April 6, 2015 - This week's post is also available from the Cochrane Child Health blog.
Head injuries due to bicycle crashes are a common reason that children present to the emergency department. Bicycle helmets were designed to decrease head injuries. Different approaches to encourage bicycle helmet use have been evaluated. These range from legislation where individuals are required by law to wear a helmet when cycling to media campaigns and other health promotion activities, such as promoting the use of bicycle helmets in schools or offering free helmets through community-based programs.
An overview of Cochrane systematic reviews  was conducted in order to bring together evidence from reviews that focused on different aspects of the topic of bicycle helmet use. The reviewers identified three systematic reviews [2-4] that included 35 studies involving children. The reviews looked at:
Some of the key findings:
The authors concluded that bicycle helmets are effective in reducing head injuries in children. They also concluded that both legislative and non-legislative interventions are helpful in reducing injuries and promoting helmet use. However, the authors noted that there are some who oppose helmet legislation. The main reasons are that they feel that this may encourage people to cycle more recklessly or less frequently.
Dr. Tony Woodward, Chief of Emergency Medicine at Seattle Children's Hospital states that "there's no question that the best way to protect your child when they're on a bike, scooter, or skates is to wear an appropriately sized helmet. In the emergency department, the children we see who are the most seriously injured are the ones that don't have helmets or have helmets that are inappropriately sized or inappropriately worn."
Finally, check out the TREKK resources on severe head injury. Helmets prevent injury, but accidents still happen!
 Russell, K., Foisy, M., Parkin, P., & Macpherson, A. (2011). The promotion of bicycle helmet use in children and youth: an overview of reviews. Evidence-Based Child Health: A Cochrane Review Journal, 6(6), 1780-1789. doi: 10.1002/ebch.901
 Owen, R., Kendrick, D., Mulvaney, C., Coleman, T., & Royal, S. (2011). Non-legislative interventions for the promotion of cycle helmet wearing by children. Cochrane Database of Systematic Reviews, (11). doi:10.1002/14651858.CD003985.pub3
 Macpherson, A., & Spinks, A. (2008). Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane Database of Systematic Reviews, (3). doi:10.1002/14651858.CD005401.pub3
 Thompson D., Rivara, F., & Thompson, R. (1999). Helmets for preventing head and facial injuries in bicyclists. Cochrane Database of Systematic Reviews, (4). doi:10.1002/14651858.CD001855
TREKK (Translating Emergency Knowledge for Kids) Resources:
ChildSafetyLink. (2014). Keep Kids Safe: A Parent's Guide to Helmet and Recreation Safety.
Government of Manitoba. (2013). Bike Helmet Safety Video.