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Tuesday, November 9, 2010

Overview of Bicycle Crash Data and Why We Should Teach Bicycle Safety to Kids

Below is an overview of the nature and severity of bicycle injuries among children and the value of helmet use for children.  This "overview" is the preface to a comprehensive survey of thirty bicycle safety training programs around the U.S. undertaken in 1998 by the Harborview Injury Prevention and Research Center at the University of Washington in Seattle.  The overview, posted below, provides an excellent survey of a full range of first generation bicycle safety programs.  Many of these programs have evolved in 2010 to become state-of-the-art training programs across the U.S.  I've included links to just a few here:

Effective Cycling (League of American Bicyclists):  now "Smart Cycling" bicycle education program
Travis County (TX) Super Cyclist Program:  Now Texas Super Cylcist Program Statewide in Texas

The following post is from  
Training Programs for Bicycle Safety
September 3, 1998
by the 
Washington Traffic Safety Commission
Harborview Injury Prevention and Research Center
Authors are Frederick P. Rivara, M.D., M.P.H. and  Jane Metrik, B.S.


Each year approximately 800 bicyclists are killed and as many as 500,000 require emergency room care for injuries. More than one third of all bicyclist deaths occur among youth ages five to 20, and 41% of non-fatal injuries occur to children under the age of 15 years (National Highway Traffic Safety Administration, 1997). Nationally, bicyclists ages 14 and under are at five times greater risk for injury than older cyclists (NHTSA, State Legislative Fact Sheet, 1998). Fatality rates (per million population) for ages 10 to 15 were the highest at 6.46, followed by ages 5 to 9 at 4.58. Similarly with injury rates, children 10 to 15 years old are by far the most vulnerable age category of all age groups (Fatality Analysis Reporting System, NHTSA, 1996). In recent years, injuries to older teens and young adults have accounted for a larger portion of the total. The proportion of pedalcyclists between the ages 25 to 64 involved in crashes that resulted in fatalities was nearly twice as high in 1996 as in 1986 (46% and 25%, respectively).

Washington State was estimated to have 712 total traffic fatalities in 1996, which  included 14 (2%) pedalcyclist fatalities (Fatality Analysis Reporting System, NHTSA, 1996). In Washington state, there are approximately 1700 police reported bicycle injuries involving collisions with motorists each year. Over 60 percent of these injuries involve
bicyclists who are 15 years or older. Bicycle injuries are nearly as frequent in the state as pedestrian injuries.

While the majority of bicycle injuries do not involve motor vehicles (MV), collision with vehicles markedly increases the likelihood of serious injury. In the largest study of bicycle injuries conducted to date, investigators at the Harborview Injury Prevention and Research Center (HIPRC) found that MV accounted for 17 percent of all bicycle related
injuries, but increased the likelihood of severe injury by nine fold (Thompson et al,  1996).

Prevention of bicycle injuries can be approached through the use of bicycle helmets, educational programs to improve riding behavior and safety, educational programs aimed at motor vehicle drivers, and environmental changes to decrease the likelihood of bicycle-motor vehicle collisions.


Head injuries account for one-third of emergency room visits, two-thirds of hospitalizations, and three-fourths of deaths involving bicycles. Helmets have been shown to be extremely effective in decreasing the  risk of head injuries. Rigorous studies indicate that they reduce the risk of head injuries by 85%, and brain injuries by 88% (Thompson, Rivara, and Thompson, 1989). All types of helmets appear to be effective, and they appear to work as well in collisions which involve motor vehicles as they do in falls or other crashes without MV involvement. They work at all ages. In addition, they decrease the risk of injuries to the upper and mid-face by as much as two-thirds.

Although helmets have been determined to be the single most effective way of reducing head injuries and fatalities resulting from bicycle crashes, only 18 percent of all bicyclists wear bicycle helmets (Traffic Safety Fact Sheet, NHTSA,1998). Thus, there is a need for an education program that will increase the knowledge about helmet use and  effectiveness. The program developed by the HIPRC has been successful in increasing helmet use from 2% in 1986 to over 50% in 1996. However, use is low among teens and may have decreased in all age groups in the last 2 years.

Other community based bicycle helmet programs have been successful. A common thread to all of them is that they are community-wide, multi-faceted and long term. Nevertheless, many of these educational programs appear to reach a plateau in their effect at about 50% helmet use. Another type of intervention, not mutually exclusive with educational programs, is legislation. NHTSA (1997, p.2) maintains that, “...the enactment of laws requiring the use of bicycle helmets, along with education and visible enforcement, is likely to be the most promising way to increase bicycle helmet usage.” Unfortunately, attempts at getting legislation passed in the state have been unsuccessful over the last 5 years.

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