Children's bicycle helmet use and injuries in Hillsborough County, Florida before and after helmet legislation

Abstract

The purpose of this research was to explore the changes in children's bicycle helmet use and motor vehicle bicycle related injuries in Hillsborough County, Florida before and after passage of the Florida's bicycle helmet law for children under the age of 16. The results show a significant increase in bicycle helmet use among children, ages 5-13, in the post-law years compared with the pre-law years. Also, there has been a significant decline in the rates of bicycle related motor vehicle injuries among children in the post-law years compared with the pre-law years. Although there have been complementary educational and outreach activities in the county to support helmet use, it appears that the greatest increase in use occurred after the passage of the helmet law. It is recommended that educational efforts continue to sustain helmet use rates and decreases in injuries. R esearch has shown that bicycle helmets effectively prevent head and brain injuries and related deaths. A recent meta-analytic report on helmets showed a summary odds ratio efficacy of 0.40, 0.42, 0.53, and 0.27 for head, brain, facial, and fatal injuries, respectively. 1 Legislation may be important in increasing bicycle helmet use.2 3 The increase in average probability of helmet wearing in mandated helmet states was 18.4%, 4 and in 2002, 20 states had such laws, all applying to individuals under age 18. 5In 1997 a Florida law adopted in 65 of 67 counties required that riders under 16 wear a helmet. A 1999 Florida study showed that children riding bicycles where the law was in effect were twice as likely to wear helmets as those in non-participating counties. 6 The relationship between the Florida legislation and bicycle related injuries is unknown. METHODSSince 1993, observations of helmet use in children 5-13 have been conducted in Hillsborough County, Florida (population 998 948). This age group includes those most likely to experience bicycle related injuries. 7Observation protocols followed guidelines established by the Harborview Injury Prevention and Research Center.8 Key issues were 9 :(1) Observers always obtained study approval through the county sheriff's office.(2) Youth showing obvious signs of puberty were excluded from the study.(3) Children's bicycles could not be equipped with training wheels and the helmet must have been observed on the head or being removed from the head.(4) Observation times (non-school settings) were limited to <20 minutes at any one site to avoid duplicate counts. At schools, observers were positioned at bike racks during the observation period.(5) All observers were trained for one or more days. Inter-rater reliability consistently exceeded 90%.County census tracts (n=167) were divided into two ordinal lists stratified by income and the population of children, ages 0-14. 9 Each of these lists was divided into deciles of approximately 17 tracts each. Three tracts were selected randomly from each decile-a total of 60 tracts with at least two observations sites chosen from each. Approximately 120 observation ...

Road Traffic Injuries in Iran: The Role of Interventions Implemented by Traffic Police

“…A review of twelve studies from different countries showed that the baseline rates of motorcycle helmet use in different studies range between 4 to 59 percent; however after legislation, this range changed to between 37 to 91 percent (Karkhaneh et al 2006). Researchers have investigated the long-term effects (2 to 11 years) of helmet legislation as compared to short-term ones (less than one year; Cameron et al 1994;Delamater and Patino 2003;Hagel et al 2005;Kanny et al 2001;Leblanc et al 2002;Liller et al 2003) and they have shown that between 10 and 40 percent remained unchanged after the legislation for both motorcyclists and bicyclists.…”

Bicycle Helmet Legislation and Injury Patterns in Trauma Patients Under Age 18

“…Previous studies that looked at race as a variable were in predominantly Caucasian populations. Liller et al, in a 2003 study of helmet use in Hillsborough County, FL which is 75% Caucasian, 15% Black, and 18% Hispanic, found that helmet use was highest before and after legislation in the White population [23]. A Maryland study of three counties [24] showed higher helmet use after legislation, but again, in a mainly Caucasian, middle-class population.…”

Effectiveness of bicycle helmet legislation to increase helmet use: a systematic review

“…Two studies used nonequivalent control groups, 15 27 and 10 were interrupted time series or pre-post observational studies. 16 21 25 26 28-33 While four included studies involved children of school age exclusively, [26][27][28][29] eight included all riding ages. 15 16 21 25 30-33 Among the 12 studies, various cyclist factors were recorded including: age (11), gender (10), location (8), time of day (7), racial characteristics (3), bicycle type (2), backpack use (2), accompaniment (2), and type of road (1) (table 2).…”