Preschool cyclists, even those on tricycles, benefit from wearing helmets as much as older children, a national study suggests.
"Even young children who do not ride cycles in the street sustain severe injuries and need protection from head injury," researchers concluded. Although children younger than 5 account for a small percentage of bike-riding injuries, the new study found that their injuries are comparable in severity to those of older children.
The study is based on a nationwide database of pediatric trauma cases, including 4,041 children hospitalized for bicycle-related injuries. About 5% of the injured children--219 in all--were younger than 5; the rest were 5 to 14 years old. Tricycle-related injuries were counted as bicycle injuries in the database.
Almost none of the injured children--less than 3% of the preschoolers and about 3% of those 5 to 14--wore a helmet at the time of their injury. Head trauma was the most common serious injury among both older and younger children hospitalized after bicycling mishaps.
While most injury-prevention efforts are aimed at school-age children and adolescents, researchers said the wear-a-helmet message should target preschoolers as well. An estimated 200,000 to 300,000 bicycles for preschool-age children are sold each year in the United States.
"Helmet use by young children would likely prevent most head injuries [in cyclists] and might help form habits that would result in improved helmet-use rates as these young cyclists grow older," researchers concluded.
The study was conducted by a team from Children's Memorial Hospital and Northwestern University Medical School in Chicago and Tufts-New England Medical Center in Boston. The results were published in this month's Annals of Emergency Medicine.
Aside from the severity, which was similar, researchers found a slightly different pattern of injuries in very young cyclists, compared with older ones. Preschool riders are more likely than older ones to be injured in the driveway or yard, and less likely to be hurt in the street. They were also less likely than older riders to be involved in crashes with motor vehicles.