Most Cyclists Who Suffer Head Injuries Aren't Wearing Helmets

Plus, kids and certain other groups are more likely to be injured, according to a new study

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Seventy-eight percent of adult cyclists and 88 percent of young riders who suffered head and neck injuries were not wearing helmets when they were injured, according to a new study published in the journal Brain Injury that analyzed 76,032 cycling injuries between 2002 and 2012.

This is troubling, given that earlier research has shown that only about 29 percent of adult cyclists and 42 percent of child cyclists always wear helmets.

In the new study, when researchers broke down these cycling injuries using demographic data, they found that when compared with adults, especially those older than 40, kids 17 and younger were the least likely to have been wearing helmets when hurt. Men were far less likely to be wearing helmets than women. And black and Hispanic cyclists who were hurt were less likely to have been wearing helmets than cyclists categorized as white or Asian/Pacific Islander.

“There is a general underutilization of helmets among cyclists,” says Shahrzad Bazargan-Hejazi, Ph.D., one of the study authors and a professor in the department of psychiatry and pediatrics at Charles R. Drew University of Medicine and Science in Los Angeles.

While it’s not surprising that helmet wearers are less likely to be seriously injured, the study does highlight the fact that members of certain demographic groups are more likely to be hurt, more likely to stay in the hospital longer, and more likely to die after an accident.

This suggests that these groups may be most likely to benefit from interventions encouraging helmet use, the study authors write. Helpful interventions include helmet giveaways and community programs that teach cycling tips, according to Bill Nesper, executive director of the League of American Bicyclists.

“Wearing a helmet is one of the easiest things you can do to protect yourself if you’re riding,” Nesper says.

Here’s what you need to know about the new research and what to look for if you’re shopping for a new bike helmet.

What the Study Found

The researchers behind the study wanted to examine helmet use among people who had suffered head and neck injuries while cycling. To do so, they used results from the National Trauma Data Bank, which logs patient records from over 900 trauma centers and emergency rooms across the U.S.

Injuries were much more severe for anyone not wearing a helmet, and people who suffered injuries that were reported to the database used helmets at low rates in the first place: Twelve percent of injured kids wore helmets, 21 percent of injured men wore helmets, and 28 percent of injured women did. Only 6 percent of injured black cyclists wore helmets, and only 7.6 percent of injured Hispanic cyclists did, compared with 27.3 percent of injured white cyclists and 26.6 percent of injured Asian/Pacific Islander cyclists.

More on Cycling

Within the injured group that the study analyzed, men were more likely to have to stay in the hospital or an intensive care unit longer than women, had more severe injuries, and were 36 percent more likely to die than women. Injured black and Hispanic cyclists had longer hospital stays than white cyclists, and were respectively 19 percent and 17 percent more likely to die from injuries.

It’s possible, however, that some of what looked like an increased risk for black and Hispanic cyclists was statistical noise, Bazargan-Hejazi says. Being male and young were by far the biggest risk factors—men made up just over 81 percent of the reported injuries.

For everyone, the results show that wearing helmets is significantly linked to a reduced risk for longer hospital stays, serious injuries, and death. These findings should help support further study into ways to encourage helmet use, the study authors write.

“Education is necessary but not sufficient,” Bazargan-Hejazi says. Researchers need to also look into ways to change attitudes about wearing a helmet and help cyclists better assess the risks of head injury.

“I’m guessing people think if they’re not riding fast, they don’t need a helmet,” says Peter Anzalone, senior test project leader for bike helmets at CR, who encourages cyclists of all ages to wear a helmet every time they ride. “People don’t seem to realize how easily they can get severely injured by falling and hitting their head.”

Getting a Helmet

The key, according to Anzalone, is figuring out how to get people to wear helmets more consistently. Wearing a helmet is associated with an almost 70 percent lower risk of serious head injury in a crash.

Nesper says that programs that distribute free helmets can help, as can modeling good behavior. Research indicates that the children of adults who always wear helmets are much more likely to consistently wear helmets. Nesper says it helps, too, to see that high-profile people such as LeBron James—whose nonprofit foundation distributes bikes to kids, among other programs—regularly wear a helmet while biking.

If you’re looking for a new helmet or ways to ride safely, here are a few tips:

  • Find a certified safe helmet that you like enough to wear regularly. Anzalone recommends trying different options until you find a style, size, model, and weight that works for you.
  • Consider a helmet with concussion-reducing technology, such as MIPS (Multi-directional Impact Protection System) or WaveCel, if there’s one in your budget, but know that any helmet certified by the Consumer Product Safety Commission will help protect your skull.
  • Adjust your helmet’s fit. Tighten the chinstrap so that opening your mouth causes the helmet to press down on the top of your head. Follow our step-by-step guide to make sure your helmet fits correctly.
  • Beyond wearing a helmet, take other key steps for safety, Nesper says. Use lights if you are riding at night, and try to find a safe route that you feel comfortable riding. He also recommends supporting policies that will make cycling safer, such as rules that would either slow down cars or create more separation between cars and bikes on busy streets.

Head shot image of CRO Health editor Kevin Loria

Kevin Loria

I'm a science journalist who writes about health for Consumer Reports. I'm interested in finding the ways that people can transform their health for the better and in calling out the systems, companies, and policies that expose patients to unnecessary harm. As a dad, I spend most of my free time trying to keep up with a toddler, but I also enjoy exploring the outdoors whenever possible. Follow me on Twitter (@kevloria).