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Bicycling Exposure and Severe Injuries in School-age Children: A Population-Based Study

Bicycling Exposure and Severe Injuries in School-age Children: A Population-Based Study Abstract Objectives: To examine exposure to bicycling and its association with severe bicycle injuries in school-age children in a defined population. Design: Random-digit dialing telephone survey and analysis of hospital discharge records. Setting: Metropolitan Toronto, Ontario. Subjects: Sample of parents of children aged 5 to 17 years who owned a bicycle; all children who were admitted to hospitals with bicycle-related injuries from April 1989 to March 1991. Main Outcomes: Median annual bicycling hours and distance by age and sex; age- and sex-specific incidence rates by population at risk, cumulative exposure hours, and riding distances. Results: More than half of the children of all age groups were exposed to bicycling more than 100 hours per year. Boys spent more hours and rode longer distances than girls in every age group. The overall annual injury rates were 8.1 and 3.4 per 10000 population at risk for boys and girls, respectively. About half of the injuries suffered were head injuries. When rates were estimated on the basis of exposure, boys still experienced a higher injury rate than girls. Boys displayed a slight increase with age in rates per unit of exposure hours. Conversely, age appeared to be negatively associated with overall and head injury rates when exposure was expressed by distance ridden. Conclusions: Boys had a higher injury rate than girls, and bicycle-related injuries are more likely to be associated with exposure time than distance ridden.(Arch Pediatr Adolesc Med. 1995;149:437-441) References 1. Waller JA. Bicycle ownership, use, and injury patterns among elementary school children . Pediatrics . 1971;47:1042-1050. 2. Kraus JF, Fife D, Conroy C. Incidence, severity, and outcomes of brain injuries involving bicycles . Am J Public Health . 1987;77:76-78.Crossref 3. Friede AM, Azzara CV, Gallagher SS, Guyer B. The epidemiology of injuries to bicycle riders . Pediatr Clin North Am . 1985;32:141-151. 4. Centers for Disease Control. Bicycle-related injuries: Data from the National Electronic Injury Surveillance System . MMWR Morb Mortal Wkly Rep . 1987; 36:269-271. 5. Nixon J, Clacher R, Pearn J, Corcoran A. Bicycle accidents in childhood . BMJ . 1987;294:1267-1269.Crossref 6. Selbst SM, Alexander D, Ruddy R. Bicycle-related injuries . AJDC . 1987;141: 140-144. 7. Joly MF, Foggin PM, Zvagulis I, Pless IB. Bicycle accidents among children in the urban environment . Can J Public Health . 1989;80:351-354. 8. Cushman R, Down J, MacMillan N, Waclawik H. Bicycle-related injuries: a survey in a pediatric emergency department . Can Med Assoc J . 1990;143:108-112. 9. Thompson DC, Thompson RS, Rivara FP. Incidence of bicycle-related injuries in a defined population . Am J Public Health . 1990;80:1388-1390.Crossref 10. Waksberg J. Sampling methods for random digit dialing . J Am Stat Assoc . 1978;73:40-46.Crossref 11. Statistics Canada, Household Surveys Division. Household Facilities by Income and Other Characteristics . Ottawa, Ontario: Supply and Services Canada; 1992. Catalogue 13-218. 12. Statistics Canada. Post Censal Annual Estimates of Population for Census Divisions and Census Metropolitan Areas, June 1, 1990 (Component Method) . Ottawa, Ontario: Supply and Services Canada; 1990;6. Catalogue 91-212. 13. Christoffel KK, Scheidt PC, Agran PF, Kraus JF, McLoughlin E, Paulson JA. Standard definitions for childhood injury research: excerpts of a conference report . Pediatrics . 1992;89:1029. 14. Vulcan AP, Cameron MH, Heiman L. Evaluation of mandatory bicycle helmet use in Victoria, Australia . In: 36th Annual Proceedings, Association for the Advancement of Automotive Medicine . Des Plaines, III: Association for the Advancement of Automotive Medicine; 1992:219-234. 15. Pascarella EA. A Study of Youthful Bicycle Riders in an Urban Community . Chapel Hill, NC: Highway Safety Research Center, University of North Carolina; 1971. 16. Waller JA, ed. Injury Control: A Guide to the Causes and Prevention of Trauma . Lexington, Mass: DC Heath & Co; 1985:202. 17. Armson CJ, Pollard CW. Child cyclist injuries: a prospective study . Med J Aust . 1986;144:144-146. 18. Agran PF, Winn DG. The bicycle: a developmental toy versus a vehicle . Pediatrics . 1993;91:752-755. 19. Hu X, Wesson DE, Parkin PC, Chipman ML, Spence LJ. Current bicycle helmet ownership and use and related factors among school-aged children in metropolitan Toronto . Can J Public Health . 1994;85:121-124. 20. Baker SP, Li G, Fowler C, Dannenberg AL. Injuries to Bicyclists: A National Perspective . St James, NY: The Johns Hopkins Injury Prevention Center, Snell Memorial Foundation; 1993. 21. Thompson RS, Rivara FP, Thompson DC. A case-control study of the effectiveness of bicycle safety helmets . N Engl J Med . 1989;320:1361-1367.Crossref 22. Kimmel SR, Nagel RW. Bicycle safety knowledge and behavior in school age children . J Fam Pract . 1990;30:677-680. 23. Preston B. Child cyclist accidents and cycling proficiency training . Accid Anal Prev . 1980;12:31-40.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Bicycling Exposure and Severe Injuries in School-age Children: A Population-Based Study

