Estimates of the incidence and costs associated with handlebar-related injuries in children
Flaura K Winston1, Harold B Weiss, Michael L Nance
1TraumaLink, The Children's Hospital of Philadelphia, 10th Floor, 34th Street and Civic Center Blvd, Philadelphia, PA 19104, USA.
Insights
Bicycle handlebar injuries in children cause significant health risks and costs. Safer handlebar designs could reduce these injuries and associated expenses, benefiting public health and the economy.
Area of Science:
- Public Health
- Pediatric Trauma
- Injury Prevention
Background:
- The U.S. Consumer Product Safety Commission is evaluating handlebar regulations for impact performance.
- This is in response to the risk of abdominal and pelvic organ injuries in bicyclists.
Purpose of the Study:
- To estimate the national incidence and costs of handlebar-related abdominal and pelvic organ injuries.
- To inform potential safety regulations for bicycle handlebars.
Main Methods:
- National estimates were derived by extrapolating hospital discharge data from 19 states.
- Injury association with handlebars was estimated from a pediatric trauma center case series.
- Costs included hospital charges, lifetime medical payments, productivity losses, and quality-adjusted life-years.
Main Results:
- In 1997, an estimated 886 handlebar-associated injuries occurred in U.S. children (1.15 per 100,000).
- Total estimated costs reached $9.6 million in hospital charges, $10 million in lifetime medical costs, $11.5 million in productivity losses, and $503.9 million in monetized quality-adjusted life-years.
Conclusions:
- Handlebar-related injuries pose a significant health risk to children.
- These injuries incur substantial healthcare costs.
- Mandating safer handlebar designs may yield significant health and economic benefits.
Background:
The US Consumer Product Safety Commission is considering handlebar regulation regarding impact performance to address the risk of abdominal and pelvic organ injuries in bicyclists.
Objective:
To provide national estimates of incidence and costs of handlebar-related abdominal and pelvic organ injuries.
Design And Setting:
Censuses of hospital discharge data from 19 states were extrapolated to determine national estimates. The percentage of abdominal and pelvic injuries associated with handlebars was estimated based on a case series from a pediatric trauma center. Costs were estimated using standard methods.
Participants:
All subjects younger than 20 years treated as inpatients and discharged from acute care hospitals for non-motor vehicle bicycle-related injury in 19 states in 1997 and at a pediatric trauma center located in one of the states between January 1, 1996, and December 31, 2000.
Main Outcome Measures:
Incidence of bicycle-related handlebar abdominal and pelvic organ injury, total hospital charges, lifetime medical payments, lifetime productivity loss, and lifetime monetized quality-adjusted life-years.
Results:
An estimated 1147 subjects (95% confidence interval, 1082-1215; 1.49 per 100 000 subjects 19 years and younger) in the United States had serious non-motor vehicle-involved bicycle-related abdominal or pelvic organ injury leading to hospitalization in 1997, and 886 (95% confidence interval, 828-944; 1.15 per 100 000 subjects 19 years and younger) of these injuries likely were associated with handlebars. The estimated national costs associated with handlebar-related abdominal and pelvic organ injuries were $9.6 million in total hospital charges, $10.0 million in lifetime medical costs (including claims processing), $11.5 million in lifetime productivity losses, and $503.9 million in lifetime monetized quality-adjusted life-years.
Conclusions:
Handlebar-related abdominal and pelvic organ injuries pose a serious health risk to children and result in substantial health care costs. Requirements for safer handlebar designs may provide one avenue to achieve a health and economic benefit.
