Effectiveness of Bicycle Safety Helmets in Preventing Serious Facial Injury FREE

Diane C. Thompson, MS; Martha E. Nunn, DDS, MS; Robert S. Thompson, MD; Frederick P. Rivara, MD, MPH

[+] Author Affiliations

Reprints: Diane C. Thompson, MS, Harborview Injury Prevention and Research Center, 325 Ninth Ave, Box 359960, Seattle, WA 98104-2499 (e-mail: dct@u.washington.edu).

JAMA. 1996;276(24):1974-1975. doi:10.1001/jama.1996.03540240052030

Text Size: A A A

Published online

Article

References

ABSTRACT

ABSTRACT | REFERENCES

Objective. —To assess the effectiveness of helmets in preventing facial injuries.

Design. —Case-control study between March 1, 1992, and August 31, 1994.

Setting. —Seven Seattle, Wash, area hospitals including the regional trauma center and a large staff-model health maintenance organization.

Patients. —Cases were patients with serious facial injury, ie, fractures or lacerations; controls were patients who had injuries other than facial. Minor facial injuries were excluded to avoid ascertainment bias in those seeking care for serious injuries to other areas.

Results. —Serious facial injuries occurred to 700 (20.7%) patients. Helmets were used by 47% of cases and 57% of controls. After adjusting for age, sex, speed, and surface, we found that helmets reduced the risk of injury to the upper face (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.26-0.49) and middle face (OR, 0.35; 95% CI, 0.24-0.50) but had no significant effect on serious injury to the lower face (OR, 0.88; 95% CI, 0.72-1.07).

Conclusions. —Bicycle helmets offer substantial protection for the upper and mid face in addition to their known protection against head injuries. Helmets do not appear to offer any protection for the lower face.

REFERENCES

ABSTRACT | REFERENCES

Thompson DC, Dannenberg AL, Thompson RS, Rivara FP. Bicycling . In: Caine C, Caine D, Lindner K, eds. Epidemiology of Sports Injuries . Champaign, Ill: Human Kinetics Publishers; 1996;:98-112.

Henderson M. The Effectiveness of Bicycle Helmets—A Review . Sydney, Australia: Motor Accidents Authority of New South Wales; 1995;.

Thompson RS, Rivara FP, Thompson DC. A case control study of the effectiveness of bicycle safety helmets . N Engl J Med . 1989;;320:1361-1367.

Thompson DC, Thompson RS, Rivara FP, Wolf ME. A case-control study of the effectiveness of bicycle safety helmets in preventing facial injury . Am J Public Health . 1990;;80:1471-1474.

Thompson DC, Rivara FP, Thompson RS. Effectiveness of bicycle safety helmets in preventing head injuries . JAMA . 1996;;276:1968-1973.

Breslow NE, Day NE. Statistical methods in cancer research . In: Breslow NE, Day NE, eds. The Analysis of Case-Control Studies, Volume 1 . Lyon, France: International Agency for Research on Cancer; 1980;:190-246. International Agency for Research on Cancer publication 32.

Lindqvist C, Sorsa S, Hyrkas T, Santavirta S. Maxillofacial fractures sustained in bicycle accidents . Int J Oral Maxillofac Surg . 1986;;15:12-18.

Grimard G, Nolan T, Carlin JB. Head injuries in helmeted child bicyclists . Inj Prev . 1995;;1:21-25.

Sosin DM, Sacks JJ, Webb KW. Pediatric head injuries and deaths from bicycling, United States . Pediatrics . 1996;;98:868-870.

Myall RWT, Sandor GKB, Gregory CEB. Are you overlooking fractures of the mandibular condyle? Pediatrics . 1987;;79:639-641.

Acton CHC, Nixon JW, Clark RC. Bicycle riding and oral/maxillofacial trauma in young children . Med J Aust . 1996;;165:249-251.

Myall RWT. Condylar injuries in children: what is different about them? In: Worthington P, Evans JR, eds. Controversies in Oral and Maxillofacial Surgery . Philadelphia, Pa: WB Saunders Co; 1994;: 191-200.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal