BACKGROUND: The research literature was systematically reviewed and results were summarized from studies assessing bicycle helmet effectiveness to mitigate head, serious head, face, neck and fatal head injury in a crash or fall. METHODS: Four electronic databases (MEDLINE, EMBASE, COMPENDEX and SCOPUS) were searched for relevant, peer-reviewed articles in English. Included studies reported medically diagnosed head, face and neck injuries where helmet use was known. Non-approved helmets were excluded where possible. Summary odds ratios (OR) were obtained using multivariate meta-regression models stratified by injury type and severity. Time trends and publication bias were assessed. RESULTS: A total of 43 studies met inclusion criteria and 40 studies were included in the meta-analysis with data from over 64 000 injured cyclists. For cyclists involved in a crash or fall, helmet use was associated with odds reductions for head [OR = 0.49, 95% confidence interval (CI): 0.42-0.57), serious head (OR = 0.31, 95% CI: 0.25-0.37), face (OR = 0.67, 95% CI: 0.56-0.81) and fatal head injury (OR = 0.35, 95% CI: 0.14-0.88). No clear evidence of an association between helmet use and neck injury was found (OR = 0.96, 95% CI: 0.74-1.25). There was no evidence of time trends or publication bias. CONCLUSIONS: Bicycle helmet use was associated with reduced odds of head injury, serious head injury, facial injury and fatal head injury. The reduction was greater for serious or fatal head injury. Neck injury was rare and not associated with helmet use. These results support the use of strategies to increase the uptake of bicycle helmets as part of a comprehensive cycling safety plan.© The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association. Language: en

Bicycle injuries and helmet use: a systematic review and meta-analysis.

Objective. To determine why people do or do not wear helmets while bicycling. Methods. A survey was conducted from August through October 1999. Two survey areas were chosen for this study: local public schools and paved bicycle trails. For the school arm of the study, 3 public elementary, middle, and high schools were selected from 3 different regions of Rochester, Minnesota, for participation in the study. For the bicycle arm of the study, 3 paved trails located in southeastern Minnesota were selected. A total of 2970 surveys were distributed to the public school system, and 463 surveys were collected from bicyclists on the paved bicycle trails. The survey population was split into 3 age categories for analysis: child (7–10), adolescent (11–19), and adult (older than 19). Results. Of the 2970 surveys distributed to Rochester public schools, 2039 (69%) were returned for analysis. Seventy-eight of the surveys that were completed in the public school system were discarded for the following reasons: age The age groups with the highest rate of bicycle helmet use were 50 to 59 years (62%) and older than 59 years (70%). The age groups with the lowest rate of bicycle helmet use were 11 to 19 years (31%) and 30 to 39 years (30%). The most common reasons given for not wearing a bicycle helmet were “uncomfortable,” “annoying,” “it9s hot,” “don9t need it,” and “don9t own one.” Bicycle helmet use was significantly influenced by peer helmet use in all 3 age groups. Children also were more likely to wear a bicycle helmet when their parents wore bicycle helmets. A majority of respondents in all 3 age groups indicated that bicycle helmets provided either “moderate” or “great” protection from head injury, although significantly more adults (65.9%) than adolescents (43.9%) believed that the protection afforded by bicycle helmets was “great.” Despite this belief, a majority of adolescents and adults indicated that there was only a “slight risk” of head injury when bicycling without a helmet. Participants in all 3 categories were more likely to wear a bicycle helmet when they indicated either that there was a “great risk” of head injury when bicycling without a helmet or that helmets provided “great protection” from head injury. Adolescents and adults who believed that bicycling without a helmet put one at “great risk” for head injury also were more likely to indicate that helmets provided “great protection” from head injury. Conclusions. The prevalence of bicycle helmet use remains low despite research indicating the high level of head injury risk when bicycling without a helmet and the significant protection afforded by bicycle helmets. With the information provided by this survey, a well-designed intervention to increase the use of bicycle helmets can be implemented. Suggestions for a campaign to promote an increase in bicycle helmet use include focusing efforts on males and females between 11 and 19 years and 30 and 39 years of age; educating the public on new bicycle helmet designs that address comfort, ventilation, and fashion; educating adolescents on the significant protection from head injury afforded by bicycle helmets; and educating the public on the risk and severity of head injury associated with bicycling without a helmet. The influence of parents and peers on bicycle helmet use may be targeted through education and statements such as, “If you wear a bicycle helmet, you are not only protecting yourself, you are also helping to protect your friends and/or children.” bicycle, helmet, injury, accident, prevention.

