Injuries: All Ages
COVID19 Era Stats from CPSC
The COVID-19 pandemic had an impact on hospital emergency room-treated injuries
from consumer products. The "Effect of the Novel Coronavirus Pandemic on Preliminary NEISS Estimates," suggests that
although consumers may have avoided the ER for some product-related injuries, they did go at nearly the same rate as
the previous year for more severe injuries. New patterns of risk arose during the pandemic. Data trends were
compared from September 2019 to September 2020.
The largest increases in ER-treated injuries across all age ranges occurred with fireworks and flares (56%),
skateboards, scooters, and hoverboards (39%), and all-terrain vehicles, mopeds, and minibikes (39%). A notable increase
in injuries from fireworks and flares is likely due to more consumers using these products at home, rather than in
community settings with professional fireworks handlers. The increase in skateboard, scooter, and hoverboard injuries
is commensurate with increased use while kids were out of school, because the age group of young children (5-9 years)
saw a 143% increase.
Although bicycles had a slight increase (1%) in overall injuries, the increase jumped to 21% for users age 40 and
above, and 39% for adults older than 70.
the full report
- 846 bicyclists died on US roads in 2019, 3 per cent lower than 2018 and 2.3 percent of all traffic fatalities
during the year. The 857 killed in 2018 had been the highest number since 1990 when it was 855. (It was 1,003 back in
- 804 Bicyclists were killed by motor vehicles.
- 40 Bicyclists 14 and under were killed.
- Average age of a bicyclist killed on US roads was 48 (36 in 2002)
- Males were 86% of those killed.
- 78% of fatal crashes were urban.
- The highest fatality cities were New York (24), Houston (16) and Los Angeles (14).
- 82.3% of the cyclists were hit by the front of the vehicle.
- 63% were on roadways not at intersections. 27% were at intersections. 10% were in other locations.
- Fatalities were in daylight 49%, dark 47%, dusk 2%, dawn 2%.
- Fatalities most often occurred between 6 p.m. and 9 p.m. regardless of season.
- 25% of the cyclists killed had been drinking. (Blood alcohol over .01 g/dl) 34% of the crashes involved either
driver or cyclist drinking.
- 2002 - 665
- 2003 - 629
- 2004 - 727
- 2005 - 786
- 2006 - 772
- 2007 - 701
- 2008 - 718
- 2009 - 628
- 2010 - 623
- 2011 - 682
- 2012 - 734
- 2013 - 749
- 2014 - 729
- 2015 - 829
- 2016 - 852
- 2017 - 783
- 2018 - 857
- 2019 - 846
Note: DOT/NHTSA continues its annoying habit of attributing the majority of cyclist deaths to "improper use of
facilities." Many safety advocates believe that "improper facility design" would be more accurate. NHTSA also refers to a
car-bike collision as a "single vehicle crash."
If five aircraft crashed killing that many passengers there would be major public reaction and calls for urgent
All deaths, not specifically ped/bike.
Statistics from the Insurance Institute for
The IIHS is consistently the best source of bicycle fatality statistics on the web. Their picture of a "typical"
bicyclist killed on our roads would be a sober male over 16 not wearing a helmet riding on a major road between
intersections in an urban area on a summer evening when hit by a car.
IIHS Fatality Facts: Bicycles - 2020
Posted March 2021:
"Each year about 2 percent of motor vehicle crash deaths are bicyclists. Although child bicyclist deaths have declined
over the years, deaths among bicyclists age 20 and older have tripled since 1975. In a majority of bicyclist deaths,
the most serious injuries are to the head, highlighting the importance of wearing a bicycle helmet."
"A total of 843 bicyclists were killed in crashes with motor vehicles in 2019. This represents a 3 percent decrease
from the 868 bicyclist deaths that occurred in 2018. Although bicyclist deaths have decreased 16 percent since 1975,
they have increased 36 percent since reaching their lowest point in 2010. Most bicyclist deaths in 2019 (90 percent)
were those ages 20 and older. Deaths among bicyclists younger than 20 have declined 90 percent since 1975, while deaths
among bicyclists 20 and older have tripled. In every year since 1975, many more male than female bicyclists were killed
in crashes with motor vehicles. The decline since 1975 among female bicyclists (34 percent) was about 3 times the
decline among male bicyclists (12 percent)."
The IIHS analysis was updated in March of 2021. They have tables, graphs and much more detail on their site. If
the link above has changed, use this search and click on
Bicycle Fatality Facts.
Bicyclist Deaths by Helmet Use
From earlier IIHS reporting
Statistics from New York City
New York issued a statement on their bicycle safety study including these
Bicycle lanes and helmets may reduce the risk of death.
- Almost three-quarters of fatal crashes (74%) involved a head injury.
- Nearly all bicyclists who died (97%) were not wearing a helmet.
- Helmet use among those bicyclists with serious injuries was low (13%), but it was even lower among bicyclists
- Only one fatal crash with a motor vehicle occurred when a bicyclist was in a marked bike lane.
Nearly all bicyclist deaths (92%) occurred as a result of crashes with motor vehicles.
- Large vehicles (trucks, buses) were involved in almost one-third (32%) of fatal crashes.
- Most fatal crashes (89%) occurred at or near intersections.
- Nearly all (94%) fatalities involved human error. All New Yorkers, whether pedestrians, bicyclists or motorists,
can help prevent crashes by following traffic signs and signals and respecting other road users.
Men and some children face particular challenges.
- Most bicyclists who died were males (91%), and men aged 45 to 54 had the highest death rate (8.1 per million) of
any age group.
- Among children aged 5-14, boys had a much higher death rate than girls; Queens had the highest child bicyclist
death rate of the five boroughs.
Published online: 12 Sep 2019. Uses statistics from the National
Trauma Data Bank. "Results: Of the 76,032 bicyclists with head/neck injury, 22% wore helmets. The lowest was among
Blacks, Hispanics, and over 17 years old. Wearing a helmet significantly reduces injury severity, HLOS, ICULOS, and
mortality (i.e total and in-hospital). Males had more severe injury, longer HLOS, ICULOS, and higher mortality than
female. Blacks and Hispanics had longer HLOS and ICULOS and higher total mortality than Whites, but had a similar
chance for in-hospital mortality."
- Men were less likely than women to wear helmets (21 percent vs. 28 percent)
- Men spent more time in hospital than women, and their injuries were more severe
- Only 12 percent of injured cyclists under 17 were wearing a helmet.
Of 6,267 patients included in the study, 25.1% were helmeted. Overall 52.4% had severe
TBI, and the mortality rate was 2.8%. Helmeted bicycle riders had 51% reduced odds of severe TBI and 44% reduced odds
of mortality. Helmet use also reduced the odds of facial fractures by 31%. Conclusion: Bicycle helmet use provides
protection against severe TBI, reduces facial fractures, and saves lives even after sustaining an intracranial
The following 20 sports/recreational activities represent the categories
contributing to the highest number of estimated head injuries treated in U.S. hospital emergency rooms in 2009.
- Cycling: 85,389
- Football: 46,948
- Baseball and Softball: 38,394
- Basketball: 34,692
- Water Sports (Diving, Scuba Diving, Surfing, Swimming, Water Polo, Water Skiing, Water Tubing): 28,716
- Powered Recreational Vehicles (ATVs, Dune Buggies, Go-Carts, Mini bikes, Off-road): 26,606
- Soccer: 24,184
- Skateboards/Scooters: 23,114
- Fitness/Exercise/Health Club: 18,012
- Winter Sports (Skiing, Sledding, Snowboarding, Snowmobiling): 16,948
- Horseback Riding: 14,466
- Gymnastics/Dance/Cheerleading: 10,223
- Golf: 10,035
- Hockey: 8,145
- Other Ball Sports and Balls, Unspecified: 6,883
- Trampolines: 5,919
- Rugby/Lacrosse: 5,794
- Roller and Inline Skating: 3,320
- Ice Skating: 4,608
The top 10 sports-related head-injury categories among children ages 14 and younger:
- Cycling: 40,272
- Football: 21,878
- Baseball and Softball: 18,246
- Basketball: 14,952
- Skateboards/Scooters: 14,783
- Water Sports: 12,843
- Soccer: 8,392
- Powered Recreational Vehicles: 6,818
- Winter Sports: 6,750
- Trampolines: 5,025
*Note: Reported incidence is known to be significantly underreported (up to 50%, McCrea Clin J Sports med
13:13-17, 2004) and do not reflect those that are treated by family doctors or other para-medical professionals.
Childrens Hospital of Philadelphia, a 2022 study by Lawrence et al that should be published soon:
- Over 1 million U.S. children and teens — many of them male — have broken bones and fractured their skulls in
bicycle injuries over the past 20 years, according to new research that brought together two decades of data.
- Boys aged 10 to 15 were particularly at risk.
- Nearly 87% of kids with skull fractures were not wearing helmets.
- More than 65,000 children were injured in biking accidents involving motor vehicles.
- The investigators found an average of 50,975 fractures annually. About 71% of patients were male.
