Protective Effect of Different Types of Bicycle Helmets

The effectiveness of bicycle helmets in preventing head injuries is well documented. There are different opinions about the effectiveness of helmets in preventing face injuries, and few studies have analyzed the effect of different types of helmets. This study was performed to examine the effect of different helmet types to head and face injuries. The use of helmets was analyzed in cyclists with head or face injuries and compared with two control groups. The main control group was cyclists that had injuries not including the head or neck, and another control group was cyclists that had been involved in an accident, regardless of whether they had sustained any injury. Cross-table and logistic regression analyses were applied to analyze the protective effect of helmets. A total of 991 injured patients served as a basis for this study. Most of the accidents, (82%) were single accidents with no other persons involved. Of patients with injuries to the head, excluding face, 11.4% had been using hard shell helmets, and 9.6% had been using foam helmets at the time of the accident. Among the emergency room controls, the proportion of hard shell helmet users and foam helmet users was 26.4% and 11.4%, respectively. Compared to non-helmet users, this gave an odds ratio of 0.36 (CI = 0.21–0.60) for getting head injuries if the cyclists had been using hard shell helmets at the time of the injury, and 0.83 (CI = 0.41–1.67) for users of foam helmets. The odds ratio for getting face injuries was 0.90 (CI = 0.58–1.41) among users of hard shell helmets, and 1.87 (CI = 1.03–3.40) for users of foam helmets. The use of hard shell helmets reduced the risk of getting injuries to the head. Children less than nine years old that used foam helmets had an increased risk of getting face injuries. All bicyclists should be recommended to use hard shell bicycle helmets while cycling.     

Protective effect of different types of bicycle helmets

The effectiveness of bicycle helmets in preventing head injuries is well documented. There are different opinions about the effectiveness of helmets in preventing face injuries, and few studies have analyzed the effect of different types of helmets. This study was performed to examine the effect of different helmet types to head and face injuries. The use of helmets was analyzed in cyclists with head or face injuries and compared with two control groups. The main control group was cyclists that had injuries not including the head or neck, and another control group was cyclists that had been involved in an accident, regardless of whether they had sustained any injury. Cross-table and logistic regression analyses were applied to analyze the protective effect of helmets. A total of 991 injured patients served as a basis for this study. Most of the accidents, (82%) were single accidents with no other persons involved. Of patients with injuries to the head, excluding face, 11.4% had been using hard shell helmets, and 9.6% had been using foam helmets at the time of the accident. Among the emergency room controls, the proportion of hard shell helmet users and foam helmet users was 26.4% and 11.4%, respectively. Compared to non-helmet users, this gave an odds ratio of 0.36 (CI = 0.21-0.60) for getting head injuries if the cyclists had been using hard shell helmets at the time of the injury, and 0.83 (CI = 0.41-1.67) for users of foam helmets. The odds ratio for getting face injuries was 0.90 (CI = 0.58-1.41) among users of hard shell helmets, and 1.87 (CI = 1.03-3.40) for users of foam helmets. The use of hard shell helmets reduced the risk of getting injuries to the head. Children less than nine years old that used foam helmets had an increased risk of getting face injuries. All bicyclists should be recommended to use hard shell bicycle helmets while cycling.     

Head and neck injuries in fatal motorcycle collisions as determined by detailed autopsy

