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Previous research has shown that bicycle helmet use among older children and adolescents continues to be low. This study determined middle school students' knowledge, attitudes, beliefs, and behaviors related to bicycle helmet use. Six middle schools in Hillsborough County, Fla., served as the research settings. A pretested survey instrument was administered to students. Overall, 3,333 sixth and seventh graders responded. Results showed that most children owned a bicycle, 38.1% owned a helmet, but only 15.8% wore a helmet the last time they rode a bike. Many students (49.7%) did not know or did not believe there was a bicycle helmet law in Florida. Predictors of helmet use were intention to use a helmet the next time one rides a bike, having a helmet, siblings' use of helmets, and friends' use of helmets. (J Sch Health. 1998;68(8):325-328), Every year in the United States, approximately 900 bicyclists are killed.[1] Moreover, bicycle-related injuries account for 23,000 hospital admissions and more than 500,000 emergency room visits.[1] Most bicycle-related injuries treated [...]

Bicycle helmet giveaway programs may increase use of helmets, but the increase may be only temporary. The Texas program increased used by 7th and 8th grade students from 3% to 38% by the end of the school year, but during the summer, use fell to 5%. This was despite the fact that 96% of the students agreed that helmet use improved safety, and 68% said they thought helmets should be worn whenever riding a bicycle. All spot observations of students showed 0% helmet use., Objective. To determine the effect of a bicycle helmet giveaway program on helmet use among children. Methods. In 1995, a bicycle helmet giveaway program was conducted in two rural towns in Texas. Helmets were given to all 403 school children in kindergarten through grade 8. Helmet education, a bicycle rodeo, and incentives to increase helmet use were part of the program. Observations of helmet use were made before the helmet program began and after the program at several intervals throughout the school year and during the summer. A self-reported survey questionnaire was administered to children in grades 4 through 8 before the helmet program began and at several intervals during the school year to determine their attitudes about helmet use, safety perceptions, and peer pressure. A questionnaire also was administered to the parents of these children to determine attitudes and bicycle helmet use among parents. Results. Helmet use increased from 3% before the giveaway to 38% at the end of the school year, 7 months later. However, during the subsequent summer, helmet use decreased to 5%. Helmet use among 7th- and 8th-grade students was 0% at all observations periods after the giveaway. Even though 96% of all students thought that helmet use increased riding safety and 68% thought helmets should be worn at all times when riding, only 25% thought that their friends would approve of helmet use. Most parents also believed that helmets increased riding safety and should be worn, but only 23% reported always wearing one when riding a bicycle. Conclusions. Bicycle helmet giveaway programs can increase helmet use temporarily, but they may not be sufficient to sustain it. This program was not effective among 7th- and 8th-grade students. Pediatrics 1998;101: 578-582; bicycles, helmets, children., ABBREVIATION. K-8, kindergarten through grade 8. Approximately 66.9 million Americans rode bicycles in 1991, and approximately half were [is less than] 21 years old.[1] Although bicycle riding might seem harmless, [...]

Bicycle helmets can substantially reduce the risk of head and brain injury during accidents. Researchers analyzed the medical records of 3,390 injured bicyclists who were treated at 7 Seattle emergency departments. Half of those who suffered non-head injuries were wearing helmets compared to only 29% of those who sustained head injuries. Helmets reduced the risk of head and brain injury by approximately 65% to 70%. Hard-shell, thin-shell and no-shell helmets were equally protective. Both children and adults benefitted from the protection offered by a bicycle helmet., Objectives.--To examine the protective effectiveness of bicycle helmets in 4 different age groups of bicyclists, in crashes involving motor vehicles, and by helmet type and certification standards. Research Design.--Prospective case-control study Setting.--Emergency departments (EDs) in 7 Seattle, Wash, area hospitals between March 1, 1992, and August 31, 1994. Participants.--- Case subjects were all bicyclists treated in EDs for head injuries, all who were hospitalized, and all who died at the scene. Control subjects were bicyclists treated for nonhead injuries. Main Results.--There were 3390 injured bicyclists in the study; 29% of cases and 56% of controls were helmeted. Risk of head injury in helmeted vs unhelmeted cyclists adjusted for age and motor vehicle involvement indicate a protective effect of 69% to 74% for helmets for 3 different categories of head injury: any head injury (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.26-0.37), brain injury (OR, 0.35; 95% CI, 0.25-0.48), or severe brain injury (OR, 0.26; 95% CI, 0.14-0,48). Adjusted ORs for each of 4 age groups ( Conclusions.--Bicycle helmets, regardless of type, provide substantial protection against head injuries for cyclists of all ages involved in crashes, including crashes involving motor vehicles. JAMA. 1996;276:1968-1973

Cyclists are more likely to use helmets when they perceive that the risk they face is great enough to demand it. The perception of risk and its degree depends on several variables, namely, the distance that has to be travelled, the length of time the travel will take, the type of terrain and bicycle type. Risk perception is also informed by age and sex of the cyclist. Females and older people are more apt to take safety measures, while males and younger people take less precautionary measures.

