Bicycle helmets a must – includes related information on the causes, and under-rating the risks of, bicycle accidents, choosing the right helmet, etc
For every kilometre travelled in Canada, bicycles are far more likely than automobiles to be in an accident and bike riders are more likely to be seriously injured than car drivers. Although bike helmets significantly reduce the number and severity of bike injuries, all too few people wear them.
Cycling rides high in popularity for sport and recreation second only to walking or hiking. More bicycles are sold in Canada (1.1 million last year) than cars. But the welcome trend is marred by a worrisome rise in cycling injuries, highest among children. Both in Quebec and in Ontario, about 50 children die from bike accidents each year, many of them under age 15. A survey of the Ontario Corner Office from 1985 to 1987 showed that 14 per cent of all childhood trauma deaths were attributable to bicycle accidents, brain and neck injuries topping the list as causes of death and disability. Cyclists often suffer worse head injuries than motorcyclists (who are far likelier to wear protective head gear). As the old adage says, “it’s as easy as falling off a bicycle!” It’s also easy to don a helmet, but only a fraction – two to five per cent – of children regularly wear bike helmets. Few parents insist that their kids wear helmets and indeed few adults themselves wear one. Yet it’s obvious, even at first glance, that bicycle helmets could prevent or minimize head injuries. Studies confirm that helmets dramatically curb the number of head injuries due to bike accidents. If those working in hospital emergency and trauma units had their way, wearing bike helmets would be compulsory for all cyclists and children carried as passengers – in the same way that hockey helmets are invariably worn. Today’s hockey players would no sooner think of skating without a helmet than without a stick. Experts hope that bike helmets will ultimately become standard cycling gear. Who has bike accidents, where and why? Studies in Canada, Australia and the U.S., demonstrate that cycling mishaps are the leading cause of hospital admissions for head injury among school-aged children – and 75-80 per cent of those who perish die because of brain injuries. Many more remain permanently brain-damaged from bike accidents. A Quebec study found that half of all cycling deaths occur in children aged five to 14. And according to a recent report in the Canadian Medical Association Journal, 26 per cent of bicycle accident victims are under age seven, 48 per cent under I 0 years of age. Young children, the group at greatest risk, are the least protected – by knowledge, cycling skills and protective headgear. A large proportion of bicycle accidents occur on neighbourhood streets and about 70 per cent of them happen to boys. According to the B.C. Medical Association, 85 per cent occur within five blocks of home. A recent Ottawa study found that 90 per cent of bike injuries take place within a kilometre of the child’s home; of the children admitted to hospital, 49 per cent had head injuries, 40 per cent broken limbs. Over half the accidents were blamed on carelessness, poor cycle control or mechanical failure. Most severe bicycle injuries result from crashes with a motor vehicle, but they can also occur from a simple fall. For example, one 18-year-old youth who was a well-trained cyclist, hit his unhelmeted head when biking with a girlfriend near his parents cottage in Northern Quebec. No motor vehicle was involved. His bike simply hit a small stone on the country road, sending him flying over the handlebars. He had a broken collar bone plus a few cuts and bruises but it was the head in july that killed him. His skull was cracked, the hemorrhage irreparably damaging the brain. After two days in a coma, he died. A bicycle helmet would almost certainly have saved his life. Why don’t kids wear them? Helmets aren’t considered cool”: they need a new, smarter image. Although hockey helmets are almost “de rigeur,” an accepted part of the equipment, bike helmets are less popular. One recent study found that although 13 per cent of the children in bike accidents owned a helmet, only two per cent of eight to twelve year olds were wearing one when injured. Why do so few people – especially so few children – wear them’? The main objections to bicycle helmets given by children are: * “No one told me to wear one.” * “They’re hot, heavy and uncomfortable.” * “They don’t look good.” * “They’re wimpy (depict weakness).” * “They’re not cool.” * “I’m a safe biker.” * “I never do stunts.” * “I only ride short distances and always on the sidewalk.” Children who own helmets are less likely to wear them when biking