Protect Head And Face Although Studies Show Certain Limitations, Protective Headgear Reduces Injuries

Wearing a helmet while bicycling or in-line skating is a good idea, but one medical school professor believes the protective gear has its limitations.

Although helmets help reduce the risk of brain injury and protect the upper two thirds of the face, they don’t help the rest of the face, Dr. Frederick P. Rivara said.

Rivara, a professor of pediatrics at the University of Washington School of Medicine, is director of Seattle’s Harborview Injury Prevention Research Center and has done extensive research on helmets and safety.

In one study, Rivara and his colleagues looked at data on bicycle accident victims brought to seven Seattle emergency rooms between March 1, 1992 and Aug. 31, 1994. Seven hundred had serious head injuries, including fractures. Helmets had been worn by 47 percent of the 700.

Overall, riders with helmets had a 50 percent lower risk of facial injury, the study found. But some parts of the face got off better than others, Rivara said.

Helmets decreased injury risk by 65 percent from the forehead to the nose but did not decrease risk for the rest of the face, he said.

Helmets overhang the forehead enough to provide some protection when a biker’s face hits an object or the ground, Rivara said. But ordinary bike helmets don’t have the full-face protection found on motorcycle helmets or some mountain biking helmets, he said.

The gap in protection is important because about one third of bike injury cases seen in emergency rooms involve the face, he said.

Riders could reduce some of the overall head risk just by making sure their helmets fit right, Rivara said. In a separate report based on 1,717 emergency room cases, people who reported their helmets fit poorly had almost double the risk of head injury compared with those who said their helmets fit well.

A helmet should sit squarely and snugly on the head, so an accident can’t tilt it toward the back, exposing more of the forehead, Rivara said.

Proper fit is especially a problem for children. Researchers examined the fit in children riding in a Seattle area bicycling event and found more than three quarters had only a fair to poor fit.

“Parents should buy the right size, and not something (children) grow into,” Rivara said.

A multipurpose helmet can work for biking, inline skating and skateboarding, avoiding the need for a separate helmet for each sport, he said. Multipurpose helmets have thicker impact-absorbing foam linings and extend farther down the back of the head than do bike helmets.

Rivara suspects bike helmets may do as well as multipurpose helmets for in-line skating.

“My kids use their bike helmets to go roller skating,” he said.

But another helmet safety expert cautions that using a bike helmet for such things as skating may be risky for more people who attempt more daring tricks on wheels.

These people are more likely to fall, and multipurpose helmets are better designed to absorb some small falls, said Stephen D. Johnson, general manager of the Snell Memorial Foundation, which sets safety standards for helmets.

Kids on skates have a greater tendency to fall backward than do bike riders, so they may need the multipurpose helmets’ extra protection in the rear of the head, he said.

However, skaters who stick to the road and avoid tricks can get probably as much benefit from a bike helmet, said Randy Swart, director of the Bicycle Helmet Safety Institute in Arlington, Va.

MEMO: Two sidebars appeared with the story: 1. MAKE SURE THE HELMET FITS THE PURPOSE The right product for the activity with the proper fit is the best formula when purchasing a helmet. Although many consider a good bicycle helmet to be an all-purpose head protector, local sales personnel stress the importance of selecting a helmet for the purpose. For instance, better bicycle helmets for children “are designed to wrap around the head more, and some cover the ears,” said Jeff Hunt, a sales specialist at REI. And while your kid may only ride on the streets, looking into a helmet designed for mountain biking may be the answer, since they provide better overall protection, Hunt noted. The more expensive bicycle helmets for road wear have adjustment straps that lock down the helmet in the back of the head and have more ventilation. Mountain bike racing helmets, like ski-racing helmets, also provide full-face and jaw protection. While most in-line skaters use bicycle helmets, those who play in-line hockey need full head and face protection, which equates into a helmet designed for ice hockey.

2. PRICE OF SAFETY Some general helmet prices in the Spokane area: Road bike: $16-$90 Mountain bike: $30-$130 Mountain bike racing: $325 In-line skating: $44-$75 Canoe-kayak: $32-$50 Skiing: $62-$300+

SOURCE: REI, Eagles Ice-A-Rena Sports Shop