The following letter to the editor written by Roger W Byard, Professor of Pathology, Allan Cala, Forensic Pathologist, Donald Ritchey, Forensic Pathologist and Noel Woodford, Head of Forensic Pathology Services has been published in The Medical Journal of Australia January 3, 2011 issue.
We would like to report the deaths of three young children in Australia as a result of hanging from bicycle helmets. Our aim is to draw attention to this rare but entirely preventable cause of childhood death.
Helmets are required to be worn when bicycles are ridden, and have been the subject of mandatory standards since 1989.1 A number of accidental deaths have, however, been reported in the United States, Scandinavia and Canada as a result of young children becoming suspended by their bicycle helmets while playing on playground equipment. This has led to a series of warnings about not allowing children to wear helmets in playgrounds.2,3
The National Coroners Information System (NCIS)4 is an electronic database containing information on coronial cases from all Australian states and territories since 2001. We undertook a review of the NCIS for all deaths of children in Australia that were associated with bicycle helmets from 2001 to 2009. Three cases of deaths due to hanging were identified; these involved a 2-year-old boy who was suspended by his helmet strap between a bunk bed and a wall (in 2003), a 3-year-old boy who was suspended by his helmet strap when he tried to climb out of a home window (in 2007), and a 5-year-old boy who was suspended from an overhead clothesline while jumping on a trampoline (in 2009).
These cases show that accidental hanging is still occurring among young children who wear bicycle helmets while engaging in activities other than bicycle riding. Importantly, hanging from bicycle helmets can occur in places other than playgrounds, sometimes by quite unusual mechanisms. Although such deaths are rare,5 it is important for parents and child carers to ensure that bicycle helmets are only worn by children for their intended purpose, and not during other activities.