Fahlstedt, M; Halldin, P; Kleiven, S
The protective effect of a helmet in three bicycle accidents--A finite element study Journal Article
In: Accident Analysis & Prevention, vol. 91, pp. 135–143, 2016.
Abstract | BibTeX | Tags: *Accidents, *Bicycling/in [Injuries], *Brain Concussion/pc [Prevention & Control], *Head Protective Devices, *Skull Fractures/pc [Prevention & Control], Computer simulation, Craniocerebral Trauma/pc [Prevention & Control], finite element analysis, Humans, Traffic
@article{Fahlstedt2016,
title = {The protective effect of a helmet in three bicycle accidents--A finite element study},
author = {Fahlstedt, M and Halldin, P and Kleiven, S},
year = {2016},
date = {2016-01-01},
journal = {Accident Analysis \& Prevention},
volume = {91},
pages = {135--143},
abstract = {There is some controversy regarding the effectiveness of helmets in preventing head injuries among cyclists. Epidemiological, experimental and computer simulation studies have suggested that helmets do indeed have a protective effect, whereas other studies based on epidemiological data have argued that there is no evidence that the helmet protects the brain. The objective of this study was to evaluate the protective effect of a helmet in single bicycle accident reconstructions using detailed finite element simulations. Strain in the brain tissue, which is associated with brain injuries, was reduced by up to 43% for the accident cases studied when a helmet was included. This resulted in a reduction of the risk of concussion of up to 54%. The stress to the skull bone went from fracture level of 80 MPa down to 13-16 MPa when a helmet was included and the skull fracture risk was reduced by up to 98% based on linear acceleration. Even with a 10% increased riding velocity for the helmeted impacts, to take into account possible increased risk taking, the risk of concussion was still reduced by up to 46% when compared with the unhelmeted impacts with original velocity. The results of this study show that the brain injury risk and risk of skull fracture could have been reduced in these three cases if a helmet had been worn.Copyright © 2016 Elsevier Ltd. All rights reserved.},
keywords = {*Accidents, *Bicycling/in [Injuries], *Brain Concussion/pc [Prevention \& Control], *Head Protective Devices, *Skull Fractures/pc [Prevention \& Control], Computer simulation, Craniocerebral Trauma/pc [Prevention \& Control], finite element analysis, Humans, Traffic},
pubstate = {published},
tppubtype = {article}
}
McIntosh, A S; Lai, A; Schilter, E
Bicycle helmets: head impact dynamics in helmeted and unhelmeted oblique impact tests Journal Article
In: Traffic Injury Prevention, vol. 14, no. 5, pp. 501–508, 2013.
Abstract | BibTeX | Tags: *Accidents, *Bicycling/in [Injuries], *Craniocerebral Trauma/et [Etiology], *Head Protective Devices/ut [Utilization], Acceleration, Biological, Biomechanical Phenomena, Computer simulation, Humans, Male, Manikins, Models, Traffic/sn [Statistics & Numerical Dat
@article{McIntosh2013,
title = {Bicycle helmets: head impact dynamics in helmeted and unhelmeted oblique impact tests},
author = {McIntosh, A S and Lai, A and Schilter, E},
year = {2013},
date = {2013-01-01},
journal = {Traffic Injury Prevention},
volume = {14},
number = {5},
pages = {501--508},
abstract = {OBJECTIVE: To assess the factors, including helmet use, that contribute to head linear and angular acceleration in bicycle crash simulation tests. METHOD: A series of laboratory tests was undertaken using an oblique impact rig. The impact rig included a drop assembly with a Hybrid III head and neck. The head struck a horizontally moving striker plate. Head linear and angular acceleration and striker plate force were measured. The Head Injury Criterion was derived. The following test parameters were varied: drop height to a maximum of 1.5 m, horizontal speed to a maximum of 25 km/h, helmet/no helmet, impact orientation/location, and restraint adjustment. Additional radial impacts were conducted on the same helmet models for comparison purposes. Descriptive statistics were derived and multiple regression was applied to examine the role of each parameter. RESULTS: Helmet use was the most significant factor in reducing the magnitude of all outcome variables. Linear acceleration and the Head Injury Criterion were influenced by the drop height, whereas angular acceleration tended to be influenced by the horizontal speed and impact orientation/location. The restraint adjustment influenced the outcome variables, with lower coefficients of variation observed with the tight restraint. CONCLUSIONS: The study reinforces the benefits of wearing a bicycle helmet in a crash. The study also demonstrates that helmets do not increase angular head acceleration. The study assists in establishing the need for an agreed-upon international oblique helmet test as well as the boundary conditions for oblique helmet testing.},
