Bicycle Helmet Wearing Research Articles

Impact of a Helmet Distribution Program in the Pediatric Emergency Department.

Bicycle helmet use has repeatedly been shown to protect riders from serious injury. Despite this, a majority of children and adolescents do not regularly wear helmets. Our primary objective was to determine if an emergency department (ED)-based helmet distribution program could increase the amount of time children report wearing helmets. This was a prospective cohort study of children aged 3 to 17 years presenting to the ED of an urban, tertiary care hospital. Participants were surveyed on their helmet use habits and perceptions regarding the efficacy and importance of helmets. Participants then received a bicycle helmet along with safety counseling in the ED and bicycle safety handouts provided by the American Academy of Pediatrics. Participants were contacted for follow-up 8 weeks after enrollment. We enrolled a total of 94 patients. Post-intervention surveys were obtained from 47% of participants. Our helmet program resulted in a statistically significant increase in the amount of time children reported wearing bicycle helmets. Prior to ED intervention, 48% of participants reported wearing a helmet "most of the time" or "all of the time." After participating, 86% of participants indicated that they wore a helmet "most of the time" or "all of the time." Participants indicated a variety of reasons for not wearing helmets. Of all patients contacted for follow-up, 16% indicated that they were involved in an accident after participating where the helmet they were given prevented a head injury. Helmet distribution programs based in the pediatric ED increase rates of bicycle helmet usage among pediatric patients. Additional study is needed to determine effect on head injury prevention.

The effect of safety attire on perceptions of cyclist dehumanisation

Increasing the uptake of active, carbon neutral forms of transport is indicated for both population health and environmental conservation. Efforts to increase cycling uptake are hindered by negative attitudes towards cyclists. Recent research from Australia has found that many people consider cyclists to be less than fully human. There is currently a lack of empirical evidence that explains these dehumanising perceptions. Most people who ride bicycles in Australia wear safety helmets as required by mandatory helmet laws. We hypothesised that people wearing bicycle helmets are perceived as less human compared to people without helmets due to reduced visibility of eyes and hair. We tested this hypothesis through a survey (n = 563) comprised of two-paired alternate forced choice questions to identify which image of a cyclist respondents consider to be less human. We then analysed the results using a Bradley-Terry probability model. We found images of cyclists wearing helmets or safety vests to have a higher probability of being selected as less human compared to images of cyclists wearing no safety equipment. The results have implications for research on cyclist dehumanisation and its mitigation.

Face Masks for Children During COVID-19

Masks remain a simple but powerful tool to help prevent the spread of COVID-19. They are especially important for children who are too young for the vaccine. Read on for answers to some frequently asked questions about masks, children, and COVID-19.A well-fitting high quality face mask reduces the chance of contracting COVID-19, as well as spreading COVID-19 infection to others. Face masks should not be worn by children if they are under 2 years old. Face masks are strongly encouraged for:Note: Infants and children under 2 years old are too young for the vaccine and too young to wear face masks. To protect them, people who have close contact with infants and young children should wear face masks.Well-fitting face masks worn by everyone 2 years old and older and adults, including child care teachers, regardless of vaccination status protects them as well as others—especially if they are not vaccinated.In K-12 schools, students, teachers, staff and visitors should be supported if they continue wearing masks. The same is true for anyone who continues wearing masks for sports.Face masks have been around for a couple of years, but mask wearing is still new to a child who is turning 2. Here are a few ideas that might help make your child more comfortable when they are getting used to wearing a mask:It may be challenging for very young children not to fidget with their face mask. Expect to give your child plenty of gentle reminders not to touch their face mask. When mask-wearing is reinforced by adults and peers, they will learn to follow directions. Just like children understand that they must wear bicycle helmets and buckle into their car seats, they will learn to wear masks correctly and routinely when needed.For children under 3, it's best to answer their questions simply in language they understand. If they ask about why people are wearing face masks, explain that sometimes people need to wear them to stay healthy.For children over 3, try focusing on germs. Explain that germs are special to your own body. Some germs and good and some are bad. The bad ones can make you sick. Since we can't always tell which are good or bad, the face masks help make sure you keep those germs away from your own body.Children with weakened immune systems or who have health conditions or special health care needs that put them at high risk for infections are encouraged to wear an N95 mask for protection. Those with medical conditions that interfere with cognitive or lung function may have a hard time tolerating a face mask. For these children, special precautions may be needed. Families are encouraged to have a plan and discuss appropriate masks and precautions with their pediatrician.Look for a well-fitting comfortable face mask that fits your child's face. The mask should fit securely under the chin but not impair vision, and cover the mouth and nose. It should fit snugly along the sides of the face without any gaps. Remember to wash hands before and after wearing it and avoid touching it once it's on. When back home, avoid touching the front of the face mask by taking it off from behind.Note: Face masks should not be worn when eating or drinking. Also, make sure the mask has no choking or strangulation hazards for young children.Along with COVID-19 vaccination and boosters, mask wearing when recommended and other safety measures such as physical distancing, testing and hand washing are key to reducing SARS-CoV-2 infection and spread. If you have any concerns about your child's health, talk with your pediatrician.American Academy of Pediatricswww.aap.org and www.HealthyChildren.orgAdapted from the HealthyChildren.org article Face Masks for Children During COVID-19 (4/21/22).The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Influencing factors analysis of helmet wearing for electric bicycle riders based on ordinal multinomial logistic model

