PEDIATRIC HEAD-INJURIES AND DEATHS FROM BICYCLING IN THE UNITED-STATES

Objective. To estimate the potential benefit of increasing bicycle hel met use among children and adolescents in the United States. Design. A ll bicycle-related deaths (Multiple Cause-of-Death Public Use Data Tap es, 1989 through 1992) and bicycle-related injuries treated in sampled emergency departments (National Electronic Injury Surveillance System , 1989 through 1993) were used to calculate traumatic brain injury-ass ociated death and head injury rates per 1000000 US residents. Preventa ble injuries and deaths were estimated by calculating the population-a ttributable risk of head injury due to nonuse of bicycle helmets. Pati ents. US residents aged 0 through 19 years who were injured or who die d as a result of a bicycle crash. Results. An average of 247 traumatic brain injury deaths and 140000 head injuries among children and adole scents younger than 20 years were related to bicycle crashes each year in the United States. As many as 184 deaths and 116000 head injuries might have been prevented annually if these riders had worn helmets. A n additional 19000 mouth and chin injuries were treated each year. The youngest age groups had the highest proportions of both head and mout h injuries. Conclusion. There continues to be a need to advocate for g reater use of bicycle helmets, particularly among young children. Helm et design changes should be considered to prevent mouth injuries.