For the most part, fractures did decrease over the two decades. They increased in 2020, which was consistent with
other reports of a significant increase in injuries during the early part of the pandemic, when stay-at-home orders
were in effect and school and summer camps were canceled.
The findings were presented to the American Academy of Pediatrics (AAP) annual meeting in 2022. Findings presented at
medical meetings should be considered preliminary until published in a peer-reviewed journal.
Recreational sports and physical activities continue to increase in popularity, with an estimated 218.5 million United
States residents older than 6 years engaging in these activities in 2018.1 The benefits of sports for youth are well
established2,3; nonetheless, there are risks related to physical injuries, including morbidity and mortality from
traumatic brain injuries (TBIs). Injury rates from recreational sports among participants 5 years and older are highest
for children 5 through 14 years of age (76.6/1000 persons) and youth 15 through 24 years of age (55.6/1000 persons).4
Sports-related activities account for an increasing proportion of TBIs.5 Children and adolescents engage in a variety
of recreational activities using motorized and nonmotorized, wheeled devices, as well as engaging in nonwheeled
activities. Some recreational sports associated with risks for head injuries include bicycling,6,7 skiing and
snowboarding (henceforth collectively termed "snow sports"),8 ice skating,9 and equestrian sports.10
- From January 2006 through December 2015, more than 2.2 million children age 5 to 17 years were treated in US
hospital emergency departments (EDs) for bicycle-related injuries. This averages to 608 cases per day, or 25 every
- Most injuries (45.7%) involved children 10 top 14 years of age and boys (72%).
- Helmet users were less likely to injure head or neck (OR: 0.52) and be hospitalized (OR: 0.71).
- Motor vehicle involvement increased the odds of bicycle-related traumatic brain injuries (TBIs) (OR: 1.98) as
well as injury-related hospitalizations (OR: 4.04).
- The most common injury regions were upper extremities (36%), lower extremities (25%), face (15%), and head and
neck (15%). The most common types of injury were bruises and scrapes (29%) and cuts (23%).
- Overall, traumatic brain injuries (TBIs) represented 11% of total injuries and were most common among patients 10
to 14 years of age (44%). About 4% of patients were hospitalized.
[Source(s): Nationwide Children"s Hospital.
2008 National Highway Traffic Safety Administration data is broken down by state on their website, and
there is more detail available.
For 2008 child injuries, including state breakdowns, see this page on the NHTSA server.
Bicycle injuries and deaths affect children and young people more often than any other age group.
- In 2005, 44 percent of nonfatal bicycle injuries occurred in children and youth age 5 to 20.
- In 2005, the rate per million of nonfatal bicycle injuries in children and youth age 5 to 20 was 462.17 compared
to 153.3 overall.
- In 2005, children and youth age 0 to 20 made up 23.4 percent of bicycle fatalities.
- In 2005, the rate per million of bicycle fatalities in children and youth age 5 to 20 was 4.37 compared to 2.64
- In 2005, children under 15 accounted for 53 percent of bicycle injuries treated in emergency departments.
- From 1999 to 2002, the average annual cost of bicycle fatalities in children and youth age 0 to 19 was $1.03
- From 1999 to 2002, the average annual cost of nonfatal bicycle injuries in children and youth age 0 to 19 was
Young cyclists are more likely than adult cyclists to die of head injuries, most of which are caused by motor
vehicle collisions. Among children and youth age 0 to 19 in 2000:
- Head injuries accounted for 62.6 percent of bicycle fatalities.
- Collisions with motor vehicles accounted for 75.7 percent of bicycle fatalities.
- 61.7 percent of motor vehicle collision deaths were due to head injury.
Statistics from the US Consumer Product Safety Commission
CPSC staff has reports of an annual average of 80 children under 16 years of age who died in bicycle-related incidents
in recent years. About half of the 500,000 bicycle-related emergency room-treated injuries in 2007 involved children
under the age of 16. When taking part in other recreational activities, CPSC recommends that you wear the right helmet
for that activity. Their
"Which Helmet for Which Activity"
publication helps parents choose the most appropriate helmet.
And this from a CPSC web page:
Q. Which sport is most likely to crash-land you in a hospital emergency room?
A. Bike accidents crash-land more kids in hospital emergency rooms than any other sport. In fact, kids ages 5 to 14
get hurt more often than bikers of any other age! Every day, about 1,000 kids end up in hospital emergency rooms with
injuries from bikes - like broken bones or brain concussions. About one kid every day dies of these injuries. Others
suffer lifetime problems, like limping or brain damage.
Bicycle-Related Injuries Among Children and Adolescents in the United States.
Statistics from a 2008 article in Clinical Pediatrics
Mehan TJ, Gardner R, Smith GA, McKenzie LB. Clin Pediatr 2008; ePub(ePub): ePub. DOI: 10.1177/0009922808324952
Describes the epidemiology of US bicycle-related injuries among children and adolescents 18 years and younger. Analyzes
NEISS data for patients seen in emergency rooms 1990 to 2005 who were injured while operating a bicycle. During the
study period an estimated 6,228,700 individuals 18 years and younger were treated for bicycle-related injuries.
Children with head injuries were more than 3 (relative risk, 3.63) times as likely to require hospitalization and were
almost 6 (relative risk, 5.77) times more likely to have their injuries result in death. The authors concluded that the
large number of bicycle-related injuries indicates that prevention of these injuries should remain an important area of
bicycle safety research and practice.
Statistics from Safe Kids International
Please check their web page for their latest Fact Sheet on Bicycle
Injuries to Children
Deaths and Injuries
- In 2001, nearly 314,600 children ages 14 and under were treated in hospital emergency rooms for bicycle-related
injuries. Nearly half (47 percent) of children ages 14 and under hospitalized for bicycle-related injuries are
diagnosed with a traumatic brain injury.
- In 2001, children ages 14 and under accounted for 36 percent of bicyclists injured in motor vehicle crashes. It
is estimated that collisions with motor vehicles account for nearly 90 percent of all bicycle-related deaths and 10
percent of all nonfatal bicycle-related injuries
- More than 40 percent of all bicycle-related deaths due to head injuries and approximately three-fourths of all
bicycle-related head injuries occur among children ages 14 and under.
- Children can be seriously hurt from colliding with handlebars during a fall, even in low speed bike crashes. One
national study of seriously injured bicyclists found that handlebar impacts accounted for 22 percent of injuries
among nonhead-injured children. Improper bicycle sizing may predispose a child to falling and expose more of his
trunk to the handlebar.
When and Where Bicycle Deaths and Injuries Occur
- Children are more likely to die from motor vehicle-related bicycle crashes at nonintersection locations (74
percent), during the months of April through October (81 percent) and between 3 p.m. and 7 p.m. (55 percent).
- Nearly 60 percent of all childhood bicycle-related deaths occur on minor roads. The typical bicycle/motor vehicle
crash occurs within 1 mile of the bicyclist"s home.
- Children ages 4 and under are more likely to be injured in nonstreet locations around the home (e.g., driveway,
garage, yard) than are children ages 5 to 14.
- Children ages 14 and under are nearly four times more likely to be injured riding in non-daylight hours (e.g., at
dawn, dusk or night) than during the daytime.
- Among children ages 14 and under, more than 80 percent of bicycle-related fatalities are associated with the
bicyclist"s behavior, including riding into a street without stopping, turning left or swerving into traffic that is
coming from behind, running a stop sign, and riding against the flow of traffic.
Who is at Risk
- Riding without a bicycle helmet significantly increases the risk of sustaining a head injury in the event of a
crash. Nonhelmeted riders are 14 times more likely to be involved in a fatal crash than helmeted riders.
- Children ages 10 to 14 are at greater risk for traumatic brain injury from a bicycle-related crash compared with
younger children, most likely because helmet use declines as children age. Helmet use is lowest (for all ages) among
children ages 11 to 14 (11 percent).
- Correct fit and proper positioning are essential to the effectiveness of bike helmets at reducing injury. One
study found that children whose helmets fit poorly are at twice the risk of head injury in a crash compared with
children whose helmet fit is excellent In addition, children who wear their helmets tipped back on their heads have a
52 percent greater risk of head injury than those who wear their helmets centered on their heads.
- Children ages 14 and under are five times more likely to be injured in a bicycle-related crash than older
- Males account for 82 percent of bicycle-related deaths and 70 percent of nonfatal injuries among children ages 14
and under. Children ages 10 to 14, especially males, have the highest death rate of all ages from bicycle-related
Bicycle Helmet Effectiveness
- Bicycle helmets have been shown to reduce the risk of head injury and the risk of brain injury. Bicycle helmets
have also been shown to offer substantial protection to the forehead and midface.
- It is estimated that 75 percent of bicycle-related fatalities among children could be prevented with a bicycle
- Universal use of bicycle helmets by children ages 4 to 15 could prevent between 135 and 155 deaths, between
39,000 and 45,000 head injuries, and between 18,000 and 55,000 scalp and face injuries annually.
