Epidemiology of bicycle injury, head injury, and helmet use among children in British Columbia: a five year descriptive study

Linn, Shai; Smith, Denis; Sheps, Sam

doi:10.1136/ip.4.2.122

Cited by 65 publications

(43 citation statements)

References 23 publications

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“…32 Our findings regarding bicycle-related amputations are consistent with multiple studies indicating that school-aged children are at the highest risk for such injuries. [47][48][49][50] Our data also showed that bicyclerelated amputations are more often complete than amputations associated with any other product. The majority of these injuries were to fingers, with some toe injuries.…”

Section: Discussionmentioning

confidence: 66%

Characteristics of Pediatric Traumatic Amputations Treated in Hospital Emergency Departments: United States, 1990–2002

et al. 2005

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ABSTRACT. Objective. To examine the characteristics of children with traumatic amputations and the products associated with these injuries.Methods. Data regarding amputation injuries to children younger than 18 years treated in US emergency departments from 1990 to 2002 were obtained from the National Electronic Injury Surveillance System. Data included demographics, product involved, and body region injured.Results. An estimated 111 600 children younger than 18 years with amputation injuries were treated in US emergency departments from 1990 to 2002. The average age was 6.18 years (median: 4 years; mode: 1 year old). Males experienced 65.5% of these injuries. Finger amputations accounted for 91.6% of all amputations, ranging from 95.2% among 0-to 2-year-olds to 87.9% among 13-to 17-year-olds. Complete amputations accounted for 70.2% of all amputations among 13-to 17-year-olds compared with 52.6% of amputations among 0-to 2-year-olds. Adolescents also had the highest proportion of amputations resulting in hospital admission (26.6% for 13-to 17-yearolds compared with 11.9% for 0-to 2-year-olds). Adolescents had the highest proportion of amputation injuries involving lawn mowers (14.1% for 13-to 17-year-olds compared with 1.4% for 0-to 2-year-olds) and the highest proportion of amputations involving tools (29.3% for 13-to 17-year-olds compared with 2.5% for 0-to 2-year-olds). The percentage of amputations involving doors peaked in the youngest age group and decreased as age increased (65.8% of all amputations for 0-to 2-year-olds compared with 14.1% for 13-to 17-year-olds).Conclusions. To our knowledge, this is the first study to use a nationally representative sample to broadly investigate amputation injuries among children. The majority of traumatic amputation injuries occur to young children, to males, and to fingers and the majority involve doors. Adolescents experience a higher proportion of more serious amputation injuries. Effective interventions exist but are inadequately used to prevent many of these injuries, including door stops and modifications, bicycle-chain and spoke guards, wearing closed-toe footwear while bicycling, a no-mow-in-reverse default feature on ride-on lawnmowers with the override switch located behind the mower operator, and a SawStop system on power saws. Use of these technical countermeasures and changes in relevant product standards to promote their implementation and use could lead to a decrease in pediatric traumatic amputations. Pediatrics 2005;116:e667-e674. URL: www.pediatrics.org/cgi

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Section: Discussionmentioning

confidence: 66%

Characteristics of Pediatric Traumatic Amputations Treated in Hospital Emergency Departments: United States, 1990–2002

et al. 2005

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“…Helmet use significantly reduced risk of head injury (OR 0.15, 0.07-0.29) and brain injury (OR 0.12, 0.04-0.40) Wasserman (1990) [ [57] Bicycling Helmet Severe head injury Decrease in severe head injury rates over years of increasing helmet use Finvers (1996) [69] Bicycling Helmet Severe head injury Significantly increased risk of severe head injury without helmet (OR 3.12, 1.13-8.75) Linn (1998) [61] Bicycling [44] Ski and Snowboard Helmet Head injury Helmet use significantly reduced risk of head injury (p < 0.05) Rughani (2011) [45] Ski and Snowboard Helmet Skull fractures Helmet use associated with lower incidence of skull (p = 0.009) and craniofacial (p = 0.03) fractures Delaney (2008) [84] Soccer Headgear Concussion Increased concussion rate with not wearing headgear (RR 2.65, p = 0.001) Kraus (1970) [24] Hockey Helmet Head injury Helmet use significantly reduced risk of head injury (p = 0.03) Bond (1995) [55] Horseback riding Helmet Head injury Significantly more severe head injuries without helmet use and higher rate of hospitalization Brandenburg and Archer (2002) [54] Rodeo Helmet Head injury Helmet use significantly reduced risk of head injury (IRR 0.43, 0.26-1.02)…”

Section: Baseball and Cricketmentioning

confidence: 98%

Helmets, head injury and concussion in sport

Bonfield

Shin

Kanter

2015

The Physician and Sportsmedicine

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Research on the mechanism of concussion in recent years has been focused on the mechanism of injury as well as strategies to minimize or reverse injury. Sports-related head injury research has led to the development of head protective gear that has evolved over the years. Headgears have been designed to protect athletes from skull fractures, subdural hemorrhages and concussions. Over the years, through experience of athletes and continued scientific research, improvements in helmet design have been made. Although these advances have decreased the number of catastrophic injuries throughout sports, the effects on concussions are promising, but largely unproven. In this review, we will discuss development of helmets and studies analyzing their level of protection for both concussion and head injury. This will help us understand what future developments are still needed to minimize the risk of concussion among athletes in various forms of sports.

