title: Relationship between Locations of Facial Injury and the Use of Bicycle Helmets: A Systematic Review.
abstract: The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR) between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; P<0.001) and of middle facial injury (OR, 1.97; P<0.001) as compared to helmet users. In the case of lower facial injury, however, only a slightly increased risk (OR, 1.42; 95% confidence interval (CI), 0.67-3.00, P=0.36) was observed. The abovementioned results can be attributed to the fact that a helmet covers the head and forehead but cannot cover the lower face. However, helmets having a chin cap might decrease the risk of lower facial injury.
authors.affiliation: Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Kun
authors.initials: K
authors.lastname: Hwang
authors.affiliation: Inha University School of Medicine, Incheon, Korea.
authors.forename: Yun Moon
authors.initials: YM
authors.lastname: Jeon
authors.affiliation: Inha University School of Medicine, Incheon, Korea.
authors.forename: Yeong Seung
authors.initials: YS
authors.lastname: Ko
authors.affiliation: Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Kim
keywords: Bicycling; Facial injury; Head protective devices