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Bike Helmet Fit Deemed Crucial

September 12, 1999

WASHINGTON (AP) _ Make sure your bike helmet fits properly _ wearing it loose may almost double the risk of head injury in an accident, a researcher warns.

``Kids and parents are not great judges of how well the helmets fit,″ said Dr. Frederick P. Rivara of Harborview Injury Prevention and Research Center, Seattle. ``Helmets that fit poorly are more likely to be off position on the head.″

Rivara and his colleagues reviewed data on 1,718 helmeted bike riders _ adults and children _ who were brought to Seattle-area hospital emergency rooms after a crash. Following their release from the hospital, the accident victims were questioned about how well they thought their helmets had fit.

Sixty-five percent reported the fit was excellent at the time of the crash, 28 percent reported it as good, and 6 percent reported it was fair or poor.

Those whose helmets did not have at least a good fit were 1.96 times more likely to have suffered head injury, the scientists reported in the September issue of the Journal of Injury Prevention.

To see what could be wrong with the fit, the researchers then focused on a subset of children ages 2 to 14 years. Children were chosen instead of adults ``because our anecdotal experience was that many children wear the helmets out of position, and this might be related to poor fit,″ the article said. However, a limitation of the study is that the findings on fit in children might not apply to adults, the researchers conceded.

Among the children, 98 had not suffered head injuries, despite having hit their head, helmet or face, but 28 others had suffered injury to the scalp, forehead, skull or brain.

The researchers measured the children’s heads. They also made plaster casts of the kids’ heads, so the helmets could be placed on the casts as though the children were wearing the helmets. The scientists then compared how well the helmets fit in the two groups of children.

They discovered the problem seemed to be whether the helmet was too wide for the child, rather than being too long. ``The head-injured children had helmets that were significantly wider than their heads, compared with children without head injuries,″ the report said.

Compared with the non-head-injured control group, 47 percent more of the head-injured children had helmets three-quarters of an inch or more wider than their heads, the article said.

The finding underscores the need for a snug fit, Rivara said.

The too-wide helmet is not an uncommon problem, said Randy Swart, director of the Bicycle Helmet Safety Institute, Arlington, Va. ``A lot of heads are narrower than helmets,″ he said.

People are more likely to adjust a helmet that’s too loose front to back, because the bouncing front of the helmet is right before their eyes, and ``you have to adjust to keep it from bumping on your sunglasses,″ he said.

Also, the government pays attention to front-to-back problems, said Michael Lindars, manager of design and marketing for Troxel, a helmet manufacturer in San Diego.

The Consumer Product Safety Commission has a test designed to make sure the helmet does not roll from front to back in an accident, Lindars said. However, CPSC does not have a standard on side-to-side fit, he said.

To create a comfortable but snug side-to-side fit, place foam pads, supplied with a new helmet, inside the helmet, according to Michael Yokota, Troxel’s manager of research and development.

Adjusting the front-to-back fit is as simple as making sure the straps are tight. But many people don’t know how or take the time, Swart said.

Those who don’t know how might want to buy their helmets at a bike store, where trained staff can assist them in fitting it, Swart said. As for taking the time, ``We recommend sitting in front of the television and playing with your helmet until you get it right,″ he said.

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