Detailed layer-by-layer autopsy of the head and neck was performed on a prospective series of 73 fatally injured motorcyclists in order to identify occult injuries, particularly soft tissue neck injuries such as hemorrhage of vertebral and carotid arteries. The fatal cases were gathered as part of a larger study of 1,082 on-scene in-depth motorcycle crash investigations in Thailand. Detailed neck dissection was done on nearly all fatal cases. Injuries were coded using the 1990 revision of the Abbreviated Injury Scale (AIS 90) and an Injury Severity Score (ISS) was determined for each case. Additional AIS codes are proposed for neck injuries that were often identified during the detailed autopsy procedures, but which are not listed explicitly among existing AIS codes. Helmet use was determined based on analysis of injury patterns and helmet damage with consideration also given to witness statements. Both helmeted and unhelmeted motorcyclists showed a high frequency of occult neck injuries such as hemorrhages in the carotid sheath or surrounding the vertebral arteries, phrenic nerve, or brachial plexus. These soft tissue neck injuries sometimes accompanied more obvious injuries to cervical vertebrae or spinal cord, but about one-third of riders had no obvious injury to suggest the presence of occult neck injury. Twenty-eight motorcyclists had been wearing a helmet at the start of the collision sequence, but only nine helmets remained in place through the entire collision event. Helmeted riders showed more severe somatic (below-the-neck) injuries than unhelmeted riders, suggesting helmeted riders are less likely to die in low-threat accidents with somatic injuries below AIS-3. The most significant finding of this study was the identification of serious internal neck injuries despite the absence of external physical evidence of trauma to the neck. Virtually all riders with significant head injuries showed some of these soft tissue neck injuries. Approximately one-third of the critically injured riders who survived at least a few hours before death showed serious occult soft tissue neck injuries.     

Severity and patterns of injury in helmeted vs. non-helmeted motorcyclists in a rural state

Introduction: Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders. Methods: Retrospective review (2014–2018) of a single level 1 trauma center’s registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student’s t-test or Pearson’s χ² p-value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained. Results: Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS. Conclusions: Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation.     

Motorcycle helmet effect on a per-crash basis in Thailand and the United States

OBJECTIVE: To compare the effectiveness of motorcycle helmets seen in prospective on-the-street motorcycle accident investigations. The data are drawn from two detailed, in-depth studies of motorcycle accidents, in which trained investigators collected extensive accident evidence on-scene immediately after the crash. This article compares helmeted and unhelmeted motorcycle riders on a per-accident basis for fatality rates, the rate of serious (AIS > 2) brain injuries among survivors, or an outcome that involved either of the two. METHODS: Nine hundred motorcycle crashes in Los Angeles and 969 crashes in Thailand were investigated in detail at the accident scenes, including photos of vehicles, skids, damage, and sometimes the rider. Helmets were collected and injury information was obtained from riders and care providers. This evidence was then used to reconstruct collision events to identify speeds, precrash motions, collision contacts, injury causation, and helmet performance. RESULTS: In both studies, approximately 6% of riders were killed and 20-25% were hospitalized. Overall, unhelmeted riders were two to three times as likely to be killed, and three times as likely to suffer either death or survival with AIS > 2 brain injury. Unhelmeted survivors had three to four times as many AIS > 2 brain injuries as helmeted riders on a per-crash basis. Nearly 100% of riders with AIS > 4 somatic injuries died. Such injuries were 30% of Thailand fatalities and 57% of L.A. fatalities, but only about 2-3% of the overall accident population. Among the 97-98% of riders with AIS < 5 somatic injuries, helmet use could prevent about three-fourths of fatalities and brain injuries. CONCLUSIONS: Helmets were extremely effective in preventing brain injury and death in 97% of the accident population in less-than-extreme crashes. Helmet use cannot prevent all fatalities because many of those killed succumb to below-the-neck injuries that a helmet cannot prevent.     

Predicting bicycle helmet wearing intentions and behavior among adolescents

INTRODUCTION: Cycling accidents in Australia, especially those resulting in head injuries, are a substantive cause of death and disability; but despite legislation and evidence that helmets reduce the risk of head injury, few adolescents wear them. METHOD: This study employed a revised version of the Theory of Planned Behavior (TPB; [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211]) to investigate the determinants of helmet use among a sample of adolescents. Participants in the initial data collection were 294 high school students in Year 8 and Year 11, with 266 completing a follow-up questionnaire measuring behavior over the previous two weeks. RESULTS: Social norms, perceptions of control, and past behavior significantly predicted intentions to use helmets and perceptions of control and past behavior predicted actual helmet use. CONCLUSIONS: Strengthening the routine of helmet use and building young people's confidence that they can overcome any perceived barriers to helmet use will improve adherence to helmet wearing behavior.     

