Our study Craniofacial Injuries for Helmeted and Unhelmeted Bicyclists in Germany was published in the Proceedings of the IRCOBI Europe 2023 Conference.
Bicycle crashes lead to many serious injuries, most often to the head. Most bicycle helmets only cover the top of the head, and it’s this partial coverage that is also tested for its protective performance in helmet standards. But is this really the area where most impacts occur? Or do we need to extend the protection area to make better helmets?
Previously, in our study published in the International Cycling Safety Conference we analyzed thousands of fully reconstructed crashes involving a bicycle from the German In-Depth Accident Study (GIDAS) to describe where the bicyclist’s head was hit as indicated by external soft tissue injuries.
What did we find? Many of impacts, were to the face. In fact, approximately two thirds of all head impacts were to the face.
Diving deeper into the matter, we compared injury patterns between helmeted and unhelmeted bicyclists. Our findings revealed a greater incidence of facial injuries among helmeted bicyclists, but a decreased occurrence of skull vault and base fractures when compared to their unhelmeted counterparts. Facial injuries shifted from the upper face to the mid- and lower face when a helmet was worn, as illustrated in the figure.
Should we worry about hitting the face? Yes, we should! Impacts to the face can not only result in facial fractures and soft tissue injuries, but also generate a moment causing rotation of the head. Rotational motion is the primary injury mechanism for most brain injuries.
Consequently, it becomes evident that the primary emphasis for head safety lies in the adoption of helmets by bicyclists, and equally important is the pursuit of augmenting their efficacy by addressing the protection of facial impacts.
What do we suggest then? Testing standards should be updated to assess protection in the facial region. This would promote more protective helmet designs.
Do these designs even exist? Yes! A visor and a chin guard likely enhance the safety of current bicycle helmets. However, permanent structure such as chin guards and visors affect field of vision and ventilation during normal use. Airbag-equipped helmets, which deploy an inflatable or expandable structure only when needed, are emerging for head protection. They have the potential to offer protection without compromising user comfort when wearing helmets.