Few children appear to be using bike helmets. Researchers analyzed data from a 1991 nationwide household survey that included interviews with 399 parents or guardians of children younger than 15 regarding bicycle and helmet use. Although one-quarter of the children had helmets, only 15% of the overall group wore helmets all or most of the time. Almost all children wearing helmets did so because of the insistence of family members for safety reasons, but 12% of respondents cited legal requirements as a factor. Helmet use decreased with age. Helmet use was four times more likely in households where someone had attended college and 4.5 times more likely when the child had had an injury needing a doctor's care. Children were more likely to wear helmets when riding in traffic, on long rides, and when reminded. The most common reason for not wearing one was that the child forgot., Objective. To describe and evaluate the helmet use patterns of children younger than 15 years of age in the United States. Methods. A national telephone survey of bicycle riders was conducted by means of the Mitofsky-Waksberg method of random-digit dialing, a survey method intended to give all telephone numbers in the continental United States an equal probability of selection. Based on information collected in the survey, a logistic regression model was used to determine and quantify the factors associated with helmet use. Results. Information was collected on the bicycle and helmet use patterns of a national sample of 399 children younger than 15 years of age who rode bicycles during the year preceding the survey. This sample projects to the approximately 26.4 million children who are estimated to have ridden bicycles in 1991. About 26% of all child riders owned or had the use of bicycle helmets, and about 15% were reported to have used their helmets all or more than half of the time when riding. Information is provided on the reasons the children did or did not wear helmets. The logistic regression analysis shows that helmet use by children is systematically related to their personal characteristics e& age and whether they had previously had bicycle-related accidents requiring medical attention), riding patterns (eg, riding surface), and household demographic characteristics eg, geographic location and whether household members had attended college). Conclusions. Helmet use rates among children remain low. Less than one fifth of the children who rode bicycles wore helmets all or more than half of the time in 1991. However, based on comparisons with earlier studies, the results of the analysis suggest that helmet use rates have been rising. Pediatrics 1996,97:166-173; bicycle helmets, survey data, logit analysis, children., ABBREVIATIONS. CPSC, Consumer Product Safety Commission; MSA, metropolitan statistical area; OR, odds ratio. Based on estimates from the US Consumer Product Safety Commission (CPSC), there are more than 0.5 million [...]

Injuries are a leading cause of morbidity and mortality in children and youth in the United States[1]. Of growing concern are injuries that occur during participation in organized sports[2]. One […]

The use of motorcycle helmets appears to play an important role in reducing fatalities and the frequency and severity of head and facial injuries. Researchers analyzed data from 386 hospitalizations after motorcycle accidents that occurred in Washington State in 1989, the year before a motorcycle helmet law was passed. Motorcyclists not wearing a helmet were three times more likely to have a head injury, four times more likely to have a serious head injury, and nearly eight times more likely to have a facial injury. By contrast, injuries to areas not protected by a helmet occurred at similar rates among helmeted and unhelmeted motorcyclists. Unhelmeted motorcyclists were over 60% more likely to die in the accident. Unhelmeted motorcyclists averaged 2.6 days longer in the hospital and were twice as likely to require readmission to a hospital. They were also more likely to require care at a convalescent hospital or rehabilitative care.

A program to encourage bicycle helmet use among school children appears to have worked. Observers recorded helmet use among children ages 5 to 12 at different sites in two similar Canadian communities, one of which had implemented a bicycle helmet use campaign designed to increase use in this age group. Before the program began, 1.3% of children wore bicycle helmets. Between 1990 and 1993 helmet use increased in both communities. However, in the community with the campaign, observed helmet use increased to 33% of children observed in 1993 compared with less than 15% of children observed in the comparison community. Helmets were more likely to be worn by girls, younger children, and children riding on bike paths and school roads as opposed to neighborhood streets. Children observed in middle- to upper-class communities were three times more likely to be wearing helmets.

Subsidizing the purchase of bicycle helmets among low-income families may not increase overall helmet use. Researchers offered the sale of bicycle helmets at a reduced rate of $10 to encourage helmet usage among children of low-income families in Toronto, Canada. Children aged from 5 to 12 years old were observed during 1,800 cycling hours. Over a period of three years, general helmet use increased from 3.4 percent to 28% among low-income and high-income residential areas. However, children in the subsidized low-income area were seen using bicycle helmets at a similarly low rate of 18% compared to other low-income areas without such subsidies. Although helmet sales and ownership increased substantially, the availability of less expensive helmets failed to encourage more active use among low-income children. Alternative methods need to focus on changing the behavior among a higher percentage of children. Upcoming legislation may also increase the rate of wearing bicycle helmets., Objective. We have previously shown that an educational program was not effective in increasing bicycle helmet use in children of low-income families. The objective of this study was to evaluate a combined educational and helmet subsidy program in the same population, while controlling for secular trends. The secondary objective was to complete a third year of surveying children's bicycle hemet use throughout the study community. Design. A prospective, controlled, before-and-after study. Subjects. Bicycling children 5 to 14 years of age from areas of low average family income. Setting. A defined geographic community within a large urban Canadian city. Intervention. In April 1992, students in three schools located in the area of lowest average family income were offered $10 helmets and an educational program; three other low-income areas served as control areas. Main Outcome Measure. Helmet use was determined by direct observation of more than 1800 bicycling children. Results. Nine hundred ten helmets were sold to a school population of 1415 (64%). Reported helmet ownership increased from 10% to 47%. However, observed helmet use in the low-income intervention area was no different from the rate in the three low-income control areas (18% versus 19%). There was no difference in the trend in helmet use during the period of 1990 through 1992 in the intervention area (4% to 18%) compared with the control areas (3% to 19%). Helmet use rates from all income areas have increased from 3.4% in 1990, to 16% in 1991, to 28% in 1992. In 1992, helmet use in the high-income areas was 48% and in the low-income areas was 20%. Conclusions. There has been a trend toward increasing helmet use in all income areas during the 3-year period. Despite encouraging helmet sales and increases in reported helmet ownership, the results of the observational study do not support the efficacy of a helmet subsidy program in increasing helmet use in children residing in areas of low average family income. Strategies to increase helmet use in children of low average family income remain a priority. Pediatrics 1995; 96:283-287; bicycle helmet, low-income families, bicycle-related head injury; subsidy program., Bicycle-related trauma accounts for at least 10% of all injury deaths in school-age children, 5 to 14 years of age.(1) In the province of Ontario, bicycle-related injuries account for 15% [...]

BICYCLE-RELATED HEAD INJURIES are a serious public health problem in the United States. Each year, more than 280 cyclists younger than age 17 years are fatally injured, and more than […]

Helmets may prevent some injuries that result from motorcycle or bicycle accidents. Injuries are the third leading cause of death in the U.S. according to age-adjusted data. Frontal impacts are the most common type of motorcycle accident which often result in injury to the head, spine, internal organs, or the extremities. Helmets distribute the force of impact and cushion the head. Studies indicate that motorcycle helmets reduce the death rate by 28%. States that have a helmet law have fewer motorcycle crashes that result in serious head injury. Between 1984 and 1988, 2,985 bicyclists died in the U.S. Head injuries were involved in 62% of these fatalities. Two studies report that helmets reduce bicyclists' risk of head injury by 63% to 85%. Community-wide bicycle safety campaigns and helmet laws have increased helmet use and reduced the rate of head injury. Parents and families have a responsibility to educate children about safe bicycle riding.

Study of cerebral concussion frequency among college football teams using helmets reveals that continuous epidemiological studies on critical sports safety equipment must be performed. The study of ten models of helmets reveal that Riddell M155 and Bike Air Power have significantly lower and higher expected concussion frequencies, respectively. The immediate return of a player following non-loss-of-consciousness injuries may have to be curbed.

BICYCLE-ASSOCIATED injuries account for an estimated 600,000 emergency room visits yearly in the United States and an estimated 50,000 emergency room visits yearly in Canada (1-4) with approximately 0.2 percent […]

A study has demonstrated that removal of football helmets in cases of suspected cervical spine injuries is dangerous. Management of cardiorespiratory emergencies is possible even when the helmet is not removed. Data should be given to sports medicine professionals to start an Emergency Medical Services (EMS) or Sports Medicine emergency action plan. EMS rules, which insist on helmet removal, need to be changed in the light of these findings.

Calls for communitywide interventions to promote bicycle safety helmet usage among children abound, yet little is known about the factors that cause parents to purchase helmets and consistently insist on their usage. The health belief model proposes that cues to action are important influences on self-protective behaviors. A communitywide field study was conducted to test the effectiveness of six different kinds of cues to action. Parents of children between the ages of 5 and 18 were selected via random-digit-dialing techniques for participation in the study. The results indicated that cues to action affected perceptions of threat but were unrelated to attitudes, intentions, or behaviors. However, perceptions of threat were found to be important influences on bicycle helmet attitudes, intentions, and behaviors.

