American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on Bicycle Safety and the Promotion of Bicycle Helmet Use

At its October 2001 meeting, the Board of Regents approved the following "Statement on Bicycle Safety and the Promotion of Bicycle Helmet Use." The statement was developed by the Subcommittee on Injury Prevention and Control of the College's Committee on Trauma.

The American College of Surgeons and its Committee on Trauma recognizes the importance of injury prevention in the spectrum of care of the trauma patient, especially with regard to the prevention of traumatic brain injury. Cycling remains an important means of transportation and recreation; however, the bicycle rider can be at significant risk of serious injury.

The College recognizes the following facts:

  • Approximately 800 people die and 17,000 are hospitalized in the United States due to bicycle-related injuries. Bicycle crashes are the fourth largest contributor to childhood injury costs and quality of life losses.
  • Bicycle injuries account for the largest number of sports-related injuries treated in emergency departments.
  • Bicycle helmets can reduce the risk of head injury by 85 percent. Bicyclists hospitalized with head injury are 20 times more likely to die as those without head injury.
  • 98 percent of bicyclists killed were not wearing a helmet at the time of injury. Helmet use is estimated to prevent 75 percent of cycling deaths.
  • As of November 2000, bicycle-related injuries and deaths had decreased in the 17 states that have youth bicycle helmet laws.
  • Helmets can benefit adult riders as well children. As more helmet laws target youth, the proportion of adults comprising bicycle fatalities has risen from 32 percent in 1975 to 71 percent in 1999.
  • Helmet laws are necessary. 43 percent of bicyclists report that they never wear a helmet, and of those who do, 44 percent report that they do so only because a law requires it.

Therefore, supported by these and other epidemiologic and outcomes data, the American College of Surgeons supports efforts to promote, enact and sustain universal bicycle helmet legislation.


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  2. Centers for Disease Control and Prevention. Injury-control recommendations: Bicycle helmets. MMWR 1995 Feb 17; 44:1-17
  3. Rodgers, GB. Bike Helmets. Consumer Products Safety Review. 1999; 4 (1); 1-4
  4. Shafi, S, Gilbert, JC, Loghmanee, F et al. Impact of bicycle helmet safety legislation on children admitted to a regional pediatric trauma center. J Pediatr Surg 1998; 33:317-21
  5. Thomas, S, Acton, C, Nixon J, et al. Effectiveness of bicycle helmets in preventing head injury in children. BMJ 1994;308:173-6
  6. Thompson, R, Rivara, FP, Thompson, DC. A case-control study of the effectiveness of bicycle helmets. NEJM 1989; 320:1361-7
  7. Thompson, DC, Rivara, FP, Thompson, R. Effectiveness of bicycle helmets in preventing head injuries. JAMA 1996; 276: 1968-73
  8. Yelon, J, Harrigan, N, Evans, J. Bicycle Trauma: A Five Year Experience. Am Surg 1995; 61: 202-205

Reprinted from Bulletin of the American College of Surgeons
Vol.87, No. 2, February 2002