Bicycle Related Injuries

About 700 bicyclists are killed and another 50,000 sustain disabling injuries each year in the United States. The Consumer Product Safety Commission reports that more than 350,000 children are treated in emergency rooms each year for bicycle-related injuries. Dr. Mark Widome, a correspondent for the "Today" show, offers some advice.

• Children as Passengers on Adult Bikes
  Rear-wheel mounted bike seats are the most popular, but they come with several disadvantages. They can make the bike extremely unstable and difficult to handle, especially if the child is not sitting still. Rear carriers are designed for children who are old enough to have good head and neck support, up until about 40 pounds or 2 to 3 years of age.
  
  If you are looking to purchase a bike seat, make sure to purchase one with a high back, wheel wells to protect the feet from spokes, and a shoulder harness/east-belt system to keep your child in place. You should also make sure that your child is wearing an approved, well-fitting safety helmet.
  
  The two-wheeled trailer has some advantages over the rear carrier seat in that the child rides closer to the ground, and usually remains upright in a spill. While trailers are more expensive than bike seats, they can hold up to 2 passengers with a combined weight of 100 pounds or less, making it the perfect choice for parents with more than one small child.
• The Essential Helmet
  The most important thing to remember when riding a bike is to wear a helmet. Three-fourths of bike fatalities are due to head trauma. Helmets can reduce the number of brain injuries by more than 80 percent.
  
  Helmets work by "packing" the brain and skull in about an inch of polystyrene. Should a fall occur, the lining of the helmet crushes slightly as it absorbs the energy of the impact. Without the helmet, the skull and brain would have to absorb this impact.
  
  Proper helmet use requires that riders follow the four "S's": size, straight, strap and sticker. A properly sized helmet is one that does not move around on the head. The helmet should be worn straight, that is, horizontal on the head, not pushed back like a baseball cap. The strap should be buckled tight under the chin so that the helmet stays on. And the sticker should indicate that the helmet meets current safety standards. Any helmet that has hit the ground should be replaced, as it may not have visible damage.
• Safe Riding Practices
  Children must have adult guidance and supervision to become safe, skilled cyclists. Make sure that your child's bike is in good working order. If your child is old enough to ride his bicycle on the street, make sure that he has the correct skills and judgment, along with a working knowledge of traffic rules and hand signals. It is also a good idea to teach him to safely cross the street by dismounting the bicycle and walking it across. Children learn by imitation, so be sure to follow the rules of bicycle safety yourself.

Helmets for Other Wheeled Activities
Many of the rules that apply to bicycle safety also apply to skateboarding and in-line skating. The American Academy of Pediatrics does recommend that children under the age of five not use skateboards because the combination of their developmental immaturity and relatively high centers of gravity make them particularly prone to head injuries. Helmets should always be safety approved, and the child should also wear elbow and knee pads, and wrist guards.

Children should never attempt to practice skateboarding or in-line skating on roadways. Their ability to control the wheels is not developed enough for them to negotiate traffic or avoid the path of an oncoming car.