The effects of a mandatory motorcycle helmet law on helmet use and injury patterns among motorcyclist fatalities

BACKGROUND: The National Highway Traffic Safety Administration (NHTSA) has found that motorcycle helmets are 37% effective in preventing death and 65% effective in preventing brain injuries in a crash. Unfortunately, in 1995 Congress lifted federal sanctions against states without helmet laws and since then there have been a number of primary motorcycle helmet laws repealed or weakened. More lives could be saved and serious injuries avoided if there was increased helmet use throughout the United States. METHODS: This study analyzed helmet use and injury patterns among motorcycle riders in the United States involved in fatal crashes from 1995 through 2003 and compared the results between states with and without a primary helmet law. Age, sex, injury severity and helmet use are some of the variables obtained from the Fatality Analysis Reporting System (FARS). RESULTS: In the 20 states and the District of Columbia, which currently have a primary helmet law, 84.0% of fatally injured riders were wearing a helmet. In the 27 states with a secondary helmet law, 36.2% of fatalities used a helmet, and in the remaining three states with no law at all, helmet use dropped to 17.6%. In the two states (Arkansas and Texas) that changed from a primary helmet law to a secondary helmet law in 1997, helmet use decreased from 78.2% in 1996 to 31.7% in 2000. CONCLUSION: If all states were to enact a primary motorcycle helmet law, helmet use would dramatically increase while decreasing the number of motorcyclist head injuries and fatalities. IMPACT ON INDUSTRY: The results of this study will hopefully persuade law makers to enact primary helmet laws in all states throughout the nation. Helmet manufacturers can use this data to design more comfortable helmets while also improving upon the protective qualities of these safety devices.     

Bicycle helmet use among persons 5 years and older in the United States, 2012

IntroductionIn 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States.MethodCDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18 + years) were asked about bicycle riding and helmet use in the last 30 days for themselves and their children (5 to 17 years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use.ResultsAmong adults, 21% rode bicycles within the past 30 days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30 days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%).ConclusionsDespite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding.Practical applicationStates and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.     

Cycle helmets and road casualties in the UK

OBJECTIVES: Bicycle helmets have been advocated as a means of reducing injury among cyclists. This assertion, derived from a number of case controlled studies carried out in hospitals, conflicts with results from population level studies. In the Western countries where these case control studies have been performed, it appears that cycling morbidity is dominated by sports and leisure users. The generalizability of studies on helmet effectiveness in relation to utilitarian transport cycling is not clear. This study therefore considers population level data for reported road traffic injuries of cyclists and pedestrians. METHODS: Generalized linear and generalized additive models were used to investigate patterns of pedestrian and cyclist injury in the UK based on the police reported "Stats 19" data. Comparisons have been made with survey data on helmet wearing rates to examine evidence for the effectiveness of cycle helmets on overall reported road casualties. While it must be acknowledged that police casualty reports are prone to under-reporting, particularly of incidents involving lower severity casualties the attractive feature of these data are that by definition they only concern road casualties. RESULTS: There is little evidence in UK from the subset of road collisions recorded by the police corresponding to the overall benefits that have been predicted by the results of a number of published case controlled studies. In particular, no association could be found between differing patterns of helmet wearing rates and casualty rates for adults and children. CONCLUSIONS: There is no evidence that cycle helmets reduce the overall cyclist injury burden at the population level in the UK when data on road casualties is examined. This finding, supported by research elsewhere could simply be due to cycle helmets having little potential to reduce the overall transport-related cycle injury burden. Equally, it could be a manifestation of the "ecological fallacy" where it could be conceived that the existence of various sub-groups of cyclists, with different risk profiles, may need to be accounted for in understanding the difference between predicted and realised casualty patterns.     

