Dec. 28, 2010 -- In a tragic Christmas Eve event that could generate new awareness around the importance of ski and snowboard safety, 5-year-old Elsie Johnson and 23-year-old Craig Shirley died after a collision on the slopes at Hogadon Ski Area in Casper, Wyo.
Elsie and her mother, Kelli, were stopped in the middle of a black diamond trail when Shirley came snowboarding down the path at a high speed and crashed into the two of them, Lt. Mark Sellers of the Natrona County Sheriff's Office said.
All three were taken to Wyoming Medical Center, where Shirley and Elsie were both pronounced dead. The hospital said Kelli Johnson was in stable condition.
Officials initially said that none of the victims of the accident wore helmets, but a Wyoming coroner later reported that Elsie was in fact wearing a helmet at the time of the crash.
Shirley's father told the Casper Star-Tribune that the trail was covered in ice.
Sellers said the circumstances of the collision are still under investigation.
"This is certainly a tragedy," National Ski Areas Association spokesman Troy Hawks said. "This really speaks to the idea that wearing a helmet is not the silver bullet defense, and skiing in control and being aware of others should be the first line of defense of safety on the slopes."
There are no state laws that require helmets or other safety gear when hitting the slopes, although some ski areas, like Aspen and Vail, require children who take a skiing or snowboarding lesson on the mountain to wear a helmet.
Recognizing the need for safer skiing and riding, the NSAA created a campaign in 2000 called Lids on Kids, a website designed to educate parents on the benefits and limitations of helmet use.
Since the campaign began, ski helmet use has increased each year. Right now, about 75 percent of skiers and riders 17 and under wear helmets when skiing, according to the NSAA. The goal of the campaign is to see 100 percent of kids wearing a helmet each time they ski or ride.
Hawks said that the number of ski fatalities and injuries have remained steady throughout the decade-long campaign. In the 2009-10 season, 25 skiers and 13 snowboarders died as a result of accidents in the United States.
To put that in perspective, 900 Americans died bicycling and 39,000 died in car accidents in 2008, according to the National Safety Counsel.
"People wearing a helmet can still have a fatal accident while skiing and riding, since there are other ways to incur a fatal injury," Hawks said. "I suppose [the steady numbers] speak to the inherent risks of the sport."
Dr. Stephen Leffler, medical director of the emergency department at Fletcher Allen Health Care at the University of Vermont, said he sees patients with varying degrees of ski injuries almost every day during ski season in his practice.
"From an emergency medicine perspective, I think helmets should be mandatory," he said. "In Vermont, we have a helmet law for people riding motorcycles. The ski helmet would not prevent every serious injury, but it would protect from a lot of them."
Dr. Bruce Bonanno, an emergency physician at Meadowland Hospital in Secaucus, N.J., said any kind of safety is important to instill in a child at an early age.
"Helmets are like seat belts," said Bonanno. "Parents get their kids to wear them, and then the parents start wearing them to set a good example for their kids."
Luckily for ski safety advocates, many kids and adults now happily put that helmet on their heads. Ten years ago, only a small fraction of recreational skiers wore helmets. The headgear was mostly saved for athletes who participated in ski racing.
But with new designs and lighter helmet options, more people are willing to wear helmets.
And then of course, there are the pros who influence trends.
Shaun White, an Olympic gold medalist snowboarder, is often seen on TV and in advertisements with a helmet on his head.
"Shaun White is an icon in the ski and boarding world," Hawk said. "Like any sport, people want to wear what the pros are wearing."
But as safe, and now as cool, as helmets are, they should still be the second line of defense, Hawks said. The NSAA states that it is each skier or snowboarder's behavior that has much or more to do with the safety of sports than any piece of equipment.
"Skiing in a controlled and responsible manner is first to ensure safety on slopes," he said.
But, Leffler said that while the loss of two people to a ski accident is tragic, fatal accidents should not discourage parents and kids from skiing and snowboarding.
"As long as kids are wearing the right equipment and are supervised properly, skiing is still a great way to spend time together outside," he said.
Hawks said it's great for children to be introduced to the sports at an early age. But, since there is no minimum age requirement for skiers and snowboarders, it's ultimately up to the parents to decide when a child is ready to hit the slopes.
"The first lesson could be right in your backyard, or maybe the kid doesn't even get the skis on on the first day," Hawks said. "But statistics show that skiing and riding are relatively safe sports, and it promotes kids to get outside during the winter and exercise."
On the NSAA website, it states: Skiing and snowboarding have always had some risks, but they also have an excellent safety record. Your chances of being seriously injured or dying on the slopes are less than one in a million, according to the NSAA. Each skier or snowboarder's behavior has as much or more to do with the safety of the sports as does any piece of equipment.
"The ski accident is tragic, and whenever this happens, it shakes the entire industry," Hawks said Hawks. "But, in our country where child obesity is a growing issue, we don't want to ever discourage kids from enjoying outdoor sports."