The effect of bicycling helmets in preventing significant bicycle-related injuries in children

Clin J Sport Med. 1996 Apr;6(2):102-7. doi: 10.1097/00042752-199604000-00007.


Objective: To identify bicycle-related injuries in children and the effect of helmet use on injury patterns and prevention.

Design: A prospective cohort of injured children with case-control design looking at serious head injuries and helmet use.

Setting: A tertiary care childrens' hospital emergency room.

Patients: All patients presenting between April 1, 1991 and September 30, 1993, between the ages of 3 and 16 years, with bicycle-related injuries were included.

Intervention: The Childrens' Hospital Injury Research and Prevention Program (CHIRPP) Database was used. Standardized information collected on each child included age and sex of the child; nature, location, and time of accident/injury; whether any safety devices were being used at the time of the accident; and the attending physician's determination of the injury(s) and treatment rendered.

Main outcome measures: Injuries were categorized as major or minor, based upon a consensus of the authors, in a retrospective fashion.

Results: Separate bicycle accidents (n = 699) were recorded resulting in 856 injuries. Only 13.7% of the children were wearing helmets at the time of their accidents. Seventy-six serious head injuries were recorded. The risk of serious head injury was significantly greater when a helmet was not worn (chi 2 0.01 < p < 0.05) This represents an odds ratio of 3.12 [confidence interval (CI) = 95% 1.13-8.75]. There was no significant difference in terms of serious injuries overall comparing helmeted and nonhelmeted children (odds ratio = 1.11, 95% CI = 0.72-1.72).

Conclusions: Helmets afford a protective effect with respect to serious head injuries.

MeSH terms

  • Adolescent
  • Athletic Injuries / epidemiology
  • Bicycling / injuries*
  • Case-Control Studies
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Cohort Studies
  • Craniocerebral Trauma / epidemiology
  • Craniocerebral Trauma / etiology
  • Craniocerebral Trauma / prevention & control*
  • Head Protective Devices* / statistics & numerical data
  • Humans
  • Incidence
  • Injury Severity Score
  • Odds Ratio
  • Prospective Studies
  • Risk Factors