Factors associated with motorcycle traffic crash fatalities among active duty U.S. Army personnel

Objective: Research on factors associated with motorcycle fatalities among active duty U.S. Army personnel is limited. This analysis describes motorcycle crash–related injuries from 1995 through 2014 and assesses the effect of alcohol use and helmet use on the risk of fatal injury among active duty U.S. Army motorcycle operators involved in a traffic crash, controlling for other factors shown to be potentially associated with fatality in this population.

Methods: Demographics, crash information, and injury data were obtained from safety reports maintained in the Army Safety Management Information System. Traffic crashes were defined as crashes occurring on a paved public or private roadway or parking area, including those on a U.S. Army installation. Analysis was limited to motorcycle operators. Odds ratios (ORs) and 95% confidence intervals (95% CIs) from a multivariable analysis estimated the effect of alcohol use and helmet use on the risk of a fatal injury given a crash occurred, controlling for operator and crash characteristics.

Results: Of the 2,852 motorcycle traffic crashes, most involved men (97%), operators aged 20–29 years of age (60%), and operators who wore helmets (95%) and did not use alcohol (92%). Two thirds of reported crashes resulted in injuries requiring a lost workday; 17% resulted in fatality. Controlling for operator and crash characteristics, motorcycle traffic crashes involving operators who had used alcohol had a 3.1 times higher odds of fatality than those who did not use alcohol (OR =3.14; 95% CI, 2.17–4.53). Operators who did not wear a helmet had 1.9 times higher odds of fatality than those who did wear a helmet (OR =1.89; 95% CI, 1.24–2.89).

Conclusions: Among U.S. Army motorcycle operators, alcohol use and not wearing a helmet increased the odds of fatality, given that a crash occurred, and additional modifiable risk factors were identified. Results will help inform U.S. Army motorcycle policies and training.     

Helmet retention system types as a risk factor to properly attach the chin strap

Objectives: This study aimed to determine the factors associated with the incorrect use of a helmet retention system (loose or open) and how often this happens.

Methods: This was an observational transversal study conducted in Curitiba, Brazil. Trained observers positioned at traffic lights collected information about the helmet fixation mode, the helmet model (full-face, open-face, modular, half), and the helmet retention system model (micrometric, double-D, fast-release). Additional data including position on the motorcycle, gender, and function of the motorcycle (as a work vehicle) were collected. The observers, collection site, and periods were randomly selected by lots.

Results: From a total of 3,050 motorcyclists, 1,807 (59.2%) had their helmets fastened correctly, 907 (29.7%) had the retention system fastened loosely, and in 336 (11.0%), the retention system was completely open. Increased odds of incorrect use were observed for the fast-release and double-D buckles compared to the micrometrics buckles, with a fixed odds ratio (OR) of 4.62 (95% confidence interval [CI], 3.89–5.51) and 3.54 (95% CI, 2.46–5.09), respectively (P <.0001). Full-face helmets had a higher chance of incorrect use (P <.0001), and passengers had a higher incidence of incorrect use of the helmet than drivers (P <.0001).

Conclusion: An important risk factor related to the incorrect use of the helmet was the type of retention system. The helmet model and being a passenger had a secondary influence on incorrect use of helmets.     

Characteristics of bicycle crashes among children and the effect of bicycle helmets

Abstract

Objective: Focusing on children (0–17?years), this study aimed to investigate injury and accident characteristics for bicyclists and to evaluate the use and protective effect of bicycle helmets.

