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Most Can't Properly Fit a Bicycle Helmet

Study says 96%, kids and grownups alike, get it wrong

(HealthDay is the new name for HealthScoutNews.)

MONDAY, Aug. 4, 2003 (HealthDayNews) -- Dr. Gregory Parkinson spent the better part of a decade completing his medical training and now has a thriving pediatrics practice on Cape Cod, yet he suspects it took him about 12 years before he learned how to put his bicycle helmet on properly.

The light bulb moment came when he was on vacation and got help from a man renting bicycles.

Now Parkinson is on a quest of sorts to show kids and parents how to master this task. In a new study appearing in the August issue of Pediatrics, Parkinson found an overwhelming majority of children, adolescents and parents cannot properly fit a bicycle helmet.

"I don't think anyone was surprised that helmets are somewhat difficult to fit," Parkinson says. "I strongly suspected that the majority would have difficulty. I didn't think 96 percent would have difficulty."

Virtually everyone agrees that wearing a helmet while riding a bike, scooter, skateboard or while in-line skating is good practice. According to the U.S. Consumer Product Safety Commission (CPSC), about 900 people -- including more than 200 children -- are killed every year in bicycle-related accidents, and about 60 percent of these fatalities involve head injuries. According to the study, in 1997 about 4,000 head injuries resulted from in-line skating. And in 1999, an estimated 59,000 skateboard injuries occurred, about 7 percent of them involving the head.

"We know that helmets prevent head injury, and we want more people to wear them," says CPSC spokesman Ken Giles.

The CPSC states that wearing a helmet can reduce the risk of head injury from bicycle accidents by up to 85 percent. But that's only if you're wearing it properly.

To find out how many people were wearing helmets correctly, Parkinson launched a study in his own private practice in Falmouth, Mass., recruiting 395 families and 479 children. While at their regular pediatric visit, the participants filled out a questionnaire and were then timed while they tried to fit a helmet. Parkinson and his staff then evaluated how they did.

Eighty-eight percent of the kids involved owned a bicycle helmet. Almost three-quarters of cyclists responded that they "always" or "almost always" used a helmet, while 69 percent of in-line skaters, 58 percent of scooter riders and 50 percent of skateboarders provided this response. Teenagers were less likely than younger children to wear a helmet. Almost all (90 percent) felt it was easy or pretty easy to fit a helmet.

Boy, were they wrong: Only 4 percent of the participants passed the test. When the parent alone fitted the helmet, nobody passed.

The three main difficulties were the helmet resting too high on the forehead, improper strap positions and excessive movement of the helmet from the front to the back of the head.

Why is it that so few are getting it right? "There are a number of reasons," Parkinson explains, "but the main one is having someone who knows how spending the time to teach you. Traditionally this has been done well in bicycle shops, but the majority of helmets are purchased elsewhere. It's not unusual to get more help fitting a pair of shoes than a helmet."

A common problem is the straps, which often aren't adjusted correctly. Parkinson says helmet manufacturers could "devise a new system" making them easier to adjust.

What's the right way? Parkinson went back to guidelines put out by the Harvard Research Center in Seattle, which published the original study on helmet effectiveness, and developed his own mantra: Be a Bike Helmet MVP.

  • M: Move it down the forehead (less than two fingers' width above the brow);
  • V: The straps should make a "V" around the ear; and;
  • P: Pull the chinstraps snugly.

"If you can do those three things in that order, it substantially improves safety," Parkinson says. The key is to do them in order. The MVP slogan is now on posters in schools throughout Parkinson's town.

"If they're going to be effective, the helmets have to cover the skull as completely as possible," Giles says. "Some people wear it sunbonnet style, kind of pushed up and on the back of head, and that's just not effective. It has to be flat on the head. The straps should make a V around the ears and the straps should be snug."

Parkinson suggests that once the straps are adjusted well, parents should sew or tie them in place. They won't have to be adjusted more than once a year, even for kids, he says.

Parkinson is also an advocate of the pediatrician getting involved in helmet safety. The American Academy of Pediatrics has recommended for some time that doctors discuss helmet use with their young patients.

And Parkinson is doing follow-up research with the kids in his original study to see if the MVP instruction has resulted in improvement.

More information

To see the correct way to fit a helmet, visit the Consumer Product Safety Commission. Parents can visit the American Academy of Pediatrics or the Bicycle Helmet Safety Institute for tips on getting kids to wear helmets.

SOURCES: Gregory Parkinson, M.D., community pediatrician, Falmouth Pediatric Associates, Falmouth, Mass.; Ken Giles, spokesman, U.S. Consumer Product Safety Commission, Bethesda, Md.; August 2003 Pediatrics
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