July 11, 2001 -- Bicycle accidents result in more than half a million emergency room visits and approximately 800 deaths in the U.S. each year, with a large percentage of fatalities occurring among children. Most of these serious injuries and deaths could be easily avoided, but experts say that fewer than one in five cyclists get one simple precautionary message: helmets save lives.
According to figures from the Insurance Institute for Highway Safety, 98% of the bicyclists killed in 1999 were not wearing helmets. Now researchers at the Mayo Clinic's Sports Medicine Center in Rochester, Minn. report in the July issue of the journal Pediatrics that two age groups -- teenagers and thirtysomethings -- are least likely to don protective headgear. In contrast, children 10 and under and adults 50 and over are most likely to wear helmets.
"People need to know that if they are on something with wheels, they should be wearing a helmet," Philip Graitcer, DMD, of Emory University in Atlanta. tells WebMD. "That goes for bicycles, skateboards, or rollerblades. But the message is often lost on adolescents because they think they are invincible." Graitcer is a professor at Emory's Center for Injury Control and director of the 10-year-old World Health Organization Helmet Initiative.
Estimates of overall bicycle helmet usage are imprecise, with studies ranging from just 15% to almost 50%. In this survey of over 2,000 people, helmet use was reported by 44% of children between the ages of 7 and 10, then floated around a third for those in their teens to their 40s. The number shot up to 62% of bike riders in their 50s.
Randy Swart, director of the Bicycle Helmet Safety Institute, says these figures are probably high. The best study conducted to date evaluating bicycle helmet use, he says, suggests that approximately 17% of cyclists routinely use helmets.
"This sounds discouraging, but it is a lot higher than it was in 1974, when I could ride around Washington D.C. and I would know everyone who wore a helmet personally," Swart tells WebMD.
Top reasons for not wearing helmets among the Mayo survey respondents were that they were "uncomfortable", "annoying", and "hot". More adults (29%) reported not owning a helmet than children (12%).
A surprisingly high percentage of those questioned from all age groups underestimated the risk of head injuries while bicycling, and fewer than half of the teens surveyed believed that helmets provided "great help" in protecting them from such injuries.
Both Swart and Graitcer say they are not surprised that teenagers appear resistant to the message that helmet use saves lives. Both disagree with the study's recommendation that education efforts should target teens.
"It is just too hard to reach [teenagers] with safety messages," Graitcer tells WebMD. "There is really more bang for the buck when you direct the message toward smaller children and their parents."
"You really have to introduce helmets in elementary school, and that is being done more and more," Swart agrees. "In Australia, they started 20 years ago with first graders and by the time they passed helmet laws, two-thirds of riders routinely wore helmets. Today it is even higher."