with friends or going to the store than when out with the family. When asked whether they thought laws should enforce the use of bike helmets, the students surveyed said “yes” and expressed willing compliance: “I’d wear one,” “I wouldn’t be different because then everyone would have to wear one,” “nobody would tease me – in fact we’d laugh at kids without helmets because they’d look foolish.” Adults who ride without helmets give reasons similar to younger groups for not wearing one, saying they’re “unlikely to crash or hit their heads” or are just on a short shopping trip.” Research clearly shows that such ideas are wishful thinking. Even toppling off at slow speed or hitting the sidewalk/ pavement can be very hard on the head. The strong case for helmets
Bike helmets can significantly reduce both the frequency and severity of brain damage from cycling accidents. One U.S. study showed that riders who wear helmets reduce their risks of head injury by 85 per cent. A 1987 study of Australian cycling club members found the rate of brain injury among unhelmeted riders in bike accidents was 45 per cent, compared to only six per cent in those who wore helmets. This study concluded that 90 per cent of bicycling deaths due to head injury could be prevented by wearing a good helmet. U.S. studies have shown that unhelmeted riders are about seven times likelier to sustain a serious head injury in an accident, and eight times more likely to suffer permanent brain damage than helmeted bikers. A pediatrician at Toronto’s Hospital for Sick Children points out that “with pedestrian accidents, there’s not as much one can do. But there’s a perfectly good way to prevent many of the most serious cycling injuries, if only we could get kids to wear helmets. It can’t be done in the hospital where one sees people after- an accident has happened. We must get to them before that.” What type of helmet? Helmets work as shock absorbers to spread and absorb the impact. Most properly designed and manufactured bike helmets consist of four primary elements: an outer shell, an energy absorbing liner, a layer of soft foam and fabric pads and a good retention system. The helmet’s outer portion distributes the load and its inner foam absorbs the shock of a blow to the head, preventing it from crushing the skull and injuring the brain. The foam liner – the life-saving portion – is usually made of expanded polystyrene or better still polypropylene or polyethylene (more costly). The liner shouldn’t be too stiff because if it doesn’t bend or crush on impact, the shock isn’t adequately absorbed. Helmet tests assess the impact-absorption/resistance, strap strength and roll-off’ ability (to make sure helmets stay on the head during an accident). Models have become successively lighter and more stylish. Many now have very thin outer shells making them more comfortable than older models. The Canadian Standards Association (CSA) has just published a Canadian National Standard for bike helmets. To date, types made by four Canadian manufacturers have been CSA-approved. The CSA hopes that in time bike helmets will be taken for granted as a vital part of cycling equipment. Approved helmets include the older hardshell types (with a heavy, solid plastic covering), the newer thinshell or micro-shell models (with a thin, semi-rigid cover over the foam liner which looks like one piece but is a double layer) and the latest, lightest most trendy no-shell types (with the foam wrapped in the thinnest of lycra sheets), reducing its weight. Most experts encourage development of the thinshell rather than the older, heavy hardshell forms, which burden the head and neck. Not by helmets alone: education also vital Helmets aren’t the only way to reduce accidents – children must also learn to stick to the rules of the road. In February 1990, a conference held in Toronto to encourage helmet use took heart from a highly successful SAFE KIDS campaign in Seattle using every means conceivable to get children to start wearing helmets. Following the campaign, sales of one brand of bike helmet in Seattle doubled over a three year period, the observed helmet usage rate among school children rising from five to 16 per cent, compared with a rise of only one per cent in a control community in Portland, Oregon. The Bicycle Helmet Coalition at Toronto’s Hospital for Sick Children is initiating similar educational programs, to promote helmet use among five to 12year-olds and to improve overall bicycling safety. The Ontario Ministy of Transportation has suggested tagging bicycles with stickers saying “Protect your head.” Besides use of helmets, education in biking respolisibility is needed. Untutored child bikers in traffic are a nightmare – and, according to some