Why are helmets are so important?

Helmets & Their Effectiveness:

According to a meta-analysis by Cochrane, “Helmets provide a 63 to 88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists. Helmets provide equal levels of protection for crashes involving motor vehicles (69%) and crashes from all other causes (68%). Injuries to the upper and mid facial areas are reduced 65%.” (1)

​

Reduced Risk of Pediatric Head Injury:

A “retrospective review of patients age ≤ 18 years hospitalized at a level I [highest level] pediatric trauma center between January 1, 2008, and December 31, 2018” found that "helmeted bicyclists involved in MVCs were significantly less likely (78.6%) to be diagnosed with a head injury compared to unhelmeted bicyclists. When a head injury was diagnosed, helmeted bicyclists were significantly less likely (44%) to sustain a severe head injury."(2)

​

Reduced Risk of Pediatric Traumatic Brain Injury:

“The national TARN Database was used to identify all adult (≥16 years) patients presenting with cycling-related injuries during a period from 14 March 2012 to 30 September 2017 … Those cyclists not wearing helmets were significantly more likely to receive TBIs and suffered a different pattern of injury to those wearing helmets.” When examining rates of cerebral contusion, non-helmeted cyclists had a 21.7% rate of cerebral contusion, while helmeted cyclists had a 7.8% rate of cerebral contusion. And, when looking at rates of subdural haematoma– symptoms of which “can include a headache that keeps getting worse[,] feeling and being sick[,] confusion[,] personality changes feeling drowsy[, and] loss of consciousness”– non-helmeted cyclists had a 22.0% rate of subdural haematoma, while helmeted cyclists had a 5.9% rate of subdural haematoma. (3)

​

Fewer Instances of Traumatic Brain Injury:

One study published in 2022 focused on the most serious trauma (Level 1): “From October 2013 to March 2020 all bicycle injuries at a Level 1 trauma center were collected for ages ≤18 years. ... Over the 8-year time period, 77 cases were identified…The majority of patients (98%) were not wearing a helmet. Loss of consciousness was reported in 44% and 21% sustained a traumatic brain injury. Twenty-eight percent required ICU care and 36% required operative interventions.” (4)

​

Less Likely to Sustain Traumatic Brain Injury:

“A prospective observational study of injured bicyclists presenting to a Level I trauma centre was performed. … Of 699 patients, 273 (39.1%) were wearing helmets at the time of injury. Helmeted bicyclists were more likely to have a GCS of 15 … [indicating someone is fully awake]. Helmeted bicyclists underwent fewer head CTs … and were less likely to sustain intracranial [brain] injury (6.3% … vs. 19.7%...)…, including skull fracture (0.9% … vs. 15.3%...) … and subdural hematoma [build-up of blood surrounding the brain] (0.0% … vs 8.1%...) … A multivariable logistic regression model showed that helmeted bicyclists were 72% less likely to sustain TBI compared with un-helmeted bicyclists” (5)