Sweden: Head Injury Trends in Bicyclists

Sweden has a long history of promoting bicycle helmets for children and has been conducting surveys since 1988 to measure helmet wearing rates in all age groups. Now, researchers at the Department of Public Health and Caring Sciences, Uppsala University, have examined trends of bicycle-related head injuries.

Sweden has a national hospital discharge register that covers the entire population of 9 million people. The register includes demographic data as well as information on cause of injury and injury diagnosis. For this analysis, data from 1987-1996 on 49,758 people were examined and head injury rates for four age groups were calculated. In this paper, head injury rates were specified as the number of hospital discharges in a year divided by the mean population.

Boys had the highest rates (65.2 hospital discharges for head injury/100,000) and older women had the lowest rates (11.4) of head injuries. Overall, boys and girls under 15 had the highest rates for head injuries, but hospitalizations for other bicycle-related injuries remained stable. During the study period, the head injury rates for children decreased by a total 46% - the equivalent of 550 fewer bicycle-related head injuries each year. For ages greater than 15, head injury and other injury annual rates increased on the average each year, although the increase was only significant for the 16-50 year age group.

In Sweden, helmet wearing among children increased from about 20% to 35% during the years 1988 to 1996, and the authors attribute the reduction they calculated in hospitalized head injuries to this increased use in helmets. They do not believe that this decrease was associated with any changes in bicycle riding because rates for discharges for other bicycle injuries remained about the same. Helmet use for adults increased during the same period, but not to the same extent – the measured adult wearing rate rose from 2% to 14%. The authors have no conclusions about why there were no decreases in their head injury rates.

Berg P, Westerling R. A decrease in both mild and severe bicycle related head injuries in helmet wearing ages – trend analyses in Sweden. Health Promot Int 2007;22:191-7.

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