Demographic and causal patterns in child cyclist head Injuries: Informing helmet test methods
File(s)
Published version
Author(s)
Dawber, William
Baker, Claire E
Sharp, David
Agrawal, Shruti
Ghajari, Mazdak
Type
Journal Article
Abstract
Children’s cycle helmets are certified using the same impact conditions as adult helmets, which can overlook important factors contributing to child head injuries. Our objective is to identify common patterns in traumatic brain injury pathologies, age, sex, riding environment, cause of injury, helmet use, and helmet injury reduction in child cyclists to inform child-specific test methods.
We reviewed 48,074 head injury cases in cyclists under 17 years across 24 studies. An aggregate data meta-analysis was conducted to identify recurring patterns overall and in studies with a high proportion of severe injuries (n = 3,542 cases).
Cases most often involved male riders (71.8%, CI: 71.6–72.1%), aged 10–13 years (40.2%, CI: 39.1–41.3%), occurring on paved roads (75.0%, CI: 74.2–75.9%) without prior collision (84.4%, CI: 84.1–84.8%). Injuries were predominantly intracranial (73.7%, CI: 71.6–75.8%). Studies with mostly severe injuries included significantly more males, on-road incidents, motor vehicle collisions, intracranial haemorrhages, and skull fractures. Helmets reduced odds of head injuries (OR = 0.44, CI = 0.41–0.47), but the efficacy was lower for severe injuries (OR = 0.61, CI = 0.58–0.65), which contrasts most findings for adult helmets.
The identified factors associated with severe injuries in child cyclists, such as vehicle collisions and intracranial injuries with rotational mechanisms, are not represented in current child helmet test procedures. This work provides a foundation for further work aimed at quantifying representative head impact biomechanics in typical and severe child cycling incidents, with the ultimate goal of developing helmet test procedures tailored specifically to children.
We reviewed 48,074 head injury cases in cyclists under 17 years across 24 studies. An aggregate data meta-analysis was conducted to identify recurring patterns overall and in studies with a high proportion of severe injuries (n = 3,542 cases).
Cases most often involved male riders (71.8%, CI: 71.6–72.1%), aged 10–13 years (40.2%, CI: 39.1–41.3%), occurring on paved roads (75.0%, CI: 74.2–75.9%) without prior collision (84.4%, CI: 84.1–84.8%). Injuries were predominantly intracranial (73.7%, CI: 71.6–75.8%). Studies with mostly severe injuries included significantly more males, on-road incidents, motor vehicle collisions, intracranial haemorrhages, and skull fractures. Helmets reduced odds of head injuries (OR = 0.44, CI = 0.41–0.47), but the efficacy was lower for severe injuries (OR = 0.61, CI = 0.58–0.65), which contrasts most findings for adult helmets.
The identified factors associated with severe injuries in child cyclists, such as vehicle collisions and intracranial injuries with rotational mechanisms, are not represented in current child helmet test procedures. This work provides a foundation for further work aimed at quantifying representative head impact biomechanics in typical and severe child cycling incidents, with the ultimate goal of developing helmet test procedures tailored specifically to children.
Date Issued
2026-07-01
Date Acceptance
2026-04-07
Citation
Accident Analysis and Prevention, 2026, 232, pp.108545-108545
ISSN
0001-4575
Publisher
Elsevier
Start Page
108545
End Page
108545
Journal / Book Title
Accident Analysis and Prevention
Volume
232
Copyright Statement
© 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.1016/j.aap.2026.108545
Publication Status
Published
Article Number
108545
Date Publish Online
2026-04-18