R. Weston1, C. Williams2, M. Crandall1 1University Of Florida,Surgery,Jacksonville, FL, USA 2Washington University,Emergency Medicine,St. Louis, MO, USA
Introduction: Bicycling is one of the most popular forms of play and exercise for children in the U.S. However, over 200,000 children per year are injured in bicycle crashes, and an estimated 22,000 pediatric bicycle-related traumatic brain injuries (TBIs) occur annually. Bicycle helmets are known to decrease the risk of head injury, but efficacy and magnitude of effect of helmet legislation have not been fully elucidated.
Methods:
This was a retrospective, observation study of children under 18 who presented after a bicycle crash and were included in the Illinois Trauma Registry from 1999-2009. Demographic information, injury types, injury severity, helmet usage, and location of injury data were collected. Multiple logistic regression analysis was used to quantify the independent effects of helmet usage on likelihood of TBI, and among those with TBI, the severity of injury. Data were then compared between communities with and without helmet legislation.
Results: A total of 3080 pediatric bicycle related crashes were identified. Children wearing helmets were less likely to sustain a TBI, OR 0.56 (CI 0.37-0.84). Boys were less likely to suffer a TBI, OR=0.80 (95% CI 0.67-0.97) while older children were more likely to suffer a TBI. Overall 5.0% of patients were noted as wearing helmets. As compared to non-Hispanic white children, Black and Hispanic children were less likely to wear helmets, OR=0.24 (95% CI 0.09-0.68) and OR=0.10 (95% CI 0.02-0.42) respectively. Those injured living within helmet zip code regions wore proportionally more helmets, 12.2%, than the overall 5.0%. There was no significant change in helmet usage between pre and post legislation in helmet legislation areas or over time in non-helmet legislation areas.
Conclusion: Rates of pediatric TBI from bicycle injury in Illinois trauma centers are not changing an appreciable amount. There was also no statistically significant change across the years of the analysis in total number of severe TBI. Similar to previous studies, non-Hispanic black populations as well as Hispanic populations were much less likely to wear helmets. Children in helmet legislation areas were significantly more likely to wear helmets throughout the years combined, although it is unclear how much of this is attributed to legislation versus other sociodemographic factors.