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“…Powell and Tranz estimated the rate of head trauma presenting to the Emergency Department among American children aged 1-14 years to be 7.3 per 10 000 children (3). Among children presenting to the Emergency Department following a cycling injury, 22-40% had sustained a head injury and the majority of children were not wearing a helmet (4)(5)(6). Approximately 40% of children who were admitted to the hospital or died owing to a cycling-related injury had experienced head trauma (7).…”

Section: Description Of the Conditionmentioning

confidence: 98%

The promotion of bicycle helmet use in children and youth: an overview of reviews

Russell

Foisy

Parkin

et al. 2011

Evid.‐Based Child Health

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Background: Bicycle-related head injuries are a common reason for paediatric emergency department visits. Helmets have been designed to reduce head injuries, and helmet use has been encouraged through mandatory helmet legislation and nonlegislation helmet promotion activities. Objectives:To synthesize the evidence published in the Cochrane Database of Systematic Reviews regarding bicycle helmet use among children, including helmet effectiveness and methods to promote helmet use. Methods:The Cochrane Database of Systematic Reviews was searched for all systematic reviews where 'bicycle * ' or 'helmet' appeared in title, abstract or keywords. Reviews were included if they examined paediatric data concerning head injuries among helmeted and nonhelmeted cyclists, helmet use or adverse consequences of helmets. Data pertaining to adults were excluded. Relevant data were extracted, entered into tables and synthesized using qualitative and quantitative methods.Main results: Three systematic reviews were identified and included 21 observational studies and 14 experimental studies. The methodological quality was assessed in only two of the reviews: the quality was similar in studies examining legislative interventions and several weaknesses were identified in the nonlegislative interventions. Among children, helmet use resulted in a 63% reduction in medically reported head injuries [adjusted odds ratio (OR): 0.37; 95% confidence interval (CI): 0.20, 0.66] and an 86% reduction in the odds of brain injuries (OR: 0.14; 95% CI: 0.05, 0.38). Enactment of mandatory helmet legislation for child cyclists reduced the odds of head injury hospitalizations by 45%, while the odds of head injury hospitalizations reduced by 27% among children in jurisdictions without legislation. There was a significant reduction in traumatic brain injury among children cycling after the passage of helmet legislation (OR: 0.82; 95% CI: 0.76, 0.89); however, there was no significant decrease in other head and facial injuries post-legislation (OR: 1.08; 95% CI: 0.90, 1.23). Legislation also resulted in a significant increase in the number of children observed wearing a helmet (prevalence ratio: 3.69; 95% CI: 2.65, 5.14). Compared with children who received no intervention, those who received nonlegislative helmet promotion activities had a significant increase in observed helmet wearing (OR: 2.08; 95% CI: 1.29, 3.34), self-reported helmet wearing (OR: 3.27; 95% CI: 1.56, 6.87) and self-reported helmet ownership (OR: 2.67; 95% CI: 0.89, 8.03). No adverse events were associated with helmet use among cyclists. Authors' conclusions:Bicycle helmets appear to be an effective way to reduce head injuries among children. Interventions to increase helmet use may be effective, particularly community-based, school-based, and those that provide free helmets; however, no effect of the interventions on helmet use were reported in randomized controlled trials. Finally, helmet legislation appears to be effective in increasing helmet use and reducing head injuries.

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Epidemiology of bicycle injury, head injury, and helmet use among children in British Columbia: a five year descriptive study

Abstract: Conclusion-The data indicate the need to control injuries by using helmets. A decrease in the number of head injuries and their severity is expected when bicycle helmet use becomes law in British Columbia. (Injury Prevention 1998;4:122-125)

Cited by 65 publications

References 23 publications

Characteristics of Pediatric Traumatic Amputations Treated in Hospital Emergency Departments: United States, 1990–2002

Characteristics of Pediatric Traumatic Amputations Treated in Hospital Emergency Departments: United States, 1990–2002

Helmets, head injury and concussion in sport

The promotion of bicycle helmet use in children and youth: an overview of reviews

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