Auto and Road User Journal
September 9, 1998
(U.S. and Canada)
Fax: (360) 335-6402
THE NATIONAL SAFE KIDS CAMPAIGN BICYCLE INJURY FACT SHEET
|(This article is reproduced with permission from the website of the National Safe Kids Campaign at http://www.safekids.org/home.html.)
More than 70 percent of children ages 5 to 14 (27.7
million) ride bicycles. This age group rides about 50 percent
more than the average bicyclist and accounts for approximately
one-third of all bicycle-related deaths and more than two-thirds
of all bicycle-related injuries. Bicycles are associated with
more childhood injuries than any other consumer product except
Head injury is the leading cause of death in bicycle
crashes and is the most important determinant of bicycle-related
death and permanent disability. Head injuries account for more
than 60 percent of bicycle-related deaths, more than two-thirds
of bicycle-related hospital admissions, and about one-third of
hospital emergency room visits for bicycling injuries. The single
most effective safety device available to reduce head injury and
death from bicycle crashes is a bicycle helmet. Helmet use is
associated with a reduction in the risk of bicycle-related death
and injury and a reduction in the severity of head injury when
a crash occurs. Unfortunately, national estimates report that
bicycle helmet use among child bicyclists ranges from 15 to 25
percent. Helmet usage is lowest (for all ages) among children
ages 11 to 14 (11 percent). Bicycle education programs and mandatory
bicycle helmet legislation are effective at increasing helmet
use and, therefore, reducing bicycle-related death and injury.
DEATHS AND INJURIES
- In 1995, more than 250 children ages 14 and under
died in bicycle-related crashes. Motor vehicles were involved
in 230 of these deaths.
- In 1996, more than 350,000 children ages 14 and
under were treated in hospital emergency rooms for bicycle-related
- It is estimated that collisions with motor vehicles
account for 90 percent of all bicycle-related deaths and 10 percent
of all nonfatal bicycle-related injuries. Collision with a motor
vehicle increases the risk of death, severity of injury, and the
probability of sustaining a head injury.
- More than 40 percent of all head injury-related
deaths and approximately three-fourths of head injuries occur
among children ages 14 and under. Younger children suffer a higher
proportion of head injuries than older children.
WHEN AND WHERE BICYCLE DEATHS AND INJURIES
- Children are more likely to die from bicycle
crashes at non-intersection locations (66 percent), during the
months of May to August (55 percent), and between 3 p.m. and 6
p.m. (39 percent).
- Nearly 60 percent of all childhood bicycle-related
deaths occur on minor roads. The typical bicycle/motor vehicle
crash occurs within one mile of the bicyclist's home.
- Children ages 14 and under are more likely to
be injured riding in non-daylight hours (e.g., at dawn, dusk or
night). The risk of sustaining an injury during non-daylight
conditions is nearly four times greater than during the daytime.
- Among children ages 14 and under, more than 80
percent of bicycle-related fatalities are associated with the
bicyclist's behavior. The most common crashes include riding
into a street without stopping; turning left or swerving into
traffic that is coming from behind; running a stop sign; and riding
against the flow of traffic.
WHO IS AT RISK
- Riding without a bicycle helmet increases the
risk of sustaining a head injury in the event of a crash. Nonhelmeted
riders are 14 times more likely to be involved in a fatal crash
than bicyclists wearing a helmet.
- Collision with a motor vehicle and crashes occurring
at speeds greater than 15 miles per hour increase the risk of
severe bicycle-related injury and death.
- Children ages 14 and under are five times more
likely to be injured in a bicycle-related crash than older riders.
- Males account for approximately 85 percent of
bicycle-related deaths and 70 percent of nonfatal injuries and
have higher bicycle-related death and injury rates than females.
Children ages 10 to 14, especially males, have the highest death
rate from bicycle-related head injury of all ages.
- Children under age 10 are at greater risk for
serious injury and are more likely to suffer head injuries than
older riders. Approximately half of all bicycle-related injuries
among children under age 10 occur to the head/face, compared to
one-fifth among older children.
- Bicyclists admitted to hospitals with head injuries
are 20 times more likely to die as those without head injuries.
BICYCLE HELMET EFFECTIVENESS
- Bicycle helmets have been shown to reduce the
risk of head injury by as much as 85 percent and the risk of brain
injury by as much as 88 percent. Bicycle helmets have also been
shown to offer substantial protection to the forehead and mid
- It is estimated that 75 percent of bicycle-related
fatalities among children could be prevented with a bicycle helmet.
- Universal use of bicycle helmets by children
ages 4 to 15 could prevent between 135 and 155 deaths, between
39,000 and 45,000 head injuries, and between 18,000 and 55,000
scalp and face injuries annually.
- Child helmet ownership and use increases with
income and educational level, yet decreases with age. Children
are more likely to wear a bicycle helmet if riding with others
(peers or adults) who are also wearing one and less likely to
wear one if their companions are not.
BICYCLE HELMET LAWS AND REGULATIONS
- Currently, 15 states and more than 30 localities
have enacted some form of bicycle helmet legislation, most of
which cover only young riders.
- Various studies have shown bicycle helmet legislation
to be effective at increasing bicycle helmet use and reducing
bicycle-related death and injury among children covered under
the law. Helmet use among children is greater in those regions
of the United States with the highest proportion of mandatory
- One example shows that five years following the
passage of a state mandatory bicycle helmet law for children ages
13 and under, bicycle-related fatalities decreased by 60 percent.
- Pursuant to the Child Safety Protection Act of
1994, the Consumer Product Safety Commission is currently developing
a mandatory federal safety standard for bicycle helmets.
HEALTH CARE COSTS AND SAVINGS
- Every bicycle helmet saves this country $395
in direct medical costs and other costs to society.
- If 85 percent of all child cyclists wore bicycle
helmets in one year, the lifetime medical cost savings could total
between $109 million and $142 million.
- A review of hospital discharge data in Washington
state found that treatment for nonfatal bicycle injuries among
children ages 14 and under cost more than $113 million each year,
an average of $218,000 per child.
PREVENTION TIPS FROM THE NATIONAL SAFE KIDS CAMPAIGN
- A bicycle helmet is a necessity, not an
accessory. Always wear a bicycle helmet every time and everywhere
- Wear a bicycle helmet correctly. A bicycle helmet
should fit comfortably and snugly, but not too tightly. It should
sit on top of your head in a level position and should not rock
forward and back or from side to side. The helmet straps must
always be buckled.
- Buy a bicycle helmet that meets or exceeds the
safety standards developed by the American National Standards
Institute (ANSI), the Snell Memorial Foundation and/or the American
Society for Testing and Materials (ASTM).
- Learn the rules of the road and obey all traffic
laws. Ride on the right side of the road, with traffic,
not against; use appropriate hand signals; respect traffic signals;
stop at all stop signs and stop lights; and stop and look both
ways before entering a street.
- Cycling should be restricted to sidewalks and
paths until a child is age 10 and able to show how well he or
she rides and observes the basic rules of the road. Parental
and adult supervision is essential until the traffic skills and
judgment thresholds are reached by each child.
This information was compiled by the National SAFE KIDS Campaign (NSKC), 1301 Pennsylvania Avenue, Suite 1000, Washington, D.C. 20004-1707.
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