Sweatt Imani H, Barr Candace, Gelinne Aaron, Woolard Alice, Quinsey Carolyn
General Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA.
General Surgery, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA.
Cureus. 2023 Jul 17;15(7):e42017. doi: 10.7759/cureus.42017. eCollection 2023 Jul.
Background Bicycle helmet use has a known protective health benefit; yet, pediatric populations have suboptimal helmet rates, which increases the risk of severe injuries. It is imperative to have an updated assessment of behavioral social disparities and for providers to be aware of them to better counsel patients. The study objective was to identify social determinants correlated with helmet use in children involved in bicycle accidents. Based on previous literature, we hypothesized that higher socioeconomic status, female sex, and Caucasian race were associated with increased helmet use. Methods A retrospective case series of 140 pediatric cases of bicycle-related traumas assessing helmet status. Participants presented to the emergency room with injuries due to a bicycle-related trauma and were subsequently admitted to the University of North Carolina (UNC) Hospital System in Chapel Hill, North Carolina (NC), from June 2006 to May 2020. The Institutional Review Board (IRB) approved study comprised a retrospective chart review of 140 cases from the pediatric (<18 years of age) trauma database with coding indicating bicycle-related injury. Zip codes were used to approximate the median household income utilizing the Proximity One government database. The primary exposure was helmet status, which was determined from the electronic record chart review. The hypothesis was formulated before the start of the study. The main outcomes measured in the study included age, sex, race, helmet status, zip code, insurance status, injury types, and mortality. Results There were a total of 140 study participants, of which 35 were female and 105 were male. Males comprised 79.6% of the non-helmeted group, while females were in the minority in both helmet status groups, with 65.7% still being non-helmeted. Additionally, 51.9% of patients who were helmeted used private insurance, and 59.3% of those non-helmeted used public insurance. Of the 71 head injuries, 88.7% were non-helmeted. Principally, this study found that 80.7% of children involved in a bicycle-related accident were not helmeted. Conclusions Despite NC legislation mandating that children under 16 years of age wear helmets while operating bicycles, many children injured in bicycle-related trauma are not complying with this requirement. This study demonstrates that specific populations have decreased rates of helmet usage and emphasize the continued need to monitor helmet behaviors.
已知使用自行车头盔对健康有益；然而，儿童群体的头盔佩戴率不理想，这增加了严重受伤的风险。必须对行为社会差异进行最新评估，以便医疗服务提供者了解这些差异，从而更好地为患者提供咨询。本研究的目的是确定与涉及自行车事故的儿童头盔使用情况相关的社会决定因素。基于以往的文献，我们假设较高的社会经济地位、女性性别和白种人与头盔使用增加有关。
对140例儿童自行车相关创伤病例进行回顾性病例系列研究，评估头盔使用情况。参与者因自行车相关创伤受伤后前往急诊室，并于2006年6月至2020年5月期间被收治入北卡罗来纳州教堂山的北卡罗来纳大学（UNC）医院系统。机构审查委员会（IRB）批准的研究包括对140例来自儿科（<18岁）创伤数据库的病例进行回顾性病历审查，编码显示与自行车相关的损伤。利用Proximity One政府数据库，通过邮政编码来估算家庭收入中位数。主要暴露因素是头盔使用情况，通过电子病历审查确定。该假设在研究开始前就已形成。本研究测量的主要结果包括年龄、性别、种族、头盔使用情况、邮政编码、保险状况、损伤类型和死亡率。
共有140名研究参与者，其中35名是女性，105名是男性。男性占未佩戴头盔组的79.6%，而在两个头盔使用情况组中女性均占少数，仍有65.7%未佩戴头盔。此外，佩戴头盔的患者中有51.9%使用私人保险，未佩戴头盔的患者中有59.3%使用公共保险。在71例头部受伤病例中，88.7%未佩戴头盔。主要地，本研究发现80.7%涉及自行车相关事故的儿童未佩戴头盔。
尽管北卡罗来纳州有立法规定16岁以下儿童骑自行车时必须佩戴头盔，但许多在自行车相关创伤中受伤的儿童并未遵守这一要求。本研究表明特定人群的头盔使用率较低，并强调持续监测头盔使用行为的必要性。
