May 22, 2000 -- Fewer kids are injured in bicycle-towed trailers than in child-mounted bicycle seats, and their injuries are also less severe, according to a report in the April issue of the journal Archives of Pediatric and Adolescent Medicine.
"But before the trailers can be recommended over child seats, more surveillance is needed," says study author Elizabeth Powell, MD, MPH, an emergency medicine specialist at Children's Memorial Hospital and assistant professor of pediatrics at Northwestern University School of Medicine, both in Chicago.
Powell reviewed data from the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission from 1990 to 1998. NEISS estimates national patterns of product-related injury, based on reports from emergency departments throughout the country.
NEISS estimates that there were 320 injuries associated with bicycle-towed trailers, vs. 2,000 injuries associated with child-mounted bicycle seats. Scrapes and bruises to the head and face were most common, accounting for 80% of trailer injuries and 45% of mounted seat injuries. Fractures and foot trauma accounted for another 40% of mounted seat injuries.
There was no significant difference between the safety of the devices when cars were involved in the accidents, but the authors urge caution in interpreting the data. "We had to search partly with keywords, because bicycle-towed trailers don't have a product code, so some injuries may not have been identified," notes Powell.
Other experts say that, for every injury, there are lots of lucky saves. "NEISS does a good job of estimating injuries, but it can't possibly project all the near misses," says Angela Mickalide, PhD, program director of the National Safe Kids Campaign and author of Cycle Smart.
Mickalide tells WebMD that the American Society of Testing Materials is developing guidelines for weight, width, and wheel size to further enhance the stability of bicycle-towed trailers. In the meantime, Cycle Smart offers several safety recommendations.
Bicycle-towed trailers are designed for and should only be used by children ages 1 through 4. Single-passenger units have a weight limit of 50 pounds to 70 pounds, and two-passenger models have a weight limit of 100 pounds. Children should always be buckled up and keep their hands and feet inside. Attachable flags should also be used to enhance visibility.
Whether riding in a trailer or a child seat, kids should always wear a protective helmet. "Kids less than 12 months of age don't have the neck strength to support a helmet, so they really shouldn't be cycling," adds Powell. "Older children should always wear a helmet that fits snugly and covers the forehead. And if you're lucky enough to live in a community with bike paths, by all means use them."
The editor of the journal provides another perspective. "Walking with your kids may be safer than cycling," says Catherine DeAngelis, MD, a professor of pediatrics at Johns Hopkins University School of Medicine in Baltimore. "And you can even talk at the same time!"
- Fewer kids are injured in bicycle-towed trailers than in child-mounted bicycle seats, but more information is needed before a recommendation can be made.
- There are six times as many injuries associated with child-mounted bicycle seats, most of which are scrapes and bruises to the head and face, fractures, and foot trauma.
- Bicycle-towed trailers are intended for one or two passengers between the ages of 1 and 4, with a total body weight of less than 100 pounds. Use of seat belts and attachable flags enhances trailer safety.
- Use of bike paths and protective helmets is recommended for all cyclists.