https://pediatrics.aappublications.org/content/pediatrics/108/1/e4.full.pdf

Barriers to Bicycle Helmet Use

Bicycle riding is a popular form of recreation among persons of all ages, and related injuries cause significant morbidity and mortality Most injuries occur in males and are associated with riding at high speed; most serious injuries and fatalities result from collisions with motor vehicles Although superficial soft tissue injuries and musculoskeletal trauma are the most common injuries, head injuries are responsible for most fatalities and long-term disabilities Overuse injuries may contribute to a variety of musculoskeletal complaints, compression neuropathies, perineal and genital complaints Physicians treating such patients should consider medical factors, as well as suggest adjusting various components of the bicycle, such as the seat height and handlebars Encouraging bicycle riders to wear helmets is key to preventing injuries; protective clothing and equipment, and general safety advice also may offer some protection

Bicycle-related injuries.

The objective of this study is to describe the epidemiology of bicycle-related injuries among children and adolescents 18 years and younger on a national level. This is a retrospective analysis of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients 18 years and younger who were seen in emergency departments (EDs) between January 1, 1990, and December 31, 2005, for injuries received while operating a bicycle. During the 16-year study period, there were an estimated 6 228 700 individuals 18 years and younger treated in US EDs for bicycle-related injuries. Children with head injuries were more than 3 (relative risk, 3.63) times as likely to require hospitalization and were almost 6 (relative risk, 5.77) times more likely to have their injuries result in death. The large number of annual bicycle related-injuries is evidence that prevention of these injuries should remain an important area of bicycle safety research and practice.

/pdf/bicycle-related-injuries-among-children-and-adolescents-in-182z4mpqzd.pdf

Bicycle-Related Injuries Among Children and Adolescents in the United States

https://www.wemjournal.org/article/S1080-6032(02)70583-8/pdf

Mechanisms of injury in competitive off-road bicycling.

BACKGROUND: Bicycle injury data from local communities are important for developing injury prevention and control programs. This study represents the efforts of one community trauma center to describe bicycle injuries. METHODS: We conducted a retrospective analysis of bicycle injury data from hospital charts, emergency medical services reports, and medical examiner reports. The review encompassed a 4-year period. The study sample included 211 trauma alert patients, ages 1 through 15 years, who were treated for bicycle-related injuries at our level II pediatric trauma center. RESULTS: Bicycle injuries accounted for 18% of all pediatric trauma alert patients. The mean age of injured children was 10 years, and 79% were males. Bicycle-motor vehicle collisions caused 84% of injuries. Only 3 children (1.4%) wore bicycle helmets. Resulting injuries included external wounds (86%), head injuries (47%), fractures (29%), and internal organs (9%). Six children died. CONCLUSIONS: Bicycle injuries are a significant cause of mortality and morbidity for children in our community. Use of safety helmets by child bicyclists is inadequate. The data from this study can be used as a baseline in testing the effectiveness of local and state interventions, including new legislation mandating helmet use by children in our state.

Profile of Pediatric Bicycle Injuries

Demographic and outcome variables of children seen in a community hospital Level II pediatric trauma center are described and patterns of injury classified according to different mechanisms. Records were reviewed retrospectively of 184 patients seen over a one year period, 63% were male and the peak age group was 13-15 years (31%). Descriptive and nonparametric statistics were used to analyze the data. Mechanisms of injury included pedestrian vs auto (27%), falls (23%), motor vehicle occupants (18%), bicycle vs auto (17%), sports injuries (3%), motorcycle crashes (2%), gunshot wounds (2%), and stabbings (2%). Penetrating injuries had higher average trauma scores but blunt injuries were associated with higher mortality. Demographics and mechanisms of injury were similar to national studies. Emphasis on the use of pediatric trauma scores by emergency medical personnel is suggested to decrease the over-triage rate. The frequency of bicycle injuries and lack of helmet use prompted a major helmet promotion campaign.

S. Puranik

Papers

Profile of Pediatric Bicycle Injuries

Experiences in the first year. Community hospital pediatric trauma center