/legal/ordinances.htm> .


Skateboarding Helmets
There was increased interest in skateboard helmets following the Fall 2005 death of a professional skateboarder during a demo, when he crashed and his helmet came off before the impact (probably from an unfastened strap). Skateboarding requires a multi-impact helmet. Bicycle/rollerblade helmets are single-impact helmets. They are not designed for trick skating, freeform skating, half-pipe skating, hot dogging, roller hockey and other radical skating styles where falls are frequent and a multi-impact helmet is required. For those sports and for skateboard use we would recommend looking for a helmet that meets the ASTM F-1492 standard and is dual certified <http://www.bhsi.org/dualcert.htm>  to the CPSC bicycle helmet standard. In 2006 the Consumer Product Safety Commission issued a recommendation that bicycle helmets are fine for skating <http://www.bhsi.org/up0603.htm> . The ASTM skateboard helmet standard, F-1492, tests helmets with three hits on the same spot, so it is designed for the falls a skateboarder expects. There is no US law requiring a skateboard helmet to meet any standard whatsoever--that's up to the manufacturer. Consumer Reports found <http://www.bhsi.org/cu_2002.htm>  in 2002 that some helmets actually labeled and advertised for skate meet the CPSC bike helmet standard but may not meet the multi-impact skateboard standard. In fact, when we go looking for skate helmets at major retailers what we find are bike helmets made of crushable, single impact EPS foam that meet the CPSC standard, with very few labeled as meeting ASTM F-1492 although they may have skaters and skateboards on the box. We recommend that you look for the sticker that says ASTM F-1492 for a skateboard or trick skating helmet. For helmets meeting both the ASTM F-1492 standard and the CPSC bike helmet standard, see our page on dual certified helmets <http://www.bhsi.org/dualcert.htm> . In the spring of 2003 the Consumer Product Safety Commission published an interesting article about skateboard injuries <http://www.cpsc.gov/cpscpub/pubs/cpsr_nws28.pdf> . They recommended wrist guards and helmets. There is one possible source for very low cost skateboard helmets in the Ian Tilmann Foundation <http://www.theiantilmannfoundation.org/>  with their Helmet For a Promise Program. If you promise to wear a helmet, they will send you one for a $7 shipping fee. If you live in Tampa, Florida you can pick up your helmet at a skate park there for free. In mid-2009 the foundation site says they have given out about 1600 helmets so far.


Skydiving Helmets
There are several manufacturers out there with specialized Skydiving helmets, easily found with a Web search <http://www.google.com/search?q=%22skydiving+helmet%22&hl=en&safe=off&start=10&sa=N> . Skydivers are generally looking for a warmer helmet than most sports, a camera mount and a close fit to keep the helmet from vibrating. There are military specifications for parachuting helmets, and a European standard as well. Unless the manufacturer meets one of those standards you don't know how the helmet will perform in a ground impact.


Snow Sport Helmets
Consumer Reports has an article in their December, 2003 issue (with "Best Gifts" on the cover) on ski helmets. It is by far the best thing we have seen on this subject. They top-rated two Giros and two Leedom's. They recommend you do not buy a Boeri Rage or a W Helmet (although it scored highest on impact tests) due to retention system problems, and replace them if you have one already. They also said that price and performance are not related. You can read the article on the Consumer Reports Web site <http://www.consumersunion.org/>  for a fee or find it in your local library.

In 2002 more than 23,000 skiers and snowboarders suffered head injuries on the slopes. That's quite an increase from 1998, when the number was 16,000. CPSC estimates that about 40 per cent of those could have been prevented or reduced in severity with a helmet. With two celebrity deaths early in 1998 the subject suddenly received more attention. The buzz has since fallen off, but an article from a Colorado paper in September of 2002 noted that two kids died in the prior season. And in 2009 actress Natasha Richardson died after falling on the bunny slope at Mt. Tremblant and suffering a closed-head injury. Ski deaths are almost a constant, and aside from Richardson the typical fatal ski crash is exactly what was described in the press as causing the Kennedy and Bono deaths: the skier slams into a tree, or less often another skier, dying of head and body injuries. Some recent medical publications have questioned the value of a helmet for this type of crash, since the velocities are such that a helmet may not help, or other injuries may kill the skier even if the head is protected. But some ski concussions result in just hitting hard snow or ice too hard, maybe as much as 20 per cent of the total head injuries. The National Ski Areas Association, with a whole raft of partners, has a Web site up called Lids on Kids <http://www.lidsonkids.org/>  that is probably the best single source of ski helmet information at present. Or check their main NSAA Web site <http://www.nsaa.org/nsaa/home/> .

