The death of Kameron Steinhoff, a well-known Punahou School and Hawaii Pacific University basketball player, of head injuries following a skateboard accident this week underscores the need for people participating in "high-risk activity" to take precautions such as wearing a helmet, an island trauma surgeon said.

Steinhoff, 21, died Tuesday night from head injuries he sustained while skateboarding that day.

Steinhoff was not wearing a helmet when he was injured early Tuesday morning while skating on a street in Kaneohe, a family friend said. The Medical Examiner’s Office said drugs and alcohol were not factors in the accident.

The number of skateboard-related injuries serious enough to require treatment in a hospital has risen in Hawaii, to 792 in 2010 from 428 in 2003, state Health Department statistics show.

Over the past five years, an average of 882 people annually — predominantly boys and men — were treated in a hospital for skateboard injuries in Hawaii, said Dan Galanis, epidemiologist with the Health Department’s injury, prevention and control program.

Between 1999 and 2008, 12 people in Hawaii died of injuries in skateboarding accidents, the department reported. All were male skaters between the ages of 17 and 34.Eight died on Oahu, and two each in Hawaii and Kauai counties. The last death before Steinhoff’s was in 2008.

One of the victims was Castle High School student Patrick Kapahu, a football player for the Knights who died in October 2006 after suffering a severe head injury in a skateboarding accident. It is not known whether he was wearing a helmet.

Galanis said that of 93 people on the trauma registry at the Queen’s Medical Center for skateboard injuries in the five-year period ending in 2010, only 7.8 percent were wearing a helmet when they were injured.

"Nearly three-fourths had traumatic brain injury," Galanis said.

Dr. Caesar Ursic, medical director of trauma at Queen’s, said yesterday that skateboarding is a high-risk activity, like mountain biking or riding a motorcycle.

Proper precautions such as wearing a helmet need to be taken when participating in these activities, said Ursic, who also is an assistant professor of surgery at the University of Hawaii medical school.

"The head is the most unforgiving organ because the brain makes us who we are. It provides us with our personality and our awareness," Ursic said. "Brain injuries are difficult to come back from. Once you have a severe brain injury, odds are you are never going to be the same."

In 1979 the U.S. Consumer Product Safety Commission issued a staff report that estimated that 140,000 skateboard-related injuries were treated in U.S. hospital emergency rooms in 1977. A year later the number of injuries dropped 38 percent, to an estimated 87,000.