Intended for healthcare professionals


Injury patterns in cyclists attending an accident and emergency department: a comparison of helmet wearers and non-wearers

BMJ 1994; 308 doi: (Published 11 June 1994) Cite this as: BMJ 1994;308:1537
  1. C Maimaris,
  2. C L Summera,
  3. C Browning,
  4. C R Palmer
  1. a Accident and Emergency Department, Addenbrooke's Hospital, Cambridge CB2 2QQ
  2. Department of Community Medicine, Institute of Public Health, University of Cambridge, Cambridge CB2 1TN
  1. Correspondence to: Mr
  • Accepted 27 April 1994


Objectives: To study circumstances of bicycle accidents and nature of injuries sustained and to determine effect of safety helmets on pattern of injuries.

Design: Prospective study of patients with cycle related injuries.

Setting: Accident and emergency department of teaching hospital.

Subjects: 1040 patients with complete data presenting to the department in one year with cycle related injuries, of whom 114 had worn cycle helmets when accident occurred.

Main outcome measures: Type of accident and nature and distribution of injuries among patients with and without safety helmets. Results - There were no significant differences between the two groups with respect to type of accident or nature and distribution of injuries other than those to the head. Head injury was sustained by 4/114 (4%) of helmet wearers compared with 100/928 (11%) of non-wearers (P=0.023). Significantly more children wore helmets (50/309 (16%)) than did adults (64/731 (9%)) (P<0.001). The incidence of head injuries sustained in accidents involving motor vehicles (52/288 (18%)) was significantly higher than in those not involving motor vehicles (52/754 (7%)) (X2=28.9, P<0.0001). Multiple logistic regression analysis of probability of sustaining a head injury showed that only two variables were significant: helmet use and involvement of a motor vehicle. Mutually adjusted odds ratios showed a risk factor of 2.95 (95% confidence interval 1.95 to 4.47, P<0.0001) for accidents involving a motor vehicle and a protective factor of 3.25 (1.17 to 9.06, P=0.024) for wearing a helmet.

Conclusion: The findings suggest an increased risk of sustaining head injury in a bicycle accident when a motor vehicle is involved and confirm protective effect of helmet wearing for any bicycle accident.


    • Accepted 27 April 1994
    View Full Text