Helmets (Parents & Childrens views)

Parents' Attitudes Towards Helmets and Their Use
A study conducted with parents and with children aged five to 14 who own bicycles showed that helmet ownership by children was significantly (p<.05) related to parental characteristics: educational level, race, perceived effectiveness of bicycle helmets, seat belt use and parental helmet ownership. Specifically, the incidence of helmet ownership was significantly higher in families in which the parent had a college or postgraduate degree (p<.001), was Caucasian (p<.05), reported always using seat belts (p<.01), owned a bicycle helmet (p<.001), and perceived helmets as effective for preventing head injury (p<.05).

Several researchers have found that a major barrier to helmet use by children and adolescents is lack of parental awareness. When parents were asked why their children do not own bicycle helmets, the most common responses were: "never thought about purchasing a helmet" (35 percent ), "never got around to purchasing a helmet" (29 percent), "child wouldn't wear it anyway" (26 percent), and the bicycle helmet was "too expensive" (16 percent). Other reasons for not purchasing bicycle helmets for their children include: "child doesn't ride enough" (19 percent) and "only rides in safe areas" (12 percent).

In the Miller et al study, parents identified magazines, television, family and friends, and pediatricians as key sources of bicycle helmet information. The only source significantly associated with increased helmet ownership was friends and family (p<.01).

Also, in Miller's study, only 48 of the 169 children interviewed owned bicycle helmets. Of these children, only 16 (33 percent) follow strict helmet-wearing rules; 10 follow partial rules and 22 had no parental rules on helmets. As might be expected, children with strict helmet rules were more likely to wear them always or most of the time. Interestingly, the incidence of helmet wearing was no greater for children who had partial rules than those with no rules.

Since lack of parental awareness was the most frequent reason for not purchasing helmets, Miller et al suggested that parental education, particularly through pediatricians, could help to increase bicycle helmet use. A number of researchers have suggested targeting education programs at pediatricians, as well as at parents.


Children's Attitudes Towards Helmets and Their Use

According to CPSC, each year about 400,000 children under the age of 15 are treated in hospital emergency rooms for bicycle-related injuries. An additional 300 die as a result of their injuries. And, about one-third of the injuries and two-thirds of the deaths of bicyclists aged five to 14 are head-related.

National statistics show that only 15 percent of children wear bicycle helmets, even though many youngsters seemed to understand that helmets could protect their head from injury. One child said "you could be paralyzed, killed, or you could suffer brain damage." CPSC found that, of those children who own helmets, 43 percent reportedly wear them always or most of the time, 11 percent wear them occasionally, and 44 percent seldom or never wear their helmets. According to the CPSC, helmet use was highest for younger children (age six or less) and lowest for older children (12 to 14 year olds).

A survey of 282 children conducted by the American Automobile Association (AAA) and the CPSC determined that children most disliked the fit of bicycle helmets (46 percent). Many reportedly complained that the helmets felt uncomfortable on the head or that the chinstraps pinch. Interestingly, when these children were asked what one thing they would change about the helmets, the majority (52 percent) said "how they look," and only 23 percent said "how they fit."

In a bicycle injury study conducted in Ohio, many of the children who do not own a bicycle helmet seemed to lack an awareness or understanding of the importance of helmets. Twenty-nine percent of the children in this study said they "never thought of wearing a helmet" and 19 percent said that wearing a helmet is "not necessary." Only 15 percent expressed negative feelings about bicycle helmets, including they did not like helmets in general or did not like the way they look (e.g., ugly or embarrassing).

In yet a third study, child helmet owners who do not wear their helmet said they do not feel it is necessary or that they forgot or lost it. On the other hand, those who do not own helmets reportedly avoid this type of head gear because of the way they look or because they are uncomfortable. Style and comfort appear to be more important barriers to helmet use for adolescents and young adults who are reluctant to wear a helmet if their peers do not.

