Estimates of the incidence and costs associated with handlebar-related injuries in children.
BACKGROUND
The US Consumer Product Safety Commission is considering handlebar regulation regarding impact performance to address the risk of abdominal and pelvic organ injuries in bicyclists.


OBJECTIVE
To provide national estimates of incidence and costs of handlebar-related abdominal and pelvic organ injuries.


METHODS
Censuses of hospital discharge data from 19 states were extrapolated to determine national estimates. The percentage of abdominal and pelvic injuries associated with handlebars was estimated based on a case series from a pediatric trauma center. Costs were estimated using standard methods.


METHODS
All subjects younger than 20 years treated as inpatients and discharged from acute care hospitals for non-motor vehicle bicycle-related injury in 19 states in 1997 and at a pediatric trauma center located in one of the states between January 1, 1996, and December 31, 2000.


METHODS
Incidence of bicycle-related handlebar abdominal and pelvic organ injury, total hospital charges, lifetime medical payments, lifetime productivity loss, and lifetime monetized quality-adjusted life-years.


RESULTS
An estimated 1147 subjects (95% confidence interval, 1082-1215; 1.49 per 100 000 subjects 19 years and younger) in the United States had serious non-motor vehicle-involved bicycle-related abdominal or pelvic organ injury leading to hospitalization in 1997, and 886 (95% confidence interval, 828-944; 1.15 per 100 000 subjects 19 years and younger) of these injuries likely were associated with handlebars. The estimated national costs associated with handlebar-related abdominal and pelvic organ injuries were $9.6 million in total hospital charges, $10.0 million in lifetime medical costs (including claims processing), $11.5 million in lifetime productivity losses, and $503.9 million in lifetime monetized quality-adjusted life-years.


CONCLUSIONS
Handlebar-related abdominal and pelvic organ injuries pose a serious health risk to children and result in substantial health care costs. Requirements for safer handlebar designs may provide one avenue to achieve a health and economic benefit.
TraumaLink, The Children's Hospital of Philadelphia, 10th Floor, 34th Street and Civic Center Blvd, Philadelphia, PA 19104, USA.
Flaura K
FK
Winston
Harold B
HB
Weiss
Michael L
ML
Nance
Cara
C
Vivarelli-O'Neill
Stephen
S
Strotmeyer
Bruce A
BA
Lawrence
Ted R
TR
Miller
D000007:Abdominal Injuries / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D004651:Employment; D004867:Equipment Design; D005249:Fees and Charges; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D010388:Pelvis / Q000293:injuries*; D015143:Philadelphia / Q000453:epidemiology; D019057:Quality-Adjusted Life Years; D014481:United States / Q000453:epidemiology