Objectives. The passage of a mandatory bicycle helmet law for children in Howard County, Maryland, provided an opportunity to compare legislation and education as strategies to increase helmet use. Methods. In 1991, a survey was mailed to fourth-, seventh-, and ninth-grade students attending a stratified sample of public schools in Howard County and in two similar suburban/rural counties without helmet laws. Results. Of 7217 students surveyed, 3494 responded (48.4%). Self-reported helmet use in Howard County rose from 11% to 37% after the law and accompanying educational campaign went into effect. Helmet changed from 8% to 13% in Montgomery County, where educational efforts were undertaken, and from 7% to 11% in Baltimore County, where helmet promotion activities were minimal. Predictors of helmet use included having friends who wore helmets, believing helmet laws are good, being in fourth grade, living in Howard County, and using seat-belts regularly. Conclusions. Legislation combined with education appears to increase bicycle helmet use substantially more than does education alone. The Howard County law may be considered successful model of a strategy to increase children's helmet use. (Am J Public Health. 1993;83:667-674), Combining education with legislation is the most effective means of encouraging bicycle safety helmet use among children. Residents of three contiguous counties in Maryland were surveyed on bicycle helmet use. Howard County was the only one with a mandatory helmet law for children under 16. Implementation of the law was combined with an educational safety program to encourage helmet use. In an adjacent county, Montgomery, there was no legislation, but there was a comprehensive bicycle safety education program incorporated into the school curriculum and involving local media. The third county, Baltimore, had no helmet legislation and no safety education program. Children in grades four, seven and nine were mailed questionnaires that were to be filled out anonymously. Children's helmet use rose from 11% to 37% after the implementation of the law and bicycle safety campaign in Howard County. Nonetheless, only a small percentage of the respondents indicated that they regularly wore safety helmets.

A school-based, bicycle helmet promotion program may increase helmet use among children from high-income families but not among those from low-income families. Increased helmet use could prevent a significant number of bicycle-related head and neck injuries in children. A study examined the effectiveness of a school-based bicycle helmet promotion program in two high-income and two low-income schools in an urban area of Canada. These schools were compared to 18 that did not have a bicycle helmet promotion program (the control schools). The number of children who used a helmet increased at all of the schools between 1990 and 1991. The increase in helmet use was similar at the low-income schools with and without a helmet promotion program. On the other hand, helmet use by children at the high-income schools rose dramatically after the program compared to high-income children who did not go through the program.

BICYCLING IS AN INCREASINGLY popular recreational activity in the United States. Each year, however, approximately 530 children (ages 0 to 19 years) and 430 adults die, and 443,000 children and […]

Although the risk of serious head injury for horse riders is higher than for most other sports, few equestrians regularly wear protective headgear. This study indicates that riders are well […]

Although bicycle helmets are effective in preventing head injuries, use of helmets among children remains infrequent. In response to the bicycling deaths of two children, Howard County, Maryland, became the first US jurisdiction to mandate use of bicycle helmets for children. Schoolchildren were lectured by police about the law before its enactment. Prelaw and postlaw helmet use was observed in Howard County and two control counties: Montgomery (which sponsored a community education program) and Baltimore County (no helmet activities). Prelaw crude helmet use rates for children were 4% (95% confidence interval [CI] 0% to 10%) for Howard, 8% (95% CI 3% to 13%) for Montgomery, and 19% (95% CI 5% to 33%) for Baltimore. Postlaw rates were 47% (95% CI 32% to 62%), 19% (95% CI 11% to 27%), and 4% (95% CI 0 to 11%), respectively. The rate of bicycle helmet use by Howard County children is now the highest documented for US children. A similar increase in helmet use among children younger than 16 years nationwide could prevent about 100 deaths and 56 000 emergency-department-treated head injuries annually. Physicians and other health professionals should consider proposing and supporting the Howard County approach in their communities.

BICYCLE-RELATED INJURIES are an important health problem among 5- to 14-year-olds [1-4], accounting for about 8 percent of all deaths in this age group in the Province of Quebec [5]. […]

Bicycle injuries cause 600 deaths and 300,000 visits to the emergency room in children under age 15 each year. In many of the injuries and in most cases of death, a head injury is involved. Despite these figures, very few children wear helmets or other protective head gear when riding their bicycles. Helmets have been shown to greatly reduce the risk of head injuries in bicycle accidents. This study examined whether promoting the use of a helmet to a youngster who is in an emergency room for a bicycle-related injury would be effective in motivating the youngster or his or her family to buy a helmet. The study randomly placed children visiting an emergency room for a bicycle-related injury into two groups, a control group and a group that received encouragement to use a helmet. A total of 334 children were involved in the study, 161 receiving the information (intervention group) and 173 in the control group. Results showed that when a follow-up was performed two to three weeks after the emergency room visit, 15 (9.3 percent) in the intervention group and 14 (8 percent) in the control group had purchased a helmet. These results indicate that the intervention used in this study to promote the use of helmets by bicyclists was not effective. Further studies are needed to find an effective way to encourage helmet use in order to decrease the risk of head injury. (Consumer Summary produced by Reliance Medical Information, Inc.)