Helmet Use Is Falling, Causing Rise in Head Injuries

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Please Wear a Helmet: Injury Rate Rises While Helmet Wearing DeclinesPlease Wear a Helmet: Injury Rate Rises While Helmet Wearing Declines

The rise of e-bikes is a net good. They get us outside, reduce our use of fossil fuels, which reduces the production of greenhouse gasses, decrease congestion on our roads and help us get exercise so that we live longer, healthier lives. What’s not to like?

Unfortunately, as e-bike use has climbed, helmet use hasn’t kept pace with their adoption. While it makes sense that if more people are riding e-bikes there will be more injuries even if the rate of injury per 100,00 people stays the same. That stinks, but what is worse is that helmet use hasn’t kept pace with rising e-bike use. As a result, we’re seeing an increase in the number of head injuries.

A new study published by JAMA Surgery examined helmet use from 2017 to 2022, finding that helmet use fell by 6 percent over that five-year span. That’s not the worst part of the study, though. It found that the number of e-bike riders who went to the hospital with head trauma rose 49 fold. That’s not 49 percent; it’s 49 times, resulting in some 8,000 visits in 2022 alone.

The bad news doesn’t end there. The study revealed that 44 percent of the injured riders were wearing helmets.

Injury severity rose

Researchers examined 1,038 cases of head injuries e-bike riders suffered and calculated that 46,000 adults and children visited emergency rooms between 2017 and 2022. Not only was there a 49-fold rise in hospital visits, there was a 43-fold rise in hospitalizations. That is, the number of people who went to the emergency room and then were admitted to the hospital rather than being discharged home that day rose 43 times.

Here’s the part that should give us pause: the researchers found that helmetless e-bike riders were twice as likely to suffer head injuries as riders who wore a helmet. They also say that the head injuries e-bike riders suffer tend to be more severe than those suffered by riders of traditional bikes.

Double whammy

The injuries e-bike riders suffer are often more severe than those experienced by traditional bike riders due to a convergence of two factors. People on e-bikes travel at greater speeds than bike riders. Some studies have estimated that on average people ride e-bikes at twice the speed of regular bikes. Twice the speed means half the reaction time should something happen, such as a car pulling out. Shorter reaction time means fewer averted accidents. Also, in the event of a fall or crash, greater speed translates to more force, which makes injuries more severe.

3 tips for wearing a helmet

Wearing a helmet will do much to help prevent a head injury in the event of a fall. But simply wearing a helmet isn’t quite enough. A rider must make some adjustments for it to do its job.

First, if the helmet has one, snug the occipital retention device at the rear of the helmet. It is often adjusted by a small dial; it doesn’t need to be tight; just snug enough to feel it press against your hair (or scalp).

Second, make sure that the helmet’s straps pass around your ears, not over them. You can adjust the length of the straps from the helmet to the strap guide that brings the forward and aft straps together so that it sits below your ear.

Third, adjust the chin strap so that it runs comfortably below the chin. There should be enough room that you can speak comfortably or slip a finger between the strap and underside of your jaw.

Of course, wearing a helmet is only one piece of making sure that each ride is as safe as possible. Moderating our speed relative to conditions can be even more important than the helmet. We love speed and we enjoy reviewing Class 3 e-bikes, but we slow down when conditions demand it. As roads narrow and the distance to pedestrians, other riders and cars drops, so does our speed.

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