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#31
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Mostly OT/Head Injury and Death
On Mar 21, 12:33*am, "
wrote: On Mar 20, 10:45*pm, Bret wrote: On Mar 20, 2:57*pm, Frank Krygowski wrote: On Mar 20, 3:27*pm, Dan O wrote: On Mar 20, 9:06*am, Frank Krygowski wrote: In another article,http://www.msnbc.msn.com/id/29772691/*: "The National Ski Areas Association (NSAA) of the United States estimated 43 percent of skiers and snowboarders wore helmets in the 2007-08 season, against 25 percent five years earlier. ... "The increase in the use of helmets has not reduced the overall number of skiing fatalities," the NSAA said in a statement. "More than half of the people involved in fatal accidents last season were wearing helmets." So more than half the fatalities were in helmets. *But fewer than half wear them. *IOW, helmet use is _positively_ correlated with fatality. Risk compensation, anyone? People who intend to ski as fast as they possibly can are the ones more likely to wear a helmet. Would they ski quite as fast, or in quite as risky a manner, if they did not wear a helmet? Judging by those figures above, probably not. It's a chicken and egg question. Are people *wearing helmets because they're doing something dangerous or doing something dangerous because they're wearing helmets? You think it's the latter. The former makes much more sense to me but I don't know. You seem pretty sure of something that is unknowable without more information. Maybe you're the type *that just doesn't know how to day "I don't know". This argument about ski helmets and behavior also suffers from a lack of information. *We don't have any idea whether the ski fatalities discussed refer to only in-bounds or also out-of-bounds skiing, and whether they are strictly impact related accidents. Good point. The recent deaths on Mt. Hood resulted from helmetless boarders hitting skiers and from boarders going head first in to tree wells. Morbidity/mortality for skiers tends to be related to binding release problems (much of the time at low speeds), collisions with trees, collisions with each other and ordinary crashes. Injuries tend to be to legs, knees and shoulders. I know one guy who broke his neck. Head injury seems to be pretty rare based on my lift ride conversations. I think tree wells kill more people than collisions. On a bike, the main cause of getting hurt is crashing, but this is not always so in skiing. *Even if you only consider crashing and rule out avalanches, most ways of riding bike are pretty safe (excluding at night without lights, and some extreme downhill MTBing). *This is not so true of downhill skiing, where style can have a big effect on how likely you are to get hurt. I hesitate to get involved in a helmet thread, but IMO looking at fatalities is not a great way to measure whether helmets do anything. *Many fatalities (ski or bike) occur in impacts where only a helmet the size of a Green Bay Cheesehead could have helped. *IMO the effect of helmets is more likely to occasionally mitigate what would have been a bad concussion into a mild concussion, or a mild concussion into just a sore spot. Whether this is worth anything is up to the wearer. Helmets also help prevent scalp injury and focal injuries -- blunt object causing skull fracture. They do not reduce diffuse axonal injury or rotational injury where the brain sloshes around in the cranium. In fact, I had one doctor tell me that boxing helmets were a bad idea because they increase the target area and mass of the head and increase rotational injury. I also think that some of the early ski helmets that were big and bulky probably created a greater risk of neck injury -- which is more likely than head injury in the usual ski fall, IMO (because snow is usually pretty soft). The newer, lighter helmets are better, and I think they are a good idea for a crowded resort or for skiers who like the trees. -- Jay Beattie. |
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#32
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Mostly OT/Head Injury and Death
In article
, " wrote: On Mar 20, 8:07*pm, Tim McNamara wrote: " wrote: When I whacked the side of my head in a CX race I also got a bunch of gravel cuts (actually it was the second time I'd fallen on this short loose descent). We had a friend who was an EMT at the race and she cleaned up my cuts while making a lot of small talk with me, which later I realized was also a subtle way of doing a mental/head-injury evaluation. Good call, that was probably exactly what he was doing. *"Who's the President" is really not that great a question for assessing these things. *Also, since problems can develop over time, he was probably re-checking periodically. She. Missed that. I don't remember if she actually re-evaluated me, but since we were more or less in the same place over the next couple of hours and I was capable of holding a conversation with the rest of the hangers-on at the scorers' tent, effectively yes. If she was good at her job, I'm sure that she did exactly that. I had a bad headache and sat around at the scorer's tent with my friends who were running the race, occasionally helping a little, until all the races were done and we cleaned up, by which time I was just kinda sore and fine to drive home. *In retrospect it seems like an obvious concussion, but the word or thought never crossed my mind at the time. *This seems like a common reaction, much like the impulse to get back on your bike w/o realizing that you're dripping blood. That's a common reaction to an accident, especially in a race. *It's probably (1) a survival instinct and (2) the