Bicycle Injury Fact Sheet

More than 70% of children ages 5 to 14 (27.7 million) ride bicycles. This age group rides about 50% more than the average bicyclist and accounts for approximately one-third of all bicycle-related deaths and more than two-thirds of all bicycle-related injuries. Bicycles are associated with more childhood injuries than any other consumer product except the automobile.

Head injury is the leading cause of death in bicycle crashes and is the most important determinant of bicycle-related death and permanent disability. Head injuries account for more than 60% of bicycle-related deaths, more than two thirds of bicycle-related hospital admissions, and about one-third of hospital emergency room visits for bicycling injuries. The single most effective safety device available to reduce head injury and death from bicycle crashes is a bicycle helmet. Helmet use is associated with a reduction in the risk of bicycle-related death and injury and a reduction in the severity of head injury when a crash occurs. Unfortunately, national estimates report that bicycle helmet use among child bicyclists ranges from 15 to 25%. Helmet usage is lowest among children ages 11 to 14. Bicycle education programs and mandatory bicycle helmet legislation are effective at increasing helmet use, and therefore, reducing bicycle-related death and injury.

National Facts
Deaths and Injuries

• In 1995, more than 250 children ages 14 and under died in bicycle-related crashes. Motor vehicles were involved in 230 of these deaths
• In 1996, more than 350,000 children ages 14 and under were treated in hospital emergency rooms for bicycle-related injuries
• It is estimated that collisions with motor vehicles account for 90% of all bicycle-related deaths and 10% of all nonfatal bicycle-related injuries. Collision with a motor vehicle increases the risk of death, severity of injury and the probability of sustaining a head injury
• More than 40% of all head injury-related deaths and approximately three-fourths of head injuries occur among children ages 14 and under. Young children suffer a higher proportion of head injuries than older children

When and Where

• Children are more likely to die from bicycle crashes at non-intersection locations (66%); during the months of May to August (55%); and between the hours of 3 P.M. and 6 P.M. (55%)
• Nearly 60% of all childhood bicycle-related deaths occur on minor roads. The typical bicycle/motor vehicle crash occurs within one mile of the bicyclist’s home
• Children ages 14 and under are more likely to be injured riding on non-daylight hours (dawn, dusk or night). The risk of sustaining an injury in non-daylight conditions is nearly four times greater than riding during the daytime
• Among children ages 14 and under, more than 80% of bicycle-related fatalities are associated with the bicyclist’s behavior. The most common crashes include riding into a street without stopping; turning left or swerving into traffic that is oncoming from behind; running a stop sign; and riding against the flow of traffic

Who is at Risk

• Children age 14 and under are five times more likely to be injured in a bicycle-related crash than older riders
Children under age 10 are at greater risk for serious injury and are more likely to suffer head injuries than older riders. Approximately half of all bicycle-related injuries among children under age 10 occur to the head/face, compared to the one-fifth among older children
• Males account for 85% of bicycle-related deaths and 70% of nonfatal injuries and have higher bicycle-related death and injury rates than females. Males ages 10 to 14 have the highest death rate from bicycle-related head injury of all ages
• Riding without a bicycle helmet increases the risk of sustaining a head injury in the event of a crash. Non-helmeted riders are 14 times more likely to be involved in a fatal crash than those wearing a helmet
• Bicyclists admitted to hospitals with head injuries are 20 times more likely to die as those without head injuries
• Collisions with a motor vehicle and crashes occurring at speeds greater than 15 mph increase the risk of severe bicycle-related injury and death

Connecticut Facts

Bicycle injury among CT persons <20 years of age
Deaths (1988-95): 24 (average 3 deaths / year, range 0 to 5)
of the 24 deaths:

• 4 (16.7%) among 5 - 9 year olds
• 13 (54.2%) among 10 - 14 year olds
• 7 (29.2%) among 15 - 19 year olds
• deaths are highest among boys 10 - 14 years of age (n=12)
• 75% of deaths are due to a collision with a motor vehicle

Non-fatal hospitalized injury (1990-94)
787 hospital admissions (average 157 admissions/yr)
of the 787 hospital admissions:

• 39 (5.0%) occurred among toddlers 1 - 4 years of age
• 230 (29.2%) among 5 - 9 year olds
• 393 (49.9%) among 10 - 14 year olds
• 125 (15.9%) among 15 - 19 year olds
• For every bicycle death there are 52 children admitted to a hospital for a non-fatal injury
• 67.7% of hospital admissions were non-motor vehicle related (fall off bicycle); 32.3 were due to collisions with a motor vehicle

Prevention
Helmet Effectiveness

• Bicycle helmets have been shown to reduce the risk of head injury by as much as 85% and the risk of brain injury as much as 88%
• It is estimated that 75% of bicycle-related fatalities among children could be prevented with a bicycle helmet
• Universal use of bicycle helmets by children ages 4 to 15 would prevent between 135 and 155 deaths, between 39,000 and 45,000 head injuries, and between 18,000 and 55,000 scalp and face injuries annually
• Children are more likely to wear a bicycle helmet if riding with others (peers or adults) who are also wearing one and less likely to wear one if their companions are not
• It is estimated that universal use of bike helmets from 1984 through 1988 could have prevented 2,500 deaths and 757,000 head injuries, or, in other words, 1 death per day and 1 head injury every 4 minutes

Helemt Laws and Regulations

• Currently, 15 states and more than 30 localities have enacted some form of bicycle helmet legislation, most of which cover only young riders
• Various studies have shown bicycle helmet legislation to be effective at increasing bicycle helmet use and reducing bicycle-related death and injury among children covered under the law
• In compliance with the Child Safety Protection Act of 1994, the Consumer Product Safety Commission is currently developing a mandatory safety standard for bicycle helmets
• One example shows that five years following the passage of a state mandatory bicycle helmet law for children ages 13 and under, bicycle-related fatalities decreased by 60%
• None of the 50 states has a bicycle helmet law that applies to all riders

Health Care Costs and Savings

• Every bicycle helmet saves this country $395 in direct health care costs and other costs to society
• If 85% of all child cyclists wore bicycle helmets in one year, the lifetime medical cost savings would total between $109 million and $142 million
• A person who survives a head injury typically needs 5 to 10 years of intensive rehabilitation services. The estimated lifetime cost of these services may exceed $4 million
• Bike helmets can be purchased for $30, or as little as $12 -- the projected annual cost of treating a head injury is $32,250 - $63,050
• The estimated yearly cost of bicycle-related injuries is more than $1 billion

Prevention Tips

• A bicycle helmet is a necessity, not an accessory. Always wear a bicycle helmet every time and everywhere you ride
• Wear a bicycle helmet correctly. A bicycle helmet should fit comfortably and snugly, but not too tightly. It should sit on top of your head in a level position, and it should not rock forward and back or from side to side. The helmet straps must always be buckled
• Buy a bicycle helmet that meets or exceeds the safety standards developed by the American National Standards Institute (ANSI), the Snell Memorial Foundation and / or the American Society for Testing and Materials (ASTM)
• Learn the rules of the road and obey all traffic laws. Ride on the right side of the road, WITH traffic, not against. Use appropriate hand signals, respect traffic signals, stop at all intersections (marked and unmarked), and stop and look both ways before entering a street
• Cycling should be restricted to sidewalks and paths until a child is age 10 and is able to show how well she or he rides and observes the basic rules of the road