Children who ice skate are at risk for head injuries and should be required to wear a helmet while skating, according to a new report.

“Children who ice skate for recreation should be afforded the same head protection as children participating in other skating activities,” lead author Jennifer McGeehan of Columbus Children’s Hospital in Ohio told Health News Online. “In fact, our study suggests that ice skaters are in greater need of head protection.”

Compared to children injured in other skating activities, such as in-line skating, rollerskating and skateboarding, children who hurt themselves while ice-skating were more likely to experience a Head injury, McGeehan and her colleagues report in the July issue of the journal Pediatrics.

“Ice is no softer on a child’s skull than concrete or asphalt,” McGeehan commented.

Because of the risk of injury, the American Academy of Pediatrics recommends that children who use skateboards or in-line skates should wear protective gear, including helmets, wrist guards and knee and elbow pads.

Currently there are no formal recommendations on whether children should wear protective gear while ice-skating, however.

The Ohio researchers compared injuries that occur when children participate in several types of skating by reviewing the medical records of more than 400 children who were treated in the emergency room after hurting themselves while ice skating, rollerskating, in-line skating or skateboarding.

Not surprisingly, more than 90 percent of injuries involved a fall. Less than a quarter of children were wearing any sort of protective gear when they hurt themselves.

About 20 percent of children who hurt themselves while ice-skating experienced a Head injury, most often a cut on the head. The proportion of injuries that involved the head was significantly higher among ice skaters than among other types of skaters.

Among rollerskaters and in-line skaters, injuries to the arms were most common, particularly the forearms. Arm injuries may be more common because rollerskaters and in-line skaters may try to stop their fall with their arms, the researchers suggest.

In contrast, ice skaters and skateboarders may be more likely to fall backward or sideways, according to the report. This makes it harder to use the arms to stop a fall, which could lead to more injuries to the head.

McGeehan and her colleagues conclude that children should be required to wear a helmet while ice-skating. Since most children ice skate at indoor rinks, helmet use should become mandatory for children at indoor rinks, the authors advise.

SOURCE: Pediatrics, July 2004.