INJURY PATTERNS IN CYCLISTS ATTENDING AN ACCIDENT AND EMERGENCY DEPARTMENT - A COMPARISON OF HELMET WEARERS AND NON-WEARERS

Objectives-To study circumstances of bicycle accidents and nature of i njuries sustained and to determine effect of safety helmets on pattern of injuries. Design-Prospective study of patients with cycle related injuries. Setting-Accident and emergency department of teaching hospit al. Subjects-1040 patients with complete data presenting to the depart ment in one year with cycle related injuries, of whom 114 had worn cyc le helmets when accident occurred. Main outcome measures-Type of accid ent and nature and distribution of injuries among patients with and wi thout safety helmets. Results-There were no significant differences be tween the two groups with respect to type of accident or nature and di stribution of injuries other than those to the head. Head injury was s ustained by 4/114 (4%) of helmet wearers compared with 100/928 (11%) o f non-wearers (P=0.023). Significantly more children wore helmets (50/ 309 (16%)) than did adults (64/731 (9%)) (P<0.001). The incidence of h ead injuries sustained in accidents involving motor vehicles (52/288 ( 18%)) was significantly higher than in those not involving motor vehic les (52/754 (7%)) (chi(2)=28.9, P<0.0001). Multiple logistic regressio n analysis of probability of sustaining a head injury showed that only two variables were significant: helmet use and involvement of a motor vehicle. Mutually adjusted odds ratios showed a risk factor of 2.95 ( 95% confidence interval 1.95 to 4.47, P<0.0001) for accidents involvin g a motor vehicle and a protective factor of 3.25 (1.17 to 9.06, P=0.0 24) for wearing a helmet. Conclusion-The findings suggest an increased risk of sustaining head injury in a bicycle accident when a motor veh icle is involved and confirm protective effect of helmet wearing for a ny bicycle accident.