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. 1999 Sep;5(3):194–197. doi: 10.1136/ip.5.3.194

Fit of bicycle safety helmets and risk of head injuries in children

F Rivara 1, S Astley 1, S Clarren 1, D Thompson 1, R Thompson 1
PMCID: PMC1730523  PMID: 10518266

Abstract

Background—Although bicycle helmets are effective in preventing head and brain injury, some helmeted individuals nevertheless sustain head injury. One of the possible reasons may be poor fit of the helmet on the head. This study was undertaken to examine the relationship between helmet fit and risk of injury.

Methods—1718 individuals who were helmeted riders in a crash were queried on helmet fit and position. A sample of 28 children 2–14 years of age who sustained a head injury while wearing a bicycle helmet and 98 helmeted individuals of the same age treated in the same hospital emergency departments for injuries other than to the head, underwent anthropometric measurements of helmet fit. Measurements were made of the child's head, the helmet, and on a cast made of the child's head.

Results—Individuals whose helmets were reported to fit poorly had a 1.96-fold increased risk of head injury compared with those whose helmets fit well. Children with head injuries had helmets which were significantly wider than their heads compared with children without head injuries. Helmet fit was poorer among males and among younger children.

Conclusions—Poor fit of helmets may be associated with an increased risk of head injury in children, especially in males. Helmets may not be designed to provide optimal protection.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clarren S. K. Plagiocephaly and torticollis: etiology, natural history, and helmet treatment. J Pediatr. 1981 Jan;98(1):92–95. doi: 10.1016/s0022-3476(81)80549-5. [DOI] [PubMed] [Google Scholar]
  2. Maimaris C., Summers C. L., Browning C., Palmer C. R. Injury patterns in cyclists attending an accident and emergency department: a comparison of helmet wearers and non-wearers. BMJ. 1994 Jun 11;308(6943):1537–1540. doi: 10.1136/bmj.308.6943.1537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. McDermott F. T., Lane J. C., Brazenor G. A., Debney E. A. The effectiveness of bicyclist helmets: a study of 1710 casualties. J Trauma. 1993 Jun;34(6):834–845. doi: 10.1097/00005373-199306000-00015. [DOI] [PubMed] [Google Scholar]
  4. Thomas S., Acton C., Nixon J., Battistutta D., Pitt W. R., Clark R. Effectiveness of bicycle helmets in preventing head injury in children: case-control study. BMJ. 1994 Jan 15;308(6922):173–176. doi: 10.1136/bmj.308.6922.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Thompson D. C., Rivara F. P., Thompson R. S. Effectiveness of bicycle safety helmets in preventing head injuries. A case-control study. JAMA. 1996 Dec 25;276(24):1968–1973. [PubMed] [Google Scholar]
  6. 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]

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