title: Tykes and bikes: injuries associated with bicycle-towed child trailers and bicycle-mounted child seats.
abstract: OBJECTIVE
  To describe the incidence, type, and severity of injuries related to the use of bicycle-towed trailers for transporting children and to compare them with injuries associated with the use of child seats mounted on adult bicycles.
  
  
  METHODS
  A retrospective analysis of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for 1990 to 1998.
  
  
  RESULTS
  There were 49 injuries to children during the 9-year study period (estimated 2338 injuries; 95% confidence interval [CI], 1121-3555): 6 were associated with the use of bicycle-towed trailers (an estimated 322 injuries; 95% CI, 158-486) and 43 were related to the use of bicycle-mounted child seats (an estimated 2015 injuries; 95% CI, 988-3042). The mean age of injured children was 2.4 years and 51% were male. A collision with a motor vehicle accounted for 2 (33%) of the injuries associated with bicycle-towed trailers; 3 (50%) of the injuries were the result of falls. A motor vehicle was involved in 4 injuries (9%) related to the use of bicycle-mounted child seats (Fisher exact test, P<.13 vs bicycle-towed trailers); 31 (72%) were the result of falls (Fisher exact test, P<.26 vs bicycle-towed trailers). Contact with a bicycle wheel or spokes was the mechanism of 1 injury associated with the use of a bicycle-towed trailer (17%) and the mechanism for 8 (19%) of the injuries associated with the use of a bicycle-mounted child seat (Fisher exact test, P<.69). The head or face was the most common site of injury, accounting for 5 (83%) injuries among those riding in bicycle-towed trailers and 21 (49%) injuries among children in bicycle-mounted child seats (Fisher exact test, P<.12). All 6 children injured in bicycle-towed trailers had contusions/ abrasions or lacerations; 22 (51%) children injured using bicycle-mounted child seats had contusions/abrasions or lacerations and 9 (21%) had fractures. Two children (33%) injured in bicycle-towed trailers and 2 (5%) injured in bicycle-mounted child seats were admitted to the hospital (Fisher exact test, P<.06).
  
  
  CONCLUSIONS
  When compared with bicycle-mounted child seats, there were fewer reported injuries to children associated with the use of bicycle-towed trailers. Motor vehicle involvement and need for hospital admission were similar among injured children in both groups, and the head or face was the most common site of injury. These data imply that ongoing surveillance efforts to identify injuries associated with use of bicycle-towed child trailers are warranted and that bicycle helmets should be worn by children riding in bicycle-towed child trailers and in bicycle-mounted child seats.
authors.affiliation: Division of Pediatric Emergency Medicine, Children's Memorial Hospital, Chicago, Ill 60614, USA. epowell@nwu.edu
authors.forename: E C
authors.initials: EC
authors.lastname: Powell
authors.forename: R R
authors.initials: RR
authors.lastname: Tanz
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D001642:Bicycling / Q000293:injuries*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male