keywords = {*Accidents, *Bicycling/in [Injuries], *Craniocerebral Trauma/et [Etiology], *Head Protective Devices/ut [Utilization], Acceleration, Biological, Biomechanical Phenomena, Computer simulation, Humans, Male, Manikins, Models, Traffic/sn [Statistics \& Numerical Dat},
pubstate = {published},
tppubtype = {article}
}
Rissel, C
The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder Journal Article
In: Accident Analysis & Prevention, vol. 45, pp. 107–109, 2012.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Humans
@article{Rissel2012,
title = {The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder},
author = {Rissel, C},
year = {2012},
date = {2012-01-01},
journal = {Accident Analysis \& Prevention},
volume = {45},
pages = {107--109},
abstract = {This paper challenges the conclusion of a recent paper by Walter et al. (Accident Analysis and Prevention 2011, doi:10.1016/j.aap.2011.05.029) reporting that despite numerous data limitations repealing the helmet legislation in Australia could not be justified. This conclusion is not warranted because of the limited time period used in their analysis and the lack of data beyond a few years before the introduction of legislation, the failure to adequately account for the effect of the phasing in of the legislation, the effect of the marked reduction in child cyclists, and the non-comparability of the pedestrian and cycling injuries and related lack of consideration of the severity of head injuries. The extent to which helmet legislation deters people from cycling is discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.},
keywords = {*Bicycling/in [Injuries], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Humans},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Bicycling/lj [Legislation & Jurisprudence], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics & Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics & Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics & Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics & Numerical Data, Trauma Severity Indices
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {*Bicycling/in [Injuries], *Bicycling/lj [Legislation \& Jurisprudence], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics \& Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics \& Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics \& Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics \& Numerical Data, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Fahlstedt, M; Halldin, P; Kleiven, S
The protective effect of a helmet in three bicycle accidents--A finite element study Journal Article
In: Accident Analysis & Prevention, vol. 91, pp. 135–143, 2016.
@article{Fahlstedt2016,
title = {The protective effect of a helmet in three bicycle accidents--A finite element study},
author = {Fahlstedt, M and Halldin, P and Kleiven, S},
year = {2016},
date = {2016-01-01},
journal = {Accident Analysis \& Prevention},
volume = {91},
pages = {135--143},
abstract = {There is some controversy regarding the effectiveness of helmets in preventing head injuries among cyclists. Epidemiological, experimental and computer simulation studies have suggested that helmets do indeed have a protective effect, whereas other studies based on epidemiological data have argued that there is no evidence that the helmet protects the brain. The objective of this study was to evaluate the protective effect of a helmet in single bicycle accident reconstructions using detailed finite element simulations. Strain in the brain tissue, which is associated with brain injuries, was reduced by up to 43% for the accident cases studied when a helmet was included. This resulted in a reduction of the risk of concussion of up to 54%. The stress to the skull bone went from fracture level of 80 MPa down to 13-16 MPa when a helmet was included and the skull fracture risk was reduced by up to 98% based on linear acceleration. Even with a 10% increased riding velocity for the helmeted impacts, to take into account possible increased risk taking, the risk of concussion was still reduced by up to 46% when compared with the unhelmeted impacts with original velocity. The results of this study show that the brain injury risk and risk of skull fracture could have been reduced in these three cases if a helmet had been worn.Copyright © 2016 Elsevier Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
McIntosh, A S; Lai, A; Schilter, E
Bicycle helmets: head impact dynamics in helmeted and unhelmeted oblique impact tests Journal Article
In: Traffic Injury Prevention, vol. 14, no. 5, pp. 501–508, 2013.