Skiers can reduce their risk of death dramatically by not skiing fast in the vicinity of trees. No other protective measure can equal the effect of not slamming into the tree to begin with! We recommend that skiers avoid slopes with trees, rocks or unpadded lift line pylons, as well as slopes where other skiers jump without being able to see their landing spot. We also recommend that they consult a member of the local ski patrol about where such danger spots are in the area where they are skiing. A German study concentrating on why skiers crash has also indicated that visual acuity and depth perception have a considerable influence. They recommend the use of glasses or contacts on the ski slope if the skier needs them for everyday use, and the use of yellow colored filters for goggles when light is flat to help spot variations in the snow. So the first step is to minimize the crashes to begin with.

An article appeared in February 2006 in the LA Times by Bill Becher titled "Headway on the Slopes". He quoted Dr Stuart Levy of Denver, whose research shows that ski helmets can cut the rate of head injuries by two thirds and the risk of ski or snowboard fatalities by 80%. Brent Hagel of the U. of Calgary studied crashes at 19 Canadian ski resorts and concluded that helmets reduced the risk of serious head injury to skiers and snowboarders by 56%. the National Ski Areas Association says that 48% of skiers and snowboarders in the US wore helmets <http://www.nsaa.org/nsaa/press/0809/helmet-usage.asp>  in the 2008-09 season.

For a very different view, see this article in Ski Canada magazine <http://www.skicanadamag.com/Features/2008/12/05/7646556.html> . This 2007 report concludes that helmets can't help much in ski crashes.

We would recommend a ski helmet as a prevention measure if the skier does use slopes or trails with trees, and for anybody concerned about the possibility of head injury even on clear slopes or icy areas. (A bicycle helmet used for skiing might afford some measure of protection, but is not designed for snow sports and is not optimal for that usage.) There is little data on the effectiveness of ski helmets in preventing ski deaths. But a group of researchers in the Department of Industrial and Manufacturing Engineering at Rochester Institute of Technology has estimated anyway that helmets could prevent 60 to 80 per cent of skiing head injuries. They went on to speculate on reasons ski helmets might not be effective, including risk compensation--skiing faster because the skier feels invincible in a helmet--inadequate protection levels of some current ski helmets, and what they believe might be an increase in neck injuries. Other researchers in the ski injury field believe that neck injuries would not be affected, and we think the neck injury theory is probably as much a red herring in skiing as it is in bicycling and motorcycling. No doubt body trauma in some tree-splat cases will cause the death even if the head is protected, and it is also possible that a skier crashing face-first might hit an unprotected part of the head even with a helmet. One of the leading medical researchers on ski injury for some 25 years has been Dr. Robert J. Johnson, M.D. of the University of Vermont. If you are with the media and seeking info, call him at 802-656-8291 or fax 802-656-4247.

In October of 1998, France launched a national campaign to promote ski helmets for children. Here is an announcement of the French campaign, in English <http://www.bhsi.org/francske.htm>  and the original French version <http://www.bhsi.org/francski.htm> . They continued it in subsequent years.

Standards for ski helmets are evolving, and worth investigating if you are considering one. There is no U.S. law or regulation that protects you from buying a sub-standard ski helmet! There are two Snell Memorial Foundation standards, a CEN 1077 European standard, and the ASTM F2040 standard published in mid-2000. For the present, either of the Snell standards: RS-98 for recreational skiing or S-98 for snow sports are the most stringent standards in the market and the ones to look for. You can find them on the Snell Web site <http://www.smf.org> . Snell has a comparison up on their Web site <http://www.smf.org/s98.html>  with the CEN and ASTM standards. You should look for a sticker in the helmet with at least the ASTM standard, since helmets certified to ASTM or either of Snell's standards are required to be more protective than a CEN-certified helmet. Note that although it is a ski and snowboard standard, it calls for a one-crash helmet, rather than the multi-impact helmet that may be more useful for your snowboarding style.

In short, we recommend that you not ski near trees, rocks or unpadded lift line pylons, watch out for other skiers, and if you choose to wear a ski helmet, look for one certified to the ASTM F2040, Snell S-98 or Snell RS-98 Standards.