experts, those under age 10 shouldn’t be there. Many authorities today question whether children younger than 10-12 years old should use a two-wheeler at all, until they can thoroughly control the bike, understand the rules of the road, analyze traffic flow and make wise decisions. Young children do not usually understand traffic complexities. They often lack the physical development necessary to manipulate bicycles safely and some ride bikes that are far too big. According to one expert at the Dalhousie Communitv Health Service, strategies to improve bicycle safety should include: better education of cyclists and motorists; enforcement of traffic laws for cyclists as well as others; improvement of the road for cyclists (more bike lanes). All bike riders, young and old, not only need good cycling skills but should adhere to traffic regulations like other road users. Traffic laws could be updated to favour bikers, particularly since bicycling is more environmentally friendly than driving a car. Choosing the right helmet * Only buy an approved type. The CSA’s new, stringent helmet standards are evidently more rigorous than most in the U.S. * Helmets should bear a label or sticker showing that they are approved by the CSA or a comparable organization, such as ANSI (American National Standards Institute) or SNELL (Snell Memorial Foundation). * Try before you buy – to get the right fit. * Ideally, buy from a store with knowledgeable personnel to help select and fit the helmet properly. * Choose a helmet with a good foam lining for maximum impact-absorption. The best types have a complete or almost complete inner liner. * Select one with adjustable straps and a quick release buckle (easy to manipulate) that fits snugly and doesn’t pinch. Adjust the straps for a snug fit not too tight but above all not too loose. * Let children choose their own certified helmet. * Don’t trade safety for style – but make sure the child likes the one selected and will wear it. * Encourage helmet use from the child’s very first cycle outing. * Be a good role model – wear helmets on every bike ride and make sure your passengers do too remember that many bike crashes happen close to home. 9 Look after the helmet- don’t bash it around too much. Bicycle helmets are designed to withstand only a single hard blow, compared to other types, such as hockey helmets, which take more buffeting (but are no substitute for a good bike helmet). 9 Always replace the bike helmet after a crash. Those with an expanded foam lining lose most of their protective value after being subjected to a violent impact or several blows at the same time, although the damage is rarely visible. * Replace old helmets. The polymers f rom which helmets are made tend to deteriorate in ultraviolet light, becoming brittle and less resistant after a time about five years of normal use. * As one expert summarizes:’Always wear a helmet it may seem inconvenient, but so is not being able to think or talk because your head has been pounded to jelly.” People grossly under-rate the risks
A 1989 U.S. survey questioning children about possible injuries from bike crashes demonstrated remarkable unawareness about their possible severity and profound ignorance of the life-saving capacity of bike helmets. Most children cited cuts, scrapes or broken bones as the most likely consequences of a bike crash. Few mentioned head injury – in reality the primary cause of death or permanent disability. Of those who did list head injuries, the kinds suggested were “concussion,””coma” or “unconsciousness.” Many children believed that helmets were just for racing or going on tours, not for ordinary biking. The surveys reveal a false sense of security about bike riding. Parents of young cyclists for instance, think that their children only ride in safe places (yet many an accident occurs on grass or on the sidewalk) or that “they ride slowly” (no guarantee).
Parents don’t buy bike helmets for several reasons: because they’ve never thought of it; because they’re too expensive (usually $40 and up); or because they think that their children ride safely and wouldn’t wear one anyway. And parents often provide poor role models by cycling without helmets. Many regard children’s bicycles as toys, not realizing how easily cycling leads to tragic injury or death. Bike accidents have diverse causes: o sheer carelessness o loss of control by the cyclist o an encounter with a motor vehicle o hitting a pedestrian or animal o uneven or rocky road surfaces 9 other road hazards (gratings, stones, streetcar
lines. ice) 9 poor visibility (darkness) o mechanical failure 9 a car door suddenly flung open o hitting protruding mirrors on trucks or vans
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