Bicycle helmet wearing and the risk of head, face, and neck injury: a French case--control study based on a road trauma registry.

Abstract

BACKGROUND:

Previous case-control studies on bicycle helmet efficacy are mostly Anglo-Saxon, and based on data from the early 1990s when hard-shell helmets were common.

METHODS:

In France, the Rhône county (1.6 million inhabitants) is covered by a road trauma registry that includes emergency department visits, hospital admissions, and fatalities. Over the 1998-2008 period, 13,797 cyclist casualties were identified. The injuries sustained were coded using the Abbreviated Injury Scale (AIS) for injuries to the head (AIS1+ and AIS3+), face (AIS1+), or neck (AIS1+). The study uses a case-control design where the control group includes cyclists injured below the neck-that is, not injured in the region associated with the helmet. We first adjusted for age, gender, and type of crash, as in a previously published Cochrane review. Then we adjusted for injury severity based on non-head, face, or neck injury, and when relevant, for crash location: type of road, urban/rural area.

RESULTS:

The fully adjusted ORs of helmeted versus unhelmeted cyclists are: for AIS1+ head injuries, 0.69 (95% CI 0.59 to 0.81); for AIS3+ head injuries sustained in urban areas, 0.34 (95% CI 0.15 to 0.65), those sustained in rural areas, 0.07 (95% CI 0.02 to 0.23); for AIS1+ facial injuries, 0.72 (95% CI 0.62 to 0.83); and for AIS1+ neck injuries, 1.18 (95% CI 0.94 to 1.47).

CONCLUSION:

This study confirms the protective effect for head and facial injuries, even though soft-shell helmets have now become more common. The reduction of risk is greater for serious head injuries. The study is inconclusive about the risk for neck injuries.

• Authors: Emmanuelle Amoros, Mireille Chiron, Jean-Louis Martin, Bertrand Thélot, Bernard Laumon
• Journal: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention (Inj Prev) Vol. 18 Issue 1 Pg. 27-32 (Feb 2012) ISSN: 1475-5785 [Electronic] England
• PMID: 21606469 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Bicycling (injuries, statistics & numerical data)
• Case-Control Studies
• Child
• Child, Preschool
• Craniocerebral Trauma (epidemiology, etiology, prevention & control)
• Facial Injuries (epidemiology, etiology, prevention & control)
• France (epidemiology)
• Head Protective Devices
• Humans
• Incidence
• Male
• Middle Aged
• Multivariate Analysis
• Neck Injuries (epidemiology, etiology, prevention & control)
• Odds Ratio
• Risk Factors
• Rural Population
• Urban Population
• Young Adult