is another snow sport that might benefit from helmet usage. Parents of sledders all did their sledding without helmets, though, and sledders are normally not in groups or clubs with shared experience on their injury problems. So they are not likely to see a need for helmets unless new statistics or medical studies make it clear. The American Academy of Orthopaedic Surgeons <http://www.aaos.org/>  has a position paper on sledding and you may also be able to find a copy of the study by John R. Tongue <http://journals.lww.com/corr/Abstract/2003/04000/The_Hidden_Dangers_of_Winter_Sliding.10.aspx>  that concludes that many sledding injuries could be avoided with helmets and recommends bicycle helmets for sledders up to age 12. CPSC data show that 7,000 sledders go to emergency rooms each year in the US with head injuries, of which 43% have brain injuries and a third are serious. In December of 1999 an AP article appeared by Ira Dreyfuss, a frequent writer on helmet topics. The article mentioned the Tongue study and cited more conservative conclusions by Dr. Fred Rivara of Harborview Injury Prevention Center who studied Seattle head injuries in sledding but did not find any protective effect for helmets, noting that there were too few children using helmets to reach a statistically meaningful conclusion. The Norwegian helmet manufacturer Hamax has a page up on precautions for sledding <http://www.hamax.com/?itemid=1101> . In 2006 the Consumer Product Safety Commission issued a recommendation that bicycle helmets are fine for sledding <http://www.bhsi.org/up0603.htm> . And there is a campaign in Canada called Protect Your Noggin <http://www.protectyournoggin.com/>  that promotes the use of helmets for sledding there.

Soccer Headgear
Articles appeared in 1998 on soccer head injuries based on a study in the November issue of the journal Neurology. A Dutch and American study of 80 long-term soccer players in their mid-twenties showed that they score poorly on tests of memory, planning and visual processing. The researchers believe that is the product of repeatedly heading the ball or colliding with other players or goalposts. The article reports that concussions are as frequent in soccer as American football. The impairment of mental function found was probably too subtle to be obvious to most people except perhaps family members. Since that article appeared it has become evident that the injury prevention community is not sure that the data can be interpreted that way. But in March of 2004 a new study by Dr. Scott Delaney showed from statistical analysis of emergency room data that in the US the rate of concussion in soccer, football and hockey is about equal.

In May of 2000, the Consumer Product Safety Commission sponsored a conference on repetitive head injuries, focused mainly on youth soccer. The consensus at the conference appeared to be that there may indeed be a head injury problem in soccer, but it is not clear whether that is from repeatedly heading the ball or from more violent collisions with other players, goals or the ground. It is also not clear that protective headgear will help, since if there is trauma from heading it may be related to snapping the head sharply to hit the ball rather than the impact of the ball on the skull. Both actions are unique to soccer. Research has begun in this field, but it will be some time before the results are in. There have been preliminary indications that heading is not the primary cause of soccer head injuries. This page is likely to be behind in that assessment, and we urge you to do a Web search for the most current info.

In a separate development, ASTM's has adopted a soccer headgear standard, F2439. It specifically excludes repetitive heading injuries from its scoope, and instead calls out headgear (headbands) that offer protection against impacts with other players, the ground or the goalposts. The first product available to meet it was the Full90 headband <http://www.full90.com/> .

If heading is determined to be the culprit in head injuries any protective headgear would have to provide head protection while still permitting the player to accurately head the ball. Most people in the field seem to think that coaches and players are unwilling to change the game rules, although in little league soccer some coaches discourage heading and have eliminated heading drills. But many coaches and organizers refuse to consider the idea that heading might have to be curtailed. Again, the exact injury cause is yet to be isolated, and probably has more to do with collisions with other players, goalposts and the ground than with heading.

In 2005 the US Soccer Federation issued a statement saying that it does not believe soccer headgear is helpful, that it believes it may make the sport more dangerous, and that USSF-sanctioned leagues may not require soccer headgear. We were, to put it mildly, not impressed with their analysis. You can find it on the USSF Web site <http://www.ussoccer.com/News/Federation-Services/2005/08/U-S-Soccer-On-Head-Injuries-And-Padded-Headgear.aspx> .

The American Academy of Neurology provides copies of its guidelines for soccer coaches on head injuries by calling (800) 879-1960 or (703) 236-6000. In addition you can check the Head Injury Hotline's on-line newsletter for an article on soccer helmets <http://www.headinjury.com/newsltr.htm#sports>  based on info from the American Academy of Pediatricians. There is more in this British Journal of Sports Medicine article <http://bjsm.bmj.com/cgi/content/abstract/39/4/226> .

Special Needs
We have another page on headgear to protect kids with head injuries or developmental disabilities <http://www.bhsi.org/special.htm>  involving head banging, or for others who just need bump protection around the home or on outings.


Unicycles have their own safety equipment needs, including shin guards for beginners to protect against hitting the pedal or crank. Apart from that, the normal bicycle and skate gear should suffice. The most comprehensive source for unicycle info we have seen is The Unicycle Page <http://www.unicycling.org/> .


