State Law Triples Use of Bicycle Helmets By Children, Helps Eliminate "Dorky" Factor

BUFFALO, N.Y. -- If you want kids to wear bicycle helmets, pass a helmet law because gentle persuasion doesn't work.

This appears to be the message from a three-year study headed by Kathleen Lillis, M.D., a pediatric emergency medicine specialist at the University at Buffalo.

Lillis reported Sunday (May 4) at the annual meeting of the Society for Pediatric Research that the percentage of children owning and wearing a helmet while riding a bicycle tripled during 1995, the first full year New York State's helmet law was in effect, compared to 1993.

An assistant professor of pediatrics at UB and medical director of emergency medicine at Children's Hospital of Buffalo, Lillis treats the injuries children suffer in bicycle accidents, the most serious of which are head injuries.

Working with a pediatric outreach coordinator, Lillis and colleagues in 1993 initiated an in-school bicycle safety program to educate students about the importance of wearing helmets. The students answered 10 questions about helmet ownership, use and bicycle safety.

In mid-1994, 18 months into the study, New York State passed a law requiring all children under the age of 14 to wear a helmet while biking. The law's passage allowed Lillis to compare answers on the questionnaires before and after the law went into effect.

A total of 8,890 public and private middle-school children completed the questionnaires prior to attending the safety course. Results showed that the number of children who said they owned a helmet increased from 31 percent in 1993 to 91.6 percent in 1995.

The percentage of children who said they always wear their helmet increased from 23 percent in 1993 to 72 percent in 1995.

"I was most impressed by the change in behavior of students in 1995, compared to 1993," Lillis said. "I'm guessing that once the law was passed, many parents insisted that their children wear helmets."

She said the law also made wearing helmets more acceptable to kids, ever fearful of looking "dorky."

"One of the items on the questionnaire was 'I don't wear a helmet because...' and a lot of kids said 'because it's not cool.' That changed after the legislation. More kids were wearing them, so some of the stigma went away."

While a lot more children may be wearing helmets, some still aren't, and when they turn up injured in Lillis' pediatric emergency room, they get a stern lecture. "We tell them we can fix arms and legs, but we can't fix heads very well," she said.

Lillis hopes her study prompts other states to enact helmet laws. She also would like to see New York State's law go further, requiring helmets on all bike riders.

"You can't expect children to wear them when parents aren't wearing them," she stated.

Also participating in the study were Susan Carden of Children's Hospital; Linda C. Duffy, Ph.D., UB associate professor of pediatrics, and Christopher J. Rook of the Women and Children's Health Research Foundation at Children's Hospital.