Abstract The helmet of riders of electric bicycles plays an important role in reducing injuries and deaths in traffic accidents. This paper conducts a questionnaire survey, data analysis and modelling to investigate the influencing factors of electric bicycle helmet wearing. First, living area, gender, age, marital status and education level are selected as independent variables for data analysis. The factor analysis divides the sentiments of electric bicyclists for wearing helmets into four aspects: safety perception, practical sensation, satisfaction perception and emergency perception, and ordinal multiple logistic models are built to analyse the influencing factors. The result shows that people aged 18−25, 26−35, 36−45 and 46−55 are 1.3, 1.8, 2.0 and 2.3 times more likely, respectively, to have at least a grade higher safety perception than those aged 56 and over; men are 0.77 times more likely than women to feel at least one grade higher about the practical perception and 1.48 times more than women about the satisfaction perception; people with primary school, junior high school, senior high school, junior college and bachelor's degree education are 1.64, 2.44, 1.50, 1.70 and 1.55 times more likely, respectively, than people with a master's degree to feel at least one grade higher about the satisfaction perception.

TIPP—Tips for Getting Your Children to Wear Bicycle Helmets

Patient Education| 2021 TIPP—Tips for Getting Your Children to Wear Bicycle Helmets Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation TIPP—Tips for Getting Your Children to Wear Bicycle Helmets. Pediatric Patient Education 2021; 10.1542/peo_document336 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: TIPP - The Injury Prevention Program Topics: protective helmet Have your children wear helmets as soon as they start to ride scooters or tricycles and if they are a passenger on the back of an adult’s bike. If they learn to wear helmets whenever they ride something with wheels, it becomes a habit for a lifetime. It’s never too late, however, to get your children into helmets. Allow your children to participate in choosing their helmet. They’ll be able to let you know if it is comfortable. And if they like the design, they are more likely to wear it. Children learn best by observing you. Whenever you ride your bike, put on your helmet. Plan bicycle outings during which all family members wear their helmets to further reinforce the message. The most important factor influencing children to wear helmets is riding with an adult who wears a helmet. There... © 2020 American Academy of Pediatrics. All rights reserved. You do not currently have access to this content.

Childhood cycling fatalities in South Australia before and after the introduction of helmet legislation.

In the years following the introduction of legislation in Australian states mandating the wearing of helmets, there was a decline in the number of deaths. Debate has occurred, however, as to why this occurred. The Traffic Accident Reporting System database, which records data for all police-reported crashes in South Australia, was searched for all cases of deaths occurring in the state in bicycle riders aged ≤14 years from January 1982 to December 2001. The numbers of deaths were then compared over the 10-year periods before (1982-1991) and after (1992-2001) the introduction of helmet legislation, and also on a yearly basis from 1982 to 2001. Comparing the numbers of deaths in the two periods before and after helmet legislation in 1991 showed a marked decrease in cases from 36 to 12. However, in examining the numbers of deaths per year in greater detail, it appears that these were already steadily reducing from nine cases per year in 1982 (2.9/100,000) to two cases in 1991 (0.67/100,000) to a virtual plateau after 1991 (ranging from 0 to 2 cases annually). It seems that the introduction of compulsory bicycle helmet wearing in South Australia came at a time when the numbers of child cyclist deaths had been steadily declining over the preceding decade. While helmet wearing clearly protects children who are still riding bicycles, the reasons for the reduction in numbers of deaths appears more complex than legislative change and likely involves a subtle interaction with other behavioural and societal factors and preferences.