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170160091013
Publisher site
See Article on Publisher Site

Abstract

Abstract Objectives: To examine exposure to bicycling and its association with severe bicycle injuries in school-age children in a defined population. Design: Random-digit dialing telephone survey and analysis of hospital discharge records. Setting: Metropolitan Toronto, Ontario. Subjects: Sample of parents of children aged 5 to 17 years who owned a bicycle; all children who were admitted to hospitals with bicycle-related injuries from April 1989 to March 1991. Main Outcomes: Median annual bicycling hours and distance by age and sex; age- and sex-specific incidence rates by population at risk, cumulative exposure hours, and riding distances. Results: More than half of the children of all age groups were exposed to bicycling more than 100 hours per year. Boys spent more hours and rode longer distances than girls in every age group. The overall annual injury rates were 8.1 and 3.4 per 10000 population at risk for boys and girls, respectively. About half of the injuries suffered were head injuries. When rates were estimated on the basis of exposure, boys still experienced a higher injury rate than girls. Boys displayed a slight increase with age in rates per unit of exposure hours. Conversely, age appeared to be negatively associated with overall and head injury rates when exposure was expressed by distance ridden. Conclusions: Boys had a higher injury rate than girls, and bicycle-related injuries are more likely to be associated with exposure time than distance ridden.(Arch Pediatr Adolesc Med. 1995;149:437-441) References 1. Waller JA. Bicycle ownership, use, and injury patterns among elementary school children . Pediatrics . 1971;47:1042-1050. 2. Kraus JF, Fife D, Conroy C. Incidence, severity, and outcomes of brain injuries involving bicycles . Am J Public Health . 1987;77:76-78.Crossref 3. Friede AM, Azzara CV, Gallagher SS, Guyer B. The epidemiology of injuries to bicycle riders . Pediatr Clin North Am . 1985;32:141-151. 4. Centers for Disease Control. Bicycle-related injuries: Data from the National Electronic Injury Surveillance System . MMWR Morb Mortal Wkly Rep . 1987; 36:269-271. 5. Nixon J, Clacher R, Pearn J, Corcoran A. Bicycle accidents in childhood . BMJ . 1987;294:1267-1269.Crossref 6. Selbst SM, Alexander D, Ruddy R. Bicycle-related injuries . AJDC . 1987;141: 140-144. 7. Joly MF, Foggin PM, Zvagulis I, Pless IB. Bicycle accidents among children in the urban environment . Can J Public Health . 1989;80:351-354. 8. Cushman R, Down J, MacMillan N, Waclawik H. Bicycle-related injuries: a survey in a pediatric emergency department . Can Med Assoc J . 1990;143:108-112. 9. Thompson DC, Thompson RS, Rivara FP. Incidence of bicycle-related injuries in a defined population . Am J Public Health . 1990;80:1388-1390.Crossref 10. Waksberg J. Sampling methods for random digit dialing . J Am Stat Assoc . 1978;73:40-46.Crossref 11. Statistics Canada, Household Surveys Division. Household Facilities by Income and Other Characteristics . Ottawa, Ontario: Supply and Services Canada; 1992. Catalogue 13-218. 12. Statistics Canada. Post Censal Annual Estimates of Population for Census Divisions and Census Metropolitan Areas, June 1, 1990 (Component Method) . Ottawa, Ontario: Supply and Services Canada; 1990;6. Catalogue 91-212. 13. Christoffel KK, Scheidt PC, Agran PF, Kraus JF, McLoughlin E, Paulson JA. Standard definitions for childhood injury research: excerpts of a conference report . Pediatrics . 1992;89:1029. 14. Vulcan AP, Cameron MH, Heiman L. Evaluation of mandatory bicycle helmet use in Victoria, Australia . In: 36th Annual Proceedings, Association for the Advancement of Automotive Medicine . Des Plaines, III: Association for the Advancement of Automotive Medicine; 1992:219-234. 15. Pascarella EA. A Study of Youthful Bicycle Riders in an Urban Community . Chapel Hill, NC: Highway Safety Research Center, University of North Carolina; 1971. 16. Waller JA, ed. Injury Control: A Guide to the Causes and Prevention of Trauma . Lexington, Mass: DC Heath & Co; 1985:202. 17. Armson CJ, Pollard CW. Child cyclist injuries: a prospective study . Med J Aust . 1986;144:144-146. 18. Agran PF, Winn DG. The bicycle: a developmental toy versus a vehicle . Pediatrics . 1993;91:752-755. 19. Hu X, Wesson DE, Parkin PC, Chipman ML, Spence LJ. Current bicycle helmet ownership and use and related factors among school-aged children in metropolitan Toronto . Can J Public Health . 1994;85:121-124. 20. Baker SP, Li G, Fowler C, Dannenberg AL. Injuries to Bicyclists: A National Perspective . St James, NY: The Johns Hopkins Injury Prevention Center, Snell Memorial Foundation; 1993. 21. Thompson RS, Rivara FP, Thompson DC. A case-control study of the effectiveness of bicycle safety helmets . N Engl J Med . 1989;320:1361-1367.Crossref 22. Kimmel SR, Nagel RW. Bicycle safety knowledge and behavior in school age children . J Fam Pract . 1990;30:677-680. 23. Preston B. Child cyclist accidents and cycling proficiency training . Accid Anal Prev . 1980;12:31-40.Crossref

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Apr 1, 1995

References