Helmet use and injuries in children’s bicycle crashes in the Gothenburg region

Abstract Aim To investigate the use and protective effect of helmets in children injured in bicycle crashes and changes in injury patterns during a period of increased helmet use. Method Injuries in 4246 children below 16 years of age, who attended an AE much less frequently by teenagers, especially girls. The adjusted odds of serious or more severe skull/brain injuries and moderate or more severe facial injuries with a helmet were about one fourth of those without a helmet. The proportion of children with skull/brain injuries did not change significantly during the period. Serious or more severe skull/brain injuries were noted more often during the latter half of the period, most often in children without a helmet. The proportion of children with facial injuries decreased, and the proportion with injuries to the upper extremities increased, also for moderate and severe injuries. The ratio between the number of children with head injuries and the number with extremity injuries decreased for injuries of any severity and for moderate or more severe injuries. Conclusions Bicycle helmets have an obvious protective effect against head injuries in children, regardless of the crash circumstances. Teenagers must be informed about the high risk of skull/brain injuries in bicycle crashes without a helmet. The increasing occurrence of injuries to the upper extremities needs attention.