Cost-effectiveness of mandatory bicycle helmet use to prevent traumatic brain injuries and death

BackgroundTraumatic brain injury (TBI) is the main cause of mortality and severe morbidity in cyclists admitted to Dutch emergency departments (EDs). Although the use of bicycle helmets is an effective way of preventing TBI, this is uncommon in the Netherlands. An option to increase its use is through a legal enforcement. However, little is known about the cost-effectiveness of such mandatory use of helmets in the Dutch context.The current study aimed to assess the cost-effectiveness of a law that enforces helmet use to reduce TBI and TBI-related mortality.MethodsThe cost-effectiveness was estimated through decision tree modelling. In this study, wearing bicycle helmets enforced by law was compared with the current situation of infrequent voluntary helmet use. The total Dutch cycling population, consisting of 13.5 million people, was included in the model. Model data and parameters were obtained from Statistics Netherlands, the National Road Traffic Database, Dutch Injury Surveillance System, and literature. Effects included were numbers of TBI, death, and disability-adjusted life years (DALY). Costs included were healthcare costs, costs of productivity losses, and helmet costs. Sensitivity analysis was performed to assess which parameter had the largest influence on the incremental cost-effectiveness ratio (ICER).ResultsThe intervention would lead to an estimated reduction of 2942 cases of TBI and 46 deaths.Overall, the incremental costs per 1) death averted, 2) per TBI averted, and 3) per DALY averted were estimated at 1) € 2,002,766, 2) € 31,028 and 3) € 28,465, respectively. Most favorable were the incremental costs per DALY in the 65+ age group: € 17,775.ConclusionsThe overall costs per DALY averted surpassed the Dutch willingness to pay threshold value of € 20,000 for cost-effectiveness of preventive interventions. However, the cost per DALY averted for the elderly was below this threshold, indicating that in this age group largest effects can be reached. If the price of a helmet would reduce by 20%, which is non-hypothetical in a situation of large-scale purchases and use of these helmets, the introduction of this regulation would result in an intervention that is almost cost-effective in all age groups.

Background Factors of Bicycle Driving Behavior and Helmet Wearing of Elementary and Junior High School Students

Background Factors of Bicycle Driving Behavior and Helmet Wearing of Elementary and Junior High School Students

Towards Model-Based Online Monitoring of Cyclist’s Head Thermal Comfort: Smart Helmet Concept and Prototype

Bicyclists can be subjected to crashes, which can cause injuries over the whole body, especially the head. Head injuries can be prevented by wearing bicycle helmets; however, bicycle helmets are frequently not worn due to a variety of reasons. One of the most common complaints about wearing bicycle helmets relates to thermal discomfort. So far, insufficient attention has been given to the thermal performance of helmets. This paper aimed to introduce and develop an adaptive model for the online monitoring of head thermal comfort based on easily measured variables, which can be measured continuously using impeded sensors in the helmet. During the course of this work, 22 participants in total were subjected to different levels of environmental conditions (air temperature, air velocity, mechanical work and helmet thermal resistance) to develop a general model to predict head thermal comfort. A reduced-order general linear regression model with three input variables, namely, temperature difference between ambient temperature and average under-helmet temperature, cyclist’s heart rate and the interaction between ambient temperature and helmet thermal resistance, was the most suitable to predict the cyclist’s head thermal comfort and showed maximum mean absolute percentage error (MAPE) of 8.4%. Based on the selected model variables, a smart helmet prototype (SmartHelmet) was developed using impeded sensing technology, which was used to validate the developed general model. Finally, we introduced a framework of calculation for an adaptive personalised model to predict head thermal comfort based on streaming data from the SmartHelmet prototype.

Bicycle helmet wearing is associated with closer overtaking by drivers: A response to Olivier and Walter, 2013

There is a body of research on how driver behaviour might change in response to bicyclists’ appearance. In 2007, Walker published a study suggesting motorists drove closer on average when passing a bicyclist if the rider wore a helmet, potentially increasing the risk of a collision. Olivier and Walter re-analysed the same data in 2013 and claimed helmet wearing was not associated with close vehicle passing. Here we show how Olivier and Walter’s analysis addressed a subtly, but importantly, different question than Walker’s. Their conclusion was based on omitting information about variability in driver behaviour and instead dividing overtakes into two binary categories of ‘close’ and ‘not close’; we demonstrate that they did not justify or address the implications of this choice, did not have sufficient statistical power for their approach, and moreover show that slightly adjusting their definition of ‘close’ would reverse their conclusions. We then present a new analysis of the original dataset, measuring directly the extent to which drivers changed their behaviour in response to helmet wearing. This analysis confirms that drivers did, overall, get closer when the rider wore a helmet. The distribution of overtaking events shifted just over one-fifth of a standard deviation closer to the rider – a potentially important behaviour if, as theoretical frameworks suggest, near-misses and collisions lie on a continuum. The paper ends by considering wider issues surrounding this topic and suggests public health research might be best served by shifting focus to risk elimination rather than harm mitigation.