@article{McIntosh2013,
title = {Bicycle helmets: head impact dynamics in helmeted and unhelmeted oblique impact tests},
author = {McIntosh, A S and Lai, A and Schilter, E},
year = {2013},
date = {2013-01-01},
journal = {Traffic Injury Prevention},
volume = {14},
number = {5},
pages = {501--508},
abstract = {OBJECTIVE: To assess the factors, including helmet use, that contribute to head linear and angular acceleration in bicycle crash simulation tests. METHOD: A series of laboratory tests was undertaken using an oblique impact rig. The impact rig included a drop assembly with a Hybrid III head and neck. The head struck a horizontally moving striker plate. Head linear and angular acceleration and striker plate force were measured. The Head Injury Criterion was derived. The following test parameters were varied: drop height to a maximum of 1.5 m, horizontal speed to a maximum of 25 km/h, helmet/no helmet, impact orientation/location, and restraint adjustment. Additional radial impacts were conducted on the same helmet models for comparison purposes. Descriptive statistics were derived and multiple regression was applied to examine the role of each parameter. RESULTS: Helmet use was the most significant factor in reducing the magnitude of all outcome variables. Linear acceleration and the Head Injury Criterion were influenced by the drop height, whereas angular acceleration tended to be influenced by the horizontal speed and impact orientation/location. The restraint adjustment influenced the outcome variables, with lower coefficients of variation observed with the tight restraint. CONCLUSIONS: The study reinforces the benefits of wearing a bicycle helmet in a crash. The study also demonstrates that helmets do not increase angular head acceleration. The study assists in establishing the need for an agreed-upon international oblique helmet test as well as the boundary conditions for oblique helmet testing.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rissel, C
The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder Journal Article
In: Accident Analysis & Prevention, vol. 45, pp. 107–109, 2012.
@article{Rissel2012,
title = {The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder},
author = {Rissel, C},
year = {2012},
date = {2012-01-01},
journal = {Accident Analysis \& Prevention},
volume = {45},
pages = {107--109},
abstract = {This paper challenges the conclusion of a recent paper by Walter et al. (Accident Analysis and Prevention 2011, doi:10.1016/j.aap.2011.05.029) reporting that despite numerous data limitations repealing the helmet legislation in Australia could not be justified. This conclusion is not warranted because of the limited time period used in their analysis and the lack of data beyond a few years before the introduction of legislation, the failure to adequately account for the effect of the phasing in of the legislation, the effect of the marked reduction in child cyclists, and the non-comparability of the pedestrian and cycling injuries and related lack of consideration of the severity of head injuries. The extent to which helmet legislation deters people from cycling is discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fahlstedt, M; Halldin, P; Kleiven, S
The protective effect of a helmet in three bicycle accidents--A finite element study Journal Article
In: Accident Analysis & Prevention, vol. 91, pp. 135–143, 2016.
Abstract | BibTeX | Tags: *Accidents, *Bicycling/in [Injuries], *Brain Concussion/pc [Prevention & Control], *Head Protective Devices, *Skull Fractures/pc [Prevention & Control], Computer simulation, Craniocerebral Trauma/pc [Prevention & Control], finite element analysis, Humans, Traffic
@article{Fahlstedt2016,
title = {The protective effect of a helmet in three bicycle accidents--A finite element study},
author = {Fahlstedt, M and Halldin, P and Kleiven, S},
year = {2016},
date = {2016-01-01},
journal = {Accident Analysis \& Prevention},
volume = {91},
pages = {135--143},
abstract = {There is some controversy regarding the effectiveness of helmets in preventing head injuries among cyclists. Epidemiological, experimental and computer simulation studies have suggested that helmets do indeed have a protective effect, whereas other studies based on epidemiological data have argued that there is no evidence that the helmet protects the brain. The objective of this study was to evaluate the protective effect of a helmet in single bicycle accident reconstructions using detailed finite element simulations. Strain in the brain tissue, which is associated with brain injuries, was reduced by up to 43% for the accident cases studied when a helmet was included. This resulted in a reduction of the risk of concussion of up to 54%. The stress to the skull bone went from fracture level of 80 MPa down to 13-16 MPa when a helmet was included and the skull fracture risk was reduced by up to 98% based on linear acceleration. Even with a 10% increased riding velocity for the helmeted impacts, to take into account possible increased risk taking, the risk of concussion was still reduced by up to 46% when compared with the unhelmeted impacts with original velocity. The results of this study show that the brain injury risk and risk of skull fracture could have been reduced in these three cases if a helmet had been worn.Copyright © 2016 Elsevier Ltd. All rights reserved.},
keywords = {*Accidents, *Bicycling/in [Injuries], *Brain Concussion/pc [Prevention \& Control], *Head Protective Devices, *Skull Fractures/pc [Prevention \& Control], Computer simulation, Craniocerebral Trauma/pc [Prevention \& Control], finite element analysis, Humans, Traffic},
pubstate = {published},
tppubtype = {article}
}
McIntosh, A S; Lai, A; Schilter, E
Bicycle helmets: head impact dynamics in helmeted and unhelmeted oblique impact tests Journal Article
In: Traffic Injury Prevention, vol. 14, no. 5, pp. 501–508, 2013.