- Child helmet ownership and use increases with the parent"s income and education level, yet decreases with the
child"s age. Children are more likely to wear a bicycle helmet if riding with others (peers or adults) who are also
wearing one. In a national survey of children ages 8 to 12, 53 percent reported that a parental rule for helmet use
would persuade them to wear a helmet, and 49 percent would wear a helmet if a state or community law required
Bicycle Helmet Laws and Regulations
- Currently, 21 states, the District of Columbia and numerous localities have enacted some form of bicycle helmet
legislation, most of which cover only young riders. At least five states now require children to wear a helmet while
participating in other wheeled sports (e.g., for scooters, inline skates, skateboards).
- Various studies have shown bicycle helmet legislation to be effective at increasing bicycle helmet use and
reducing bicycle-related death and injury among children covered under the law. One example shows that in the five
years following the passage of a state mandatory bicycle helmet law for children ages 13 and under, bicycle-related
fatalities decreased by 60 percent. Police enforcement increases the effectiveness of these laws.
- One recent study reported that the rate of bicycle helmet use by children ages 14 and under was 58 percent
greater in a county with a fully comprehensive bike helmet law than in a similar county with a less comprehensive
Health Care Costs and Savings
- The total annual cost of traffic-related bicyclist death and injury among children ages 14 and under is more than
- Every dollar spent on a bike helmet saves society $30 in direct medical costs and other costs to society.
- If 85 percent of all child cyclists wore bicycle helmets in one year, the lifetime medical cost savings could
total between $109 million and $142 million.
- A review of hospital discharge data in Washington state found that treatment for nonfatal bicycle injuries among
children ages 14 and under costs more than $113 million each year, an average of $218,000 per injured child.
Fatality Statistics for School Children
From the FARS Database, USDOT
School-Aged Children (5-18) Killed in Traffic Crashes During the School Year
September 1, 1997 to June 15, 1998 Data from the Fatality Analysis Reporting System (FARS) U.S. Department of
School-aged Pedalcyclists killed between the hours of 6:00 AM to 8:59 AM and 2:00 PM to 4:59 PM
Alabama 0 Montana 0
Alaska 1 Nebraska 1
Arizona 3 Nevada 1
Arkansas 1 New Hampshire 0
California 5 New Jersey 0
Colorado 0 New Mexico 0
Connecticut 0 New York 1
Dist. of Col. 0 North Carolina 0
Florida 3 North Dakota 0
Georgia 2 Ohio 2
Hawaii 0 Oklahoma 0
Idaho 0 Oregon 1
Illinois 3 Pennsylvania 1
Indiana 0 Rhode Island 0
Iowa 0 South Carolina 2
Kansas 0 South Dakota 0
Kentucky 2 Tennessee 1
Louisiana 0 Texas 1
Maine 1 Utah 0
Maryland 2 Vermont 0
Massachusetts 0 Virginia 0
Michigan 5 Washington 3
Minnesota 0 West Virginia 1
Missouri 1 Wisconsin 0
Statistics from the City of Boston
Boston published a comprehensive study of how cyclists are being injured, and has plans to bring the injury rate down.
Highlights involving helmets:
- Helmets In EMS incidents where helmet usage was recorded, cyclists wore helmets in less than 50% of incidents.
Men wore helmets in 43% of incidents, women 60%. This is substantially lower than the citywide helmet usage rate of
72%, which includes variation by neighborhood.
- The difference between helmet usage citywide versus in EMS incidents may imply that those who wear helmets are
less likely to require EMS attention. Further, the varying helmet use by neighborhood may lead to disproportionate
rates of EMS incidents by neighborhood.
- Between 2010 and 2012, the Boston Police Department was not reliably recording helmet usage.
- A majority of the cyclist crashes that resulted in injury involved motor vehicles.
And here is Paul Schimek's thoughtful analysis of the findings including the frequency of types of crash causes.
Statistics from many sources in a literature review
A thorough literature review in 2018 by the UK's NCHAP project found that studies probably do not produce very accurate
numbers for injury reduction.
"Head injuries were, however, found to be significantly reduced in helmeted versus un- helmeted cyclists. Thompson et
al. estimated that helmet use is associated with head injury reductions of 63-88% (Thompson et al., 2006). Dorsch et
al. (1987) also estimated high reductions of 76% for AIS 1+ head injuries; however they estimated much more
conservative values for AIS 2+ head injury (45%) and AIS 3+ head injuries (42%). Cook and Sheik (2003 ) estimated that
helmets prevent 60% of serious head injuries. Wearing a helmet was found to halve the odds of a fatality compared to a
hospitalisation of a cyclist involved in a collision (OR 0.49) (Haworth et al., 2010)" You can find more
detail in the review
starting on page 8.
Statistics from the most recent study by Robert S. Thompson, MD, Frederick P. Rivara, MD, M.P.H., and Diane C.
We found no randomized controlled trials, but five well conducted case-control studies met our inclusion criteria.
Helmets provide a 66 to 88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists.
Helmets provide equal levels of protection for crashes involving motor vehicles (69%) and crashes from all other causes
(68%). Injuries to the upper and mid facial areas are reduced 65%.
Helmets reduce bicycle-related head and facial injuries for bicyclists of all ages involved in all types of crashes,
including those involving motor vehicles. Our response to comments from critics are presented in the Feedback
Plain Language Summary
Wearing a helmet dramatically reduces the risk of head and facial injuries for bicyclists involved in a crash, even if
it involves a motor vehicle.
Cycling is a healthy and popular activity for people of all ages. Crashes involving bicyclists are, however, common and
often involve motor vehicles. Head injuries are responsible for around three-quarters of deaths among bicyclists
involved in crashes. Facial injuries are also common. The review found that wearing a helmet reduced the risk of head
or brain injury by approximately two-thirds or more, regardless of whether the crash involved a motor vehicle. Injuries
to the mid and upper face were also markedly reduced, although helmets did not prevent lower facial injuries.
Note: this team was the original 1989 source for the 85 percent effectiveness number that BHSI now has updated to
the numbers above.
Forty studies were included in the meta-analysis with data from over 64,000 injured cyclists.
For cyclists involved in a crash or fall, helmet use was associated with odds reductions for head (OR?=?0.49, 95%
confidence interval (CI): 0.42-0.57), serious head (OR?=?0.31, 95% CI: 0.25-0.37), face (OR?=?0.67, 95% CI: 0.56-0.81)
and fatal head injury (OR?=?0.35, 95% CI: 0.14-0.88). No clear evidence of an association between helmet use and neck
injury was found (OR?=?0.96, 95% CI: 0.74-1.25). Conclusions: Bicycle helmet use was associated with reduced odds of
head injury, serious head injury, facial injury and fatal head injury. The reduction was greater for serious or fatal
head injury. Neck injury was rare and not associated with helmet use.
"Helmet use was associated with reduced risk of head injury in bicycle collisions with motor vehicles of up to 74%, and
the more severe the injury considered, the greater the reduction. This was also found to be true for particular head
injuries such as skull fractures, intracranial injury and open head wounds"
"A number of states passed legislation in the 1990s requiring youths to wear helmets when riding bicycles. The effect
of this legislation on bicycling fatalities is examined using data from the Fatality Analysis Reporting System. A panel
analysis is used to account for unobservable, time-invariant factors that may correlate with the incidence of laws
across states. A control-group methodology is used to control for time-varying unobservable factors that may correlate
with the implementation of laws within states. Timing issues are also explored. A helmet law reduces fatalities by
about 15% in the long run, less in the short run. There is no evidence of spillover effects (to adults) or substitution
effects (youths choosing other methods of transportation) associated with implementation of a helmet law. Through 2000
existing helmet laws have saved 130 lives. If all states had adopted helmet laws in 1975, more than 1,500 lives would
have been saved."
Stats from two Medical Journal Articles
This link is to the
medical journal article describing the Thompson and Rivara studies documenting the effectiveness of bicycle
. There are references at the bottom to other medical journal articles. This article is the authoritative
source most often quoted on the potential for injury reduction by wearing a helmet. It is also scorned by opponents of
helmet laws. Judge for yourself.
This link is to the abstract of
a second study by the same authors with somewhat different numbers for the effect of helmets in preventing head and
facial injuries, last reviewed and updated in 1999. "Helmets provide a 63 to 88% reduction in the risk of head, brain
and severe brain injury for all ages of bicyclists." BHSI"s parent organization, the Washington Area Bicyclist
Association, has asked Federal agencies to correct their use of the often-cited 85% number in the first article.
State level estimates of the incidence and economic burden of head injuries stemming from non-universal use of
bicycle helmets, by J Schulman, J Sacks and G Provenzano
"Approximately 107,000 bicycle-related head injuries could
have been prevented in 1997 in the United States. These preventable injuries and deaths represent an estimated $81
million in direct and $2.3 billion in indirect health costs. Estimates range from 200 preventable bicycle-related head
injuries and $3 million in health costs in Wyoming (population 480 000) to 13 700 preventable bicycle-related head
injuries and $320 million in health costs in California (population 32.3 million)." (There are numbers for other states
as well, but you have to buy the article for them.)