Method: This nationwide Swedish study included children who had visited an emergency care center due to injuries from a bicycle crash. In order to investigate the causes of bicycle crashes, data from 2014 to 2016 were analyzed thoroughly (n?=?7967). The causes of the crashes were analyzed and categorized, focusing on 3 subgroups: children 0–6, 7–12, and 13–17?years of age. To assess helmet effectiveness, the induced exposure approach was applied using data from 2006 to 2016 (n?=?24,623). In order to control for crash severity, only bicyclists who had sustained at least one Abbreviated Injury Scale (AIS) 2+ injury (moderate injury or more severe) in body regions other than the head were included.

Results: In 82% of the cases the children were injured in a single-bicycle crash, and the proportion decreased with age (0–6: 91%, 7–12: 84%, 13–17: 77%). Of AIS 2+ injuries, 8% were head injuries and 85% were injuries to the extremities (73% upper extremities and 13% lower extremities). Helmet use was relatively high up to the age of 10 (90%), after which it dropped. Helmets were much less frequently used by teenagers (14%), especially girls. Consistently, the share of head injuries increased as the children got older. Bicycle helmets were found to reduce all head injuries by 61% (95% confidence interval [CI], 10: +/? 10%) and AIS 2+ head injuries by 68% (95% CI, 12: +/? 12%). The effectiveness in reducing face injuries was lower (45% CI +/? 10% for all injuries and 54% CI +/? 32% for AIS2+ injuries).

Conclusions: This study indicated that bicycle helmets effectively reduce injuries to the head and face. The results thus point to the need for actions aimed at increasing helmet use, especially among teenagers. Protective measures are necessary to further reduce injuries, especially to the upper extremities.     

Protection performance of bicycle helmets

IntroductionThe evaluation of head protection systems needs proper knowledge of the head impact conditions in terms of impact speed and angle, as well as a realistic estimation of brain tolerance limits. In current bicycle helmet test procedures, both of these aspects should be improved. Method: The present paper suggests a bicycle helmet evaluation methodology based on realistic impact conditions and consideration of tissue level brain injury risk, in addition to well known headform kinematic parameters. The method is then applied to a set of 32 existing helmets, leading to a total of 576 experimental impact tests followed by 576 numerical simulations of the brain response. Results: It is shown that the most critical impacts are the linear-lateral ones as well as the oblique impact leading to rotation around the vertical axis (ZRot), leading both to around 50% risks of moderate neurological injuries. Based on this test method, the study enables us to compare the protection capability of a given helmet and eventually to compare helmets via a dedicated rating system.     

Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors

Introduction

Children ages 5-14 years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury.

Objectives

This paper compares children's bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation.

Methods

This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14 years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household.

Results

Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9 years) and older (10-14 years) children, and in all four regions of the country.

Conclusions

While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal.     

Adolescent noncompliance with age-specific versus universal US motorcycle helmet laws: Systematic review and meta-analysis

Introduction: The U.S. experience with motorcycle helmets affords an important insight into the responses of adolescents to age-specific laws. Political contention has led to a number of U.S. state law changes back and forth between universal and age-specific laws. Because both kinds of law require adolescent motorcyclists to wear helmets, relatively few studies have focused on how the law type affects their behavior. Method: Differential behavior is tested by a systematic review of literature, leading to a meta-analysis, in relation to the experience of various states’ motorcycle helmet laws. An electronic search was conducted for before-and-after studies in U.S. states that include data on adolescent helmet usage – both with a universally applicable motorcycle helmet law, and with an age-restricted law (usually, under-21 or under-18) – from observational, injury or fatality records for a certain period (e.g., 12 months) pre and post the state law change. Results: The search yielded ten studies, including two that compared a set of age-specific law states with a set of universal law states over the same time period. Heterogeneity analysis of seven single-state studies with raw data revealed an acceptable fit for a random-effects model. Additional noncompliance with age-restricted laws was indicated by an attributable percentage among exposed of over 65% and odds ratio exceeding 4. Conclusions: About two-thirds of adolescent noncompliance with age-restricted motorcycle helmet usage laws disappears with universal applicability. Evidence from numerous international studies of youth reaction to helmet laws suggests that a large part of the greater compliance with universal laws is due to their conveying a more convincing message that helmets afford protection against injury. Practical Applications: The meta-analysis provides fresh, young-rider perspective on the continuing debate over motorcycle-helmet laws. Broader insight into adolescent psychology suggests considering alternatives to age-restricted laws more widely in safety and health policy.     

