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Hard Hats: Safety Fact Sheet

Bicycling: Head Injury Prevention

• Head injury is the most common cause of serious disability and death in bicycle crashes, accounting for more than 60 percent of deaths, two-thirds of hospitalizations and one-third of hospital admissions.
• Bikes are associated with more childhood injuries than any other consumer product, except the automobile.
• Motor vehicles are involved in 90 percent of bicycle-related fatal crashes.
• Children and adolescents make up more than 20 percent of all bicycle-related deaths and nearly 60 percent of bicycle-related injuries.
• Approximately half of all bicycle-related injuries among children under age 10 occur to the head and face, compared to 20 percent among older children.
• Not wearing a bicycle helmet increases the risk of being involved in a fatal crash by 14 times.
• Wearing helmets could have prevented 75 percent of fatal bicycle crashes involving children and adolescents.
• On average, some 250 children in the United States under the age of 14 die annually in bike crashes, while nearly 400,000 are treated in the emergency room.
• Of the estimated 6 million Texans who ride bicycles, nearly 1 million are children between the ages of 5 and 14.
• Bicycle helmets can reduce the risk of head injury by 85 percent.
• Only 25 percent of cyclists wear helmets all or most of the time.
• Universal use of helmets could prevent one death daily and one brain injury every four minutes.
• Bicycle deaths most often occur in urban, rather than rural areas. More than one­-third of those deaths occur at intersections.
• Direct costs of cyclists injuries are estimated at $81 million, and indirect costs are estimated at $2.3 billion.

Other Wheeled Sports: Head Injury Prevention

In-Line Skating

• In-line skating one of the fastest growing recreational sports in the US.
• More than 67,000 children aged 5-14 were treated in emergency rooms for in-line skating-related injuries in 1998.
• Injuries resulting from bicycles, scooters, skateboards, and in-line and roller skates accounted for well over half a million emergency room visits for children 14 and under.
• Skaters instinctively extend their arms to prevent head impact; however, skaters commonly reach speeds of 10 to 17 mph or more. At high speed, arm strength is insufficient to prevent the head from hitting the ground.

Skateboards and Scooters

• Skateboard-related injuries account for an estimated 50,000 emergency department visits and 1,500 hospitalizations among children and adolescents in the United States each year.
• Non-powered scooter-related injuries accounted for an estimated 9,400 emergency department visits between January and August 2000, and 90 percent of these patients were children younger than 15 years.
• Children younger than 8 years accounted for 31 percent of those injured.
• Head and face injuries occurred in 29 percent of skateboard-related crashes
• See Skateboard and Scooter Safety Guidelines.

Sources: The Centers for Disease Control and Prevention, the Bicycle Helmet Safety Institute, National Highway Safety Administration, National SAFE KIDS Campaign, American Academy of Pediatrics, and the Texas Department of Health.

Skateboard and Scooter Safety Guidelines

The American Academy of Pediatrics recommends the following:

1. Children younger than 10 years should not use skateboards without close supervision by an adult or responsible adolescent. Children younger than 5 years should not use skateboards; instead, parents and pediatricians should encourage them to undertake activities that are more developmentally appropriate.
2. Skateboards must never be ridden in or near traffic, regardless of traffic volume.
3. "Skitching a ride," or holding on to the side or rear of a moving vehicle while riding a skateboard, should never be done. It is particularly dangerous because the rider cannot accommodate a sudden stop or swerve of the vehicle.
4. Pediatricians should advise parents, teachers, and others to strongly recommend that all skateboarders wear a helmet and other protective gear (including wrist guards, elbow pads, and knee pads) to prevent or reduce the severity of injuries resulting from falls. The helmet should be a bicycle helmet that complies (and is so labeled) with the Consumer Product Safety Commission (CPSC) standard or a multi-sport helmet that complies with the N-94 standard established by the Snell Memorial Foundation. 
5. Communities should continue to develop skateboarding parks and encourage youth to practice there. These parks are preferred to home-constructed ramps and jumps, because they are more likely to be monitored for safety and separate the skateboarder from pedestrian and motor vehicle traffic. Existing guidelines for such parks should be standardized.
6. Until additional information is available, pediatricians should counsel parents on the use of non-powered scooters according to the following CPSC recommendations:

• Children younger than 8 years should not ride scooters without close adult supervision.
• Children should not ride scooters in streets, in traffic, or at night.
• Children should wear helmets, knee pads, and elbow pads while using scooters.

7. The academy strongly emphasizes the need to monitor the amount and nature of non-powered scooter use and resultant injuries.

Last Published: 1/17/2007