competitive spirit. Adrenaline does a lot of things. We have a theory on rbr about this. Even if you aren't injured, you tend to jump back in the race without fully checking the situation. I once fell in a CX race and twisted my bars. I straightened them and continued. Unfortunately, I was using a threaded stem drilled as the cable stop for a front canti brake, and it sank slightly in the process, so later in the lap I got to a tricky descent and discovered I had no front brakes. Fun! I think it's at least in part an extension of the survival instinct. Injured animals try very hard to conceal their injury, because showing it makes one a target for predators. In the case of sports, it shows your competitors that you're at a disadvantage. And in racing the thing we train ourselves to do is to go forward as fast as we can, so when we're standing by the race course not going forward it creates a sense of distress and urgency. And not only adrenaline (short term) but testosterone (long term), too. People who had higher levels of in utero testosterone exposure tend to be more aggressively competitive in personality and also to have some biological advantages (e.g., greater cardiac efficiency). An interesting cue to this is the ratio between the length of the index finger and ring finger (2D:4D ratio)- the longer the ring finger is compared to the index finger, the higher the in utero exposure to testosterone. UK researcher John Manning was able to predict the outcome of a foot race with remarkable accuracy by only looking at the 2D:4D ratio of the competitors; of the 10 competitors he accurately ranked 8 of them in this way. The two errors were runners who reversed their predicted finish order. There's a PBS show about this that was quite interesting. There was also a correlation between this ratio and aggressiveness in personalities in men, ability to connect emotionally to others, eye-hand coordination, etc. Once when the same gang was running a multi-lap MTB race, we had a guy go by the scorer's table with blood dripping from his forehead. My pal Rod had to run up the hill after him to force him to stop. He really wanted to continue and Rod had to be very firm to persuade him to stop and get bandaged up. This guy was ~50 and not a reckless youngster. I think there's probably no age limit on this sort of thing. Amusingly, another time we kept seeing this woman go by the start/finish with blood seemingly dripping down her inside leg. We were a little freaked out, but she didn't notice. It turned out to be a cherry flavored energy gel that she had tucked under her shorts hem and had burst somehow. Bleagh. And kind of humorous, as it turns out. Topic drift alert. The last 'cross race I promoted (in 2000) included one of the strongest of the women racers; she had given birth about 6 weeks earlier. She was off her game as far as racing went, but dang- she was out there. Chicks are tough! FWIW: http://en.wikipedia.org/wiki/Concussion http://www.mayoclinic.com/health/concussion/DS00320 Yeah, I looked this stuff up afterwards, and have now internalized the parts about evaluation and not losing consciousness, but you generally don't think of these things after you yourself get whacked. Nope, we really don't. I remember losing the front end on an off-camber straightaway in a 'cross race and going down hard, whacking my head and getting that sort of stinging dazed feeling in my sinuses. But what did I check first when I jumped up? The bike, not myself. Bill Nealy had some funny cartoons about this in his books on mountain biking. Avoiding concussions is a good thing. Yes, it certainly is. Fortunately, concussions in cycling are a rare thing unlike high-contact sports like boxing, rugby, football, etc. |
#33
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Mostly OT/Head Injury and Death
In article
, Bret wrote: On Mar 20, 2:57*pm, Frank Krygowski wrote: On Mar 20, 3:27*pm, Dan O wrote: On Mar 20, 9:06*am, Frank Krygowski wrote: In another article,http://www.msnbc.msn.com/id/29772691/*: "The National Ski Areas Association (NSAA) of the United States estimated 43 percent of skiers and snowboarders wore helmets in the 2007-08 season, against 25 percent five years earlier. ... "The increase in the use of helmets has not reduced the overall number of skiing fatalities," the NSAA said in a statement. "More than half of the people involved in fatal accidents last season were wearing helmets." So more than half the fatalities were in helmets. *But fewer than half wear them. *IOW, helmet use is _positively_ correlated with fatality. Risk compensation, anyone? People who intend to ski as fast as they possibly can are the ones more likely to wear a helmet. Would they ski quite as fast, or in quite as risky a manner, if they did not wear a helmet? Judging by those figures above, probably not. It's a chicken and egg question. Are people wearing helmets because they're doing something dangerous or doing something dangerous because they're wearing helmets? You think it's the latter. The former makes much more sense to me but I don't know. You seem pretty sure of something that is unknowable without more information. Maybe you're the type that just doesn't know how to day "I don't know". There is some chicken-and-eggness, but the numbers are quite interesting: fewer than half (43%) of skiers wear helmets and yet more than half of the fatalities were wearing helmets. Clearly a fatal skiing accident is more likely among helmet wearers than non-helmet wearers. The reasons for that are unclear. Risk compensation is certainly one possible explanation, e.g., that people are likelier to take risks on the assumption that they are protected by the helmet. Or, conversely, non-helmet wearers might ski more cautiously. There are other possible explanations. For example, novices might be more likely to wear helmets and more likely to suffer an accident through inexperience, underestimating dangers and lack of skills. The presence of a helmet could be completely extraneous to the cause of death- they'd have been killed either way. |
