The Injury Free Coalition for KidsThe Injury Free Coalition for Kids®® is a national program of the is a national program of the Robert WoodRobert Wood

Johnson Foundation at Columbia University Medical Center’s Johnson Foundation at Columbia University Medical Center’s Mailman School of Public Health.Mailman School of Public Health.

Wheeled SportsPreventing Injuries To Children

Michael J. Mello, MD, MPHEugene Y. Fukudome BS

Wheeled Sports

Bicycles

•700-900 people die in bicycle-related injuries each year in the United States

•More than 500,000 people are treated in hospital emergency departments for bicycle-related injuries

•The majority of bicycle injuries occur in children less than 15 years old

Bicycles

•Head injuries account for 1/3 of emergency room visits by bicycle riders

•90% of people killed in 2000 were not wearing a helmet while bicycling

Bicycles

Injuries to the face, muscles, bones, as well as bruises, cuts and scrapes also occur in bicycle riders

Bicycles

•Always wear a helmet when riding your bicycle

•Ride a bicycle that is the correct size for you

•Keep bicycle in good repair, and check the breaks often

•One person per bicycle: no riding on handlebars or pegs.

Bicycles

•Ride on the right side of the road

•Use hand signals:

−left arm straight out = left turn

−left arm bent up at elbow = right turn

•Kids (10 and under) should only ride on the sidewalk

•Stop and look both directions before turning on to a street

Bicycles

•Learn and obey all traffic rules, signs, and signals

•Always watch for cars

•Walk bicycles across busy intersections

•Be visible to cars

•Wear bright clothing

•At night, use reflectors and lights

Bicycles

•Bicycle riding is a popular form of recreation and transportation

•67-85 million Americans ride bicycles

•70% of children 5-14 years old ride bicycles

Bicycles

•Two hands on handlebars

•Don’t carry large things while riding

•Do not drink alcohol or use drugs before riding

•Never use headphones while riding your bicycle

Skateboards

•5.8 million children and adolescents less than 18 years old skateboard

•750,000 children and adolescents skateboard on a weekly basis

•Skateboarding is more popular among males

Skateboards

•Skateboarding deaths are rare

•Skateboarding injuries result in 50,000 visits to the emergency room and 1,500 hospitalizations yearly

•25% of hospitalizations are due to skateboarders colliding with cars

Skateboards

•The most common areas injured while skateboarding are the ankle, wrist, and face

•Boys are injured much more frequently than girls

Skateboards

•Children under 5 should not skateboard

•Children 6 - 10 years of age should skateboard only with close supervision

•Beginners should use skateboards with a short deck and wide wheels

•Never skateboard in traffic

•Never hold on to moving vehicles while skateboarding

Skateboards

•Skateboard in skate parks

•Skateboard protective gear:

– Helmet

– Wrist guards

– Elbow pads

– Knee pads

•Gloves will help protect your hands

In-line skates

•In-line skates were introduced in the 1980s

•Around 37 million people of all ages in-line skate

•Over 17 million people under 18 years of age skate

In-line Skates

•In-line skaters tend to fall forward

•Thus, injuries to arms and hands such as fractures, and dislocations are common

•Head and leg injuries also occur while in-line skating

In-line Skates

•Death resulting from in-line skating is rare

•In-line skating is responsible for some 153,000 injuries each year

In-line Skates

•In-line skating protective gear:

– Helmet

– Wrist guards

– Elbow pads

– Knee pads

•Avoid in-line skating in traffic

•Never hold on to moving vehicles while in-line skating

In-line Skates

• Do not in-line skate at night

• Beginners should avoid hills

• Beginners and intermediate skaters should use skates with 3 or 4

wheels

• Beginners should consider skating lessons

Scooters

•The currently popular scooter was introduced in 2000

•These light-weight scooters utilize low-friction wheels, and achieve speeds of 5-8 mph

•In 2000, more than 11 million people used a scooter

Scooters

•Between 1999 and 2002, there were 20 deaths resulting from scooters

•There were an estimated 40,500 trips to the emergency room as a result of scooter injuries in 2000

•85% of scooter injuries occurred in children younger than 15 years old

Scooters

•Common scooter-related injuries include fractures, dislocations, sprains, cuts, and bruises, and affect the wrist, elbow, lower arm, and knee

•Head and face injuries also occur

•Injuries tend to occur when scooter wheels hit a small object, while performing a trick, or while trying to stop

Scooters

•Always wear protective gear while riding a scooter:

– Helmet

– Knee pads

– Elbow pads

•Do not use wrist guards while riding a scooter because wrist guards make it difficult to grip the handlebars

Scooters

•Children younger than 8 years of age should be closely supervised while riding a scooter

•Never use scooters on wet or sandy surfaces; ride on smooth, paved surfaces

•Beginners should avoid hills

Scooters

•Never use scooters at night

•Avoid using scooters in traffic, rather, use the sidewalk

•One person per scooter

•Always test out your breaks before riding

•Wear sturdy shoes

The Problem

•Many research studies have shown that protective equipment such as helmets prevent or decrease the severity of injury

•Yet some children and adolescents continue to neglect safety equipment

•Thus, many preventable injuries, some severe, continue to occur

Cost

•Injuries are costly, both financially and personally

•For example, medical bills for bicycle-related injuries can total $81 million per year

•There are additional costs such as pain, suffering, anxiety, and disability that result from injury

Community Concern

Community Concern

Environmental Change

Environmental Change

EvaluationEvaluation

Education Education & &

AwarenesAwarenesss

Education Education & &

AwarenesAwarenesss

Epidemiologic

Data

Epidemiologic

Data

Coalitions Coalitions

Physical Environme

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Physical Environme

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Outcome Data

Outcome Data

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Model for Injury Prevention

Injury Prevention

• There are different kinds of helmets for different activities

Bicycle

Scooter / Skateboard

Injury Prevention

•Choose a helmet that complies with US Consumer Product Safety Commission standards (check the label)

•Helmets must fit properly and be worn correctly to be effective

•Do not purchase large helmets for your child to “grow into”

Injury Prevention

•Make sure the front of the helmet is facing forward

•Helmets should be straight, and should NOT tilt forwards or backwards

Injury Prevention

Chin straps should be snug enough that the helmet cannot be moved from side to side

Injury Prevention

•Helmets that have been through a crash should be discarded, and a new helmet should be purchased

•Parents can set an example for children by always wearing their helmet