U.S.A.: Legislation and helmet wearing

Many reports have indicated that legislation requiring children to wear bicycle helmets increases helmet use in six months to one year. But what happens over an extended period of time such as four or five years? Lisa Pardi and her colleagues at the Akron Children’s Hospital in Ohio, United States of America, were able to analyze injury data for a five-year period and found that injuries remained lower four years after the passage of a helmet law for children.

In Akron, at the beginning of 2000, bicycle injuries for children were increasing. An 82% increase was seen from one year to the next, despite an active hospital-based, low-cost bicycle helmet programme. Armed with these data, community leaders were able to convince the Akron city council to pass a law requiring helmet wearing for all children under 16 years old. Pardi’s group examined hospital discharge data for the year before and the five years following passage of the law. Here’s what they found:

• The bicycle-related injury rate decreased by 27% during the five years after the law was passed.
• Extremities were the most common part of the body injured.
• Overall, 5 to 9 year old boys and 10 to 16 year old boys showed a decrease in head injuries.
• The head injury rate for 5 to 9 year old girls dropped by 22% in the final year of the study compared to the baseline data, while the head injury rate for the 10 to 16 year old girls decreased only by 2.2%. Compared to boys, the rate for girls was much lower.

Since this study used only hospital discharge data, there were limitations to the conclusion. No information was obtained about bicycle riding frequency or helmet wearing rates during this period. Police reported no enforcement activity for repeat offenders of the law and they said the number of bicycle education rodeos had decreased in the years following the passage of the law.

Editor’s note: The data reported in this study do not allow detailed analysis of the head injury trends.

Pardi LA, Salemi G, Salvator AE. The Effect of bicycle helmet legislation on pediatric injury. J Trauma Nursing 2007;14(2):84-87.

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