Summary of head injury risks, helmet benefits and areas for future injury reduction
| Injury risk | Helmet | Target future injury reduction | ||||
|---|---|---|---|---|---|---|
| All head injuries—as proportion of all injuries and/or rate | Concussion—as proportion of all injuries and/or rate | Severe TBI | Benefit | Evidence strength | ||
| Football (soccer)23–33 36 49–53 | 4–20% all levels | 3% all levels UEFA: 0.06/1000 h Boys high school: 0.59 per 1000 A–E (comp) College male 1.08 per 1000 A–E (comp) | Minimal risk | 63% reduction concussion | One population study, limited laboratory studies | Goal keepers |
| Rugby37 54–56 | 14–25% 8.1/1000 h (youth). 6.6/1000 h (pro) | 5–15% 6.9/1000 h (youth) 4.1/1000 h (pro) | Minimal risk | None. Positive trend with novel design | Multiple well-designed laborarory and population studies | Concussion |
| American Football51 53 57 | H/F 12% (high school) H/F 8% NCAA | 6.1% Boys high school: 1.55 per 1000 A–E (comp) College male 3.02 per 1000 A–E (comp) | Medium risk≈7 catastrophic head injuries per annum US College/High School | 74% decrease in fatalities and 84% reduction in serious head injury since 1976. | Multiple well-designed laboratory and population studies | Concussion |
| Projectile Sports48 51 53 | 3–25% cricket | Baseball–Boys high school: 0.05 per 1000 | Minimal risk | Not quantified | Laboratory studies, limited population studies | Facial injury in cricket |
| athletic exp (overall) | ||||||
| 11% baseball | 0.0043/1000 hrs (elite) | |||||
| Cricket: 1.5/1000 h | ||||||
| Equestrian58–62 | 19–48% | 15% | High risk | Not quantified, but large | Laboratory studies, limited population studies | Severe and fatal head injury |
| 0.1 to 4.2 per 1000 rides | ||||||
| Bicycle39 63–65 | General: 54 H/F/N ED pres per 100 000 population (with helmet) | Not quantified | Medium risk | 63–88% reduction HI | Multiple well-designed laboratory and population studies | Severe and fatal head injury and concussion |
| Road race: 0.59 per 100 000 km (with helmet) | ||||||
| Alpine Sports34 66–70 | 15–30% (all levels) | 9.6% skiers | High risk | 15–60% reduction HI | Multiple well-designed laboratory and population studies | Severe head injury in competitive snow sports |
| 14.7% snow boards (high school and college) | ||||||
| 2010 Winter Olympics—17% | 0.05/1000 h (elite) | Concussion in all snow sports | ||||
| 2010 Winter Olympics—17 per 1000 competitors | ||||||
NCAA, National Collegiate Athletic Association; TBI, traumatic brain injury.