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EDITOR
We studied national trends in hospital admissions among English
cyclists during 1991-5 and found significant reductions in admissions
of cyclists with head injury.1 Data from annual surveys of
cycle helmet usage during this period indicate that the proportion of
children always wearing a helmet increased from 3% in 1991 to 20% in
1995,2 this last figure corresponding well with the 16%
of cyclists observed wearing a helmet in a separate large survey in
1994.3 The total number of non-fatal serious cycling
injuries, however, remained constant during this time, leading us to
conclude that the most plausible explanation for the decline in serious
head injuries was an increase in use of cycle helmets.
In response to our paper both Adams and Hillman and Wardlaw refer to
data on fatalities among cyclists4; helmets are, however, less likely to be beneficial in the very serious injuries that are
potentially fatal since the
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