Bicycling is a popular recreational activity among children and adults in America. It is estimated that approximately 40 million children ride bicycles each year, and about 450,000 children are treated in the emergency department for bicycle-related injuries yearly.
Unfortunately, only 25 percent of children use helmets all or most of the time while cycling, or other activities such as rollerblading, skate-boarding, or riding scooters. Of the 450,000 ER visits for these injuries, one-third are for head injuries. These are often very serious and account for most bicycle-related deaths. Many of the non-fatal injuries lead to lifelong disability associated with brain damage.
It is well-established that bicycle helmets are effective in preventing head injuries associated with bicycling. Studies overall have shown that helmets decrease the risk of head and brain injury by 85 percent. The risk of facial injuries is also reduced by 65 percent.
Use of bicycle helmets can prevent or lessen the severity of brain injury by absorbing some of the energy and spreading the sharp initial blow over a larger surface area and lessening the peak force of the blow at impact.
The essential part of the helmet designed for impact protection is a thick layer of firm polystyrene plastic foam that crushes on impact, absorbing the force of the blow.
Hard-shell helmets also have a hard outer shell of plastic or fiberglass that helps provide a shield against sharp objects and holds the polystyrene foam together if it cracks in a fall or crash. They are sturdier and warmer, but also heavier than soft-shell models.
Soft-shell models have no hard outer shell, but are made of an extra-thick layer of polystyrene covered by a cloth or surface clothing. The cloth cover is an essential part of the helmet and must always be worn to hold it together if the polystyrene cracks on impact. Soft-shell helmets are lighter, but may be less durable. All helmets should include a chin strap to keep them in place in event of a crash.
You should only buy a helmet that meets the bicycle helmet safety standards of the Consumer Product Safety Commission (CPSC). All helmets made or imported for use after 1999 must comply with this mandatory safety standard and will be appropriately labeled inside the helmet. Helmets meeting the CPSC standards are available at bicycle shops and at various department/toy stores. Please do not sell, re-use, donate or buy a used bike helmet as it may be too old to provide protection or may have been in a crash.
Helmets come in roughly four different sizes and are well-ventilated for comfort and acceptability. The helmet should be positioned so it is worn squarely on the top of the head (without tilting it backwards) so it sits low on the forehead.
The helmet fits well if it doesn’t move around on the head or slide down over the wearer’s eyes when pushed or pulled. Installing or removing inside pads will help keep it snug. The chin strap, when secure, should allow only two fingers to be inserted between the strap and chin, in order to make it comfortably snug and not allow the helmet to come off or shift over the eyes.
There is even an infant-sized soft-shell variety of helmets. They are very light, which is important for young children whose necks may not be strong enough to hold a hard-shell helmet. Babies younger than one year old have a relatively weak neck structure so bike travelling is not recommended for them. Infant or children’s helmets should fit for several years and has removable pads that can be replaced with thinner ones as your child’s head grows. Young children who ride as passengers must wear an appropriate-sized helmet and sit in a bicycle-mounted child seat, or preferably, a bicycle-towed child trailer.
Many national safety organizations and government agencies have called for universal helmet use by all bicyclists regardless of age. Several strategies have been used, such as creating bicycle helmet safety campaigns and promoting helmet use through community initiatives, school-based education programs, and economic incentives.
The most effective factors promoting helmet use by children have been 1) state mandatory helmet use laws and/or local ordinances and two) helmet use by an accompanying parent.
Please serve as a model for your children, for your own safety and that of your child, and ensure that your child wears a helmet every time he or she rides a bike.
For more information, visit www.EsseHealth.com.
By Michael Danter, M.D., Esse Health Pediatrician
9979 WingHaven Blvd., Suite 206
O'Fallon, MO 63368