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Accid Anal Prev. 2018 Sep;118:11-17. doi: 10.1016/j.aap.2018.05.019. Epub 2018 May 26.

Bicycle-related injuries among children treated in US emergency departments, 2006-2015.

Author information

1
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States. Electronic address: Rebecca.McAdams@NationwideChildrens.org.
2
Division of Health Behavior and Health Promotion, The Ohio State University, College of Public Health, 1841 Neil Avenue, Columbus, OH, 43210, United States. Electronic address: Swidarksi.5@osu.edu.
3
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States. Electronic address: Roxanne.Clark@nationwidechildrens.org.
4
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States. Electronic address: Kristin.Roberts@nationwidechildrens.org.
5
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States; Department of Pediatrics, The Ohio State University, College of Medicine, 700 Children's Drive Columbus, OH, 43205, United States; Division of Epidemiology, The Ohio State University, College of Public Health, 1841 Neil Avenue, Columbus, OH, 43210, United States. Electronic address: Ginger.Yang@nationwidechildrens.org.
6
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States; Department of Pediatrics, The Ohio State University, College of Medicine, 700 Children's Drive Columbus, OH, 43205, United States; Division of Epidemiology, The Ohio State University, College of Public Health, 1841 Neil Avenue, Columbus, OH, 43210, United States. Electronic address: Lara.McKenzie@NationwideChildrens.org.

Abstract

OBJECTIVE:

One of the leading causes of non-fatal injury among children is bicycling. Past studies indicate that helmets are protective against bicycle-related injuries and involvement of motor vehicles is associated with severe injuries, but research utilizing a nationally representative data set for this population and focusing on these risk factors does not exist. The objective of this study was to describe the epidemiology of bicycle-related injuries among children treated in hospital emergency departments (EDs) in the United States (US).

METHODS:

A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System for children 5-17 years of age who were treated in US EDs from 2006 through 2015 for a bicycle-related injury. Helmet use and motor vehicle involvement were two variables that were created and coded using keyword searches of the case narratives. Rates of injuries over time were described. Multivariate logistic regression along with 95% confidence intervals (CIs) were used to contrast types of injuries sustained among injured helmet users with non-users.

RESULTS:

An estimated 2 219 742 (95% CI: 1 871 120-2 568 363) children 5-17 years of age were treated in US EDs for bicycle-related injuries over the 10-year study period, an average of 608 injuries per day. Most injuries (45.7%) involved children 10-14 years of age. The rate of bicycle-related injuries significantly decreased from 447.4 per 100 000 children in 2006 to 321.1 per 100 000 children in 2015 (P < 0.001). Helmet use at the time of injury was significantly associated with lower likelihood of head and neck injuries (OR: 0.52 [95% CI: 0.40-0.59]) and hospitalizations (OR: 0.71 [95% CI: 0.54-0.94]), but there was no significant change in the rate of injury among helmet users over the study period (P = 0.224). Motor vehicle involvement increased the odds of bicycle-related traumatic brain injuries (TBIs) (OR: 1.98 [95% CI: 1.49-2.64]) as well as injury-related hospitalizations (OR: 4.04 [95% CI: 3.33-4.89]).

CONCLUSIONS:

Despite decreasing injury rates, bicycling remains an important source of injury for children. Helmet use has demonstrated significant protective effects for TBIs, head and neck injuries, and hospitalizations. Motor vehicle involvement increased the risk of hospitalization. More efforts are needed to promote use of helmets and to reduce the possibility of bicycle-motor vehicle collisions to prevent bicycle-related injuries among children.

KEYWORDS:

Bicycle; Children/adolescents; Helmet; Injury; Motor vehicle; NEISS

PMID:
29843009
DOI:
10.1016/j.aap.2018.05.019
[Indexed for MEDLINE]

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