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Estimates of the Incidence and Costs Associated With Handlebar-Related Injuries in Children
Flaura K. Winston, MD, PhD;
Harold B. Weiss, PhD, MPH;
Michael L. Nance, MD;
Cara Vivarelli-O'Neill, MPH;
Stephen Strotmeyer, MPH;
Bruce A. Lawrence, PhD;
Ted R. Miller, PhD
Arch Pediatr Adolesc Med. 2002;156:922-928.
Background The US Consumer Product Safety Commission is considering handlebar regulation
regarding impact performance to address the risk of abdominal and pelvic organ
injuries in bicyclists.
Objective To provide national estimates of incidence and costs of handlebar-related
abdominal and pelvic organ injuries.
Design and Setting Censuses of hospital discharge data from 19 states were extrapolated
to determine national estimates. The percentage of abdominal and pelvic injuries
associated with handlebars was estimated based on a case series from a pediatric
trauma center. Costs were estimated using standard methods.
Participants All subjects younger than 20 years treated as inpatients and discharged
from acute care hospitals for non–motor vehicle bicycle-related injury
in 19 states in 1997 and at a pediatric trauma center located in one of the
states between January 1, 1996, and December 31, 2000.
Main Outcome Measures Incidence of bicycle-related handlebar abdominal and pelvic organ injury,
total hospital charges, lifetime medical payments, lifetime productivity loss,
and lifetime monetized quality-adjusted life-years.
Results An estimated 1147 subjects (95% confidence interval, 1082-1215; 1.49
per 100 000 subjects 19 years and younger) in the United States had serious
non–motor vehicle–involved bicycle-related abdominal or pelvic
organ injury leading to hospitalization in 1997, and 886 (95% confidence interval,
828-944; 1.15 per 100 000 subjects 19 years and younger) of these injuries
likely were associated with handlebars. The estimated national costs associated
with handlebar-related abdominal and pelvic organ injuries were $9.6 million
in total hospital charges, $10.0 million in lifetime medical costs (including
claims processing), $11.5 million in lifetime productivity losses, and $503.9
million in lifetime monetized quality-adjusted life-years.
Conclusions Handlebar-related abdominal and pelvic organ injuries pose a serious
health risk to children and result in substantial health care costs. Requirements
for safer handlebar designs may provide one avenue to achieve a health and
economic benefit.
From TraumaLink (Drs Winston and Nance and Ms Vivarelli-O'Neill) and
the Division of Pediatric General and Thoracic Surgery (Dr Nance), The Children's
Hospital of Philadelphia, the Division of General Pediatrics, Department of
Pediatrics (Dr Winston), and Department of Surgery (Dr Nance), University
of Pennsylvania School of Medicine, Philadelphia, and Center for Injury Research
and Control, University of Pittsburgh, Pittsburgh, Pa (Dr Weiss and Mr Strotmeyer);
and Pacific Institute for Research and Evaluation, Calverton, Md (Drs Lawrence
and Miller).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Bicycle-Related Injuries to Children and Parental Attitudes Regarding Bicycle Safety
Ortega et al.
CLIN PEDIATR 2004;43:251-259.
ABSTRACT
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