Helmet Use and Risk of Head Injuries in Alpine Skiers and Snowboarders

Objective. To examine the potential effects of bicycle safety helmet cost subsidy on bicycle head injury rates and costs. Design. Using empiric data on the incidence and costs of bicycle injuries to children, we examined the hypothetical effects of various bicycle helmet subsidies in a cost-effectiveness analysis. A hypothetical cohort of 100 000 5- through 9-year-olds was followed for 5 years after helmet cost subsidization. Sensitivity analyses were done of three different levels of safety helmet subsidy ($5, $10, $15), three discount rates (2%, 4%, 6%), 10 levels of safety helmet use ranging from 10% to 100%, and the occurrence or nonoccurrence of catastrophic head injuries. Patients. Forty-three children 5 through 9 years of age and 27 children 10 through 14 years of age with head injuries due to bicycling were identified through emergency department surveillance of a population of 29 533. Setting. Group Health Cooperative of Puget Sound, a large health maintenance organization. Outcome measures. Bicycle head injuries prevented and the savings or costs associated with various subsidy, safety helmet use, and discount rates. Results. Hypothetically, an increase in bicycle helmet use rates to 40% to 50% due to subsidies of $5 or $10 prevents 564 to 840 head injuries in a cohort of 100 000 5- through 9-year-olds over 5 years. Under these conditions and a 2% discount rate, cost savings ranging from $189 207 to $427 808 will result when catastrophic head injuries are included in the analysis. Conclusion. Subsidization of bicycle safety helmets to achieve a cost of $14 to $20 per helmet and use rates of 40% to 50% will likely prove cost-effective. Empirical evidence from a Seattle campaign suggests that such helmet use rates are achievable.

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Evaluation of a Promotional Strategy to Increase Bicycle Helmet Use by Children

PEDIATRICS ◽

10.1542/peds.91.4.772 ◽

1993 ◽

Vol 91 (4) ◽

pp. 772-777

Author(s):

Patricia C. Parkin ◽

Laura J. Spence ◽

Xiaohan Hu ◽

Katherine E. Kranz ◽

Linda G. Shortt ◽

...

Keyword(s):

Low Income ◽

Head Injuries ◽

Control Area ◽

High Income ◽

Bicycle Helmet ◽

Helmet Use ◽

Modest Increase ◽

Promotional Strategy ◽

Intervention Area ◽

Low Income Families

Bicycle-related head injuries are an important cause of death and disability, despite the availability of helmets. The objective of this study was to evaluate the effectiveness of a school-based bicycle helmet promotion program in increasing helmet use by children while controlling for secular trends. Two high-income and two low-income schools in an urban Canadian community were selected to receive a bicycle helmet promotion intervention, with the remaining 18 schools serving as controls. Approximately 1800 observations of bicycling children were made at randomly selected observational sites 2 to 5 months after the intervention to assess changes in behavior. Helmet use at all observation sites tripled from 3.4% (1990, preintervention) to 16% (1991, postintervention). In the high-income intervention area, observed helmet use rose dramatically from 4% to 36% in contrast to the more modest increase in the high-income control area from 4% to 15%. In the low-income intervention area, there was a modest increase from 1% to 7%, but it did not differ from the increase in the low-income control area from 3% to 13%. The program was highly successful in children of high-income families but not in children of low-income families. Developing strategies for low-income families remains a priority.

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Commentaries on ‘Bicycle helmet legislation for the uptake of helmet use and the prevention of head injuries’

Evidence-Based Child Health A Cochrane Review Journal ◽

10.1002/ebch.193 ◽

2008 ◽

Vol 3 (1) ◽

pp. 35-38

Author(s):

Mark Stevenson ◽

Rebecca Ivers ◽

Lynne Warda

Keyword(s):

Head Injuries ◽

Bicycle Helmet ◽

Helmet Use

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Why I Have Difficulty Being Enthusiastic About Recommending That Children Wear Helmets on Bicycles

PEDIATRICS ◽

10.1542/peds.79.3.487a ◽

1987 ◽

Vol 79 (3) ◽

pp. 487-488

Author(s):

ALLEN R. CIASTKO

Keyword(s):

Head Injuries ◽

Family Physicians ◽

Bicycle Helmet ◽

Helmet Use

To the Editor.— Dr Weiss in his study of bicycle helmet use in Pediatrics (1986;77:677-679) makes a plea to pediatricians and family physicians to advocate bicycle helmet use based on the frequency and severity of head injuries reported in other studies of bicycle accidents. Unfortunately, most studies quoted either reviewed bicycle injuries in isolation from other types of injury or were national death report statistics which represent only the tip of the iceberg (ignoring relative morbidity statistics).

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Helmets Matter: Kentucky All-Terrain Vehicle Crashes Seen at a Tennessee Trauma Center

The American Surgeon ◽

10.1177/000313481808400239 ◽

2018 ◽

Vol 84 (2) ◽

pp. 289-293

Author(s):

George M. Testerman ◽

Daniel C. Prior ◽

Tamie D. Wells ◽

Sarah E. Rollins ◽

Stephen L. Oesch

Keyword(s):

Relative Risk ◽

Trauma Center ◽

Injury Severity ◽

Trauma Registry ◽

Head Injuries ◽

Multiple Logistic Regression Analysis ◽

Multiple Logistic Regression ◽

Helmet Use ◽

State Laws ◽

Helmet Laws

All-terrain vehicle (ATV) safety laws, including helmet use, vary by state and are sporadically enforced. Kentucky state laws require safety helmets only for younger riders. We hypothesized that ATV riders injured in Kentucky and seen at a Tennessee trauma center would more likely be unhelmeted, have more severe head injuries, and have higher mortality rates than those injured in Virginia or Tennessee. A Trauma Registry review of 750 injured ATV riders from June 1, 2005, through June 1, 2015 examined state location of accident, helmet use, markers of injury severity, and outcomes. Multiple logistic regression analysis examined predictors of severe head injuries and death with P < 0.05 significant. Unhelmeted ATV rider status predicted more severe head injuries (relative risk 23.5, P < 0.001) and death (relative risk 4.6, P < 0.001). ATV riders injured in the state of Kentucky were twice as numerous. In addition, they were more likely than ATVriders injured in Tennessee or Virginia to be unhelmeted, to have severe head injuries, and to sustain fatal injuries (all P < 0.001). This single trauma center study lends support for maintaining and enforcing current universal helmet laws for ATVriders of all ages in states where they are in effect and highlights the need to upgrade helmet laws that apply only to some riders.

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