Annually in Sweden over 1000 cyclists have to visit an emergency care centre due to a head injury
after a bicycle crash (Stigson 2015). For Great Britain in 2018, the road casualty statistics indicate that 4205 pedal
cyclists suffered a serious injury or fatality - more than 11 per day. The hospital data for England Scotland and Wales
reveal that 18,546 pedal cyclists were admitted to hospital as the result of a transport-related accident between April
2018 and March 2019. Of these, based on previous matching of hospital and police-reported data, 78 percent are likely
to have sustained a head injury (Talbot et al. 2014). Thus, in Great Britain it is likely that 40 cyclists a day are
admitted for head injuries. In total 70 percent of the head injuries occur in a single bicycle crash (Stigson 2015).
Even though less than a fifth of the head injuries occur when a passenger car was involved, these crashes often result
in the most severe injuries.
Accident Analysis and Prevention
2018 Aug;117:85-97. doi: 10.1016/j.aap.2018.03.026. Epub 2018 Apr 17.
Bicycle helmets - To wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuries
Helmet statistics from the Norwegian Institute of Transport Economics
Alena Høye, Institute of Transport Economics, Oslo.
The use of bicycle helmets was found to reduce head injury by 48%, serious head injury by 60%, traumatic brain injury by 53%, face injury by 23%, and the total number of killed or seriously injured cyclists by 34%. Bicycle helmets were not found to have any statistically significant effect on cervical spine injury. There is no indication that the results from bicycle helmet studies are affected by a lack of control for confounding variables, time trend bias or publication bias. The results do not indicate that bicycle helmet effects are different between adult cyclists and children. Bicycle helmet effects may be somewhat larger when bicycle helmet wearing is mandatory than otherwise; however, helmet wearing rates were not found to be related to bicycle helmet effectiveness. It is also likely that bicycle helmets have larger effects among drunk cyclists than among sober cyclists, and larger effects in single bicycle crashes than in collisions with motor vehicles. In summary, the results suggest that wearing a helmet while cycling is highly recommendable, especially in situations with an increased risk of single bicycle crashes, such as on slippery or icy roads. Copyright 2018. Published by Elsevier Ltd.
Whilst the bulk of the insights and products of the survey will be published after the COST Action has been completed,
some preliminary results are provided now. As was expected, the data gathered from survey participants in different
countries reflected significant variations in cycling habits and use of helmets. Both the similarities and the
differences are important for general and country-specific implications.
Preliminary results from the survey offer important insights. The median distance cycled per week ranged from 30 km in
Israel to 150 km in Greece. The overall median distance among all participating countries was around 50 km per week.
More than 40% of all cyclists commonly rode city/hybrid bikes, 20% rode mountain bikes, and 15% rode road bikes. More
than 60% of respondents reported wearing a helmet "always" or "almost always", and nearly 30% report wearing them
"never" or "almost never". Thus, both use and non-use of helmets seem to be strong habits that transcend times,
situations, and locations. Approximately 25% of all respondents reported having been involved in at least one crash in
the past year, with the lowest frequency in the Netherlands (15%) and the highest in Australia (46%) and Spain (45%).
Among the most severe crashes, 53% were single-person accidents involving a fall. Less than 10% of crashes were
reported to police, and only 32% of cyclists involved in a crash with a motor vehicle reported their accident to
authorities. Further analysis of the complete survey results will be conducted to determine the influence of
demographics, bicycle types, and attitudes about bicycling and helmet usage. Correlations between these factors and
crash data will then be drawn.
How many cyclists sustain head/brain injury?
Stats from SWOV of the Netherlands
Annually, in the Netherlands, approximately 67,000 casualties of cycling crashes are treated at a first-aid department
(Source: Injury Information System LIS), 8,000 cyclists are admitted to hospital (Source: National Medical Registration
LMR), and 190 people die as a consequence of a cycling crash (Source Statistics Netherlands - Unnatural deaths). Of the
seriously injured bicycle casualties admitted to hospital, a third were diagnosed with head or brain injuries (32%).
Head injury is the general category and generally implies brain injury, but sometimes there is head injury without
And more from the same paper:
- Of the cyclists with serious injury who are admitted to hospital following a crash with motorized traffic, almost
half (47%) are diagnosed with head/brain injury. After crashes not involving motorized traffic this is the diagnosis
for just under one third (29%) of the cyclists.
- Proportionally, head/brain injury occurs most frequently among children and young people. In crashes with
motorized traffic more than 60% of the young seriously injured cyclists (0-17 years old) have sustained head/brain
injury; in the case of crashes not involving motorized traffic, the percentages range from 33 to 56% for these age
groups (compared with the 29% average).
- Approximately three-quarters of all head/brain injury sustained by are the result of crashes not involving
motorized traffic. For young children (0-5 years old) as many as nine out of ten head/brain cyclist-only crashes,
i.e. crashes without another road user being involved, or crashes into an object.
- The risk of head/brain injury in crashes not involving a motor vehicle is particularly high for children in the
age groups 0-5 and 6-11 years old; for cyclists over 65 the risk increases rapidly as they get older.
Research has shown that a bicycle helmet offers protection against sustaining serious head or brain injury in crashes.
The most reliable estimates indicate that at speeds of up to 20 km/h helmets reduce the risk of head injury by 42%, the
risk of brain injury by 53%, and the risk of facial injury by 17%, whereas they increase the risk of neck injury by
32%. These estimates are partly based on research carried out in countries like the United States and Australia, where
standards for bicycle helmets are stricter than they are in Europe and can offer protection at higher impact
Qualified by this
The European standard for bicycle helmets is not as strict as the standards in, for example, the US and Australia. At
the present European standard the helmet is adequate in cyclist-only crashes, but offers insufficient protection in
crashes involving other road users (Kemler et al., 2009). Therefore, the effectiveness of these non-European helmets
cannot simply be compared with the helmets used in the Netherlands.
"According to the Korea Road Traffic Authority, the number of bike accidents in 2013 was 4,249, but it
increased to 5,659 in 2017. In addition, head injuries were the most common among bike accidents between 2012 and 2016,
accounting for 38 percent, according to the Ministry of Health and Welfare."
Of the 2200 cyclists observed, 1109 (50.4%) wore a helmet. Males (OR = 0.78, 95%CI = 0.65–0.95), young adults (OR = 0.65, 95%CI = 0.51–0.84), visible minorities (OR = 0.38, 95%CI = 0.28–0.53), and bike-share users (OR = 0.21, 95%CI = 0.15–0.28) were less likely to be wearing a helmet, whereas children (OR = 3.92, 95%CI = 2.17–7.08) and cyclists using racing bicycles (OR = 3.84, 95%CI = 2.62–5.62) were more likely to be wearing a helmet. The majority (139/213; 65.3%) of assessed cyclists wore properly fitting helmets. Children had the lowest odds of having a properly fitted helmet (OR = 0.13, 95%CI = 0.04–0.41). Compared to 2011, helmet use during the pandemic increased significantly (1109/2200 (50.4%) vs. 2192/4789 (45.8%); p = 0.032).
Stats from the Canadian Institute for Health Information
Cycling injuries are by far the most common injury from
Canadian summer sports and recreational activity, accounting for half of all hospital admissions in this category. In
2009-2010, 4,324 Canadians were hospitalized as a result of a cycling injury, with close to half of these injuries
occurring in June, July and August.
While the annual number of cycling injury hospitalizations remained relatively stable between 2001-2002 and 2009-2010,
the number of cycling-related head injuries decreased significantly, from 907 to 665, over the same period. Among the
most severe cycling injury admissions of the past decade (those requiring admission to a special trauma centre), 78% of
those hospitalized with a head injury were not wearing a helmet when their injury occurred.
Statistics from Transport Canada
Most Canadian deaths were unhelmeted riders
Transport Canada statistics show that 88 per cent of the 80
cyclists who died nationwide in 2001 were not wearing helmets.
Stats from an article published in Pediatrics 2002; 110(5):e60.
In Canada, the bicycle-related head injury
rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and
territories that did not adopt legislation (27% reduction).
Statistics from the abstract of an article from JAMA, the Journal of the American Medical Association:
Bicycle Associated Head Injuries and Deaths in the United States From 1984 Through 1988: How Many Are
Jeffrey J. Sacks, MD, MPH; Patricia Holmgreen, MS; Suzanne M. Smith, MD; Daniel M Sosin, MD
Objective. -To estimate the potential benefits from more widespread bicycle safety helmet use.
Design.-Review of death certificates and emergency department injury data for 1984 through 1988.
Categorization of deaths and injuries as related to bicycling and head injury. Using relative risks of 3.85 and 6.67
derived from a case-control study and varying helmet usage from 10 per cent to 100 per cent, population attributable
risk was calculated to estimate preventable deaths and injuries.
Setting.-Entire United States.
Main Outcome Measures. -Numbers of US residents coded as dying from bicycle related head injuries, numbers of
persons presenting to emergency departments for bicycle-related head injuries, and numbers of attributable bicycle
related deaths and head injuries.
