May 19, 2004

Getting children to wear helmets can be almost as tough as convincing them that Brussels sprouts are tasty. But even though many kids think a few bumps and bruises are the worst that could happen when they take a spill on their bike, scooter, in-line skates, or skateboard, the fact is that many kids are seriously - and needlessly - injured because they opt not to don a helmet.

A new SAFE KIDS Campaign study found that only 41% of children ages 5 to 14 in the United States wear helmets while participating in wheeled activities. SAFE KIDS' first national observational survey of child helmet use included 8,159 kids and 1,396 adults in 46 states.

Some of the study's revealing findings include:

• helmet use is lowest in the highest-risk locations - residential streets, where most bike accidents happen
• kids are more likely to wear helmets when they're with an adult wearing a helmet, or if they live in a state with a mandatory helmet law
• girls are more likely to wear helmets than boys are

Heads Up
Head injuries are one of the most serious ways that kids are getting hurt while riding their bikes. According to SAFE KIDS, bikes are the second leading cause - next to automobiles - of childhood injuries from consumer products. Almost half (or 47%) of kids hospitalized for bike-related injuries have a traumatic brain injury and up to 80% of bike-related deaths are from head injuries, says SAFE KIDS. But helmets can dramatically reduce the risk (by up to 88%) of brain injury in a bike accident.

Helmet How-Tos
Not only are many kids not wearing helmets, more than a third (35%) of the kids in the study who said they wore helmets were wearing them improperly. The most common helmet mistakes were tilted helmets and loose or unbuckled chin straps, the study found.

So just wearing a helmet isn't enough to prevent head injuries - your child's helmet must also fit and be secured properly. To ensure that your child's helmet fits every time, make sure that:

• the helmet sits level on your child's head and isn't tilted forward or backward
• the helmet is tight enough (with straps fastened) that no sudden pulling or twisting can move the helmet around on your child's head
• your child does not wear a baseball cap under the helmet
• the straps form a "V" underneath each earlobe
• the helmet has strong, wide straps that fasten snugly under the chin
• the strap is tight enough that no more than a finger's width fits beneath the strap
• the rim of the helmet is the width of one to two fingers above the eyebrows
• the buckle is flush against the skin under the chin (have your child open his or her mouth to make sure that it feels snug on the chin and hugs the head)
• the helmet is always fastened while riding

Replacing a Helmet
If your child's helmet was made before 1999 (look inside the helmet to see what year it was made), it should be replaced with a newer helmet that meets or exceeds the safety standards developed by the U.S. Consumer Product Safety Commission (CPSC). You should also immediately replace your child's helmet if he or she has a significant fall and hits any surface hard with the helmet. After taking a serious hit, helmets lose their capacity to absorb shock. They're designed that way - the inner foam structure is altered by a very hard blow.

Affordable Safety
The American Medical Association calls helmets the single most cost-effective safety device ever made - they range from about $20 in discount stores to $150 in sporting and bicycle shops. That's a small price to pay to help save your child from serious injury and even death. Whether your state has a law about helmet use or not, lay down the law for your family's sake and make wearing a helmet mandatory in your household.

Reviewed by: Steven Dowshen, MD
Date reviewed: May 2004

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