#34
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Mostly OT/Head Injury and Death
On Mar 21, 11:35*am, Tim McNamara wrote:
In article , *Bret wrote: It's a chicken and egg question. Are people *wearing helmets because they're doing something dangerous or doing something dangerous because they're wearing helmets? There is some chicken-and-eggness, but the numbers are quite interesting: *fewer than half (43%) of skiers wear helmets and yet more than half of the fatalities were wearing helmets. *Clearly a fatal skiing accident is more likely among helmet wearers than non-helmet wearers. The reasons for that are unclear. *Risk compensation is certainly one possible explanation, e.g., that people are likelier to take risks on the assumption that they are protected by the helmet. *Or, conversely, non-helmet wearers might ski more cautiously. There are other possible explanations. *For example, novices might be more likely to wear helmets and more likely to suffer an accident through inexperience, underestimating dangers and lack of skills. *The presence of a helmet could be completely extraneous to the cause of death- they'd have been killed either way. The other thing to remember is this: We're dealing with VERY small sample sizes. There are something like 40 deaths per year in US skiing. (There must be many millions of hours spent skiing.) Compare to about 40,000 deaths from motoring. This tells us two things: First, any calculations will be heavily influenced by random variation. (For example, if we get 45 skiing deaths next year, the helmeteers will yell "It's a 13 percent increase!!!!" But it will be just random variation.) Second, we're once again comparing infinitesmals. Even if your odds of dying while skiing helmeted are greater than your odds of dying while skiing unhelmeted, both odds are negligible. Professional handwringers and helmet lobbyists will never admit that, of course. Anti-disclaimer: I haven't downhill skied for about 40 years, so this kerfuffle's effect on skiing doesn't matter much to me. - Frank Krygowski |
#35
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Mostly OT/Head Injury and Death
On Mar 21, 3:33*am, "
wrote: I hesitate to get involved in a helmet thread, but IMO looking at fatalities is not a great way to measure whether helmets do anything. Well, when helmeteers start saying "Someone died, therefore everyone must wear helmets," looking at fatalities becomes very pertinent. Especially when doing so disproves the helmeteers point. Many fatalities (ski or bike) occur in impacts where only a helmet the size of a Green Bay Cheesehead could have helped. * Right. Which is why robust data shows they've never had a positive effect on fatalities. IMO the effect of helmets is more likely to occasionally mitigate what would have been a bad concussion into a mild concussion, or a mild concussion into just a sore spot. Or most likely, a minor scratch into no scratch at all. But to a helmeteer, every minor scratch is still a dreaded "head injury!!!!" .... because they can use the imprecise definition of "head injury" to terrify people, and to claim helmets prevent "up to 85% of head injuries." - Frank Krygowski |
#36
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Mostly OT/Head Injury and Death
In article
, " wrote: On Mar 20, 10:45*pm, Bret wrote: On Mar 20, 2:57*pm, Frank Krygowski wrote: On Mar 20, 3:27*pm, Dan O wrote: On Mar 20, 9:06*am, Frank Krygowski wrote: In another article,http://www.msnbc.msn.com/id/29772691/*: "The National Ski Areas Association (NSAA) of the United States estimated 43 percent of skiers and snowboarders wore helmets in the 2007-08 season, against 25 percent five years earlier. ... "The increase in the use of helmets has not reduced the overall number of skiing fatalities," the NSAA said in a statement. "More than half of the people involved in fatal accidents last season were wearing helmets." So more than half the fatalities were in helmets. *But fewer than half wear them. *IOW, helmet use is _positively_ correlated with fatality. Risk compensation, anyone? People who intend to ski as fast as they possibly can are the ones more likely to wear a helmet. Would they ski quite as fast, or in quite as risky a manner, if they did not wear a helmet? Judging by those figures above, probably not. It's a chicken and egg question. Are people *wearing helmets because they're doing something dangerous or doing something dangerous because they're wearing helmets? You think it's the latter. The former makes much more sense to me but I don't know. You seem pretty sure of something that is unknowable without more information. Maybe you're the type *that just doesn't know how to day "I don't know". This argument about ski helmets and behavior also suffers from a lack of information. We don't have any idea whether the ski fatalities discussed refer to only in-bounds or also out-of-bounds skiing, and whether they are strictly impact related accidents. On a bike, the main cause of getting hurt is crashing, but this is not always so in skiing. Even if you only consider crashing and rule out avalanches, most ways of riding bike are pretty safe (excluding at night without lights, and some extreme downhill MTBing). This is not so true of downhill