Cycling injuries treated in emergency departments: need for bicycle helmets among preschoolers

To describe the incidence, circumstances, and severity of bicycle-related injuries among children treated in US emergency departments (EDs) and to compare injuries in children aged 1 to 4 years (young children) with those in children and adolescents aged 5-9 and 10-14 years (intermediate-age and older children, respectively).

Emergency department survey from the National Center for Health Statistics National Hospital Ambulatory Medical Care Survey for January 1, 1992, through December 31, 1997.

National probability sample of patients who sought care in EDs; data for children 1 to 14 years old were used.

Incidence and description of bicycle-related injuries among children grouped by age treated in US EDs.

The 6-year weighted estimate of bicycle-associated injuries was 2,176,173. Young children had 270,098 ED visits; their average annual incidence was 45,016, a rate of 28.8 per 10,000 (95% confidence interval [CI], 19.1-38.5). Children in the intermediate-age and older groups had an incidence of 82.0 (95% CI, 66.6-97.4); and 86.4 (95% CI, 70.4-102.4) per 10,000, respectively. The highest rates of bicycle-related injuries were observed among boys in the intermediate-age (108.3 per 10,000 per year) and older groups (123.8 per 10,000 per year). Few injured children were involved in collisions with motor vehicles (<1% of young and 4% of intermediate-age groups). The annual incidence of head trauma was 4.0 per 10,000 (95% CI, 0.4-7.5) for young children, 9.3 per 10,000 (95% CI, 4.3-14.2) for intermediate-age children, and 8.1 per 10,000 (95% CI, 3.5-12.8) for older children. Children aged 5 to 9 years had the highest rates of face trauma (estimated 29.8 per 10,000). The incidence of extremity fractures (range, 6.9-17.6 per 10,000) was similar for all groups.

Although boys in the intermediate-age and older groups have the highest incidence of bicycle-related injuries, young children are also commonly injured. The anatomic sites of injury among young cyclists (head and face trauma and extremity fractures) are similar to those observed in both other groups. Bicycle helmets are indicated for the youngest children as well.