Abstract
Most of the nearly 1,000 fatal bicycle-related injuries annually could be prevented if riders used safety helmets. Helmet use by adult bicyclists has received relatively little attention because educational campaigns to promote helmet use generally focus on children. Helmet use by adult and child bicyclists at 120 suburban and rural sites in three Maryland counties was observed on two Saturdays in 1990-91 during an evaluation of the impact of a mandatory helmet law. Concordance or discordance of helmet use within various groups of bicyclists--adults only, adults with children, and children only--was recorded. Helmet use among 2,068 adult bicyclists was 49 percent, 51 percent, and 74 percent in the three counties. In two counties combined, 52 percent (365 of 706) of solo adult bicyclists wore helmets compared with only 5 percent (5 of 94) of solo child bicyclists (P < .001). Helmet use or nonuse was concordant among 87 percent of 277 adult-adult pairs, 94 percent of 50 child-child pairs, and 91 percent of 32 adult-child pairs of bicyclists observed. Concordance rates of helmet use or nonuse were similarly high among pairs of adult bicyclists of the same or mixed sexes. These data are consistent with the concept that both adults and children tend to adopt the helmet-wearing behaviors of their companions. Public health efforts focused on adults should encourage helmet use by adult bicyclists both to prevent head injuries and to provide a role model for children.
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Selected References
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- Coté T. R., Sacks J. J., Lambert-Huber D. A., Dannenberg A. L., Kresnow M. J., Lipsitz C. M., Schmidt E. R. Bicycle helmet use among Maryland children: effect of legislation and education. Pediatrics. 1992 Jun;89(6 Pt 2):1216–1220. [PubMed] [Google Scholar]
- Cushman R., Down J., MacMillan N., Waclawik H. Helmet promotion in the emergency room following a bicycle injury: a randomized trial. Pediatrics. 1991 Jul;88(1):43–47. [PubMed] [Google Scholar]
- Cushman R., James W., Waclawik H. Physicians promoting bicycle helmets for children: a randomized trial. Am J Public Health. 1991 Aug;81(8):1044–1046. doi: 10.2105/ajph.81.8.1044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DiGuiseppi C. G., Rivara F. P., Koepsell T. D. Attitudes toward bicycle helmet ownership and use by school-age children. Am J Dis Child. 1990 Jan;144(1):83–86. doi: 10.1001/archpedi.1990.02150250093041. [DOI] [PubMed] [Google Scholar]
- DiGuiseppi C. G., Rivara F. P., Koepsell T. D., Polissar L. Bicycle helmet use by children. Evaluation of a community-wide helmet campaign. JAMA. 1989 Oct 27;262(16):2256–2261. [PubMed] [Google Scholar]
- Dorsch M. M., Woodward A. J., Somers R. L. Do bicycle safety helmets reduce severity of head injury in real crashes? Accid Anal Prev. 1987 Jun;19(3):183–190. doi: 10.1016/0001-4575(87)90002-9. [DOI] [PubMed] [Google Scholar]
- Howland J., Sargent J., Weitzman M., Mangione T., Ebert R., Mauceri M., Bond M. Barriers to bicycle helmet use among children. Results of focus groups with fourth, fifth, and sixth graders. Am J Dis Child. 1989 Jun;143(6):741–744. doi: 10.1001/archpedi.1989.02150180123033. [DOI] [PubMed] [Google Scholar]
- Kiburz D., Jacobs R., Reckling F., Mason J. Bicycle accidents and injuries among adult cyclists. Am J Sports Med. 1986 Sep-Oct;14(5):416–419. doi: 10.1177/036354658601400516. [DOI] [PubMed] [Google Scholar]
- Kimmel S. R., Nagel R. W. Bicycle safety knowledge and behavior in school age children. J Fam Pract. 1990 Jun;30(6):677–680. [PubMed] [Google Scholar]
- Runyan C. W., Earp J. A., Reese R. P. Helmet use among competitive cyclists. Am J Prev Med. 1991 Jul-Aug;7(4):232–236. [PubMed] [Google Scholar]
- Runyan C. W., Runyan D. K. How can physicians get kids to wear bicycle helmets? A prototypic challenge in injury prevention. Am J Public Health. 1991 Aug;81(8):972–973. doi: 10.2105/ajph.81.8.972. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sacks J. J., Holmgreen P., Smith S. M., Sosin D. M. Bicycle-associated head injuries and deaths in the United States from 1984 through 1988. How many are preventable? JAMA. 1991 Dec 4;266(21):3016–3018. [PubMed] [Google Scholar]
- Thompson R. S., Rivara F. P., Thompson D. C. A case-control study of the effectiveness of bicycle safety helmets. N Engl J Med. 1989 May 25;320(21):1361–1367. doi: 10.1056/NEJM198905253202101. [DOI] [PubMed] [Google Scholar]
- Vulcan A. P., Cameron M. H., Watson W. L. Mandatory bicycle helmet use: experience in Victoria, Australia. World J Surg. 1992 May-Jun;16(3):389–397. doi: 10.1007/BF02104437. [DOI] [PubMed] [Google Scholar]
- Wasserman R. C., Buccini R. V. Helmet protection from head injuries among recreational bicyclists. Am J Sports Med. 1990 Jan-Feb;18(1):96–97. doi: 10.1177/036354659001800116. [DOI] [PubMed] [Google Scholar]
- Wasserman R. C., Waller J. A., Monty M. J., Emery A. B., Robinson D. R. Bicyclists, helmets and head injuries: a rider-based study of helmet use and effectiveness. Am J Public Health. 1988 Sep;78(9):1220–1221. doi: 10.2105/ajph.78.9.1220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weiss B. D. Bicycle helmet use by children. Pediatrics. 1986 May;77(5):677–679. [PubMed] [Google Scholar]
- Williams A. F. Observed child restraint use in automobiles. Am J Dis Child. 1976 Dec;130(12):1311–1317. doi: 10.1001/archpedi.1976.02120130017003. [DOI] [PubMed] [Google Scholar]