In a 1994 survey conducted by the Centers for Disease Control and Prevention, children most frequently pointed to low perceived risk of injury or simply "never considered the issue" as the main reasons for not owning a helmet or wearing one more often

Children in the CPSC/AAA survey suggested that helmet manufacturers use "cooler" colors and more interesting and varied designs. They also indicated that a role model, such as a celebrity or professional athlete, who would talk about the importance and benefits of helmets, might encourage some children to wear bicycle helmets. Other children indicated that discussing the consequences of riding a bicycle without a helmet would be effective in promoting helmet use. Still others suggested that retailers and local communities run promotions (e.g. wear a bike helmet and get a free pizza) to increase helmet use among children.

A number of researchers have found that the incidence of helmet use was higher among those who ride with peers wearing helmets than those who ride alone or with peers who do not wear helmets. Children were also more likely to wear helmets if their parents wear them.

No conclusive evidence has been uncovered to show that children who wear helmets as youngsters continue to wear them as they grow older. However, in a study conducted in Oregon where mandatory helmet laws exist, researchers predicted that because younger children were more likely to comply with helmet laws, helmet use by Oregon children may continue to increase as younger children grow up with the law.


Number of Head Injuries, Causes and Ways to Prevent Them

Bicycle injury rates are reportedly highest for five to 15 year-olds, with these children accounting for three-fourths of all bicycle head injuries. Within this group, females five to nine years of age and males 10 to 14 years old have the highest injury rates per 100,000 population, according to Thompson et al. For all age categories, males are injured more often than females. This may be attributed, in part, to the fact that males ride more frequently and spend more time on bicycles than females.

According to one study, children are reportedly six times less likely than adults to wear helmets even though they are over twice as likely to sustain a severe head injury.

Studies show that the most common cause of death and serious disability from bicycle crashes is head injury. Head and brain injuries are the primary or contributing cause of death in 62 percent to 90 percent of all bicycling fatalities. Riding at speeds greater than 15 miles per hour - which is not unusual -- increased the risk of severe injury by 40 percent.

Grimand, Nolan and Carlin carried out one study that demonstrates the effectiveness of bicycle helmets. This study reveals that the majority of injuries sustained by helmeted bicyclists were mild. However, helmeted children were as likely as unhelmeted children to suffer facial injuries. Helmeted bicyclists who suffered head injury, in many instances, did not properly wear the helmet.

Overall, helmets have been found to decrease the risk of head and brain injury by 70 percent to 88 percent and facial injury to the upper and mid-face by 65 percent. Acton et al recommend that manufacturers make helmets so they cover a larger area of the head, with chinstraps and visors to provide maximum protection for the head and face.

Thompson et al recommend that steps be taken to reduce the number of bicycle crashes among adults and children. Also, Thompson et al discuss the need for bicycle-friendly riding environments to encourage cycling and reduce crashes. These would include improvements in road design, bicycle design, and bicyclist behavior, all of which contribute to better safety.

Every year, about 100,000 people visit hospital emergency rooms to treat injuries sustained from in-line skating accidents. An estimated 65,000 children under the age of 15 sustain in-line skating injuries, of which 29,000 will fracture a bone and 7,000 will injure their faces or heads. The number of injuries related to in-line skating increased 184 percent from 1993 to 1995. According to the CPSC, as many as two-thirds of injured in-line skaters were not wearing safety gear (i.e., helmets, elbow and knee pads, wrist guards and gloves). The rise in the number of in-line skating injuries underscores the need to encourage skaters to wear safety gear.

When in-line skating, females are generally more likely than males to wear some protective gear. However, females reportedly wear helmets as infrequently as males. Advanced and beginner skaters are much more likely to wear helmets than are average skaters. Teenagers are the least likely to wear any protective equipment (including helmets) compared with children and adults. Helmets are reportedly worn by 10.3 percent of older skaters, 8.1 percent of children, 2.0 percent of adults, 0.0 percent of teenagers.

As with many bicyclists, in-line skaters' lack of knowledge of the importance of protective equipment (including helmets), discomfort from the equipment, perceived unattractive appearance while wearing protective gear, and cost all contribute to low rates of safety equipment usage.