Pediatric bicycle injury prevention and the effect of helmet use: the West Virginia experience.

OBJECTIVES

The primary objective was evaluation of the injury pattern of children 14 years old or less involved in bicycle accidents and comparison of the differences between those wearing a helmet and not wearing a helmet.

METHODS

This was a retrospective cohort study of all pediatric patients involved in bicycle crashes from 2008 through 2010 who were treated within the West Virginia Trauma System. A case was selected for further analysis if "bicycle" and "blunt cause of injury" were present in the Mechanism of Injury field and if age was 14 years old or less. Descriptive statistics were calculated on all variables. Differences between the helmeted and un-helmeted cohorts were tested using the Wilcoxon test or Fisher's exact test as appropriate. In all cases an alpha of 0.05 was selected as the threshold for statistical significance.

RESULTS

The helmeted group had a concussion rate of 19.4% while concussions were noted in 37.4% of the un-helmeted group (p = 0.0509). Additionally, there was a significant difference in the rate of skull fractures seen. Skull fractures occurred in 3.2% of the helmeted and 17.4% of the un-helmeted (p = 0.0408) riders. The rate of intra-cranial hemorrhage was 0% in helmeted riders and 17.4% in un-helmeted riders (p = 0.0079). Finally, perhaps the largest indicator of the effectiveness of helmets in the pediatric bicycle population is the mortality rate. While not statistically different, 100% (n = 2) of the deaths occurred in the un-helmeted group.

CONCLUSION

This study of the West Virginia pediatric population demonstrates findings similar to prior studies looking at the effectiveness of helmets in preventing injuries during a bicycle crash. Bicycle helmets were shown to significantly reduce the rates of both skull fractures and intracranial hemorrhage. Based on this, the expanded use of helmets within the pediatric population should continue to be encouraged both from an educational and legislative standpoint.