[3165.2] Bicycle Helmet Laws Decrease the Rates of Fatal and Incapacitating Injuries Resulting from Bicycle-Motor Vehicle Collisions in Children
William P. Meehan, Lois K. Lee, Christopher M. Fischer, Rebekah C. Mannix. Medicine, Boston Children's Hospital, Boston, MA; Emergency Medicine, Beth Israel Deaconness Medical Center, Boston, MA; Orthopaedics, Boston Children's Hospital, Boston, MA.
BACKGROUND: Approximately 900 people die in bicycle crashes annually in the United States, ¾ of them from traumatic brain injuries. Many states have mandatory bicycle helmet laws for children. The effects of such laws on the national rates of injury are unknown.
OBJECTIVE: Assess the association between bicycle helmet legislation and bicycle-related deaths/incapacitating injuries.
DESIGN/METHODS: We conducted a cross sectional study of all bicyclists aged 0-16 years included in the Fatality Analysis Reporting System (FARS) who died or suffered an incapacitating injury between January 1999 and December 2009. The FARS defines an incapacitating injury as one that prevents a person from walking or normally continuing the activities the person was capable of before the injury. Date law enactment was obtained from several sources including the Insurance Institute for Highway Safety and the Governor's Highway Safety Administration. We compared rates of deaths/incapacitating injuries per age-specific state populations, between states with helmet laws and those without helmet laws. We used a clustered Poisson multivariate regression model to adjust for factors previously associated with rates of motor vehicle fatalities: elderly driver licensure laws, legal blood alcohol limit (< 0.08% vs. ≥ 0.08%), and household income.
RESULTS: A total of 2,451 bicycle-related fatalities/incapacitating injuries were sustained by children <16 years old. There were no statistical differences in median household income, the proportion of states with elderly licensure laws, or the proportion of states with a blood alcohol limit of > 0.08 between states with helmet laws and those without helmet laws. The mean unadjusted rates of fatalities/incapacitating injuries was 2.0/1,000,000 in states with helmet laws, compared to 2.5/1,000,000 in states without helmet laws (p= 0.03). After adjusting for potential confounding factors, states with mandatory helmet laws continued to be associated with a lower rate of fatalities/incapacitating injuries (adjusted Incidence Rate Ratio 0.81; 95% CI 0.67, 0.98).
CONCLUSIONS: Bicycle helmet safety laws are associated with a lower incidence of fatalities/incapacitating injuries among pediatric bicyclists involved in motor vehicle collisions. Our findings support the legislation of mandatory bicycle helmet use by children.
Session: Platform Session: Injury Prevention (8:00 AM - 10:00 AM)
Date/Time: Monday, May 6, 2013 - 8:15 AM
Room: 151B - Walter E. Washington Convention Center
Course Code: 3165