Wakeboarding and Waterskiing Helmets?
During the summer of 2000 the subject of helmets for wakeboarding was under active discussion in an Internet list devoted to the sport. Questions have been raised about the efficacy of any helmet to protect the brain from injury in a water impact at wakeboarding speed, as well as the usual water sport questions of weight, vents, drainage and "bucketing (scooping up water)," and the possibility that the larger profile of the helmet would actually increase the volume of water displaced upon impact and might thereby increase the severity of the impact. Anecdotal evidence indicates there may be more head injuries in wakeboarding than in slalom water skiing, but as far as we know the injury rates and difference in injury mechanisms is not documented. In 2001 an email informed us of the Web site of Think Helmets <http://www.thinkhelmets.com/> . They have a helmet they say is designed for water skiing and wakeboarding, and is resistant to bucketing. But the description does not even mention impact tests or impact protection, and there is a prominent warning label at the bottom of the page where they say the helmets are not certified to a standard and were not designed to be protective. Ouch.


Wheelchair Athletes
If you go fast in a wheelchair you probably should be using a helmet. Considering how much your clear thinking helps you to overcome the other obstacles you face, preserving brain function is critical to you. Wheelchair users have a unique set of requirements. The distance to the ground in a fall is less than a bicycle, so the intial impact will probably be less severe, but can still be life-threatening. You generate less cooling air for a given amount of exertion than a bicycle rider. And your speed can be considerable but on average is likely to be less than a bicycle, lessening the risk of snagging your head in a fall on angular helmet features. For those reasons you should probably ignore our often-repeated advice about rounder, smoother helmets and just go for the helmet with the biggest vents. Pay attention to the vents on top. Those are not particularly important for bicycle riders, but when you are moving at lower speeds you want the hot air to be able to rise off your head. If you have a head support in back you will need a rounder helmet, and perhaps a thick pad behind your back to give you room for the helmet. Helmets with oversized vents are not cheap, since more sophisticated manufacturing techniques are required, but the difference may be worth it for you.


Canoe and Kayak
Whitewater sports have their own helmets. The impacts are lower than in bicycling, but more frequent, and the sharp rock hazard results in a need for more coverage. Water must drain from the helmet as well to prevent "bucketing," and some canoeists mention the ear as a vulnerable area if your head is being dragged under water. A bike helmet will be better than a bare head for whitewater, but a canoeing helmet should be considerably better adapted to the sport. ASTM is working slowly on a whitewater standard, but does not have it in place yet, so you are on your own to make a choice. There are some whitewater helmets out there with multi-impact EPP foam in them instead of the squishy foam, which should be an improvement for very hard impacts. (As an illustration, Cascade <http://www.sporthelmets.com/>  is one brand made that way.).


Protection for the Head-Injured
If you want a bicycle helmet for bicycle riders who have previously suffered a brain injury, check out this page <http://www.bhsi.org/helm4inj.htm> .


Some people take their dogs along on bicycles. It is only natural to think about protecting your pet's head as well as your own. Cycle Touring with Joey <http://www.kangarooconnection.com/dogsonbicycles.html>  is a unique page that includes instructions for making a dog helmet. It begins with a styrofoam inner layer, so it might actually do some good in a crash.


Other Activities
Bicycle helmets show up now in an amazing number of activities, partly because there are more of them in consumers' hands and more in daily use than any other helmet. You may be asking if a bike helmet is adequate or necessary for bungi jumping, skydiving, snowmobiling, mountaineering, spelunking, jousting, construction work, car surfing, baseball, football, hockey, tricycles <http://www.bhsi.org/trike.htm>  or extreme tiddlywinks. The answer in most of those cases is that if there is a helmet designed specifically for the activity it usually will offer more protection for that activity, and is optimized for the type of hazard encountered in the activity, rather than the type of hazards encountered in bicycling. (Tricycling and roller skating are essentially the same activity as bicycling, so according to the Consumer Product Safety Commission <http://www.bhsi.org/up0603.htm>  bicycle helmets fit there.) Bicycle helmets are narrowly focused on providing protection for one single hard impact on a very hard, completely unyielding surface, while still minimizing weight and providing ventilation. The design tradeoffs that produce a good bicycle helmet may not produce the best helmet for your sport. It may seem ok to you to accept inadequate protection to try a new activity without buying a new helmet, but we would not recommend that. We recommend that you try renting the helmet you really need, or borrowing one from a friend. The "savings" from using a bike helmet could bring you a lifetime of sorrow and a brain that never works as well again. But if you have no real alternative, a bicycle helmet is likely to be better than a bare head. Even the family we heard from who had used theirs while sitting in their basement during a tornado warning might have gotten some help if objects had started blowing around



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