Abstract | BibTeX | Tags: *Accidents, *Bicycling/in [Injuries], *Craniocerebral Trauma/et [Etiology], *Head Protective Devices/ut [Utilization], Acceleration, Biological, Biomechanical Phenomena, Computer simulation, Humans, Male, Manikins, Models, Traffic/sn [Statistics & Numerical Dat
@article{McIntosh2013,
title = {Bicycle helmets: head impact dynamics in helmeted and unhelmeted oblique impact tests},
author = {McIntosh, A S and Lai, A and Schilter, E},
year = {2013},
date = {2013-01-01},
journal = {Traffic Injury Prevention},
volume = {14},
number = {5},
pages = {501--508},
abstract = {OBJECTIVE: To assess the factors, including helmet use, that contribute to head linear and angular acceleration in bicycle crash simulation tests. METHOD: A series of laboratory tests was undertaken using an oblique impact rig. The impact rig included a drop assembly with a Hybrid III head and neck. The head struck a horizontally moving striker plate. Head linear and angular acceleration and striker plate force were measured. The Head Injury Criterion was derived. The following test parameters were varied: drop height to a maximum of 1.5 m, horizontal speed to a maximum of 25 km/h, helmet/no helmet, impact orientation/location, and restraint adjustment. Additional radial impacts were conducted on the same helmet models for comparison purposes. Descriptive statistics were derived and multiple regression was applied to examine the role of each parameter. RESULTS: Helmet use was the most significant factor in reducing the magnitude of all outcome variables. Linear acceleration and the Head Injury Criterion were influenced by the drop height, whereas angular acceleration tended to be influenced by the horizontal speed and impact orientation/location. The restraint adjustment influenced the outcome variables, with lower coefficients of variation observed with the tight restraint. CONCLUSIONS: The study reinforces the benefits of wearing a bicycle helmet in a crash. The study also demonstrates that helmets do not increase angular head acceleration. The study assists in establishing the need for an agreed-upon international oblique helmet test as well as the boundary conditions for oblique helmet testing.},
keywords = {*Accidents, *Bicycling/in [Injuries], *Craniocerebral Trauma/et [Etiology], *Head Protective Devices/ut [Utilization], Acceleration, Biological, Biomechanical Phenomena, Computer simulation, Humans, Male, Manikins, Models, Traffic/sn [Statistics \& Numerical Dat},
pubstate = {published},
tppubtype = {article}
}
Rissel, C
The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder Journal Article
In: Accident Analysis & Prevention, vol. 45, pp. 107–109, 2012.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Humans
@article{Rissel2012,
title = {The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder},
author = {Rissel, C},
year = {2012},
date = {2012-01-01},
journal = {Accident Analysis \& Prevention},
volume = {45},
pages = {107--109},
abstract = {This paper challenges the conclusion of a recent paper by Walter et al. (Accident Analysis and Prevention 2011, doi:10.1016/j.aap.2011.05.029) reporting that despite numerous data limitations repealing the helmet legislation in Australia could not be justified. This conclusion is not warranted because of the limited time period used in their analysis and the lack of data beyond a few years before the introduction of legislation, the failure to adequately account for the effect of the phasing in of the legislation, the effect of the marked reduction in child cyclists, and the non-comparability of the pedestrian and cycling injuries and related lack of consideration of the severity of head injuries. The extent to which helmet legislation deters people from cycling is discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.},
keywords = {*Bicycling/in [Injuries], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Humans},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Bicycling/lj [Legislation & Jurisprudence], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics & Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics & Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics & Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics & Numerical Data, Trauma Severity Indices
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {*Bicycling/in [Injuries], *Bicycling/lj [Legislation \& Jurisprudence], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics \& Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics \& Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics \& Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics \& Numerical Data, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}