Statement on general helmet use
The American College of Surgeons Committee on Trauma (ACS COT), through its Subcommittee
on Injury Prevention and Control, prepared the following statement to educate surgeons
about the effectiveness of general helmet usage in preventing severe traumatic brain injury
and to encourage surgeons to support appropriate legislation in their respective states. The
ACS Board of Regents approved the statement at its June 3–4 meeting in Chicago, IL.
Helmet use is widely accepted as an effective means of preventing se- vere traumatic brain injury (TBI) in bicyclists and motorcycle riders.
Previous ACS statements on helmet use are as follows:
•“Statement on bicycle safety and the promotion of bicycle helmet use,” available at facs.org/about-acs/statements/75-bicycle-safety
•“Statement in support of motorcycle helmet laws,” available at facs.org/
In addition, there is an increasing appreciation of the significance of
concussive injuries and the long-term effects of repetitive trauma to the
head. In light of these trends, helmet usage in other recreational activities has become increasingly popular. The ACS supports the following:
• Traditional helmets are designed and tested to protect against severe TBI
using primarily linear acceleration models. This strategy may not be the
most effective for protection against concussive and repetitive injuries, which
have a rotational component. 1, 2 We strongly support research in helmet
design to specifically evaluate performance in protection against concussion and repetitive injuries.
•Design of head protection should be targeted to the specific activity, age,
gender, and level of competition.
•Sufficient data are available to support helmet usage for participants in alpine
sports (skiing and snowing boarding). 3 Although some data would suggest
an increase in risk-taking behavior with helmet usage, the benefit of helmet
protection remains strong. 4
• There is strong support for wearing a motorcycle or motorsports helmet
when riding all-terrain vehicles. 5 ♦
The COT finds that, at present, insufficient evidence is available to make any
statement regarding helmet usage in specific sports, such as lacrosse and soccer.
1. Hoshizaki TB, Post A, Oeur RA,
Brien SE. Current and future
concepts in helmet and sports
injury prevention. Neurosurgery.
2014; 10( 75);Supplement 4:S136-S148.
2. McIntosh AS, Andersen TE, Bahr
R, et al. Sports helmets now and
in the future. Br J Sports Med.
2011; 45( 16):1258-1265.
3. Hume PA, Lorimer AV, Griffiths
PC, Carlson I, Lamont M.
Recreational snow-sports injury
risk factors and countermeasures:
A meta-analysis review and Haddon
matrix evaluation. Sports Med.
2015; 45( 8):1175-1190.
4. Thomson CJ, Carlson SR. Increased
patterns of risky behaviours among
helmet wearers in skiing and
snowboarding. Accid Anal Prev.
2015; 75( 2):179-183.
5. U.S. Consumer Product Safety
Commission. All-terrain vehicle
safety. Available at: www.cpsc.gov/
July 15, 2016.