Bicycle Helmets

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Abstract
Bicycling has become extremely popular in the last 5 years. There were an estimated 88 million cyclists in the United States in 1988.1 In addition to providing efficient transportation, bicycling can afford an enjoyable form of aerobic exercise. It is not without hazards, however. In 1985, there were more than 500 000 emergency room visits and 1300 deaths attributable to bicycles.2 Many of those injured on killed were children and adolescents. The most common cause of death (70% to 80% of cases) and the leading cause of disability from bicycling is head injury.3,4 One third of injured bicyclists treated in emergency room have head injuries, as do two thirds of those admitted to the hospital.5-7 The majority of bicycle crashes involving children do not involve cars. Most children are injured falling from their bicycles on colliding with fixed objects. The manufacture of relatively low-cost, light-weight bicycle helmets capable of protecting against much of this head injury has been accomplished because of recent technological advances. Voluntary impact standards have been developed by the Snell Memorial Foundation and the American National Standards Institute (ANSI), and helmets meeting these standards have a label (Snell or ANSI) affixed to the helmet. Studies in Australia8 and England9 have clearly demonstrated the efficacy of helmet use, and a recent study in Seattle showed that helmets reduced the risk of head injury by 85% and of brain injury by 88%.3 Despite this, helmets are used by less than 5% of child bicyclists. Reasons for nonuse have varied, but generally are thought to be due to a lack of awareness of the problem, peer pressure, and a lack of availability of helmets at many retail outlets where bicycles are purchased.

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