Originally published by Medscape.com November 2001

This summer, don't let your kids head out for even a quick bike ride without reminding them to put on their helmets.

If what you hear is, "But Mom, it's too hot!" or the all-time classic, "I don't want to!" be firm. You may be preventing a devastating head injury.

Each year almost 400,000 children are treated in emergency departments for bicycle-related injuries, reports the American College of Emergency Physicians (ACEP). The organization predicts that wearing bicycle helmets could prevent 39,000-45,000 of those head injuries per year.

"A reduction in risk among helmet wearers of 63% for upper head injuries and 86% for loss of consciousness" was reported in a study in the British Medical Journal. The study's author, Dr. S. Thomas, notes, "The association between wearing helmets and reduced risk of head injury among child bicyclists is now compelling."

Not surprisingly, head injuries were more likely to occur on paved surfaces than on grass, gravel, or dirt. You may be surprised to know, however, that collisions with vehicles were not the top cause of accidents in this study.

"Only 31 [7% of the 455 in the study] had contact with another moving vehicle. Most children were injured after losing control and falling from their bicycle," adds Dr. Thomas.

Although 64% of the injured children in the study owned helmets, only a third were actually wearing helmets at the time of the accident. What factors could have encouraged that other third to wear their helmets?

Trauma nurses in Florida tried to answer this question.

Making Helmets Top Priority

Alarmed by the number of serious head injuries in nonhelmeted children, nurses working in the Pediatric Referral Trauma Center and emergency department of Broward General Medical Center developed a community-wide bicycle safety program.

They created a thorough educational program that coincided with a new law on helmet use. Their program included:

Nurse visits to elementary schools to discuss safe biking and helmet use.
Bicycle rodeos at elementary and middle schools.
Safety fairs at local churches and malls.
Print awareness campaigns using student-designed posters.
Helmet safety packets distributed at all emergency rooms.
An educational packet designed for parents.
Free and discounted helmets made available to the children.
The outcome of the campaign was promising. Helmet use rose from 5% to 20%--a fourfold increase.

"Although this increase was significant, the fact remains that nearly 80% of the children admitted [to the hospital] with injuries from bicycle crashes were not helmeted. The number of nonhelmeted children remains much too high," notes article author Susan T. Borglund, RN, MSN, CCRN.

What's a Parent to Do?

Parents can learn more from organizations like the Brain Injury Association and the National Highway Traffic Safety Administration (NHTSA). Both are good resources for literature and information on the subject.

The two organizations have jointly created bicycle safety information, including the HeadSmart Bicycling Safety video. NHTSA makes the video available to schools, youth groups, religious groups, and others.