The effects of bicycling helmets in preventing significant bicycle-related injuries in children

Finvers KA, Strother RT, Mohtadi N.
Clinical Journal of Sports Medicine, 1996 Apr;6(2):102-7

BRIEF NOTES
This is not a complete Commentary but a summary of observations and criticisms that have been made relating to this paper

Summary of paper (based on authors' abstract)

All children presenting to the Albert Children's Hospital Emergency Department from April 1991 to September 1993 were entered into the CHIRPP database. Standardized information collected included age and sex of child, nature, location and time of injury; whether any safety devices were being used; and the attending physician's determination of injuries and treatment rendered. Bicycle accidents resulted in 856 injuries. 13.7% of children were wearing a helmet at the time of injury. 76 serious head injuries were recorded. The risk of serious head injury was significantly greater when a helmet was not worn. There was no significant difference in serious injuries overall comparing helmeted and non-helmeted children.

General observations

Peer criticism

By Towner et al, 2002:

No cycling exposure data presented and no clear information on population helmet wearing rates in this age group.
The most seriously injured may be excluded as these are taken direct to the Intensive Care Unit.
It is not clear if helmets protect against non-serious injuries.
No numerical data presented on serious injuries to the rest of the body.
No adjustment for possible confounding factors.
Self-reporting of important information.
Parents may false positive report helmet use in injured children.
Average age (8 - 9 years) given by no standard deviation.
Insufficient data to draw clear conclusions.

References

Towner et al, 2002

Towner E, Dowswell T, Burkes M, Dickinson H, Towner J, Hayes M, 2002. Bicycle helmets - a review of their effectiveness: a critical review of the literature. Department for Transport Road Safety Research Report 30.