Motor vehicle restraint system use and risk of spine injury

OBJECTIVE: Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the relationship between the occurrence of mild to severe cervical and thoracolumbar spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs. METHODS: A retrospective cohort study was conducted among subjects obtained from the 1995-2004 National Automotive Sampling System. Cases were identified based on having sustained a spine injury of >/=1 on the Abbreviated Injury Scale (AIS), 1990 Revision. Risk risks (RRs) and 95% confidence intervals (CIs) were computed comparing occupant restraint systems with unrestrained occupants. RESULTS: We found an overall incidence of AIS1 cervical (11.8%) and thoracolumbar (3.7%) spinal injury. Seatbelt only restraints were associated with increased cervical AIS1 injury (RR = 1.40, 95% CI 1.04-1.88). However, seatbelt only restraints showed the greatest risk reduction for AIS2 spinal injuries. Airbag only restraints reduced thoracolumbar AIS1 injuries (RR = 0.29, 95% CI 0.08-1.04). Seatbelt combined with airbag use was protective for cervical AIS3+ injury overall (RR = 0.29, 95% CI 0.14-0.58), cervical neurological injury (RR = 0.19, 95% CI 0.05-0.81), and thoracolumbar AIS3+ injury overall (RR = 0.20, 95% CI 0.05-0.70). CONCLUSIONS: The results of this study suggest that seatbelts alone or in combination with an airbag increased the incidence of AIS1 spinal injuries, but provide protection against more severe injury to all regions of the spine. Airbag deployment without seatbelt use did not show increased protection relative to unrestrained occupants.     

Reality and risk of contact-type head injuries related to bicycle-mounted child seats

Objective

The authors have treated numerous children who have been injured by falling from bicycle-mounted child seats. Despite the greatly increased use of such seats, the understanding of their risk and the importance of helmet use remains alarmingly poor. The objective of this study was to confirm the risk of bicycle-mounted child seats and to evaluate the efficacy of helmets, seat belts, and back seat height in terms of preventing or mitigating contact-type head impacts that occur in falls from bicycle-mounted child seats.

Materials and methods

Biometrical dummy tests were performed to examine contact-type head injuries in falls from stationary bicycles. A bicycle with an anthropometric test dummy placed in a bicycle-mounted child seat was tipped over. Each test was repeated three times and three-dimensional acceleration was measured using accelerometer. Head Injury Criteria (HIC) were calculated and the respective influences of a helmet, a seat belt, and increased height of the back of the seat on such impacts were evaluated.

Results

Only helmets unequivocally lowered maximal acceleration and/or HIC values with statistical significance. The seat belt lowered HIC values as long as it was used with the high-back seat. Only when the dummy wore a helmet sitting in a high-back seat did the HIC show less than the threshold of 570 for three-year-old children. The HIC showed the lowest score of 161.5 when the dummy wore both a helmet and a seat belt sitting in a high-back seat.

Conclusions

Riders in bicycle-mounted child seats definitely have higher risks of contact-type head injuries. In transporting a child on a bicycle-mounted child seat, parents must use both a child-bicycle helmet and a high-back child seat at least; a seat belt is highly recommended as long as it is used with the other safety devices.

Impact on Industry

The bicycle-mounted child seat should have a high enough back and an appropriate seat belt to protect the head of the child from a contact-type injury.     

