Nichole Hodges’ 7- and 10-year-old daughters know the routine: before taking a bicycle ride, they have to put on helmets. They’ve been strapping on the protective shells since they were navigating tricycles around the driveway.
As a program manager in Nationwide Children’s Hospital Center for Injury Research and Policy, Hodges has seen enough statistics to know the value of always wearing a helmet.
“They know that wearing a helmet is just what we do in our family,” Hodges says. Bike helmets reduce the risk of brain injury by 88 percent in the case of a crash, she says. “We wish we had such simple remedies for the other injuries that we research.”
Traumatic brain injuries caused by bicycle crashes range from mild concussions, which can cause disorientation for a few hours, to severe permanent disability and even death.
Statistics compiled from the National Electronic Injury Surveillance system from 2002 to 2009 show that bicycle accidents resulted in more traumatic brain injuries than any other type of physical activity engaged in by Ohio children ages 19 and younger. Of the 11 youth deaths during those years from traumatic brain injuries, all were caused by traffic-related bicycle accidents, according to data prepared by the Ohio Department of Health, Violence and Injury Prevention.
“There are hundreds of thousands of ER incidents each year that are bike-related injuries,” says pediatrician and New Albany resident Dr. Cameron K. Miller. “Not all are severe, some of them are just cuts and scrapes or sometimes we see kids who break their arms, but in cases where people do end up dying, nine out of 10 weren’t wearing helmets.”
Some central Ohio communities – Columbus and Bexley, notably – have responded to such statistics by enacting laws requiring the use of bike helmets.
Miller was encouraged when Columbus City Council unanimously passed its helmet law in July 2008. The law requires riders 18 years old and younger to wear helmets that fit properly while riding bikes, scooters, skateboards, inline skates and roller skates. Those who don’t obey can receive a citation and be fined up to $25.
Putting on a helmet “is right up there with wearing seat belts and using car seats – it’s all in the same concept of preventative care,” Miller says.
Columbus Division of Police records show that not one citation has been given. But according to the Ohio chapter of the American Academy of Pediatrics, that may have less to do with police action than with citizens’ willingness to obey laws. Since helmet laws have been added to cities’ books throughout Ohio, there has been a 60 percent decrease in bicycle-related fatalities and an increase in helmet use, according to the AAP.
New Albany Mayor Nancy Ferguson says the city has never felt the need to create helmet laws because riders rarely are seen without helmets.
“Those who cycle for fitness in our community really take cycling seriously and they always wear helmets,” Ferguson says. “That has been a good influence on people who might be riding on the bike paths.”
Ferguson says she’s never been approached by a group or a parent who wants to pursue bicycle helmet laws in New Albany.
The city’s Police Department isn’t in favor of such laws, preferring a more proactive approach to bicycle safety, says Interim Police Chief Greg Jones.
“I don’t think people would view being cited and fined for lack of a bicycle helmet, or having their children cited and fined for the same, as a positive learning experience,” Jones says.
The Police Department chooses instead to promote its annual city summer programs such as Safety Town and the Bicycle Rodeo, where children receive helmets and learn how to safely ride on roads and bike paths. New Albany police hand out coupons for free ice cream cones to children wearing helmets.
When the city of Bexley passed a bicycle helmet law in July 2010, Bexley police stated they had no plans to hand out citations.
“In proposals (in favor of the bicycle helmet law), parents were saying ‘My kids say it’s not cool or it’s uncomfortable to wear a helmet, and this law would help me to reinforce this good, common-sense policy of wearing a helmet because the law is a higher power than me,’” Bexley Mayor Ben Kessler recalls.
Bexley police also hand out coupons to children wearing helmets. Since the law was passed, Kessler says, he hasn’t seen riders violating the law.
Leading scientific studies come to conflicting conclusions on whether or not helmet laws actually prevent head injuries. A paper published by the National Bureau of Economic Research in February 2013 showed that helmet laws are associated with lower rates of bicycle-related head injuries, but hypothesizes that this may be due to reductions in bicycle riding induced by such laws because those laws are also associated with increases in head injuries during other wheeled sports.
Recently, the Ohio chapter of the AAP has promoted a proactive approach to bicycle safety. In May, it hosted the first-ever Ohio Bicycle Helmet Safety Awareness Week to promote its Put a Lid on it campaign, which partners with hospitals, law enforcement agencies and schools to raise awareness about bicycle safety and the effects of traumatic brain injuries.
Wearing a helmet isn’t always enough – it has to be worn properly if it’s expected to work.
“The key thing is fit,” says Geoff Clark, owner of Veloscience Bike Works in New Albany.
A helmet is being worn correctly when it sits directly above the eyebrows, covering the entire forehead, and is snug enough to ensure the chin strap doesn’t sag and hands can’t fit between the head and the inside of the helmet, he says.
The first step in choosing the proper helmet is to measure the head’s circumference just above the ears, Clark says. The best and most effective helmets will have a dial on the inside that adjusts to give the rider the best fit possible.
Because of the way children grow, Clark says, helmets made specifically for them usually only work until they reach about 6 years old. After that, children typically fit best in adult-size helmets.
“It’s always best to have children fitted in person in a store rather than to just buy it in the store and give it to them,” he says.
It may be tempting to purchase a novelty helmet with cartoon characters or colorful designs, but although such helmets are required to meet Consumer Product Safety Commission standards, the foam inside tends to contract while riders sweat, which affects the fit and ultimately reduces effectiveness in the event of an accident, Clark says.
“Really, though, it’s just about wearing a helmet,” he says. “Any helmet worn properly is going to be better than not having one.”
Choosing a Helmet
Nine out of 10 bike riders who die in crashes are not wearing helmets. So how do you pick out a good helmet?
- Helmets should be snug, but not tight.
- Helmets should not move from side to side when you shake your head.
- Helmets should sit flat on top of the head and rest one to two finger-widths above the eyebrows. The forehead should be covered.
- Straps should form a “V” below the ear.
- Chin straps should be buckled snugly under the jaw. No more than one or two fingers should fit under the strap.
- If a child is between sizes, size up and use extra pads to ensure a good fit.
Melissa Dilley is a contributing writer. Feedback welcome at firstname.lastname@example.org.