Bicycle helmets work when it matters the most

Joseph, Bellal; Azim, Asad; Haider, Ansab; Kulvatunyou, Narong; OʼKeeffe, Terence; Hassan, Ahmed; Gries, Lynn; Tran, Emily; Latifi, Rifat; Rhee, Peter

doi:10.1016/j.amjsurg.2016.05.021

Cited by 47 publications

(37 citation statements)

References 13 publications

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“…Our findings are similar to those from previous studies that reported a decreased risk of facial injuries with helmet use. [13][14][15][16][17][18][19]22 The most recent meta-analysis in 2018 by Fitzpatrick et al 15 reported an odds reduction of 0.69 (95% CI, 0.63 to 0.75; P < .0001) for facial injuries among helmeted riders. Our study sample consisted of more helmeted than nonhelmeted riders compared with other study samples, which had included fewer helmeted riders.…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have reported a preventative effect of helmet use to the lower face, a few studies have found no preventative effects, and still other studies have reported an increased risk of injury to the lower facial third with helmet use. 4,11,13,[15][16][17][18][19] Unlike American football, hockey, or lacrosse helmets, the standard bicycle helmet design does not include a face mask designed to protect the maxillofacial region. 5,19 As such, we hypothesized that the frequency of maxillofacial injuries for bicyclists who wear helmets would equal the frequency of maxillofacial injuries for the nonhelmet-wearing bicyclists.…”

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confidence: 99%

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Helmets Decrease Risk of Bicyclist-Related Maxillofacial Injuries But Not Severity

Dillon

Dodson

2019

Journal of Oral and Maxillofacial Surgery

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Purpose: Given the increasing use of bicycles for local transportation and recreation, the purpose of the present study was to measure the effects of bicycle helmets on the frequency and severity of maxillofacial injuries. The specific aims were to measure and compare the frequencies and severity of maxillofacial injuries between injured bicyclists who had or had not worn helmets. Materials and Methods: We implemented a retrospective cohort study and enrolled a sample of bicyclists who had been injured from January 4, 2012 to March 31, 2018 and had presented to Harborview Medical Center for evaluation and treatment. The primary predictor variable was helmet use (yes vs no). The primary outcome variables were 1) the presence of a maxillofacial injury (yes vs no); and 2) injury severity, measured using the Face Abbreviated Injury Scale (FAIS). The other study variables were grouped into demographic or injury-related variables. The appropriate univariate, bivariate, and multivariate logistic regressions statistics were computed, and statistical significance was set at P < .05. Results: The sample included 1379 subjects, with a mean age of 39.6 AE 18.9 years (range, 1 to 91 years), and 78.4% were male. The frequency of facial injuries between the helmeted and nonhelmeted bicyclists was 17.3% and 30.6%, respectively (relative risk, 0.6; 95% confidence interval, 0.5 to 0.7; P < .0001). The protective effect held after adjusting for age, gender, and alcohol exposure. The FAIS score between the helmeted and nonhelmeted riders was 1.8 AE 0.5 and 1.9 AE 0.6, respectively (P = .8). Conclusions: The helmeted bicyclists were 40% less likely to have a facial injury from bicycle accidents. For those cyclists with a facial injury, however, the injury severity was not different between the helmeted and nonhelmeted wearers. This might have been because, that unlike American football helmets, standard bicycle helmets do not include a face mask to protect the face.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Helmets Decrease Risk of Bicyclist-Related Maxillofacial Injuries But Not Severity

Dillon

Dodson

2019

Journal of Oral and Maxillofacial Surgery

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“…However, cycling is reported to be the third most dangerous mode of transport, resulting in injuries and mortalities. Head injuries are the most typical injuries observed among fatalities reported [1][2][3]. Studies have shown that these head-related injuries can be significantly reduced by the usage of helmets [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Thermal-Performance Evaluation of Bicycle Helmets for Convective and Evaporative Heat Loss at Low and Moderate Cycling Speeds

et al. 2019

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The main objective of the study was to investigate the thermal performance of five (open and closed) bicycle helmets for convective and evaporative heat transfer using a nine-zone thermal manikin. The shape of the thermal manikin was obtained by averaging the 3D-point coordinates of the head over a sample of 85 head scans of human subjects, obtained through magnetic resonance imaging (MRI) and 3D-printed. Experiments were carried out in two stages, (i) a convective test and (ii) an evaporative test, with ambient temperature maintained at 20.5 ± 0.5 °C and manikin skin temperature at 30.5 ± 0.5 °C for both the tests. Results showed that the evaporative heat transfer contributed up to 51%–53% of the total heat loss from the nude head. For the convective tests, the open helmet A1 having the highest number of vents among tested helmets showed the highest cooling efficiency at 3 m/s (100.9%) and at 6 m/s (101.6%) and the closed helmet (A2) with fewer inlets and outlets and limited internal channels showed the lowest cooling efficiency at 3 m/s (75.6%) and at 6 m/s (84.4%). For the evaporative tests, the open helmet A1 showed the highest cooling efficiency at 3 m/s (97.8%), the open helmet A4 showed the highest cooling efficiency at 6 m/s (96.7%) and the closed helmet A2 showed the lowest cooling efficiency at 3 m/s (79.8%) and at 6 m/s (89.9%). Two-way analysis of variance (ANOVA) showed that the zonal heat-flux values for the two tested velocities were significantly different (p < 0.05) for both the modes of heat transfer. For the convective tests, at 3 m/s, the frontal zone (256–283 W/m2) recorded the highest heat flux for open helmets, the facial zone (210–212 W/m2) recorded the highest heat flux for closed helmets and the parietal zone (54–123 W/m2) recorded the lowest heat flux values for all helmets. At 6 m/s, the frontal zone (233–310 W/m2) recorded the highest heat flux for open helmets and the closed helmet H1, the facial zone (266 W/m2) recorded the highest heat flux for the closed helmet A2 and the parietal zone (65–123 W/m2) recorded the lowest heat flux for all the helmets. For evaporative tests, at 3 m/s, the frontal zone (547–615 W/m2) recorded the highest heat flux for all open helmets and the closed helmet H1, the facial zone (469 W/m2) recorded the highest heat flux for the closed helmet A2 and the parietal zone (61–204 W/m2) recorded the lowest heat flux for all helmets. At 6 m/s, the frontal zone (564–621 W/m2) recorded highest heat flux for all the helmets and the parietal zone (97–260 W/m2) recorded the lowest heat flux for all helmets.

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“…An estimated 900 deaths and 494,000 visits to emergency department occurred due to bicycle-related injuries in the USA, translating into an expenditure of over $2 billion on bicycle-related traumatic brain injuries (TBI). 1 Brain and maxillofacial trauma, and dental injuries are common amongst bicycle riders. 1 Bicycle accidents may also result in trauma to the abdominal organs including the liver, spleen and kidney.…”

mentioning

confidence: 99%

“…1 Brain and maxillofacial trauma, and dental injuries are common amongst bicycle riders. 1 Bicycle accidents may also result in trauma to the abdominal organs including the liver, spleen and kidney.…”

mentioning

confidence: 99%