Bicycle helmets and risky behaviour: A systematic review

A long-standing argument against bicycle helmet use is the risk compensation hypothesis, i.e., increased feelings of safety caused by wearing a helmet results in cyclists exhibiting more risky behaviour. However, past studies have found helmet wearing is not associated with risky behaviour, e.g., committing a traffic violation was positively associated with a lower frequency of helmet use. There is a lack of consensus in the research literature regarding bicycle helmet use and the risk compensation hypothesis, although this gap in knowledge was identified in the early 2000s. This is the first study to carry out a systematic review of the literature to assess whether helmet wearing is associated with risky behaviour. Two study authors systematically searched the peer-reviewed literature using five research databases (EMBASE, MEDLINE, COMPENDEX, SCOPUS, and WEB OF SCIENCE) and identified 141 unique articles and four articles from other sources. Twenty-three articles met inclusion criteria and their findings were summarised. Eighteen studies found no supportive evidence helmet use was positively associated with risky behaviour, while three studies provided mixed findings, i.e., results for and against the hypothesis. For many of these studies, bicycle helmet wearing was associated with safer cycling behaviour. Only two studies conducted from the same research lab provided evidence to support the risk compensation hypothesis. In sum, this systematic review found little to no support for the hypothesis bicycle helmet use is associated with engaging in risky behaviour.

Bicycle helmets – To wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuries

A meta-analysis has been conducted of the effects of bicycle helmets on serious head injury and other injuries among crash involved cyclists. 179 effect estimates from 55 studies from 1989–2017 are included in the meta-analysis. The use of bicycle helmets was found to reduce head injury by 48%, serious head injury by 60%, traumatic brain injury by 53%, face injury by 23%, and the total number of killed or seriously injured cyclists by 34%. Bicycle helmets were not found to have any statistically significant effect on cervical spine injury. There is no indication that the results from bicycle helmet studies are affected by a lack of control for confounding variables, time trend bias or publication bias. The results do not indicate that bicycle helmet effects are different between adult cyclists and children. Bicycle helmet effects may be somewhat larger when bicycle helmet wearing is mandatory than otherwise; however, helmet wearing rates were not found to be related to bicycle helmet effectiveness. It is also likely that bicycle helmets have larger effects among drunk cyclists than among sober cyclists, and larger effects in single bicycle crashes than in collisions with motor vehicles. In summary, the results suggest that wearing a helmet while cycling is highly recommendable, especially in situations with an increased risk of single bicycle crashes, such as on slippery or icy roads.

3D assessment of damaged bicycle helmets and corresponding craniomaxillo-mandibular skull injuries: A feasibility study

ObjectivesIn the Netherlands, cyclists continue to outnumber other road users in injuries and deaths. The wearing of bicycle helmets is not mandatory in the Netherlands even though research has shown that wearing bicycle helmets can reduce head and brain injuries by up to 88%. Therefore, the aim of this study was to assess the feasibility of using 3D technology to evaluate bicycle-related head injuries and helmet protection. MethodsThree patients who had been involved in a bicycle accident while wearing a helmet were subjected to multi-detector row computed tomography (MDCT) imaging after trauma. The helmets were separately scanned using the same MDCT scanner with tube voltages ranging from 80kVp to 140kVp and tube currents ranging from 10mAs to 300mAs in order to determine the best image acquisition parameters for helmets. The acquired helmet images were converted into virtual 3D surface hence Standard Tessellation Language (STL) models and merged with MDCT-derived STL models of the patients’ skulls. Finally, all skull fractures and corresponding helmet damage were visualized and related. ResultsImaging bicycle helmets on an MDCT scanner proved to be feasible using a tube voltage of 120kVp and a tube current of 120mAs. Merging the resulting STL models of the patients’ skull and helmet allowed the overall damage sustained by both skull and helmet to be related. ConclusionOur proposed 3D method of assessing bicycle helmet damage and corresponding head injuries could offer valuable information for the development and design of safer bicycle helmets.

Consequences of Underestimating Impalement Bicycle Handlebar Injuries in Children.

