Adventist Health Castle doctor talks helmet safety & head injuries

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Bicycle accidents can cause severe head injuries to Hawaii keiki riding the roads without a helmet. It causes more head injuries every year than baseball, football, skateboards, kick scooters, horseback riding, snowboarding, ice hockey, in-line skating and lacrosse according to the health experts at Adventist Health Castle. Executive Director of Hawaii Pacific Neuroscience, Dr. Kore Liow says the science is very clear: wearing a helmet can cut the risk of brain trauma significantly.

The statistics are shocking. Bike accidents crash-land more kids in hospital emergency rooms than any other sport. In fact, kids ages 5 to 14 get hurt more often than bikers of any other age. Every day, about 1,000 kids end up in hospital emergency rooms with injuries from bikes and about one kid every day dies of these injuries. Most injuries (45.7%) involved children 10–14 years of age and boys (72%).

The most common injury on the body were upper extremities (36%), lower extremities (25%), face (15%), and head and neck (15%). The most common types of injury were bruises and scrapes (29%) and cuts (23%).

More than 40 percent of all bicycle-related deaths are due to head injuries and  95% of bicyclists killed in 2006 reportedly were not wearing helmets. These types of patients can suffer lifetime problems, like limping or brain damage.

What are the most common reasons for these type of accidents? Motorists failing to yield the right of way to a bike caused 42% of accidents. 39% occurred because cars were making a turn and didn’t notice a bike. 86% of bike accidents involved an automobile or truck. Only 11% involved a bike only and 3% a bike and pedestrian.

Wearing a helmet does reduce the risk of sustaining a head injury. Riders without helmets are 14 times more likely to be involved in a fatal crash than helmeted riders. Children ages 10 to 14 are at greater risk for traumatic brain injury from a bicycle-related crash compared with younger children, most likely because helmet use declines as children age. Helmet use is lowest (for all ages) among children ages 11 to 14 (11%).

Correct fit and proper positioning are essential to the effectiveness of bike helmets at reducing injury. One study found that children whose helmets fit poorly are at twice the risk of head injury in a crash compared with children whose helmet fit is excellent. In addition, children who wear their helmets tipped back on their heads have a 52 percent greater risk of head injury than those who wear their helmets centered on their heads. It is estimated that 75% of bicycle-related fatalities among children could be prevented with a bicycle helmet. Child helmet ownership and use increases with the parent’s income and education level, yet decreases with the child’s age. Children are more likely to wear a bicycle helmet if riding with others (peers or adults) who are also wearing one.

Currently, 21 states, the District of Columbia and numerous localities have enacted some form of bicycle helmet legislation, most of which cover only young riders.  At least five states now require children to wear a helmet while participating in other wheeled sports (e.g., for scooters, inline skates, skateboards). Hawaii law states “No person under sixteen (16) years of age shall operate a bicycle on a street, bikeway, or any other public property unless that person is wearing a properly fitted and fastened bicycle helmet. This requirement also applies to a person who rides upon a bicycle while in a restraining seat that is attached to the bicycle or who rides in a trailer towed by the bicycle.”

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