Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries
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Traumatic brain injury is a leading cause of disability in bicycle riders. Preventive measures including bicycle helmet laws have been highlighted; however, its protective role has always been debated. The aim of this study was to determine the utility of bicycle helmets in prevention of intra-cranial hemorrhage. We hypothesized that bicycle helmets are protective and prevent the development of intra-cranial hemorrhage.
We performed a 4-year (2009–2012) retrospective cohort analysis of all the patients who presented with traumatic brain injury due to bicycle injuries to our level 1 trauma center. We compared helmeted and non-helmeted bicycle riders for differences in the patterns of injury, need for intensive care unit admissions and mortality.
A total of 864 patients were reviewed of which, 709 patients (helmeted = 300, non-helmeted = 409) were included. Non-helmeted bicycle riders were more likely to be young (p < 0.001) males (p = 0.01). There was no difference in the median ISS between the two groups (p = 0.3). Non-helmeted riders were more likely to have a skull fracture (p = 0.01) and a scalp laceration (p = 0.01) compared to the helmeted riders. There was no difference in intra-cranial hemorrhage between the two groups (p = 0.1). Wearing a bicycle helmet was not independently associated (p = 0.1) with development of intra-cranial hemorrhage.
Bicycle helmets may have a protective effect against external head injury but its protective role for intra-cranial hemorrhage is questionable. Further studies assessing the protective role of helmets for intra-cranial hemorrhage are warranted.
KeywordsHelmet laws Traumatic brain injury Bicycle injury
- 1.Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. http://www.cdc.gov/injury/wisqars. Accessed 03 August 2013.
- 4.National Highway Traffic Safety Administration. Traffic safety facts, 2010 data—bicyclists and other cyclists. Washington, DC: US Department of Transportation; 2012. (publication no. DOT HS 811 624).Google Scholar
- 5.Bicycle Helmet Safety Institute. Helmet laws for bicycle riders. http://www.bhsi.org/mandator.htm. Accessed 5 October 2013.
- 8.Persaud N, Coleman E, Zwolakowski D, Lauwers B, Cass D. Nonuse of bicycle helmets and risk of fatal head injury: a proportional mortality, case–control study. CMAJ 2012;184(17).Google Scholar
- 15.Wasserman RC, Buccini RV. Helmet protection from head injuries among recreational bicyclists. Am J Sports Med. 1990;18(1):96–7.Google Scholar
- 16.Centers for Disease Control and Prevention. Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged ≤19 years—United States, 2001–2009. Morb Mortal Wkly Rep. 2011;60(39):1337–42.Google Scholar