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

PEDIATRICS ◽  
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).

Cost-Effectiveness Analysis of Bicycle Helmet Subsidies in a Defined Population

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 902-907
Author(s):  
Robert S. Thompson ◽  
Diane C. Thompson ◽  
Frederick P. Rivara ◽  
Angela A. Salazar
Keyword(s):  
Cost Effectiveness ◽  
Head Injuries ◽  
Puget Sound ◽  
Cost Effectiveness Analysis ◽  
Bicycle Helmet ◽  
Discount Rates ◽  
Health Maintenance ◽  
Helmet Use ◽  
Bicycle Safety ◽  
Effectiveness Analysis

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.

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

PEDIATRICS ◽  
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.

Bicycle helmet use to reduce the impact of head injuries in ladder users

2016 ◽  
Vol 87 (12) ◽  
pp. 1026-1029
Author(s):  
Leigh R. Warren ◽  
Simon Harley ◽  
Jeffrey Dutschke ◽  
Andrew van den Berg ◽  
Christopher Dobbins
Keyword(s):  
Head Injuries ◽  
Bicycle Helmet ◽  
Helmet Use ◽  
The Impact

Bicycle Helmet Law for Children: A Case Study of Activism in Injury Control

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1248-1250
Author(s):  
Peter C. Scheidt ◽  
Modena H. Wilson ◽  
Melvin S. Stern
Keyword(s):  
Public Health ◽  
Control Measure ◽  
Head Injuries ◽  
Bicycle Helmet ◽  
Helmet Use ◽  
Local Public Health ◽  
Multiple Factors ◽  
Community Activists ◽  
Injury Control

In 1990, the first regulation requiring the use of helmets for bicyclists younger than 16 years of age was passed in Howard County, Maryland. This unexpected injury control measure resulted from the convergence of multiple factors and efforts: the bicycle-related deaths of two children from the same middle school, creative students and teachers motivated by these deaths, a responsive legislator to introduce the legislation, available surveillance and research statistics supporting the need and efficacy for helmet use, increased national awareness of the importance of helmet use to prevent bicycle-related head injuries, and organized national and local public health groups to support the legislation. This case study of activism in injury control illustrates the importance of supporting research, of well-organized public health coalitions and groups, and of creative community activists motivated by local circumstances.

Bicycle Helmet Use Among Maryland Children: Effect of Legislation and Education

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1216-1220
Author(s):  
Timothy R. Coté ◽  
Jeffrey J. Sacks ◽  
Marcie-jo Kresnow ◽  
Deborah A. Lambert-Huber ◽  
Ellen R. Schmidt ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Professionals ◽  
Community Education ◽  
Head Injuries ◽  
Similar Increase ◽  
Bicycle Helmet ◽  
Baltimore County ◽  
Helmet Use ◽  
Bicycle Helmets ◽  
Us Children

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 (nohelmet 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.

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