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Head injuries up after Alberta helmet law?

Edmonton Sun, 12th July 2003

by David Sands

Surprising stats suggest bike-accident head injuries have increased since Alberta passed a mandatory helmet law.

Figures from nine health regions show a sharp spike in the percentage of bicycle-related head injury cases coming into their emergency wards. And that spike peaks in the six months following the government's mandatory helmet law.

"I would urge caution in interpreting these statistics beyond anything more than, 'That's interesting,' " said renowned injury-prevention specialist Dr. Louis Francescutti.

Stats were compiled by emergency room surveys for six months - May to October - in each of 1999, 2000, 2001 and 2002.

The helmet law, which applies to riders under 18, took effect in May 2002.

In the years 1999 to 2001, the percentage of head injuries among all bicycle-related injuries remained relatively constant at just above 5%.

By the end of October 2002, however, it shot up to above 10% for children and just under 10% for all age groups.

The stats are "a bit of a surprise," said Alberta Transportation spokesman Leanne Stangeland. "We did introduce the bike helmet legislation and so it is a bit of a surprise there would all of a sudden be an increase like this."

The figures are "really suspect" and could be skewed by several factors, said Kathy Belton, co-director of the Alberta Centre for Injury Control and Research, which gathered the stats. "So you can't really say that bicycle head injuries are going up. There's issues in terms of how the data is reported because there's been a change in how the data is actually coded."

The "coding classification change" took effect in April 2002. "It looks like they went up (but) what you need to remember is that's just a sampling of the regional health authorities that reported. If we had the other regions, I think we might be seeing a decline," Belton said.

Health regions were under no obligation to complete the survey. Belton said the centre is now waiting for data from Alberta Health, which will include every region.

The explanations offered by the injury agency are all likely valid, Stangeland said, but one at least is disturbing if true: "... the perceived safety of wearing a helmet, thus increased risk-taking behaviour."

"We would hope that there would not be increased risk-taking behaviour - our legislation was put in place to keep kids safe, not so they take more risks," Stangeland said.

Francescutti has further cautions.

"It's a very short time frame for drawing conclusions," he said, adding the actual number of head injuries could be so small that even slight increases lead to dramatic-appearing percentage increases. And "if you take a look out there, there's been a little bit of an increase in helmet use, but it's still not as high as you might expect."

Both Stangeland and Francescutti said a long-term, in-depth analysis is required.

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