title: Bicycle helmet use to reduce the impact of head injuries in ladder users.
abstract: BACKGROUND
  The aim of this study was to determine if wearing a bicycle helmet during ladder use could reduce the incidence and severity of head injury in the event of a fall.
  
  
  METHODS
  A headform model with inbuilt accelerometers was used to determine the Head Injury Criterion (HIC) score of head impact by dropping 41 helmeted and unhelmeted headforms from eight heights. These results were compared.
  
  
  RESULTS
  There was a statistically significant difference between averaged HIC scores in helmeted and unhelmeted drops (P < 0.001). Unhelmeted HIC scores ranged from 387 at 0.25 m to 2121 at 0.6 m. Helmeted HIC scores ranged from 29 at 0.25 m to 1199 at 2.5 m. At a height of 0.5 m, the risk of severe brain injury (AIS ≥4) from direct frontal head impact is predicted to reduce from >50% to <5% with helmet use.
  
  
  CONCLUSIONS
  There was a significant decrease in the HIC scores when helmets are used and it is likely that the benefits would be seen in the clinical setting. These results provide an argument for the use of a bicycle helmets by all ladder users, in particular those over age 50 who are at increased risk of head injuries. We recommend that bicycle helmet use be incorporated into ladder injury prevention strategies.
authors.affiliation: Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
authors.forename: Leigh R
authors.initials: LR
authors.lastname: Warren
authors.affiliation: Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Harley
authors.affiliation: Centre for Automotive Safety Research, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Dutschke
authors.affiliation: Centre for Automotive Safety Research, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: van den Berg
authors.affiliation: Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dobbins
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology / Q000517:prevention & control*; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000517:prevention & control*; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012720:Severity of Illness Index
keywords: accidental fall; brain; closed head injury; craniocerebral trauma; injury; trauma; traumatic brain injury