skiing, where style can have a big effect on how likely you are to get hurt. I hesitate to get involved in a helmet thread, but IMO looking at fatalities is not a great way to measure whether helmets do anything. Many fatalities (ski or bike) occur in impacts where only a helmet the size of a Green Bay Cheesehead could have helped. IMO the effect of helmets is more likely to occasionally mitigate what would have been a bad concussion into a mild concussion, or a mild concussion into just a sore spot. Whether this is worth anything is up to the wearer. And now that you are involved, head injuries beyond abrasions are from stopping and sloshing, and from neck twists, neither of which are ameliorated by bicycle helmets. Even when a bicycle helmeted head strikes an object, the head decelerates. Helmets do nothing to prevent neck twists. -- Michael Press |
#37
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Mostly OT/Head Injury and Death
In article
, " wrote: On Mar 20, 9:26*am, Bret wrote: I once fell on my face while skiing at Aspen with enough violence that my plastic sunglasses broke. I thought I was ok at first but on the next chairlift ride I started developing vertigo and became nauseous. It was all I could do to side-slip down from the top of Ajax mountain and walk to our rented condo where I went straight to bed. The guy I had been skiing with kept skiing, but eventually he told some other people in our party (large company ski trip) what had happened and after a couple of hours they woke me up saying it was dangerous to sleep after a head injury. One of them was a nurse and she shined a flashlight in my eyes and said my pupils were dilated indicating a concussion. Since someone else in our party had already died that day of pneumonia in a different condo, they were really worried that the company ski trip's death rate would climb to an embarrassing level. So they wouldn't let me sleep and they wouldn't let me drink. I had to sit there with the worst headache of my life and listen to them talk. At one point one of them said that we should go out drinking because that's what Steve (the dead guy) would want them to do. We didn't. I was allowed to sleep for brief intervals overnight and only had a bad headache the next morning and so I went skiing. I don't remember why I didn't go to the hospital. I think the sleeping danger is not that sleeping will make it worse, but that it could mask a more serious loss of consciousness. If you'd gone to the hospital they would also have shined lights in your eyes and might have let you sleep at some point, but probably would wake you up every couple of hours to make sure they could still wake you up. When I whacked the side of my head in a CX race I also got a bunch of gravel cuts (actually it was the second time I'd fallen on this short loose descent). We had a friend who was an EMT at the race and she cleaned up my cuts while making a lot of small talk with me, which later I realized was also a subtle way of doing a mental/head-injury evaluation. I had a bad headache and sat around at the scorer's tent with my friends who were running the race, occasionally helping a little, until all the races were done and we cleaned up, by which time I was just kinda sore and fine to drive home. In retrospect it seems like an obvious concussion, but the word or thought never crossed my mind at the time. This seems like a common reaction, much like the impulse to get back on your bike w/o realizing that you're dripping blood. It is the nature of a concussion to impair thinking. A concussed person is the last to know. Send me in, Coach! -- Michael Press |
#38
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Mostly OT/Head Injury and Death
In article
, Bret wrote: On Mar 20, 9:45*pm, " wrote: On Mar 20, 8:07*pm, Tim McNamara wrote: " wrote: When I whacked the side of my head in a CX race I also got a bunch of gravel cuts (actually it was the second time I'd fallen on this short loose descent). We had a friend who was an EMT at the race and she cleaned up my cuts while making a lot of small talk with me, which later I realized was also a subtle way of doing a mental/head-injury evaluation. Good call, that was probably exactly what he was doing. *"Who's the President" is really not that great a question for assessing these things. *Also, since problems can develop over time, he was probably re-checking periodically. She. *I don't remember if she actually re-evaluated me, but since we were more or less in the same place over the next couple of hours and I was capable of holding a conversation with the rest of the hangers-on at the scorers' tent, effectively yes. I was once in that situation and was asked what day it was, I answered "They tell me it's Thursday". Apparently, I'd already been asked that question and been corrected. -- What day is it? -- Four. -- Michael Press |
#39
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Mostly OT/Head Injury and Death
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#40
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Mostly OT/Head Injury and Death
Paul M. Hobson wrote:
wrote: Ask skiers wearing helmets if they'd slow down without the helmets. I wouldn't slow down without my helmet. I only wear it b/c it's so convenient. It's strapped on and my goggles are strapped to it = no yard sale if I take a tumble. The only thing I worry about when I'm on the slopes is my left wrist, having spent the past 2 years recovering from two wrist surgeries. Can you wear an inline skating type wrist guard? -- Tom Sherman - 42.435731,-83.985007 LOCAL CACTUS EATS CYCLIST - datakoll |
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