Main Results. - From 1984 through 1988, bicycling accounted for 2985 head injury deaths (62 per cent of all
bicycling deaths) and 905,752 head injuries (32 per cent of persons with bicycling injuries treated at an emergency
department). Forty-one percent of head injury deaths and 76 per cent of head injuries occurred among children less than
15 years of age. Universal use of helmets by all bicyclists could have prevented as many as 2500 deaths and 757,000
head injuries, i.e., one death every day and one head injury every 4 minutes.
Conclusions.-Effective community-based education programs and legislated approaches for increasing bicycle
safety helmet usage have been developed and await only the resources and commitment to reduce these unnecessary deaths
Statistics from the Institute for Traffic Safety Analysis
Traffic Fatality Trends in the US, UK and Australia: A Comparative Analysis
Riley Geary has compiled and
presented comparative fatality stats for the three countries. The format is stark, but easy to master in a few minutes,
and the results are illuminating. In injury reduction we are well behind Australia (mandatory helmets) and the UK
(fewer helmets than here). Is it possible that we are not doing something right?
The ITSA data has disappeared from the web for the moment.
The Potential for Cycle Helmets to Prevent Injury:
A Review of the Evidence
TRL Report PPR 446 - Findings
Assuming that cycle helmets are a good fit and worn correctly, they should be
effective at reducing the risk of head injury, in particular cranium fracture, scalp injury and intracranial (brain)
- Cycle helmets would be expected to be effective in a range of accident conditions, particularly:
- the most common accidents that do not involve a collision with another vehicle, often simple falls or tumbles
over the handlebars; and also
- when the mechanism of injury involves another vehicle glancing the cyclist or tipping them over causing their
head to strike the ground.
- A specialist biomechanical assessment of over 100 police forensic cyclist fatality reports predicted that between
10 and 16% could have been prevented if they had worn an appropriate cycle helmet.
- Of the on-road serious cyclist casualties admitted to hospital in England (HES database):
- 10% suffered injuries of a type and to a part of the head that a cycle helmet may have mitigated or prevented;
and a further
- 20% suffered "open wounds to the head", some of which are likely to have been to a part of the head that a cycle
helmet may have mitigated or prevented.
- Cycle helmets would be expected to be particularly effective for children, because:
- the European Standard (EN 1078) impact tests and requirements are the same for adult and child cycle helmets -
both use a 1.5 m drop height test; and so
- given that younger children are shorter than older children and adults, their head height would be within the
drop height used in impact tests, so a greater proportion of single-vehicle accidents are likely to be covered by the
Standard for children.
- No evidence was found for an increased risk of rotational head injury with a helmet compared to without a
- In the literature reviewed, there is a difference between hospital-based studies, which tend to show a
significant protective effect from cycle helmets, and population studies, which tend to show a lower, or no, effect.
Some of the reasons behind this were due to:
- the lack of appropriateness of the control groups used; and
- limitations in the available data, such as knowledge of helmet use and type of head injury.
UK - Reported death rates per billion passenger kilometres -2008 data
Death rate per billion passenger kilometres
BHSI Note: We do not know how they got to their billions of kilometers traveled numbers, a number that nobody has
been able to reliably estimate for cyclists in the US. We would also like to see this computed on the basis of exposure
hours, since cars travel so much faster on highways than bicycles. The numbers for motorcycles are interesting.
- Motorcycles: 88.8
- Walking: 30.9
- Bicycle: 24.2
- Car: 1.9
- Van: 0.5
- Bus or Coach: 0.1
- Rail: 0.3
- Water: 0.9
A translation of statistics from a publication of the French Consumer Safety Commission (Commission de la Securite des
Helmets for Cyclists
- Bicycle accidents occur two times out of three to children under 15.
- They occur mostly to boys (71% of the injured; 80% if you include 15 to 25 year olds)
- Accidents are associated with sports or leisure activities, close to home for the youngest group. Use of the
bicycle for transportation is also responsible for a large number of accidents, and of those a large number of
victims are over 65.
- Falls represent 90 per cent of the causes of the accidents.
- The head is hit in 38 per cent of the accidents. This figure rises to 55 per cent for infants of 1 to 5 years
and 48 per cent for those of 5 to 10 years.
- Contusions are the most important lesions in bicycle accidents (40 per cent of the cases). The rate of fractures
is equally large among children of 10 to 15 years of age and those over 65.
- The rate of hospitalization is high (18 per cent of the accidents). This figure rises to 30 per cent of the
people from 45 to 64 years old and 40 per cent of those over 65.
Bicycle vs. Other Activities
Statistics from the US Consumer
Product Safety Commission
Consumer Product Safety Review
Sports Head Gear
Estimated Emergency Room-TreatedBHSI note: Includes
Head Injuries for Selected Sports
any head injury, including areas not covered by helmets: ears, mouth, eyes and
|Est. Number of Head Injuries
||Est. Number of
Source: National Electronic Injury Surveillance System, CPSC
n/a = Sample size too small to report estimate.
Includes injuries suffered participating in the activity and/or patients wearing the apparel and equipment
associated with the activity.
Includes injuries to head, ears, mouth, eyes, and face.
*Includes cases where patient was admitted, was held for observation, was treated and transferred to another
hospital, was dead on arrival, or died in the ER.
This chart also appeared in a March, 2006 press release on a CPSC Helmet Guide.
Statistics from CPSC"s NEISS data
Injury Estimates for the Top 25 Product GroupingsTotal product-related injuries treated in hospital emergency rooms
From the 2007 NEISS Data Highlights
Stairs, Ramps, Landings, Floors 2,324,938
Beds, Mattresses, Pillows 560,129
Bicycles & Accessories 515,871
Chairs, Sofas, Sofa Beds 476,109
Bathroom Structures & Fixtures 330,102
Non-glass Doors, Panels 321,665
Tables, not elsewhere classified 309,252
ATV"s, Mopeds, Minibikes, etc. 278,671
Baseball, Softball 277,702
Exercise, Exercise Equipment 264,921
Desks, Cabinets, Shelves, Racks 262,171
Cans, Other Containers 248,126
Ladders, Stools 227,769
All Toys 224,827
Playground Equipment 219,625
Swimming, Pools, Equipment 155,322
Glass Doors, Windows, Panels 155,269
Workshop Manual Tools 131,396
Carpets, Rugs 128,361
Other Misc. Furniture & Accessories 122,662
To construct your own custom query for NEISS data, visit this CPSC page and be prepared to spend some time mastering the
intricacies of the database!
Statistics from the Dr Pietro Tonino of Loyola U. School of Medicine
Based on data from CPSC
Sports-related injuries presenting at US hospital emergency rooms.
Data for 2005. These would be the more serious injuries. There is no adjustment for exposure data to relate the number
of hours spent by US residents in each of the activities.
|Track & Field
Dr. Tonino"s study was reported in the Washington Post on June 19, 2006.
- Every year the estimated number of bicycling head injuries requiring hospitalization exceeds the total of all the
head injury cases related to baseball, football, skateboards, kick scooters, horseback riding, snowboarding, ice
hockey, in-line skating and lacrosse.
Statistics from American Sports Data
Comprehensive Study of Sports Injuries in the US
The teaser for this study (the site is dead now) indicates
that in the US in 2002 there were 51.7 million bicycle riders and they had 3.8 million injuries. Basketball led the
list with 5.3 million injuries, followed by football with 4.0 million. For injuries per 1000 participants, they rank
cycling fourth with 7.3, below basketball with 13.2, football with 32.3 and in-line skating with 11.4. Their numbers
include both emergency room visits and less serious injuries, which they say are five times more numerous than those
requiring emergency room care. They will sell you the full study for about $500 to $600. The teaser is an interesting
Old Statistics from Failure Analysis Associates
Injuries Associated with Example Items in 1989
(Chart copyright 1995 by FaAA, data repeated here because we have
not seen anything like it since and can"t find it any more on the web.)
||Number of Injuries
|Stairs, Steps, Ramps and Landings
|Bicycles and accessories
|Household Chemicals & Cleaning Products
|Doors (Not Glass)
|Pens and Pencils
|First Aid Equipment
|Combs or Hairbrushes
Note: Emergency room treated injuries projected from Consumer Product Safety Commission data... (rest is obscured on
And more estimates from the same source:
Estimate of Fatal Risk by Activity
||Fatalities per 1,000,000
|Living (all causes
|Cosmic Radiation from
|Home Living (active)
|Traveling in a School Bus
|Passenger Car Post-collision fire
|Home Living, active & passive (sleeping)
Data compiled by Failure Analysis Associates, Inc. (see Design News, 10-4-93)
For more recent stats please see Dom Nozzi"s Listing of Comparative
E-bikes and Powered Scooters
From the abstract:
Conclusions: E-bike and powered scooter use and injury patterns differ from more traditional pedal operated
- Riders injured using E-bikes were more likely to suffer internal injuries (17.1%) and require hospital admission
- Powered scooter injuries were nearly three times more likely to result in a diagnosis of concussion (3% of
scooter injuries vs 0.5% of E-bike injuries).
