Academic journal article Journal of School Health

Injury Control Recommendations for Bicycle Helmets

Academic journal article Journal of School Health

Injury Control Recommendations for Bicycle Helmets

Article excerpt

Each year, nearly 1,000 persons die from injuries caused by bicycle crashes, and 550,000 persons are treated in emergency departments for injuries related to bicycle tiding. Approximately 6% of bicycle riders treated in emergency departments require hospitalization. Head injuries account for 62% of bicycle-related deaths, for 33% of bicycle-related emergency department visits, and for 67% of bicycle-related hospital admissions.

Bicycle helmets are effective in preventing head injury.[1] Community programs to increase bicycle helmet use can reduce the incidence of head injury among bicycle riders, thereby reducing the number of riders killed or disabled. Increasingly, state and local laws are being developed for mandatory use of bicycle helmets.

These guidelines were developed by the Centers for Disease Control and Prevention (CDC) for state and local agencies and organizations that are planning programs to prevent head injuries among bicyclists through use of bicycle helmets. The guidelines are based on a review of literature on bicycle-related injuries, bicycle helmets, and evaluation of legislation and community programs. The guidelines were reviewed and approved by the CDC Advisory Committee for Injury Prevention and Control and by other experts in prevention of bicycle-related injuries.


Bicycling is a popular activity in the United States. Bicycles are owned by approximately 30% of the U.S. population, and 45% of bike owners ride at least occasionally.[2] Approximately 80% to 90% of children own a bicycle by second grade.[3]

From 1984 through 1988, an annual average of 962 U.S. residents died from and 557,936 persons were treated in emergency departments for bicycle-related injuries.[4] Approximately 6% of persons treated for bicycle-related injuries require hospitalization.[5,6] The annual societal cost of bicycle-related injuries and deaths is approximately $8 billion.[7]

Head injury is the most common cause of death and serious disability in bicycle-related crashes.[1] Head injury accounts for 62% of bicycle-related deaths.[4] In addition, approximately 33% of bicycle-related emergency department visits and 67% of all bicycle-related hospital admissions[5,8] involve head injuries.[1,4,5]

Head injury accounts for approximately 44% of deaths resulting from injury in the United States,[9] and approximately 7% of brain injuries are bicycle-related.[2] Among survivors of nonfatal head injuries, the effects of the injury can be profound, disabling, and long-lasting.[9] Even after minor head injuries, persons may experience persistent neurologic symptoms such as headache, dizziness, reduced memory, increased irritability, fatigue, inability to concentrate, and emotional instability. These symptoms sometimes are referred to as the "postconcussional syndrome."[10]

From 1984 through 1988, more than 40% of deaths from bicycle-related head injury occurred among persons younger than age 15.[4] In all age groups, death rates were higher among males. Death rates from bicycle-related head injury were highest among males ages 10-14. During the same years, more than 75% of persons treated in emergency departments for bicycle-related head injury were younger than age 15. Rates for bicycle-related head injury also were higher for males than females in all age groups. Rates were highest among males ages 5-15.[4]

Nearly 90% of deaths from bicycle-related head injury result from collisions with motor vehicles.[4] However, motor vehicle collisions cause less than 25% of the nonfatal bicycle-related head injuries treated in emergency departments.[1,11] Excluding collisions with motor vehicles, common causes of nonfatal bicycle-related head injuries include falls, striking fixed objects, and collisions with other bicycles.[1,11]


Implementation of effective bicycle helmet programs could have a substantial impact on rates for fatal and nonfatal bicycle-related head injury. …

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