Impalement bicycle handlebar trauma injuries are rare; however, on initial assessment, they have the potential of being underestimated. We reviewed our prospective trauma database of 3,894 patients for all bicycle injuries from January 2010 to May 2015. Isolated pedal bike injuries were reported in 2.6% (N = 101) of the patients who were admitted to the trauma service. Fifteen patients suffered direct handlebar trauma. Patients were grouped into blunt trauma (n = 12) and impalement trauma (n = 3). We examined gender, age, injury severity score (ISS), Glasgow Coma Scale score, use of protective devices, need for surgical intervention, need for intensive care (ICU), and hospital length of stay. Mean age was 9.6 years. All children with penetrating injuries were males. Mean ISS was less than 9 in both groups. None of the children were wearing bicycle helmets. Three patients who sustained blunt injuries required ICU care due to associated injuries. All of the children with impalement injuries required several surgical interventions. These injuries included a traumatic direct inguinal hernia, a medial groin and thigh laceration with resultant femoral hernia, and a lateral deep thigh laceration. Impalement bicycle handlebar injuries must be thoroughly evaluated, with a similar importance given to blunt injuries. A high index of suspicion must be maintained when examining children with handlebar impalement injuries, as they are at risk for missed or underestimation of their injuries.

Urban College Student Bicycle Commuting: A Look at Differences in Riding Behavior by Gender

Many bicycling collisions are attributable to individual rider behavior. Prior research demonstrates gender differences in active transportation. Research for on-road, in-traffic riding behavior between genders is limited. In this study, bicycle commuters (n=671) traveling to a large, metropolitan university in Provo, Utah were directly observed over two weeks during fall, 2014 at peak morning and peak night commute times. Data were collected for passing bicyclists: Rider characteristics and behaviors. 23.10% of bicycle commuters were female, 22.21% wore bicycle helmets, 3.24% used hand signals to indicate turning or slowing, and 10.94% used both a front and rear light while riding at night. Significant associations were observed between gender and road position even after controlling for rider and environmental factors (women more often used the crosswalk (OR=1.72, 95% CI [1.22, 2.34]), sidewalk (OR=1.39, 95% CI [1.01, 1.93]), and traveled in the wrong-direction (OR=1.41, 95% CI [1.01, 1.94])); and use a night headlight (OR=1.40, 95% CI [1.40, 5.76]). Bicyclists’ behavior changed with traffic volume and day/night conditions. Understanding gender differences will be important for targeting different risk factors and promoting safe commuting among all genders.

Bicycle helmet use among persons 5 years and older in the United States, 2012

IntroductionIn 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States. MethodCDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18+years) were asked about bicycle riding and helmet use in the last 30days for themselves and their children (5 to 17years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use. ResultsAmong adults, 21% rode bicycles within the past 30days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%). ConclusionsDespite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding. Practical applicationStates and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.

406 Racial and Ethnic Differences in Behavioral Risk Factors Among Young Adult Male Emergency Department Patients

406 Racial and Ethnic Differences in Behavioral Risk Factors Among Young Adult Male Emergency Department Patients

Jane Pirkis: analysing and improving mental health in Australia

Jane Pirkis had a taste for public health and wellbeing ever since childhood when her mother, a nurse, made her and her brother wear bicycle helmets and seatbelts long before they were mandatory back in her hometown of Launceston, TAS, Australia. Pirkis, now Director of the Centre for Mental Health in the Melbourne School of Population and Global Health at the University of Melbourne, VIC, Australia, quickly realised studying psychology as a teen that the field could make a difference in Australian society.

Correction: Bicycle Helmet Wearing Is Not Associated with Close Motor Vehicle Passing: A Re-Analysis of Walker, 2007

Correction: Bicycle Helmet Wearing Is Not Associated with Close Motor Vehicle Passing: A Re-Analysis of Walker, 2007

Bicycle helmet wearing is not associated with close motor vehicle passing: a re-analysis of Walker, 2007.

ObjectivesTo re-analyse bicycle overtaking data collected by Walker (2007) with a view to assess factors associated with close passing (<1 m), to adjust for other observed factors in a multivariable analysis, and to assess the extent to which the sample size in the original analysis may have contributed to spurious results.MethodA re-analysis of 2,355 motor vehicle passing events recorded by Walker that includes information on cyclist's distance to the kerb, vehicle size and colour, city of observation, time of day, whether the event occurred while in a bikelane and helmet wearing. Each variable was considered for a final, multivariable model using purposeful selection of variables. The analysis was repeated using multiple logistic regression with passing distance dichotomised by the one metre rule. Bootstrap p-values were computed using sample sizes computed from conventional values of power and effect size.ResultsThe previously observed significant association between passing distance and helmet wearing was not found when dichotomised by the one metre rule. Other factors were found to be significantly associated with close passing including cyclists' distance to the kerb, vehicle size and city of observation (Salisbury or Bristol, UK). P-values from bootstrap samples indicate the significance of helmet wearing resulted from an overly large sample size.ConclusionsAfter re-analysis of Walker's data, helmet wearing is not associated with close motor vehicle passing. The results, however, highlight other more important factors that may inform effective bicycle safety strategies.