- E-bike-related injuries were also more than three times more likely to involve a collision with a pedestrian than
either pedal bicycles (OR=3.3) or powered scooters (OR=3.3)
- There was no evidence that powered scooters were more likely than bicycles to be involved in a collision with a
- Rates of pedal bicycle-related injuries have been decreasing, particularly among children, but reported E-bike
injuries have been increasing dramatically particularly among older persons.
Released in 2012.
A Gallup poll sponsored by the US Government to find out bicyclist and pedestrian behavior and attitudes. It took
four years to publish. If the link above does not work, please use
this one and then click on the Survey link under Pedestrians and Bicycles. (NHTSA often moves things, so you may
have to back up and start at their home page.) We consider the findings on riding
suspect because they are based on interviews rather than observational studies:
- Half (50%) of bicyclists wear a helmet for at least some trips, with 35 percent using them for all or most
- Nine of 10 support helmet laws for children, while 62 percent support such laws for adults. (Here is an excerpt from the study with details.)
- 46% of those 16 and older have regular access to a bicycle, with access increasing with increases in household
- 43 percent ride a bicycle at least once in the summer months, making an estimated 2.484 billion trips during the
summer of 2002.
- Bicycling declines with age, with those under 20 most likely to bicycle and doing so more frequently, while the
majority over 45 did not bicycle during the summer months.
- The majority of bicycling trips were for recreation or for exercise, while just one in 5 trips were made to
conduct errands (14%) or for commuting to work or school (5%).
- About half of all trips (48%) were made on paved roads. An additional 13 percent were on shoulders of paved
roads, and 5 percent on bike lanes on roads. One in 7 was made on sidewalks (14%) or bike trails/paths (13%).
- Only half (50%) of bicyclists say bike paths are available in the area they ride, while 32 percent say bike lanes
are available. However, over half of those who do not use available bicycle paths or lanes say they don"t use them
because they are not convenient, available, or go where they need to go.
- More than one in 10 bicyclists (13%) felt threatened for their personal safety on the most recent day they rode
their bicycle in the past 30 days in the summer of 2002, with 88 percent of these feeling threatened by
- One in 5 bicyclists rode in the dark or near-dark for at least part of their trip, with 63 percent of these
saying they took actions to make themselves more visible to motorists.
- About 4 percent of bicyclists or 2.04 million, were injured while riding in the past two years. About .5 million
of these were hit by a motorist.
- Half (50%) of bicyclists wear a helmet for at least some trips, with 35 percent using them for all or most
- Nine of 10 support helmet laws for children, while 62 percent support such laws for adults.
- Nearly half (48%) of those 16 and older are satisfied with how their local community is designed for making
bicycle riding safer. About as many (47%) would like to see changes including more bike lanes (38%) and bike paths
Note: BHSI does not endorse the optimistic findings of this next study! In addition, the total number of riders
killed cited in point two has not been accurate for a decade, and current deaths each year are closer to 600.
Statistics from the Consumer Product Safety Commission
- Bicycle helmet usage has increased from 18 percent in 1991 to 50 percent in 1998
- Bike-related crashes kill 900 people every year and send about 567,000 to hospital emergency rooms with
- Wearing a bike helmet can reduce the risk of head injury.
- Today there are an estimated 80.6 million riders, 43 percent of whom never wear helmets and 7 percent of whom
wear helmets less than half the time
- Of bikers who now report wearing a helmet, 98 percent said they wore a helmet for safety reasons, 70 percent said
they wore a helmet because a parent or spouse insisted on it and 44 percent said they did so because a law required
- 69 percent of children under 16 wear a helmet on a regular basis while riding a bike, according to parents.
- 38 percent of adult bike riders regularly wear their helmets.
Here is the Press Release on the study
, and here is the whole text
. There are other estimates
further down this page that we consider more realistic for the nation as a whole. For example, the University of North
Carolina has conducted reliable observational studies showing a statewide helmet usage rate of 17 per cent. On the
other hand, usage observed in Seattle in 1998 was 60% for children, 37% for teens and 71% for adults. Helmet use in
western Washington state is 56%, but just 33% for eastern Washington where helmet promotion campaigns have not been as
intense. (Source: Diane Thompson, MS, Epidemiologist, Harborview Injury Prevention & Research Center)
Statistics from a publication of the U. S. Consumer Product Safety Commission.
Bicycle Use and Hazard Patterns in the United States
Note: We recommend caution in using these figures, since a number of people in the bicycle community questioned
the validity of the survey techniques used for this study. - BHSI
The exposure survey found that only 11.8 million (18 percent) of the entire population of about 67 million
bicyclists wear helmets all or most of the time. Another 6 percent, representing about 4 million riders, reported that
they wear helmets sometimes, but less than half of the time.
The proportion of children under age 15 who wear helmets all or most of the time was about 15 percent. HF reports
(in part IV) that the low usage rate for children may be partly related to peer pressure. Some studies show that
children are not inclined to wear helmets if their social group disapproves of helmet use. However, helmet use in all
age groups appears to be increasing. Just over half of the current users (53 percent) began wearing helmets in the last
And here is Michael Ravnitzky"s article on how to get better statistics from
Usage Data from Actual Observation of Cyclists in Portland
Portland, Oregon, has been tracking bicycle traffic and
helmet use since 1992, building a unique database. Their link to their 2008 report is broken, but this
page mentions the report
. It has a chart of helmet use by year, and in the appendices are charts by year and
gender. Their summary: "Helmet use is at an all-time high, and has risen steadily since the 1990"s. In 2008, 80% of
recorded cyclists wore helmets, up from 63% in 1997 and 76% in 2007." The helmet counts track weekday transportation
cyclists, not weekend recreational riders who would be likely to have lower helmet use. The numbers are impressively
high, but most US communities should have higher helmet use rates for commuter and transportation cyclists.
Usage Data from Actual Observation of Cyclists in Alaska
"Our department initiated a project during the summer of
2000 to document the observed use of bike helmets in communities around Alaska. We needed to develop a statistical
baseline of helmet use. The data is preliminary, but it looks to be a 35% use rate in larger places (Anchorage,
Fairbanks, Juneau), about 17% in smaller cities, and almost non-existent in rural areas." Source: David Thomson, Health
Program Manager, Community Health & EMS, Alaska Division of Public Health
Usage Data from Actual Observation of Cyclists in Seattle
"Here in Seattle our OBSERVED helmet use in 1998 was 60%
for children, 37% for teens and 71% for adults. We use a formal sampling scheme to select observation sites and then
count helmet use among the bicyclists riding by. These observations have been done almost yearly since 1985. We also
have had a very effective multifaceted helmet campaign plus legislation in the area surrounding Seattle. Helmet use in
Washington state is 56% for western WA and 33% for eastern WA where campaigns have not been as intense. Helmet use does
vary by area, but at least here the numbers are good and improving slowly." Source: Diane Thompson, MS, Epidemiologist,
Harborview Injury Prevention & Research Center, Seattle, WA. By email, April 23, 1999.
Usage Data from Actual Observation of Cyclists in Duval County, Florida
The Duval County Health Department
estimates that "for every bike injury prevention intervention dollar ($1) spent in Jacksonville, FL an estimated $23.46
is saved in medical costs, public programs, property damage, future earnings and quality of life by our residents.
2000 Duval County Helmet Usage Rate:
- Under 5 years old: 100%
- 5 to 10: 74.3%
- 11 to 13: 31.1%
- 14 to 17: 0%
- 18 to 30: 25.4%
- Over 30: 30.2%
2001 Duval County Helmet Usage Rate:
- Under 10 years old: 64.7%
- 11 to 13: 17.9%
- 14 to 29: 35.4%
- Over 30: 26.6%
Observed usage rates in two cities in Broward County:
- Ft. Lauderdale: 25%
- Hollywood: 15%
Duval County Bicycle Fatality Rates
Per 100,000 riders
Conclusion: 58% reduction since the Duval County bike safety program geared up.
Usage Data from Actual Observation of Cyclists in Hawai'i
Helmet Use in Hawai'i
Source: Hawai'i Dept of Transportation
This study was based on observations at 136 sites on the islands of
O"ahu, Maui, Kaua"i and the Big Island.
BHSI note: we do not know why the variations are so large from year to year.
1997: 26 per cent
Usage Data from Actual Observation of Cyclists in Alberta
Alberta data from the summer of 2002,
Usage Rate Statistics from The National Survey of Children"s Health
Use this page
and search for "Helmets" either by State or by National level. Children 6 to 17 years old wearing helmets
Always (38%) or Usually (15%) would total to 53% usually in helmets. The state breakdowns seem to track those numbers.
In the subgroup breakdowns the high income group are reported as "Always" wearing helmets 48% of the time, with the
lowest income group at 32%. Nationwide the 6 to 11 year old group are reported wearing helmets usually plus always as
Statistics from the State of Utah
In 2004 the State of Utah published a ten year
observational study of helmet use in Utah
. It has pages of interesting statistics on helmet use by age groups as
well as crashes.
Surveys have shown that 75% to 81% of League members always wear helmets when they ride, and another
9 to 13% wear them most of the time.
