Background

Bicycling is a popular activity in the United States. Bicycles are owned by approximately 30% of the U.S. population, and 45% of bike owners ride at least occasionally (2). Approximately 80%-90% of children own a bicycle by the time they are in second grade (3).

From 1984 through 1988, an annual average of 962 U.S. residents died from and 557,936 persons were treated in emergency departments for bicycle-related injuries (4). Approximately 6% of persons who are treated for bicycle-related injuries require hospitalization (5,6). The annual societal cost of bicycle-related injuries and deaths is approximately $8 billion (7).

Head injury is the most common cause of death and serious disability in bicycle- related crashes (1). Head injury accounts for 62% of bicycle-related deaths (4). In addition, approximately 33% of all bicycle-related emergency department visits and 67% of all bicycle-related hospital admissions (5,8) involve head injuries (1,4,5).

Head injury accounts for approximately 44% of all deaths resulting from injury in the United States (9), and approximately 7% of brain injuries are bicycle-related (2). Among survivors of nonfatal head injuries, the effects of the injury can be profound, disabling, and longlasting (9). Even after minor head injuries, persons may experience persistent neurologic symptoms (e.g., headache, dizziness, reduced memory, increased irritability, fatigue, inability to concentrate, and emotional instability). These symptoms are sometimes referred to as the "postconcussional syndrome" (10).

From 1984 through 1988, greater than 40% of all deaths from bicycle-related head injury were among persons less than 15 years of age (4). In all age groups, death rates were higher among males. Death rates from bicycle-related head injury were highest among males 10-14 years of age. During the same years, greater than 75% of persons treated in emergency departments for bicycle-related head injury were less than 15 years of age. Rates for bicycle-related head injury were also higher for males than females in all age groups; the rates were highest among males 5-15 years of age (4).

Nearly 90% of deaths from bicycle-related head injury result from collisions with motor vehicles (4). However, motor vehicle collisions cause less than 25% of the nonfatal bicycle-related head injuries that are treated in emergency departments (1,11). Excluding collisions with motor vehicles, common causes of nonfatal bicycle-related head injuries include falls, striking fixed objects, and collisions with other bicycles (1,11).

Next >> Bicycle Helmets and the Prevention of Head Injury
Increasing the Use of Bicycle Helmets
Recommendations
Bicycle Helmet Legislation
Organizations that Provide Information on Bicycle Helmet Campaigns
Components of a Community-Based Bicycle Helmet Campaign