Intended for healthcare professionals


Bicycle helmets: it's time to use them

BMJ 2000; 321 doi: (Published 28 October 2000) Cite this as: BMJ 2000;321:1035
  1. Frederick P Rivara, professor of paediatrics. (,
  2. Diane C Thompson, research scientist.,
  3. Robert S Thompson, director.
  1. Harborview Injury Prevention and Research Center, Departments of Pediatrics and Epidemiology, Box 359960, 325 Ninth Avenue, Seattle, WA 98104, USA
  2. Department of Preventive Care, Group Health Cooperative of Puget Sound, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA

    The evidence that they reduce head injuries is too strong to ignore

    Papers p 1055

    Bicycling is a worldwide activity. In both developed and developing countries it serves as an important means of transportation as well as an enjoyable recreational activity for adults and children. Thus, injuries related to bicycling are comparatively common, and head injuries account for one third of visits to emergency departments, up to two thirds of hospitalisations, and three quarters of deaths.1 Head injuries also carry a substantial risk of long term disability. Thus, preventing head injuries associated with this common, worldwide activity is important.

    Safety helmets for bicycling have been available for at least 20 years. Although randomised controlled trials have become the gold standard for providing evidence of the effectiveness of clinical interventions, these trials are not feasible for examining whether helmets prevent head injuries. Given that the rate of head injury is about 20 injuries per 100 000 people, a randomised controlled trial would need to involve tens …

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