Changes in the pattern of paediatric bicycle injuries in relation to helmet use 1980-2014

INTRODUCTION: This study aimed to describe long-term changes in injury pattern in bicycle accidents among children in relation to the increasing use of bicycle helmets. METHODS: This was a descriptive register study of all children aged 6-14 years with injuries from bicycle accidents who were treated at a Danish university hospital in the 1980-2014 period. Diagnoses and helmet use were analysed and stratified by gender and age group. Diagnoses were grouped into head injuries, severe head injuries, facial injuries, bone fractures, spinal injuries and internal injuries. We defined severe head injuries as skull fractures and intracranial injuries including concussions, haemorrhages and lacerations. RESULTS: We included 13,294 children, 58.7% were boys. From 1980-1984 to 2010-2014, the use of helmets increased from 0% to 49.9% in boys and from 0% to 57.1% in girls. The proportion of boys and girls with head injuries decreased from 31.3% to 17.4% and from 29.6% to 10.1%, respectively. A similar reduction was found in the proportion of children with severe head injuries. In the study period, the proportion of children with facial injuries, fractures, spinal injuries and internal injuries in trunk remained unchanged. Eighteen children died from their injuries, none of whom wore a helmet. CONCLUSIONS: In the study period, the proportion of head and severe head injuries decreased by 50% along with an increase from 0% to 50% in helmet use. The proportion of facial injuries, spinal injuries, bone fractures and injuries to the internal organs remained unchanged.