title: Helmet use and bicycle-related trauma in patients presenting to an acute hospital in Singapore.
abstract: BACKGROUND
  To describe the relationship between bicycle helmet use and injury pattern sustained by patients presenting to an emergency department (ED) in Singapore for bicycle-related trauma.
  
  
  METHODS
  Data was collected from all individuals treated for bicycle-related trauma between September 1, 2004 and May 31, 2005 using a closed-ended questionnaire.
  
  
  RESULTS
  160 bicyclists with mean age of 34.4 years (range 10 to 89 years) were surveyed. Among them, 80 percent were male and 30.6 percent were non-residents. Helmets were worn by 10.6 percent of the patients. Alcohol was clinically detected in 11.3 percent of bicyclists. There was no difference in bicycle helmet use between Singaporeans and non-residents (p-value is 0.275). However, compared to younger bicyclists, bicyclists aged 30 years or older (p-value is less than 0.05), and compared to recreational or sport bicyclists, those who commute by bicycle, tended not to wear helmets (p-value is less than 0.01). Compared to Singaporeans (p-value is less than 0.05), non-residents and bicyclists aged 30 years or older (p-value is 0.011) believed that helmets did not protect against head injury. Comparing the helmeted group with the non-helmeted group, injury patterns by body region were: head injury 5.9 percent versus 40.0 percent (p-value is less than 0.01); facial injury 5.9 percent versus 37.1 percent (p-value is less than 0.05). Not wearing a helmet, being hit by a motor vehicle and age were significantly associated with higher injury severity scores, after adjusting for several potential confounding factors.
  
  
  CONCLUSIONS
  Bicycle helmet use was low in our sample of injured patients. When worn, protection against injury was demonstrated. A campaign to promote use of bicycle helmets should be targeted at non-residents and older bicyclists. Authorities should consider compulsory helmet laws for bicyclists and expanding anti-drunk driving campaigns to target alcohol-intoxicated bicyclists.
authors.affiliation: Emergency Department, Tan Tock Seng Hospital, Singapore. kenneth_heng@ttsh.com.sg
authors.forename: K W J
authors.initials: KW
authors.lastname: Heng
authors.forename: A H P
authors.initials: AH
authors.lastname: Lee
authors.forename: S
authors.initials: S
authors.lastname: Zhu
authors.forename: K Y
authors.initials: KY
authors.lastname: Tham
authors.forename: E
authors.initials: E
authors.lastname: Seow
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D001642:Bicycling / Q000293:injuries*; D002648:Child; D006259:Craniocerebral Trauma / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005151:Facial Injuries / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires