Send to

Choose Destination
J Paediatr Child Health. 2018 Sep;54(9):968-974. doi: 10.1111/jpc.13925. Epub 2018 Apr 24.

Helmet use in bicycles and non-motorised wheeled recreational vehicles in children.

Ong JS1,2,3,4,5, Soundappan SV1,2,3,4,5, Adams S1,2,3,4,5, Adams S1,2,3,4,5.

Author information

Department of Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Department of Trauma, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Department of Surgery, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Brown Group, Neuroscience Research Australia, Sydney, New South Wales, Australia.



Injuries involving non-motorised wheeled recreational vehicles (NMWRV) and bicycles are a common cause for hospitalisation in children. Studies show that helmet use whilst bicycle riding can decrease mortality and morbidity due to head injury. However, there remains an important proportion of children who are non-helmet users (NHU). This study aims to investigate helmet use and attitudes and injury patterns in children presenting with trauma after riding bicycles and other NMWRVs.


A prospective cohort study was undertaken over 8 months of children aged 0-16 years, who presented with injury secondary to bicycle or NMWRV to the emergency department of two tertiary paediatric centres. Demographics, incident, injury severity and attitudes towards helmet use were compared between helmet users and NHU.


A total of 342 children were included - 41% (n = 139) scooter riders, 39% (n = 133) bicyclists, 18% (n = 61) skateboarders and 2% (n = 9) in-line skaters. Of those interviewed (n = 161), 58% (n = 93) wore a helmet, with children riding bicycles significantly more likely to be helmeted than NMWRV (75 vs. 48%, P = 0.01). NHU were more likely to be admitted to hospital (P = 0.05) and to sustain a major head injury (P = 0.009). The main influence on helmet use was parental rules. The biggest factor influencing non-helmet use was perceived low levels of danger.


Despite legislation mandating this, helmet use is not universal in cyclists, particularly younger riders. Even fewer NMWRV riders use them. To promote helmet use, a multifaceted approach aimed at altering community norms and individual behaviours and attitudes is required.


community; education; emergency medicine; helmet; public health


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center