Statistics from Consumer Reports
A risk survey conducted in 2008 and published in 2009 by Consumer Reports
concluded that 58 per cent of American
cyclists never wear helmets. It also showed that 24 per cent sometimes do not fasten their seat belts. Here is
the press release describing the article
. The survey is available to subscribers on the CU website.
Usage data from a Consumer Reports poll
A Consumer Reports poll taken in March 2009 found that "82 percent
said they felt it was "very" or "extremely" important to wear a helmet while cycling, but only 44 percent said they
would actually wear one." We can't find it on the web now.
Usage data from a CDC poll of high school students
The US Centers for Disease Control reports that its National Youth Risk Behavior Surveillance System
2009 that the percentage of high school students who rarely or never used a helmet while bicycling was 84.7 percent.
The rate has improved since 1991, when it was 96.2 percent. We have a slide from
Stats from a 2003 Swedish literature search
Sweden has conducted an international literature search, summarized in
a study published in 2003. (See page four for the English abstract.)
They found that helmet laws can achieve
level of usage not achieved by education alone, that helmet laws reduce head injuries, and that helmet laws can result
in a reduction of cycling by young people. We have the abstract up on our site
this article in the Korea Times
Stats from a 2009 article on Korean helmet use
indicates that 3 percent of Korean children now wear helmets, and "In 2008, bicycle accidents accounted for 14 percent
of traffic accident victims with 46 percent of them being under 20 years old." They go on to give some numbers for the
US: "In the United States, the helmet-wearing rate was 3.8 percent in 1991, but education and guidance campaigns raised
the rate to 14.9 percent in 2007." We do not know their source for that.
Stats from an Aussie study of helmet use and injuries
A study from the Government of Western Australia Department
of Health showed that helmet use had reduced the incidence and severity of head injuries there. It is based on hospital
data, and shows that the number of closed head injuries was cut in half with increased helmet use over time, though
other injuries did not change significantly in number. The head injuries were less serious, and hospital stays were
shorter. We have lost the link to the study.
San Francisco usage data
From the San Francisco Municipal Transportation Agency:
71 Percent of SF cyclists wear bike helmets.
Reported July 25, 2011 in
a blog of the San Francisco Examiner.
Boston Statistics from Scott Osberg
I just got back from 3 weeks of counting bicycle helmets in Boston"s Back Bay. I replicated my 1996-97 observations
and preliminary analyses indicate helmet use is holding steady at around 31-35 percent. Considering the huge medical
and public health communities in Boston and the affluence of Back Bay where I collected the data, one would certainly
expect helmet use among riders there to exceed any national average.
Stats from Bell Sports" Bell Mile Marker, December 2005:
"From a survey Bell conducted last year, we know
that nearly 60% of kids don"t wear helmets when they ride bikes." Note: last year would have been 2004.
Cost of Injuries
Economic Statistics from the Children"s Safety Network
BICYCLE HELMETS SAVE MEDICAL COSTS FOR CHILDREN
Annually, 196 children younger than age 15 die from bicycle-related
injuries. Approximately 8,900 additional children were hospitalized for bicycle-related injuries, and another 344,000
were treated and released in emergency departments. Bicycle helmets prevent 52 to 60 percent of bike-related head
injury deaths (for all ages), as well as an estimated 68 to 85 percent of nonfatal head and scalp injuries, and 65
percent of upper and middle face injuries, even when misuse is considered. Thus, bicycle helmets significantly reduce
the total medical costs for bike-related head injuries. (Note: BHSI usually quotes
a later study showing that "helmets provide a 63 to 88% reduction in the risk of head, brain and severe brain injury
for all ages of bicyclists.
A. Costs Saved
- Every $10 bike helmet generates $570 in benefits to society. (Although the retail cost of bicycle helmets
typically range from $10 to $70, nonprofit organizations can buy them in bulk for as little as $7 and distribute them
nearly at cost.)
- These savings include $50 in medical costs, $140 in future earnings and other tangible resources, and $380 in
quality of life costs.
- For each child bicycle helmet law that is passed, it costs $11 per new user and generates $570 in benefits to
- If 85 percent of all child cyclists wore helmets in 1 year, the lifetime medical cost savings would total $197 to
- It is very expensive to treat a child with a bike-related head injury. These medical costs may sometimes last the
child"s lifetime. For example, in 1991, bicycle crashes to children ages 4 to 15 caused 52,000 nonfatal head injuries
and 93,000 nonfatal face scalp injuries. Lifetime medical payments for these injuries will approach $394
- 2,200 of the children who sustain these head injuries will suffer permanent disabilities that will affect their
ability to work. Universal bicycle helmet use by children aged 4 to 15 would prevent 1,200 to 1,700 of these
permanently disabling injuries.
- Every bicycle helmet saves health insurers $57 and auto insurers $17.
- These cost savings estimates may be conservative, as they ignore other significant benefits. For example:
- Parents will spend less time and money caring for injured children.
- Lawyers will file fewer lawsuits seeking compensation for child cyclists" injuries.
B. LIVES SAVED AND INJURIES PREVENTED
- Universal bike helmet use by children aged 0 to 14 would prevent 212 to 294 deaths annually.
- Universal bike helmet use by children aged 0 to 14 would prevent 382,000 to 529,000 bicycle-related injuries
C. BICYCLE HELMET USE
- Helmet use among children aged 14 and younger is approximately 15 percent nationwide.
- Parents report that 85 percent of children who own bicycle helmets wear them. The usage rate does not vary by
Note: All costs are in 2004 dollars and were computed using the methodology outlined by Miller, Romano, and
Spicer. Numbers may not correspond to totals due to rounding.
These numbers are from Childhood Injury Costs &
Children"s Safety Network Economics and Data Analysis Resource Center
(www.edarc.org) Phone: 301-755-2728 E-mail: email@example.com
Pacific Institute for Research and Evaluation
11720 Beltsville Drive, Suite 900, Calverton, MD 20705 Rev: 10/05
- In 2010, the number of people injured by NOT wearing a bike helmet was 51,000--enough people to fill Nationwide
Arena in Columbus 2 1/2 times.
- Currently in Ohio, estimates indicate that just 10-20% of children wear bike helmets, yet more than 70 percent of
children ages 5 to 14 ride a bicycle regularly.
- 75 percent of bike-related fatalities would be prevented with a helmet. Helmet use can reduce the risk of head
injury and severe brain injury.
- Apart from the automobile, bicycles are tied to more childhood injuries than any other consumer product,
including trampolines, ladders and swimming pools.
- Universal use of bicycle helmets by children ages 4 to 15 could prevent between 135 and 155 deaths, between
39,000 and 45,000 head injuries, and between 18,000 and 55,000 scalp and face injuries annually.
- A $10 bike helmet saves healthcare system $41 per child.
- If 85 percent of the children injured in the U.S. per year wore helmets, we could save up to $256 million in just
Statistics from the Bicycle Helmet Safety Institute
Mandatory Helmet Laws
We know of 22 state laws (including the District of Columbia) requiring minors to wear
helmets while bicycling, and more than 201 local ordinances, some of which cover all ages. Please check our page on mandatory helmet laws
for more current info.
Motorcycle Helmet Laws
Depending on the particular measure that is employed, states with universal helmet laws
have motorcyclist fatality rates that are on average 22-33% lower in comparison to the experience with no helmet law.
Additionally, partial coverage helmet laws are associated with reductions in motorcyclist fatality rates of 7-10%, on
There is no good free public source of current helmet market data that we know of.
If you are researching the helmet market and call us to ask about these numbers we will not have anything to add to
what is on this page! That goes for the Usage Rate numbers above as well. When we find out
anything new, it appears here within hours.
Statistics from various sources gathered
by the Bicycle Helmet Safety Institute
How Many Helmets are Sold Each Year?
(This section was updated in 2020)
We have asked many manufacturers if they had a good estimate of how many helmets are sold in the US market each year.
If they do have that info, they are not sharing it. So we are reduced to reporting rumor and speculation on this
subject. The best guesses we have found are in the 12 to 15 million helmets per year range. For 2017 dollar amounts,
see the Open PR estimate below. The bulk of those would be mass merchant sales, rather than the helmets sold in bike
shops. The 4,800 bike shops in the US market were rumored to sell about 700,000 helmets in the May-June-July quarter of
2009. In the September 1, 2010 issue of Bicycle Retailer and Industry News, Easton-Bell"s Greg Shapleigh is
quoted saying that they sold 11 million helmets in 2009 "across all brands and categories." That would include bike,
hockey, football, snow and baseball helmets, but BRAIN reported that "the majority of those were for cycling." The
article was not on BRAIN"s website when we last checked on September 3,
2010. But BRAIN published new numbers in its October 1, 2010 issue, attributed to the Leisure Trends Group. Based on a
year that started in July 2009 and ran through June 2010, they estimated 1,661,036 helmets sold by bike shops totaling
$88,573,775. From January 2010 to June 2010 they estimated a 6.64% decline in unit sales and a 3.00% decline in dollar
value. The numbers included adult, child and helmet accessories. They did not estimate helmet sales by big box stores.
Here is the article in Bicycle Retailer and Industry News where the numbers
The National Bicycle Dealer"s Association may have more numbers, but you have to pay
for their annual US Bicycle Market Report. It was $700 for non-members the last time we checked, and we could not
publish the numbers here in any event.
In addition to the US, our best rumors on the size of the global helmet market put the total at about 50 million
helmets per year. Three very large Chinese OEM manufacturers who make helmets for other brands account for about half
of that. But some of the numbers cited by US brands are included in that 25 million, since many US-branded helmets are
made by Chinese OEM manufacturers.
We do not have precise price trend information either. We noted a small price increase in advertised mass merchant
sales prices in our area after 2000, ending in mid-2004 when Wal-Mart began marketing a helmet for $7.14, and others
followed. In the May 1, 2002 issue of Bicycle Retailer and Industry
News, reporter Matt Wiebe said that helmet sales in the US for 2001 totaled $150 million. He did not identify
his source for that estimate, but in the next paragraph he did quote then Bell Sports President Bill Fry. The NBDA says
helmet sales increased by 4% in dollars and 2% in volume in 2014, indicating a modest price rise.
In 2020 a company called Market Study Report published Global Helmets Market Growth
2020-2025 with some actual teaser numbers in their web description: "According to this study, over the next five
years the Helmets market will register a 2.6% CAGR in terms of revenue, the global market size will reach $ 5796.4
million by 2025, from $ 5240.6 million in 2019. We think CAGR is for Compound Annual Growth Rate. There is a full study
description at the link.
Bell Sports informed us that they manufactured more than four million bicycle helmets per year in the US in 2002-03
although they have some models made in Asia. They did not give us total sales.
If you need very old market estimates for comparisons, back in 1990, Bell Helmets was good enough to share
with us their market estimates for total industry sales of bicycle helmets for 1989-1990. We were grateful to have
these numbers from Bell, since they were not available to us elsewhere, and still are not. Bell cautioned at the time
that the usage rates, which they referred to in marketingspeak as Usage Penetration rates, were approximate.
Industry-wide helmet sales (millions)
||2.5 to 3.0
||3.5 to 4.0
Open PR 2017 statistics on World-wide helmet sales
We don't quite know what to make of the study advertised for
sale on the
site that appeared in November of 2018. There are teasers advertising the study, including this one with a
prediction of the global market and projecting a compound annual growth rate:
"The worldwide market for Helmet is expected to grow at a CAGR of roughly 1.5% over the next five years, will reach
5590 million US$ in 2023, from 5130 million US$ in 2017."
There are also stats on the percentage of national market share. We are not familiar with the source and don"t know
anything about the quality of their research.
Reporting on the NSGA"s 2015
edition of its Sporting Goods Market report. The report was published in mid-2015 and covers 2014 sales: "Bike helmets
were up 4 percent in dollars and 2 percent in units. Total dollar sales for helmets were $195 million last year."
The estimates are based on an annual online survey of more than 15,000 households. See the BRAIN article for more info
Statistics from Leisure Trends:
Helmet sales (bike shops): 12 months ending July 2014
- 1.8 million units sold (+7.2%)
- 1.5 million adult/.3 million kids
- $104 million value (+7%)
- Average Retail Price $56.50
- Top Brands: Specialized, Giro, Bontrager, Bell, Bern
Reported at Interbike 2014.
A Look At Some Of The Bicycle Industry"s Vital Statistics
The U.S. bicycle industry is approximately a $6
billion per year industry, counting the retail value of bicycles, related parts, and accessories through all channels
of distribution, according to the National Bicycle Dealers Association. Bicycle sales for the U.S., including both the
dealer and mass merchant channels are as follows:
Million Bicycles Sold
(* indicates projections)
Year 20" wheels All wheel
and above sizes
2005 14.0* 19.8*
2004 13.0* 18.3*
2003 12.9* 18.5*
2002 13.6* 19.5*
2001 11.3* 16.7*
2000 11.9* 20.9*
1999 11.6* 17.5*
1998 11.1* 15.8*
1997 11.0* 15.2*
1996 10.9 15.4
1995 12.0 16.1
1994 12.5 16.7
1993 13.0 16.8
1992 11.6 15.3
1973 15.2 (record high year)
Source: Bicycle Manufacturers Association
Bicycles and related products appeal primarily to a recreation market in the United States, though there is an
influential and growing number of people using bicycles for transportation.
Bicycle usage is at an all-time high, with over 100 million U.S. bicycle owners, a figure which has grown
substantially each year since 1983, according to the Bicycle Institute of America. Of that 100 million, 55 million were
adults (age 16 and up), while 45 million were children. 31 million adults rode regularly, defined as at least once a
week. There were about 4.9 million bicycle commuters, 250,000 bicycle racers, 25 million mountain bike/hybrid riders,
1.7 million bicycle tourers, and 3.8 million participants in recreational bicycle events.
How Many Cyclists are there in the US?
2017 Statistics from Bicycle Retailer and Industry News:
See their August 2017 stats issue
. There are finally polls that recognize the
differences in responses from "occasional" riders and the more frequent ones. Covers the percentage of US residents
with no access to a bicycle, for instance.
Older stats reported by Bicycle Retailer and Industry News June 1, 2009)
BRAIN reported stats from the National Sporting Goods Association used mail surveys to a panel of 10,000 households to
estimate that riders over six years old who rode six or more times per year were:
2000 43.1 million
Of the 44.7 million, 42.5 percent reported that they rode between six and 24 days during the year.
(BHSI thinks bike riders are not very accurate when asked by pollsters about their riding.)
Below are some rare stats that a manufacturer actually published, but they date back to the mid-1990"s and the
manufacturer is no longer in business.
Old Statistics from the Headstrong Group:
How Many Helmets are Sold Each Year?
From Headstrong Group (no longer in business--this is old stuff!)
Market Share of Some Major Manufacturers:
Manufacturer 1993 1994 % 1995 est.
Bell Sports 3,000 4,000 40% 4,500
Cycle Products1,500 2,000 20 2,000
Headstrong 1,700 17 3,300
Troxel 1,500 1,000 10 1,000
Other 1,000 1,300 13 2,200
----- ----- -----
Total 7,000 10,000 13,000
Note: The brochure where this chart appears did not make it clear whether these estimates are for the U.S., North
American or World helmet markets. It also does not say whether or not it includes the non-bicycle part of Headstrong"s sales of
baseball, equestrian, ski, snowboard and skating helmets. Source is cited as "Various industry reports and internal estimates."
Whatever the accuracy of the figures, we are indebted to Headstrong Group as the only manufacturer to publicly publish their
Old numbers from the Bicycle Market Research Institute
How Many Active American Cyclists are There?
(As reported in Bicycle Retailer and Industry News
- There are 58.7 million Americans who are active cyclists.
- Thirty percent of them live in California, New York and Illinois.
- California accounts for 14.5 percent of the nation"s riders and 18 percent of all its mountain bike riders.
These numbers are much lower than others often cited, including those from the U.S. Consumer Product Safety Commission.
We do not have the definition of "active cyclist" to confirm how the total was reached. This data was contained in a
study titled BIKETRAC Bicycling Participation and Usage Study sold by BMRI at that time.
How do dealers regard helmet brands?
The NBDA once posted the results of a dealer survey rating helmet brands by consumer demand, availability,
profitability, marketing support, etc. The Consumer Demand rankings were Giro, Bell, Pro-tec, Specialized, Trek, Louis
Garneau and Vigor. The dealers ranked the product lines in order Giro, Specialized, Bell, Louis Garneau, Vigor, Trek.
We can"t find it any more on the NBDA site, and did not note the year.
Other Pages to Check
Statistics you can buy
We have not seen any of these reports and don't know anything more about any of
Bicycle Retailer and Industry News
reported on available stats in February, 2022. They recommend starting with
customs statistics and say about half way down this page: "There are two other major sources of data for the U.S.
market. Both are behind paywalls that prevent BRAIN from publishing more than snippets on occasion. However industry
members can access more of this data by contracting with The NPD Group
." This is a much more authoritative recommendation
than anything we could produce.
Intelligence has a report titled Global Luxury Road Biking Helmet Market Status, Trends and COVID-19 Impact Report
2021. Their description: "The Global Luxury Road Biking Helmet market study provides details of recent developments,
trade regulations, value chain optimization, market share, impact of established and emerging market players, analyses
gaps in terms of untapped business segments, regional territory and regulations, growth analysis pattern, driving
forces, new developments, influencing trends, innovations and challenges in the market." The .pdf has 120 pages. The
cost is $2350.
QYResearch Reports has another report you can purchase titled "Global Cycling Helmet Market Research Report."
NPD Group has reports on cycling products including
helmets. Their website says they have "offices in 30 cities across the Americas, Europe, and Asia-Pacific."
Hive Research has a 2022-2027 Global and Regional Bike Helmet Industry Status and Prospects Professional Market
Research Report Standard Version that covers both bicycle and motorcycle helmet markets. The cost is about $3,500.
Journalist Observer has a 2019 report titled Global Youth Helmet Market 2019 for sale for an undisclosed
price. It tracks the youth helmet market.