The determinants of motorcyclists helmet use: Urban arterial road in Khon Kaen City,Thailand

IntroductionCurrently, Thailand incurs the highest death toll of motorcyclists in the world. The aim of this study was to explore the factors influencing helmet use of motorcyclists in Khon Kaen City, Thailand by using the Logistic regression analysis.MethodThe samples, consisting of 27,977 riders and 6,947 riding passengers, were collected by CCTV installed at several signalized intersections along urban arterial roads.ResultsThe observation results reveal that only 67% of motorcyclists wore the helmets. The analysis results reveal that the helmet use of motorcyclists was significantly associated with the riding status, number of passengers, apparent age, motorcycle class, time of day, the presence of police booths at intersections and, especially, red light running behavior. The riders tended to wear helmets at 2.7 times higher rates than passengers. Adult motorcyclists tended to wear the helmets at 2.8 times higher rates than children. The motorcyclists riding the motorcycles over 125 cc tended to wear the helmets 1.9 times higher than those riding motorcycles under 125 cc. The motorcyclists riding in the morning and the afternoon tended to wear the helmets 5.0 and 3.8 times higher than in the evening. The motorcyclists riding through intersections with police booths tended to wear the helmets 2.2 times higher than those riding through intersection without police booths. However, the red light running riders intend to wear the helmets 0.6 times less than the legal riders.ConclusionsThe outcome of this study could determine the factors influencing motorcyclist's helmet use.Practical ImplicationsIt will be useful for a development of 100% helmet use program designed to lessen the fatality of motorcyclists along the urban arterial roads.     

工业安全帽抗冲击性能研究*

为研究安全帽安全性与保护性问题,利用落锤冲击实验,对不同材质安全帽吸能率、冲击力峰值进行研究。结果表明:随冲击能量增加,安全帽受冲击力峰值呈指数倍增长,吸能率呈指数倍下降;ABS树脂与玻璃钢材质安全帽头模受冲击力峰值小于HDPE材质安全帽;当冲击能量大于60 J,HDPE材质安全帽丧失保护功能;ABS安全帽能够承受最大冲击力能量值为70 J,玻璃钢安全帽最大承载力高于ＡＢＳ树脂安全帽。研究结果可为安全帽质量设计提供理论依据。     

A new laboratory rig for evaluating helmets subject to oblique impacts

Current requirements and regulations governing motorcycle helmets around the world are based on test results of purely radial impacts, which are statistically rare in real accidents. This study presents a new impact rig for subjecting test helmets to oblique impacts, which therefore is able to test impacts of increased statistical relevance to real motorcycle accidents. A number of different head-helmet interfaces have been investigated. A test rig was constructed to produce oblique impacts to helmets simulating those occurring in real motorcycle accidents. A Hybrid III dummy head was fitted with accelerometers to measure the accelerations arising during impact testing. The equipment used for data collection was validated in both translational and rotational acceleration. In order to better resemble the human head, an artificial scalp was fitted to the hybrid dummy. The same test rig was used to investigate the performance of a number of different helmets. Impact velocities ranging from 7.3 to 9.9 m/s were tested using a number of different impact angles and impact areas. This study shows that the new test rig can be used to provide useful data at speeds of up to 50 km/h and with impact angles varying from purely tangential to purely radial. The rotational accelerations observed differ greatly depending on both helmet and scalp designs. For example, a helmet with a sliding outer shell placed on an experimental head fitted with an artificial scalp (made to resemble the human scalp) reduces rotational accelerations of the head by up to 56%, compared with those of an experimental head fitted with a fixed scalp and conventional helmet. The degree of slippage between the skull and the scalp, and between the scalp and the helmet, leads to considerable variation in the results. This innovative test rig appears to provide an accurate method for measuring accelerations in an oblique impact to a helmet. In order to obtain a good level of repeatability in oblique impact testing, it is crucial that the helmet be fixed to the head in the exact same way in each individual test. Both the position and the angle of impact must be reproduced identically in each test. The test rig used here has shown that this type of rig can be used to compare different helmet designs, and it therefore is able to contribute to achieving safer helmets.