Chapter 6: Play Areas/Playgrounds and Transportation
6.4 Toys
6.4.2 Riding Toys and Helmets
6.4.2.2: Helmets
All children one year of age and over should wear properly fitted and approved helmets while riding toys with wheels (tricycles, bicycles, etc.) or using any wheeled equipment (rollerblades, skateboards, etc.). Helmets should be removed as soon as children stop riding the wheeled toys or using wheeled equipment. Approved helmets should meet the standards of the U.S. Consumer Product Safety Commission (CPSC) (1). The standards sticker should be located on the bike helmet. Bike helmets should be replaced if they have been involved in a crash, the helmet is cracked, when straps are broken, the helmet can no longer be worn properly, or according to recommendations by the manufacturer (usually after three years).
It is not recommended that infants (children under the age of one year) wear helmets or ride as a passenger on wheeled equipment (2).
RATIONALE
Injuries occur when riding tricycles, bicycles, and other riding toys or wheeled equipment. Helmet use is associated with a reduction in the risk of any head injury by 69%, brain injury by 65%, and severe brain injuries by 74%, and recommended for all children one year of age and over (2-4).Helmets can be a potential strangulation hazard if they are worn for activities other than when using riding toys or wheeled equipment and/or when worn incorrectly.
Infants are just learning to sit unsupported at about nine months of age. Until this age, infants have not developed sufficient bone mass and muscle tone to enable them to sit unsupported with their backs straight. Pediatricians advise against having infants sitting in a slumped or curled position for prolonged periods due to the underdevelopment of their neck muscles (5). This situation may even be exacerbated by the added weight of a bicycle helmet on the infant’s head.
COMMENTS
The CPSC helmet standard was published in March 1998 (6). Bike helmets manufactured or imported for sale in the U.S. after January 1999 must meet the CPSC standard. Helmets made before this date will not have a CPSC approval label. However, helmets made before this date should have an ASTM International (ASTM) approval label. The American National Standard Institute (ANSI) standard for helmet approval has been withdrawn, and ANSI approval labels will no longer appear on helmets. The Snell Memorial Foundation also no longer certifies bike helmets.Concern regarding the spreading of head lice when sharing helmets should not override the practice of using helmets. The prevention of a potential brain injury heavily outweighs a possible case of head lice. While it is best practice for each child to have his/her own helmet, this may not be possible. If helmets need to be shared, it is recommended to clean the helmet between users. Helmets should be cleaned according to manufacturer's instructions.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care HomeRELATED STANDARDS
6.4.2.1 Riding Toys with Wheels and Wheeled EquipmentREFERENCES
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U.S. Consumer Product Safety Commission (CPSC). 1998. Safety standard for bicycle helmets. http://www.bhsi.org/cpscstd.pdf.
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U.S. Consumer Product Safety Commission. 2016. CPSC guidelines for age-related activities. Bicycle Helmet Safety Institute. http://www.helmets.org/ageguide.htm.
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Thompson, D. C., F. P. Rivara, R. S. Thompson. 1996. Effectiveness of bicycle safety helmets in preventing head injuries: A case-control study. JAMA 276:1968-73.
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Head Start. An Office of the Administration of Children and Families Early Childhood Learning & Knowledge Center (ECLKC). 2014. Play it safe: Walking and biking safely. https://eclkc.ohs.acf.hhs.gov/hslc/tta-system/family/for-families/safety/safety-prevention/PlayitSafeWal.htm.
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Bicycle Helmet Safety Institute. 2016. Should you take your baby along? http://www.helmets.org/little1s.htm.
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U.S. Consumer Product Safety Commission (CPSC). 2017. CPSC’s Bicycle Helmet Standard. http://www.helmets.org/cpscstd.htm.
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ADDITIONAL REFERENCE:
Centers for Disease Control and Prevention. 2015. Head injuries and bicycle safety. http://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/headinjuries.html.
NOTES
Content in the STANDARD was modified on 3/31/2017.