Intervention Review

Helmets for preventing head and facial injuries in bicyclists

  1. Diane C Thompson2,
  2. Fred Rivara1,*,
  3. Robert Thompson3

Editorial Group: Cochrane Injuries Group

Published Online: 25 OCT 1999

Assessed as up-to-date: 7 NOV 2006

DOI: 10.1002/14651858.CD001855

How to Cite

Thompson DC, Rivara F, Thompson R. Helmets for preventing head and facial injuries in bicyclists. Cochrane Database of Systematic Reviews 1999, Issue 4. Art. No.: CD001855. DOI: 10.1002/14651858.CD001855.

Author Information

  1. 1

    Child Health Institute, Division of General Pediatrics, Seattle, WA, USA

  2. 2

    University of Washington, Harborview Injury Prevention Center, Seattle, USA

  3. 3

    Group Health Cooperative of Puget Sound, Department of Preventive Care, Seattle, USA

*Fred Rivara, Division of General Pediatrics, Child Health Institute, 6200 N.E. 74th Street, Suite 210, Seattle, WA, 98115-8160, USA. fpr@u.washington.edu.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 25 OCT 1999

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Each year, in the United States, approximately 900 persons die from injuries due to bicycle crashes and over 500,000 persons are treated in emergency departments. Head injury is by far the greatest risk posed to bicyclists, comprising one-third of emergency department visits, two-thirds of hospital admissions, and three-fourths of deaths. Facial injuries to cyclists occur at a rate nearly identical to that of head injuries. Although it makes inherent sense that helmets would be protective against head injury, establishing the real-world effectiveness of helmets is important.

Objectives

To determine whether bicycle helmets reduce head, brain and facial injury for bicyclists of all ages involved in a bicycle crash or fall.

Search methods

We searched CENTRAL, MEDLINE, EMBASE, Sport, ERIC, NTIS, Expanded Academic Index, CINAHL, PsycINFO, Occupational Safety and Health, and Dissertations Abstracts. We checked reference lists of past reviews and review articles, studies from government agencies in the United States, Europe and Australia, and contacted colleagues from the International Society for Child and Adolescent Injury Prevention, World Injury Network, CDC-funded Injury Control and Research Centers, and staff in injury research agencies around the world. The searches were last updated in November 2006.

Selection criteria

Controlled studies that evaluated the effect of helmet use in a population of bicyclists who had experienced a crash. We required studies to have complete outcome ascertainment, accurate exposure measurement, appropriate selection of the comparison group and elimination or control of factors such as selection bias, observation bias and confounding.

Data collection and analysis

Two authors independently extracted data. Odds ratios with 95% confidence intervals were calculated for the protective effect of helmets for head and facial injuries. Study results are presented individually. Head and brain injury results were also summarized using meta-analysis techniques.

Main results

We found no randomized controlled trials, but five well conducted case-control studies met our inclusion criteria. 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%.

Authors' conclusions

Helmets reduce bicycle-related head and facial injuries for bicyclists of all ages involved in all types of crashes, including those involving motor vehicles. Our response to comments from critics are presented in the Feedback section.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Wearing a helmet dramatically reduces the risk of head and facial injuries for bicyclists involved in a crash, even if it involves a motor vehicle

Cycling is a healthy and popular activity for people of all ages. Crashes involving bicyclists are, however, common and often involve motor vehicles. Head injuries are responsible for around three-quarters of deaths among bicyclists involved in crashes. Facial injuries are also common. The review found that wearing a helmet reduced the risk of head or brain injury by approximately two-thirds or more, regardless of whether the crash involved a motor vehicle. Injuries to the mid and upper face were also markedly reduced, although helmets did not prevent lower facial injuries.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

使用安全帽來避免腳踏車騎士頭部及臉面傷害的效果

每一年,美國大約有900人死於腳踏撞擊,500,000多人送急診治療。至今頭部損傷是腳踏車騎士最嚴重的危險,其中的1/3需要急診治療,2/3需要住院,3/4面臨死亡。對於腳踏車騎士,臉面傷害的機率與頭部損傷的機率相類似。雖然指出其中深層道理:安全帽能夠保護頭部避免損傷,卻也確定安全帽真實效能的重要性。

目標

確認所有年齡層的腳踏車騎士在撞擊或摔倒時,安全帽能否減少頭部、腦部及臉部傷害。

搜尋策略

搜索以下資料庫:CENTRAL, MEDLINE, EMBASE, Sport, ERIC, NTIS, Expanded Academic Index, CINAHL, PsycINFO, Occupational Safety and Health, and Dissertations Abstracts.檢查相關的參考文獻,回顧性文獻,來自美國歐洲澳洲等政府之研究結果,以及來自以下研究機構的結果International Society for Child and Adolescent Injury Prevention, World Injury Network, CDCfunded Injury Control and Research Centers, and staff in injury research agencies around the world. International Society for Child and Adolescent Injury Prevention, World Injury Network, CDCfunded Injury Control and Research Centers, and staff in injury research agencies around the world.找尋至2006十一月為止的資料。

選擇標準

控制組選自經歷腳踏車撞擊且有安全帽效能評估的族群。要求研究結果必須有完整性,明確的治療方式。恰當篩選對照組,排除或控制篩選偏差,觀察偏差,以及交互影響等因子。

資料收集與分析

兩位作者分別提出結論數據。安全帽保護頭部及臉部效能的Odds ratios with 95% CI之統計數據分別被計算。使用metaanalysis 總結分析頭部及腦部的損傷摘要結論。

主要結論

並沒有發現隨機控制組的實驗設計組,但有五個嚴謹的事件控制組的研究,符合篩選標準。安全帽減少所有年齡層63∼88%頭部腦部傷害及嚴重頭部損傷。安全帽也提供機車撞擊(69%)以及其他故事(68%)相當的保護程度。減少65%臉部中上部份的損傷。

作者結論

安全帽減少腳踏車相關的頭部臉部傷害,涵蓋各年齡層腳踏車騎士,包括機車在內的各種型式的撞擊。我們對於批評者的答覆可以進入下列網址查詢, www.cochraneinjuries.lshtm.ac.uk/helmetcommentpdf.

翻譯人

本摘要由高雄榮民總醫院陳淑梅翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

戴安全帽大幅度減少腳踏車騎士在撞擊時(甚至包括機車撞擊),頭部臉部傷害的危險。在各年齡層戴安全帽是一種健康且流行的活動。腳踏車騎士的撞擊經常普遍與機車相關。頭部傷害佔腳踏車撞擊死亡原因的3/4,臉部傷害也是常見的。調查發現:不論是否與機車有關的撞擊,戴安全帽減少大約2/3以上的頭部或腦部傷害風險。雖然對於中上部位的臉部傷害也顯著降低,但安全帽並未証實減少臉部下半部位的傷害,。